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Permit CITY OF TIGARD Ap ,�, A, DEVELOPMENT SERVICES PLUMBING PERMIT 1 J 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # • PLM98 -0456 DATE ISSUED: 01/05/99 PARCEL: 1 S 1 35DD- 03301 1 SITE ADDRESS...: 11945 SW PACIFIC HWY #242 SUBDIVISION • HOFFARBER TRACTS NO.1 ZONING: C —G BLOCK LOT :002 JURISDICTION: TIG CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:B FLOOR DRAINS • 0 TRAPS • 0 STORIES ° 0 WATER HEATERS ° 0 CATCH BASINS ° 0 FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS : 0 SINKS • 0 URINALS • 0 GREASE TRAPS • 1 LAVATORIES • 0 OTHER FIXTURES 1 TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Add ice maker and grease trap. Owner: FEES YUMMY BOWL type amount by date recpt 11945 SW PACIFIC HIGHWAY PRMT $ 25.00 GEO 01/05/99 99- 311917 SUITE #242 SPCT $ 1.25 GEO 01/05/99 99- 311917 TIGARD OR 97223 Phone #: Contractor THE PLUMBING ON 4838 SE 111TH AVE PORTLAND OR 97266 Phone #: 760 -9323 $ 26.25 TOTAL Reg #.. : 121158 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection 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- m10 through DAR 952 -0001 -0080. You lay obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issued By. � P e rmittee Signature: I /11f1 + + + + + + + + + + + + + + + + + + ++ ++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Permit Application Plan Check 13125• SW HALL BLVD. Commercial and Residential Rec'd By TIGARD, OR 97223 Date Rec'd /a - 5- Qg (503) 639 -4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit# ®c,f'I -d Related SWR #' 335' Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job V u yvi rvi Li IS oc-W ( Sink 9.00 Address Streetitcldress Suite Lavatory 9.00 4 5 w _ 5 3c4 . 2 (4 -2- Tub or Tub /Shower Comb. 9.00 Bldg # City /State Zip Shower Only 9.00 Name Water Closet 9.00 r i4. s i e. Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 aia6. se /ces0 Washing Machine 9.00 C' tate Zi Phone �� G� 7� Floor Drain/Floor Sink 2' 9.00 Name / may 3 9.00 l0 "HO( let, 4° 9.00 Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00 Gas piping requires a separate mechanical permit. City /State Zip Phone Laundry Room Tray 9.00 Urinal 9.00 Name Other Fixtures (Specify) 9.00 Contractor Mailing Address S �,`' /lef mde P r i 9.00 9 433 & $' / / /I9 9.00 Prior to permit /State Zip Phone Sewer - 1st 100' 30.00 issuance, a copy O r bit r d Olt q '7Z 6 6 3 5 -' /6 U Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date • required if Q i 2 i l 5 d 3 -1 L, - d 9 Water Service - 1st 100' 30.00 expired In COT Plumbing Uc. # Exp. Date Water Service - each additional 200' 25.00 database "15 C / ‘ - P8 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 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial 0 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 O No O Grease Traps 9.00 C If yes, see back of form to Indicate work performed by QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or rlser diagram Is required It Quantity Total Is > 9 iA r WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL I hereby acknowledge that I have read this application, that the information given is come., that I am th- owner or authorized agent of the owner, and 5% SURCHARGE that • Ian ubmitted are i corn • liance with Or- , on State Laws. 1 -6 re of Owner /Ag= t OW Date **PLAN REVIEW 25% OF SUBTOTAL / A £•_ / Required only It fixture qty. total Is > 9 q. �i/i /�� ` i TOTA ( 4 ,= 4 , " a m =P�� Phone R.6 G/a) *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge fleoliw-b- -All New Commercial Buildings require plans with isometric or riser diagram 9f and plan review 1:ldstatplu napp.doc 7/2/99 PLEASE COMPLETE: Fixture Type . . . Quantity by Work Performed New - Moved 1 Replaced '''''''''''''''''''''''''' Sink Lavatory Tub or Tub/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 Fixtures (Specify) Qtefor-,c-- *Y COMMENTS REGARDING ABOVE: it/c iieop p p,p,p----9-7-0 P < T ors.2.- lAds-bArdurnapp.doe 7/7/98 Page No. 1 CASE HISTORY FOR CASE NO.: PLM98 -0456 YUMMY BOWL 11945 SW PACIFIC HWY Unit: 242 02/04/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By PLMC003 Application received / / / / 12/09/98 RECD GEO 12/09/98 GEO PLMO005 Permit Created / / / / 12/09/98 'DONE GEO 12/09/98 GEO PLMCO20 Hold for / / / / 12/30/98 Work done without permit. Double fees HOLD HAP 01/04/99 DST required for permit PLM98 -0456. Fees waived per Hap on'01/04/99 and release hold. DLH PLMCO34 Hold Release to Ready Status / / / /. 01/04/99 Released to ready per Hap. DLH PASS DLH 01/04/99 DST PLMC040 (F) Ready to issue / / / / 12/09/98 Contractor needs to sign plumbing PASS GEO 12/09/98 GEO i s application prior to issuance. • PLMCO50 (F) Issue permit / / / / 01/05/99 PASS GEO 01/05/99 DST • PLMC740 Misc. Inspection 12/09/98 / / / / 12/09/98 GEO PLMC799 Final Inspection / / / / 02/01/99 PASS MS 02/01/99 MRS • •- PLMC800 Case Finaled / / / / 02/01/99 PASS MS 02/01/99 MRS • • • • • • • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested `! AM PM BLD Location 1 t -1 s 113-C e Suite MEC Contact Person C y_AA_ Ph 4 t - 3 PLM ?(S 4S1.0 Contractor Ph 7 / /4 o - 7 SWR BUILDING Tenant/Owner vy[ ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain I spec ii• n Note c : �f , 4 ; �J Slab �" 4 SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof I Misc: Final PASS PART FAIL �a ✓,� PLUMBING Post & Beam Under Slab /i Top Out Water Service Sanitary Sewer - •'n Drains • PART FAIL ECHANICAL 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 Ext �� Other Date 21(// Inspector �a Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. P 1