Permit CITY OF TIGARD PLUMBING PERMIT
^ , DEVELOPMENT OPMENO SERVICE DATE ISSUED: ° 10/12/98 M98 -0369
PARCEL: 1S136CD -00200
SITE ADDRESS...: 11705 SW PACIFIC HWY #L
• SUBDIVISION ° ZONING: C -G
BLOCK LOT ° ° ° ° ° ° ° ° ° ° ° ° °° J•URISDICTION: TIG
CLASS OF WORK° °:ALT GARBAGE DISPOSALS °: 0 MOBILE HOME SPACES.: 0
TYPE OF USE ° COM WASHING MACH— ° 0 BACKFLOW PREVNTRS. ° : 0
OCCUPANCY GRP ° °:M FLOOR DRAINS ° ° ° ° ° °: 2 TRAPS ° ° ° ° ° ° ° ° ° ° ° ° ° °: 0
STORIES ° 0 WATER HEATERS 2 CATCH BASINS ° 0
FIXTURES - - - - -- LAUNDRY TRAYS ° 0 SF RAIN DRAINS ° ° ° ° °: 0
SINKS— °°° ° ° ° °: 4 URINALS 0 GREASE TRAPS ° 0
LAVATORIES°°° °: 0 OTHER FIXTURES°°°.: 1
TUB /SHOWERS°°°: 0• SEWER LINE (ft)°° °: 0
WATER CLOSETS °: 4 WATER LINE (ft)° °°: 0
DISHWASHERS. . ° °: 0 RAIN DRAIN (ft) ° ° °: 0
Remarks: Plumbing TI
Owner -: • -• - -- FEES
PACIFIC CROSSROADS PROPERTIES type amount by date recpt
BY WYSE INVESTMENT SERVICES CO PRMT $ 117.00 DEB 10/12/98 98- 309902
200 MARKET STE 345 PLCK $ 29.25 DEB 10/12/98 98- 309902
PORTLAND• OR 97201 5PCT $ 5.85 DEB 10/12/98 98- 309902
Phone #:
Contract or
POWER PLUMBING CO
P 0 BOX 23144
TIGARD OR 97281
Phone #: 244 -1900 $ 152 °10 TOTAL
Reg #° .: 000523
REQUIRED INSPECTIONS
This permit is ,issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Underfloor /Under
applicable laws. All work will be done in accordance with Top -out Insp
approved plans. This permit will expire if work is not started Final Inspection
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 : 1. • - Permittee Signature: 4, .
Call 639 -4175 by 7:00 p. m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application Plan Check# ( � e---
13125 SW HALL BLVD. Commercial and Residential Recd By
TIGARD, OR 97223 Date Rec'd - 05 -- `2 7
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit# ' �'� Mill %'
Related SWR • ,yAi% i
6 u p q v � /� / Called
l Name of Development/Project FIXTURES (intlividuat) =H> " '', K IMI
Job gib Pk) sPo r b &Wm Sink 9.00
Address 1Streett '� Address I1 \� Suite Lavatory 1 - 9.00
N n/
1 l C8 S V) PAe • H W y L_ Tub or Tub /Shower Comb. 9.00
• Bldg # ; City /State Zip Shower Only 9.00
J ' b to /012 Water Closet I 9.0 2 f� pc)
Name 7 ,
Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
Washing Machine 9.00
City /State Zip Phone
Floor Drain /Floor Sink 2" 2 9.00 f CJ®
Name 3" 9.00
P h FRI g ii ()GOD J 4" 9.00
Occupant iMaiailling Address /, ` PO O, F` 6'
Suite Water Heater 0 conversion 0 like kind 9.00
1 1 N ik Pft( RA L- Gas piping requires a separate mechanical permit. `
/State �� r � � Zip Phone Laundry Room Tray 9.00
V Urinal 9.00
• Pow � t ex (� V
I i 1 , nit R
b 1 Other Fixtures (Specify) On n n6 '� 1u t - , I ' 9.00 , co
PI 1�f Y
9.00
Contractor Mailing Address `` ++ ,, it e •
P 0 Z Li y 9.00 '
Prior to permit ity /St to Zip Phon Sewer - 1st 100' 30.00
issuance, a copy (JC 31aI IDYL �i 2, -i4QO Sewer - each additional 100' 25.00
. of all licenses are Oregon Cone C nt. Board Lic.# Exp. Date - .
