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Permit CITY OF TIGARD PLUMBING PERMIT .11-6111t � DEVELOPMENT SERVICES PERMIT #: PLM2000 -00007 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/25/2000 SITE ADDRESS: 11834 SW PACIFIC HY PARCEL: 2S101 BB -00301 W SUBDIVISION: TIGARD ROAD GARDENS ZONING: C -G BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: 9 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 3 OTHER FIXTURES: 4 TUB /SHOWERS: SEWER LINE: ft 'WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing TI. FEES Owner: Type By Date Amount Receipt EQUIVA SERVICES/TEXACO PRMT DST 01/25/200C $230.00 00- 321379 3800 ST HELENS RD PLCK DST 01/25/200C $57.50 00- 321379 PORTLAND, OR 97296 5PCT DST 01/25/200C $18.40 00- 321379 Phone 1: 503 - 225 -4223 Total $305.90 Contractor: EAGLE PLUMBING 13801 S FORSYTHE RD OREGON CITY, OR 97008 REQUIRED INSPECTIONS Phone 1: 503 - 650 -8703 Water Service Insp #: L IC 47914 Top -out Insp Reg Final Inspection PLM 3 -154PB O 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. i � Issued By: , � // Permittee Signature: Call (503) 6 94175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check # O/ - 0 Y 13125 SW HALL BLVD. Commercial and Residential Rec'd By 3 TIGARD, OR 97223 Date Rec'd 00 (501639 -4171 Date to P.E. f' lye -DO • Print or Type Date to DST / Incomplete or illegible applications will not be accepted Reellated ated �cM2 -GY��7 R SWR # ZOdU -D g Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job la>'at^a F nd Maki RefvdeJ Sink 4 11.50 fi. Address Street Address 1 f _ - Suite Lavatory 11.50 3 c1 11854 614) OC 14wL _ Tub or Tub /Shower Comb. 11.50 Bldg # City/State Zip Shower Only 11.50 T7 11223 • Name r Water Closet/ rival (Specify) 2_ 11.50 .- Fq,ujuc� dekv1C�,o hwasn 11.50 Owner Mailirlg Address Strife Garbage Disposal 11.50 300 1■11 •.', q n.o koc, 4 • Washing Machine/Laundry Tray (Specify) 11.50 City/State , Phone Poe 972,94, _a2S - ij223 Floor Drain /Floor Sink 2" 3 11.50 jrz Jai' Name 3" 4 11.50 y / L. L I 1 1 O 4" 11.50 Occupant Mailing dress � ' I p Suite Water Heater 0 conversion 0 like kind 11.50 ) non Y1 to 5I I I - LL!LD Gas piping requires a separate mechanical permit. I /l - 5 City/State 1 ?`9( Zip Phone MFG MFG Home New Water Service 28.00 Pt PM w td q l o a25- / 33 MFG Home New San/Storm Sewer 28.00 Name y� 1 l.0(G 1.t? r LLCM b FrCh.,2 .¢G Hose Bibs 3 11.50 3,4,0 Contractor Mailing b ddress � ' Suite Rain Drains 11.50 13go 1 S' Ft_� Sl I .t.r_ ... 1e or Drinking Fountain 11.50 Prior to permit City/State Zi�1 (� Phone Other Fixtures (Specify) 15.00 issuance, a copy . ©ktc oi'- C;--1-4 q 04-5 (050 8 of all licenses are Orego Const. Co Board Lic.# Exp. Date M 6 ? £ n a t, i. 7/.P 1t required if 4 I 1 7 G l / q/23/ expired in COT Plumbing Lic. # Exp. Dopte database 3 I Sy 1 L/ /3o) a OD Name Sewer - 1st 100' 38.00 Architect ( 0)yiT e( Ri i '-1-.QCt Sewer - each additional 100' 32.00 Or Mailing Address Suite Water Service - 1st 100' 38.00 1100 MI Ft•Orv 550 Water Service - each additional 200' 32.00 Engineer ity /Sta Zip Phone 663_ Foe: Hand G /Zoq ./ - Sgii T Storm & Rain Drain - 1st 100' 38.00 Describe work to be done: Storm & Rain Drain - each additional 100' 32.00 New? Repair 0 Replace with like kind: Yes 0 No 0 Commercial Back Flow Prevention Device 32.00 Residential tial O Commercial jet Residential Backflow Prevention Device* 19.00 Additional description of work: Catch Basin 11.50 - Insp. of Existing Plumbing 50.00 Are you capping, moving or replacing any fixtures? per/hr Yes No 0 Specially Requested Inspections 50.00 If yes, see back of form to indicate work performed by per /hr fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain, single