Permit CITY TIGARD PLUMBING PERMIT
deI' DEVELOPMENT SERVICES PERMIT #: PLM1999 - 00197
. ,��I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/22/1999
NALDIfr SITE ADDRESS: 11705 SW PACIFIC HWY B PARCEL: 1S136CD - 00100
SUBDIVISION: ZONING: C -
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing TI work.
FEES
Owner:
Type By Date Amount Receipt
WYSE INVESTMENT SERVICES PRMT BON 10/22/199 $50.00 99- 319281
200 SW MARKET ST STE 345 MISC BON 10/22/199£ $2.50 99- 319281
PORTLAND, OR 97201
Total $52.50
Phone 1: 294 - 0400
Contractor:
MICHAEL + CO PLUMBING
P 0 BOX 23008
TIGARD, OR 97281 REQUIRED INSPECTIONS
Phone 1: 639-3189 Top -out Insp
Reg #: LIC 000678 Final Inspection
•
PLM 26 -333PB
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within '180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: 6/ Permittee Signa ure:
Call (503) 639 -4175 by 7:00 P.M. for an inspection nee. -'d the ne business day
•
06/14/99 MON 14:16 FAX 503 598 1960 CITY OF TIGARD C O07 1
CITY OF TIGARD Plumbing Permit Application (4--et7C
13125 SW HALL BLVD. Plan Che l
Commercial and Residential Rec'd By
TIG:ARD,' DR 97223 Date Rec'c: (e -/ e -52"
(503) 639 -4177 Date to P.EE. to -57/
Print or Type Date to DST 7,// 9f
Incomplete or illegible applications will not be accepted Permit# Pt-1 I19 - dol9
Related SV•IR # ootto
Called 7 - 1-( q(1
Name of Development/Project
Mr.P. S {inclivfOO ` : " `,V New °= :� ,
0 , �� � .._�� r ...M. . ,..�.).� ;:' �. _�. ..�Ir:i:.u��.���'��.�:c'� ;�;r. i �:ttl�E� ; , ;}q±titT�'r;
Job
U GIL Sink 11.50
Address Street Address I Suite Lavatory L 11.50 i r je
I11O� 4.w, 1 .Irk . ( Tub or Tub /Shower Comb. 11.50
Bldg # �Ci '/State Zip
I I6 -0 9 722 3 Shower Only - 11.50
Name Water Closet 11.50 dr f a
VL-f 41\i %*Tj,At-Ntr 2UIcy Dishwasher / - 11.50
Owner Mailing Address S ui a Garbage Disposal 11.50
.� 6 7 '' 5 Washing Machine
r /State Zip Phone 11.50
42.11 ij7 OR G 3) 44 -6400 Floor Drain /Floor Sink 2" 11.50
e , 3" 11.50
�) ) � 1- 1` 4t2 4 . .
11.50
Occupant Mailing Addre s Suite
1 7i ' � IPA I�I� r Water Heater 0 conversion 0 like kind I
11.50 /. Gas piping requires - a separate mechanical permit. 1 s0
Ci /State Zip Phone Laundry Room Tray 11.50
T1 4-Al2,0 �
Vi . 9 7225 7p20, - 1 Urinal
�L / e-0 11.50
1: �1 Other Fixtures (Specify) 15.00
Contractor Mail'n�Address O ' Suite
t fG�'jJ( owo
Prior to permit City/State tp Phone Sewer - 1st 100'
issuance, a copy T�o� p ,o2 7 7 a g/ 38.00
of all licenses are Oregon Const• Cont. Board Lic.# Exp. Date Sewer - each additional 100' 32.00
required if Water Service -1st 100' 38.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 32.00
database Storm & Rain Drain - 1st 100'
Name 38.00
Storm & Rain Drain - each additional 100' 32.00
Architect OitAA 4- STL > Mobile Home Space 32.00
Of Mailing Address Suite Suite Commercial Back Flow Prevention Device or Anti- 32.00
5� W. ✓. *- ('d 0 Pollution Device
Engineer City /State Zip Phone C *
g �� � � n � I 817 Residential Back Prevention Device* 19.00
�� WogRi Tx .76102 4l5 -'34_5 , (Irrigation timing.devices` require a separate
Describe work to b e done: _ restricted energy permit)
New 0 Repair 0 Replace with like kind: Yes 40 No 0 Any Trap or Waste Not Connected to a Fixture 11.50
' Residential 0 Commercial ® Catch Basin 11.50
Additional description of work: -
t � � ' Insp. of Existing Plumbi 50.00
I\ VJ . Tc I L� per /hr
Are you capping, moving or replacing any fixtures? Specially Requested Inspections 50.00
les • No 0 per/hr
Rain Drain, single family dwelling 45.00
If yes, see bac4 of form to indicate work performed by
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES.
QUANTITY TOTAL O:v -4;) :
• I hereby acknowlec ge that I have read this application, that the Information Isometric or riser diagram is required H Quantity Total is > 9 "' ' a 1
given is ..rrect, that I am the owner or authorized agent of the owner, and
surcharge except Residential Backflow ,
1 *SUBTOTAL ?p pm ,a=;
•
that ��s �mittei re in mplrance with Oregon State Laws. ; � ; , ; ,�;r, r ,�.._,_... � ,,:c
,
iii, wm /Agent Date q ti
� �� Cl/ 5 %SURCHARGE :x_�;';'i
�_'�? dA
Con 1-14)-Lip !Name y Z tik ii:46 ; 7 ; ic •
t so Per P me r1 S Phone ** 25% OF SOW
�. _., r ,,,u
�p PLAN REVIEW 2 SUBTO : k��yu'.a' °^ ;a�' =
U8 7 ) Required only y: a:
h, if fixture total is > 9 ,p. +
-/ •7 1 . Si�D,�.Qe��'Y :Fi'`_
�¢� 78 "lHl .., ....� ,; . ,- ,; ..
