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Permit
CITY OFTIGARD � ..A, PLUMBING PERMIT % % , � i � ; � � DEVELOPMENT SERVICES PERMIT ISSUED: 12�O -0850 PARCEL: 15135DD -03301 SITE ADDRESS...: 11945 SW PACIFIC HWY #250 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 • 2 TRAPS • 0 STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0 FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0 SINKS • 0 URINALS • 0 GREASE TRAPS • 0 LAVATORIES • 0 OTHER FIXTURES • 0 TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Plumbing TI — moving two floor drains Owner: FEES MILT BROWN type amount by date recpt 11945 SW PACIFIC HIGHWAY PRMT $ 25.00 B 12/02/97 97- 301323 TIGARD OR 97223 SPCT $ 1.25 B 12/02/97 97- 301323 Phone #: Contract or GRIDLINE PLUMBING & HEATING DUNCAN & DUNCAN INC 4343 SE 37TH PORTLAND OR 97202 Phone #: 771 -8790 $ 26.25 TOTAL Reg #..: 007410 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Top —out Insp 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 l80 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 - 01-810 through OAR 952-01 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issued By _ ILL, // L------- Permittee Signature: ] l �� +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Application Rec'd By e 13125 SW BLVD. Commercial and Residential Date Recd Z -1 ' Date to P.E. h TIGARD, OR 97223 Date to DST (503) 639 -4171 Permit # (. - Vj a Print or Type Related SWR # /4 Incomplete or illegible applications will not be accepted Called Name of D On back indicate Work Performed by fixture. Job II G 1 Theiz4 FIXTURES (Individual) - . QTY PRICE AMT Address otre tt Add / Suite Sink 9.00 ,/ - Z 5d I M y5 7J ) Bldg Lavatory 9.00 Bldg # City/State Zip Tub or Tub /Shower Comb. 9.00 l eAtik - C- Name /� s '' Shower Only 9.00 _ s t , f fps Water Closet 9.00 Owner Mai Ing Addres Suite Dishwasher 9.00 • Garbage Disposal 9.00 • City/State Zip Phone Washing Machine 9.00 Name c Floor Drain 2" 9.00 -5 y d7`0e, 3" 9.00 Occupant Mailing Add Ms Suite a" ' 9.00 City/State Zip Phone Water Heater 0 conversion 0 like kind 9.00 Laundry Room Tray 9.00 Aame / r r Urinal 9.00 (, DA,,v, /2,,,,,,,d, � ,44, - Other Fixtures (Specify) 9.00 Contractor Mailing ddress uite 14 3 3 SE, 3 774 i 4::iQx rel c/9ro. p1e.1'4 9.00 /5x Prior to permit City/S ate Zip Phone 9.00 issuance, a copy eve 97,2„ Z 9.00 of all licenses are TO44#1411/ gOn� Cont. Board Lic.# Exp. � --9 Sewer 9.00 required if f " / � Sewer - 1st 100' 30.00 expired in COT P umbing Uc. # Ex p. Date Sewer - each additional 100' 25.00 database P' 0--409 ?B it .� _ _ Name Water Service - 1st 100' 30.00 Architect Water Service - each additional 200' 25.00 Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00 Storm & Rain Drain - each additional 100' 25.00 Engineer City/State Zip Phone Mobile Home Space 25.00 Commercial Back Flow Prevention Device or Anti- 25.00 Describe work New 0 Addition 0 Alteration Repair O Pollution Device to be done: Residential 0 Non - residential 0 Residential Backflow Prevention Device' 15.00 Ad 'tional description of work: // J 7� AV ��& ?�� U �e� , fir An y Tra p or Waste Not Connected to a Fixture 9.00 Ke � _ P� ' L ex e � Catch Basin 9.00 :�/ Insp. of Existing Plumbing 40.00 per/hr Existing use of ' /� ,, Specially Requested Inspections 40.00 building or property 5 9�Pi1�s�y 4 j)`G%�-e per/hr Rain Drain, single family dwelling 30.00 Proposed use of ,� Grease Traps 9.00 building or property ND-- C�is1/17,, QUANTITY TOTAL I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quanity Total is > 9 given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL Q+j that pl s su itted are in co iance with Oregon State Laws. Z*j ■ Sig ure ner /AA t Date 5% SURCHARGE ( 2S on ct Person Name Phone PLAN REVIEW 25% OF SUBTOTAL 1 a A Ai c m,e --,q4} 77. �'7 y7/ Required only if fixture qty. total Is > 9 TOTAL /� 24/ 2+ *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge I: ldstsTptmapp.doc 5/97 PLEASE COMPLETE: Fixture Type ' Quantity by Work Performed New Moved .. Replaced Removed /Capped Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 2� 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I:\dsts\plmapp.doe 5/97 — Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0850 MILT BROWN 11945 SW PACIFIC HWY Unit: 250 11/18/98 Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By • PLMC003 Application received / / / / 12/01/97 RECD B . 12/02/97 BON PLMC005 Permit Created / / / / 12/02/97 DONE B 12/02/97 BON PLMCO50 (F) Issue permit / / / / 12/02/97 PASS B 12/02/97 BON PLMC725,Top -out Insp 12/02/97 / / 12/16/97 one case drain moved PASS TLP 12/16/97 J *H PLMC725 Top -out Insp 12/16/97 / / / / 12/16/97 J *H PLMC740 Misc. Inspection 12/16/97 / / / / 12/16/97 J *H PLMC799 Final Inspection 12/16/97 / / 09/30/98 I noted that bup96 -0195, fire PASS TLP 09/30/98 TLP suppression system, has not had any 'nspections. Jeanne T. • • PLMC800 Case Finaled / / / / 10/06/98 10/06/98 JT • • • i CITY OF TIGARD BUILDING INSPECTION DIVISION MST A.,a 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 �� BUP 0---9 Q / Date Requested [ - l� AM PM BLD Location ! t ( (" 6 did P i(�i f.r.) Suite 2-- MEC Contact Person (J Ph 7 7 (- ern PLM 7 Contractor G1 Ll06 PLM fS l- Ph SWR BUILDING Tenant/Owner SAP \AtAy ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain ,, / SGN Crawl Drain Inspection Notes: (p eremi r a ( U / Z©� Slab /� /+ , 1 SIT Post & Beam Ext Sheath/Shear 2 2 6 ,CC4T C V C D iIi S Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL ( o Be� Under Slab Top Out Water Service Sanitary Sewer :• - 9 rains � ns S 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 �3 // /� 1 Other Date v /� Insp / _ E Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.