family dwelling 45.00 WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50 I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL - given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required if Quantity Total is > 9 that plans submitted are in compliance with Oregon State Laws. *SUBTOTAL Signature of Owner /Agent Date X 30 C �C - /-4-00 7% SURCHARGE /' l Contactt Person Names Phone /�'T v One. C Ross 5b31,So-$ -PLAN REVIEW 25% OF SUBTOTAL 57, 5 1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9 2 BATH HOUSE $250.00 TOTAL • 3 BATH HOUSE $285.00 - (This fee Includes all plumbing fixtures in the dwelling and the first 100 feet of sanitary sewer storm sewer and water service) 'Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention Device, which is $25 + 7% surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review. I:\dsts \forms\plumapp.doc 7/19/99 ■ • PLEASE COMPLETE: Fixture Type Quantity by Performed New Moved I Replaced Removed /Capped Sink Lavatory 2, Tub or Tub /Shower Combination Shower Only Water Closet 2. Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Laundry. Room Tray Urinal Other Fixtures (Specify) 0fot1K.trth r i-N 1, McP f5,101. COMMENTS REGARDING ABOVE: • I: 1dstsVormslplumapp.doc 7 /19/99 04/07/2000 Activities for Case #: PLM2000 -00007 2:54:13 PM • Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To . Done By Disp. Level By Updated Notes PLMC003 Application received • 01/05/2000 KJP RECD No Hold BON 01/10/2000 PLMC005 Permit Created 01/10/2000 BON DONE No Hold BON 01/10/2000 PLMC007 Plans routed to Plans Examiner 01/10/2000 BON DONE No Hold BON 01/10/2000 PLMC008 Plans Approved /Routed to DST 01/13/2000 01/13/2000 01/18/2000 MRS SENT No Hold MRS 01/18/2000 PLMC120 Plumbing Undersl 01/13/2000.01/13 /2000 01/27/2000 MRS PASS No Hold AKJ 01/27/2000 PLMC711 Water Service lnsp 01/13/2000 .01/13/2000 No Hold MRS 01/13/2000 PLMC725 Top -out Insp 01/13/2000 01/13/2000 02/22/2000 TLP PASS No Hold AKJ 02/22/2000 PLMC799 Final Inspection 01/13/2000 01/13/2000 04/05/2000 MRS PASS No Hold AKJ 04/05/2000 ' PLMC015 DST Post Review Complete 01/21/2000 GEO DONE • No Hold GEO 01/21/2000 PLMA040 (F) Ready to issue 01/21/2000 GEO DONE No Hold DST 01/25/2000 Sewer fee paid on 1/25/00 (SWR2000- 00008) PLMCO50 (F) Issue permit 01/25/2000 GEO DONE No Hold DST 01/25/2000 PLMC705 Sewer Inspection 01/27/2000 01/27/2000 01/27/2000 MRS PASS No Hold AKJ 01/27/2000 PLMC800 Case Finaled 04/05/2000 AKJ DONE No Hold AKJ 04/05/2000 • • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP �j Date Requested n "I S CO AM PM BLD Location / l % 3 LI B'Cr Pod Suite MEC Contact Person Ph (.09 ' 7 PLM 2C O — (Cx)D7 Contractor Ph SWR T BUILDING Tenant/Owner 1 [/WGL(AO ELC Retaining Wall ELR Footing Access: FPS Foundation 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 % _ ` _ �AJ - Roof _ f / Misc: .� /A _ - ' - .ems / � ��� l + r te ' Final PASS PART FAIL P(UMBINd) Post & Seam Under Slab Top Out Water Service Sanitary Sewer Rain Drains - S PART FAIL .4 CHANICAL C � 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 f✓ 5) " 7 7 other Date l 6 6 Inspector � Ext � Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP Date Requested (/27/00 AM PM BLD Location 1 g B L A P fi / Suite MEC Contact Person cA Ph (.pSS —g`70 CM 'WOO? Contractor Ph SWR - p BUILDING Tenant/Ownerc C- 6 E LC _I Retaining Wall ELR Footing Access: FPS Foundation 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 PART FAIL Post & Beam er Top Out Water Service :ulLiT: Rain Drains Final PART FAIL ANICAL 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 Date 1 /� X1 Inspector ��.�/ Ext t3K Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.