Cy 5,EsA,25,}6a.41-4A44....&,. -i v - i sm f TOTAL 114. < i tip -, 2 50
; tf , � •1Pu5E 2 * ` ' r' " `Minimum permit fee is ,6
C,'
c, a PI 0.0 n • Q I ng`an 12rst.4, � Pr'evention which i 50 + 5s $25 + 5% surcharge
t`eefof to rar .1sewerstarm •sewed 'wa, r,Vs'erVlce, ' tepF, **iiirNe ommercial Buildings require plans with isometric or riser diagram
and plan review
1 :ldstsVormsiptumapp. doe 6/ u99
•
Nio dCU
= exPv� y'3a 9
., Cc , ,0 -29 -9r
Qtcw1l) . c ef , sAUvaiU
U 0 / 1 4 7 iviuiv 1 4 : I t s r .y i u u 3 O 3 19 U U.1.117 1'1 GARD 10008
•
PLEASE COMPLETE:
..,;�•����;���-�� • - �� ��� "��� ��,� � � � •.� • � -.: �.{.��' �:;�.`;: � • �,�;. �::: ° � � ?`i;.' %.�:::':f zjj; sF ?:: .3 %:ii,:;;;;;::,:.
•:i: >i5>' >`i�£:i:i::i ?i: ^ fii%%;:::?> fii: �: i :::i:;:i`i:3::i::::i:..:.::.:: ••............ ••.`>;,:. <.i:.�:'.Y:.2::5:: ;.• {.: {• %ii ::•:;;;� :: ::::::::::::«:: ±.:;:•: "•i: : : <.;;: ': ,.:;::c• •4::oy:; ...............:.:.,,.:. �:.:.:.:.:,, : .:::. �....,....
:: i::: F: i::::::;:; x` o-:;:::::,..: �::.::..: �:::.:•.+a t:: �;> i:; J:: g::';:::: c;::;;; c::;::: ::::: »:r.::::. + %::;::::�i:}>:; ::•::::.: .:;•i »:: <:` ; ; ? ;: ;i::+ :•::•i +r. .. .. pi:.�:::::Y; ...: ....: ..: ...:.. ^:: �: .:: o- :,::;:.. :.:.::.;: .:..,,.: x.;:!:;; :;; :: .. ,..
Sink • ..... . ......:.:::: :.:..::.:.;;:::.:.;:. > :p� : d: : >:
Lavatort
Tub or 1 "ub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3 "
4"
Water Heater
Laundry Room Tray
Urinal '
Other FiKtures (Specify)
COMMENTS REGARDING ABOVE:
•
i:WstsVortns\plumepp.docf 2/99
•
• _ l
11/09/1999 Activities for Case #: PLM1999 -00197
10:52:57 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 06/18/1999 DEB DONE No Hold DEB 06/25/1999
PLMC005 Permit Created 06/25/1999 DEB DONE No Hold DEB 06/25/1999
PLMC007 Plans routed to Plans Examiner 06/25/1999 DEB DONE No Hold DEB 06/25/1999
PLMC120 Plumbing Undersl 07/06/1999 07/06/1999 No Hold MRS 07/06/1999
PLMC008 Plans Approved /Routed to DST 07/06/1999 07/06/1999 07/06/1999 MS - SENT . No Hold MRS 07/06/1999
PLMC725 Top -out Insp 07/06/1999 07/06/1999 10/25/1999 TLP DONE No Hold TLP 10/25/1999
PLMC799 Final Inspection 07/06/1999 07/06/1999 10/29/1999 MS PASS No Hold MRS 11/01/1999
PLMC015 DST Post Review Complete 07/14/1999 BON DONE No Hold BON 07/14/1999
PLMC040 (F) Ready to issue 07/14/1999 BON DONE No Hold BON 07/14/1999 Needs plumber identified before
issuing permit.
PLMCO50 (F) Issue permit 10/22(1999 BON DONE No Hold BON 10/22/1999
PLMA800 Case Finaled 11/09/1999 JMT DONE No Hold JMT 11/09/1999
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171
BUP
Date Requested (010)--5 g AM PM BLD ��
Location / ( 70S `) AL'%C4tc_, 16(( Suite MEC
Contact Person c eiyyL � Ph V O PLM 1 '0 9
Contractor Ph SWR
BUILDING : �''` ° ° °' Tenant/Owner ELC
Retaining Wall ELR
Footing Access: I' ��'.Cij'lti�f�12P�J FPS
Ftg Drain // SGN
Crawl Drain Inspection Notes.
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
RT FAIL
PLUMBIN
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
1 Drains
�' - PART FAIL
HANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk Date 7()/07 S Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
eJ '
CITY OF TIGARD BUILDING INSPECTION DIVISION MsT
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
r Date Requested /OY. AM PM � BLD j a 7pee-e Location / ( c t - �" Suite p MEC
Contact Person P h PLM
Contractor Ph SWR
BUILDING ;.a `' „ =� . ;: Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab • SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS • FAIL
_ rye=
Post & Beam
' Under Slab
Top Out
Water Service
Sanitary Sewer
Ran Drains
PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /
Approach /Sidewalk
Other D ate t 1/ 2
\ '
Inspector ,' Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•