Permit CITY OF TIGARD
iu.,. ;� DEVELOPMENT SERVICES PLU MBING PE RMIT
/Nei I ' PERM I T # • PLM98 -0006
� � .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 01/09/98
PARCEL: 2S102CB -00303
SITE ADDRESS...: 13165 SW PACIFIC HWY
SUBDIVISION • NORTH TIGARDVILLE ADDITION ZONING: C —G
BLOCK • LOT :033 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRP..:P3 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 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: Installing two commercial backflow prevention devices.
Owner: FEES
THE WESTWIND GROUP type amount by date recpt
1410 SW JEFFERSON PRMT $ 50.00 B 01/09/98 98- 302394
PORTLAND OR SPCT $ 2 °50 B 01/09/98 98- 302394
Phone #:
Contract or
LIVING COLOR LANDSCAPE CO
PO BOX 514
WILSONVILLE OR 97070
Phone #: 678 -3364 $ 52.50 TOTAL
Reg #. °: 6167
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Backflow Prey
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 peroit will expire if work is not started
within 180 days of issuance, or if work is suspended for yore
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 lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: Permittee Signature f'
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171 Date to Ds
Permit # � u qb- c te
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job /� L,•,"99 e. ic--- ; r ae-5.1 ✓w i FIXTURES •(Individual) QTY. PRICE" AMT .
Address Street Address Suite Sink 9.00
‘1 3 /G $' S.(2). 14t.414. 1, .. Lavatory 9.00
Bldg # City/State Zi
-t-�` 04-, Tub or Tub /Shower Comb. 9.00
77. / �/ / 7 Shower Only 9.00
'- (v)--C-S ri,�/ ��,,,p Water Closet 9.00
Owner Mailing Address / _ Suite Dishwasher 9.00
/ y�6 .54-J- i �sd ` , Garbage Disposal 9.00
City/State Zi of
Phone
zy yyo Washing Machine 9.00
. o'Po (
I Name Floor Drain 2' 9.00
/5 .' i!/ k..--1 L 3' 9.00
Occupant Mailing Address ,� Suite ' 4• 9.00
/ ; / h it . 5 id ) /4"Lkil Water Heater 0 conversion 0 like kind 9.00
Cgy /State Zip / Phone
/ / q ri-✓0/t n 2 Laundry Room Tray 9.00
Nar(te / / Urinal 9.00
�-i I/r (d�av l�r./suyti Cc( • Other Fixtures (Specify) 9.00
Contractor Mailing AIldress Suite 9.00
A_o • Rox S/`/ 9.00
Prior to permit City/State Zip Phone
issuance, a copy t,,,,i5d,.rv,A, ok 57070 , 7F -3 if 9.00
of all licenses are Oregon Const. dont. Board Lic.# Exp. Date 9.00
required if
expired in COT Plumbing Lic. # Exp. Date Sewer - 1st 100' 30.00
database Q l-. Ctt - W / 6,7 1/ /34 , y k Sewer - each additional 100' 25.00
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 J
Describe work New 0 Addition 0 Alteration FA Repair 0 Pollution Device
to be done: Residential 0 Non - residential & Residential Backflow Prevention Device' 15.00
Additional description of work: / Any Trap or Waste Not Connected to a Fixture 9.00
ti 5 c/ •2 r - 4 412/ W S 4 ✓ nit' G,b Catch Basin 9.00
� Insp. of Existing Plumbing 40.00
per /hr
Existing use of n n Specially Requested Ins 40.00
building or property h -P c ✓Gi1- . _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of �t Grease Traps 9.00
building or property Q . ;1 ^^ ✓�✓T ,
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 4D
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that plans submitted are in compliance with Oregon State Laws. , : _ Z,,.S ,
Signature of Owner /Agent Date 5% SURCHARG A.
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
C� on / Required only if fixture qty. total is > 9
Y' ) 5 kr - ba- , G 77 - 35c' - / TOTAL S2_1'0
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
i:\dststplmapp.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"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:1dsts\plmapp.doe 5/97
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: /71c( A.M. t P.M. MST:
Location: _ , ./ —4. BUP:
Tenant: Suite: Bldg: MEC:
Contractor: Phone: PLM: F F"066c
Owner' Phone: ELC:
1 . 4 /� i t. "' ry - —i ELR:
SIT:
BUILDING BLDG (con't) MECHANICAL ELECTRICAL SITE
Site Post/Beam Po eam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MLSC.
Masonry Ceiling Rain Drain A/C UG Slab 7fig,F€7-'`
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Are Approved Approved Approved
Appr /Sdwlk Not Approved N e Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
���'�'�: /� Ai "ice_ iJ � / ��� /�
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PJftor reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: /Th . 0.-- Date! / V qi Page of
O
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: /� ?--4/— V g A.M. <, P.M. MST:
Location: X 1.3 11a 5 Z & , Al- (/ BUP:
Tenant: 6(./ 1. 11 Suite: Bldg: MEC: G - /�y�- l
Contractor: � / L /L _i. �p 72 3 3 6 9c Uv V b
/ _, P J � Phone PLM:
Owner: / / .tz fl Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) LUMBING ?� MECHANICAL ELECTRICAL SITE
Site Post/Beam Yost/Beam Post/Beam Cover /Service Sewer /Stone
Footing Roof UndFUSlab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab /
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt __ �
Approved Approved Approved Approved 4in .
Appr /Sdwlk Not Approved ` o • pproved Not Approved Not Approved Not A roved
FINAL FINAL FINAL
O Call for reinspection D Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: P 1,, _ Date: ( /-�' ?/ 7 7 Page / of
..