l,
required if .� l Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25,00
database 311 I 01` n e) Storm & Rain Drain - 1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
or Mailing Address • Suite Commercial Back Flow Prevention Device or Anti- - 25.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device" 15.00
(Irrigation timing devices require a separate
Describe work to be done: . • restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes No O Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial W Catch Basin • 9.00
Additional description of work: • -
Insp. of Existing Plumbing 40.00
per /hr
Specially Requested Inspections 40.00
per /hr
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes No O Grease Traps 9.00
- If yes, see back of form to indicate work. performed by QUANTITY TOTAL ( ;R `"
fixture. FAILURE TO ACCURATELY REPORT FIXTURE ' '" *
I somet ri c or r di agram i s requ if Quant Total is >s ", ,_
WORK COULD RESULT IN INCREASED SEWER.FEES:
*SUBTOTAL r "` .: ' `" "_
I hereby acknowledge that I have read this a � "`' lication, that the information '`' ° `" ' CO .
given, is correct, that I am the -owner or authorized agent of the owner, and 5% SURCHARGE , " ;'"`" r - ,. �,
that plans submitted are in compliance with Oregon State Laws. *t!::%! C_ 1 0 ,. =
. f Ow nt Date * *PLAN REVIEW 25% OF SUBTOTAL'
le ib cdgr R equired only if fixture qty, total is > 9 1..._ aq_ 4 . z
� 3�, `„ #.;�s�, m � -1
TO TAL -" . it I
Contact ia • n - Name Ph a " F n' Y � "; ° < ' ", i 5L .
3 �3�(- „` . `I l yt1 � y �J i -J + q �j3 `Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
' Prevention Device, which is $15 + 5% surcharge -
' *All New Commercial Buildings require plans with isometric or riser diagram
- and plan review
I: \dsts\plumapp.doc 7/2/98
•
PLEASE COMPLETE:
- New . ...................................................................................................... .......... .. ................................................................................................................................................................................
. .. Moved Reptaced Removed/Capped
Sink
Lavatory • 2.
Tub or Tub/Shower Combination
Shower Only
Water Closet • z Z
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2" I
3
4"
Water Heater
Laundry Room Tray •
Urinal
Other Fixtures (Specify) pra i m 9
(Ch. )14 ref 11,t
- _
COMMENTS REGARDING ABOVE:
•
•
I:\dstspIumapp doc 7/7/98
3/7/00 Activities for Case #: PLM98 -00369
8:47:56 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 10/8/98 DRA RECD BON 10/9/98
PLMC005 Permit Created 10/9/98 B DONE BON 10/9/98
PLMC799 Final Inspection 10/23/98 TLP PASS J *H 10/24/98
PLMC007 Plans routed to Plans Examiner 10/9/98 B SENT BON 10/9/98
PLMC008 Plans Approved /Routed to DST 10/9/98 TLP PASS TLP 10/9/98
PLMC71 Water Line Insp 10/9/98 TLP 10/9/98
PLMC720 Underfloor /Underslab 10/9/98 • 10/14/98 TLP PASS J *H 10/14/98 •
PLMC725 Top - out Insp 10/9/98 10/20/98 TLP FAIL TLP 10/20/98 NOTEST ON SYSTEM
PLMC015 DST Post Review Complete 10/12198 B DONE BON 10/12/98
PLMC040 (F) Ready to issue 10/12/98 B PASS BON 10/12/98
PLMCO50 (F) Issue permit 10/12/98 DEB DONE DRA 10/12/98
PLMC800 Case Finaled 10/24/98 TLP PASS J *H 10/24/98
PLMC725 Top -out Insp 10/22/98 TLP PASS J"H 10/24/98
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639- 4171`��
qq 1 BUP
Date Requested 11�� 9' AM )( PM BLD S
Location 1/ ' i) /'4 Al Suite � --- MEC
Contact Person � P ll Ph/ 30 / . 6 OG ' // PLM 9 -0349
Contractor /� .� -�Y/4 / s l )Ph ?j L/ l JQ6 SWR
BUILDING M f z 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
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall J C75 F /,y
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final — f
P: • ; RT FAIL
•'e eam
Unde Slab
ater ' ervice
Sanitary Sewer
ains
PART FAIL
M CHANIrC
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICALx ; `: -_
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
;TA
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 a
Approach /Sidewalk
Other Date U Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.