Permit CITY TI GAR PLUMBING PERMIT
t A' A PERMIT #: PLM1999 -00238
DEVELOPMENT SERVICE R I G 1 N
± 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/2/99
SITE ADDRESS: 13185 SW PACIFIC HWY B-4 PARCEL: 2S102C6 -00302
W
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT: 033 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2
OCCUPANCY GRP: FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of a water heater and two (2) back flow prevention devices, and an indirect floor drain. Floor drain
replaces an existing drain. Dummy sewer permit (SWR1999- 00161).
FEES
Owner:
Type By Date Amount Receipt
ALADDIN MOTOR INNS PRMT GEO 8/2/99 $87.00 99- 317332
10155 SW CAPITOL HWY 5PCT GEO 8/2/99 $6.09 99- 317332
PORTLAND, OR 97219
Total $93.09
Phone 1:
Contractor:
SUNSET PLUMBING CO
G LONG ENTERPRISES INC
PO BOX 23263AU REQUIRED INSPECTIONS
TIGARD, OR 97281 -3263
Phone 1: 245 -4926 Rough -in Insp
Reg #: L IC 0120893 Underfloor /Underslab
e
g RP /Backflow Preventer
PLM 34 -246PB Insp existing /capped fixtures
Final Inspection
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.
Issued B • /- i / L Permittee Signature A �� / _ L �
Call (503 .3' -4175 by 7:00 P.M. for an inspection needed the net business day
CITY OF TIGARD Plumbing Permit Application Plan C c
13'25 SW HALL BLVD. Co I II - •..l and Residential Rec'd y
TIGARD, OR 97223 O " Date Rec'd
(503) 639 -4171 - Date to P.E. • -"n0 c Wi ' Date to DST
�. Q A 4 _ - I . • _ Permit # kin / / 35
l Inc • Print or pe
- • plications will not be accepted
-� m , � „ o 0...6)./A.- 0...6)./A.- 10. 1, /� Related SWR # iff9- -6 l/W LZ 1 ` J / r� l - 0 7r 0�-4/�9.7�� Called •
� L(Q � J/ w Na /n C m e e of Dev J C, ( FIXTURES (individual) QTY PRICE AMT
Job Er,Qg (7.: ka -"l,eN 0 Sink 11.50
Address Stree ddress / � Suite Lavatory 11.50
j3 o',5" SO P�r1C1L_ $ ""I 13 "1 Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip Shower Only 11.50
_Trpgr d j oft Water Closet/Urinal (Specify) 11.50
Name //
)/,v/g/v(r [doff/ _ /t am q Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
i3 2 R'5 .S 1[) a 41, Ay, Z. ' • Washing Machine /Laundry Tray (Specify) 11.50
City/State Zip / Phone Floor Drain/Floor Sink 2" 11.50
Mar d e 3" .( 11.50 /bin!)
Na /
/ / &$ G l..& r 5 4" .11.50
Occupant Mailing Address Suite Water Heater *onversion Jike kind 11.50 ll sit
/ 3 2 irS Sw A i i c ,Q V Gas piping requires a separate me anical permit. I
City /State Zip Phone MFG Home New Water Service 28.00
9a/'d/ R` ' MFG Home New San/Storm Sewer 28.00
Nme t�
1 -__. ; n7£7 Hose Bibs 11.50
Contractor M ilin A ress Suite Rain Drains 11.50
0
_dress Z3 20 Drinking Fountain - 11.50
Prior to permit , CiV /State ZiE_ Phone Other Fixtures (Specify) 15.00
issuance, a copy 1 r�tt r � y 7G0/3ZC 7I 5 - c/`l C
of all licenses are Ore on Const. Cont. Board Lic.# Ex ate
required if r Z og q) � lb
expired in COT Plum Lic. C( J1 E xp 0 0
database c f 2 I'
database � 7
Name Sewer - 1st 100' 38.00
Architect Sewer - each additional 100' 32.00
Or Mailing Address Suite Water Service - 1st 100' 38.00
En ineer City /State Zip Phone Water Service - each additional 200' 32.00
g Storm & Rain Drain - 1st 100' 38.00
Describe work to be done: Storm & Rain Drain - each additional 100' 32.00 e
New 0 Repair 0 Replace with like kind: Yes, No 0 Commercial Back Flow Prevention Device 32.00 'b
Residential 0 Commercial i Residential Backflow Prevention Device` 19.00
d oonal.descxiptio gf ir /� `
a•rL,t� at, d1 � 4.A..... t.tidLt.&L , Catch Basin 11.50
w • J • Insp. of Existing Plumbing 50.00
Are you capping, moving or replacing any fixtures? per/hr
Yes 0 No Specially Requested Inspections 50.00
If yes, see back of form to indi ate 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 plan . itted are in compli ce with Oregon State Laws. *SUBTOTAL 'eel
ignat • Owner/ ent Date 87
OW c & -2 - Q q 7% SURCHARGE • el j
Con . t Person e Phone �p
//Y-,/ / iglu R629 - 32 70 * *PLAN REVIEW 25% OF SUBTOTAL
1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9
2 BATH HOUSE $250.00 ' TOTAL ! 5•� ✓ C1 7�
3 BATH HOUSE $285.00 ;
(This fee Includes all plumbing fixtures In the dwelling and the first
'Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention
100'Yeet of sanitary sewer storm sewer and water service) Device, which is $25 + 7% surcharge
' // ; *`A11 New Commercial Buildings require plans with isometric or riser diagram and
plan review.
1:1dstsforrnstpIumapp.doc 7 /19/99 - 0
•
•
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 /Floor Sink 2"
3"
4 "
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:ldsts\formslplumapp.doc 7119199
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
' - BUP
Date Requested .� ��7 AM PM BLD
Location ---<- J Suite A --/-1 MEC
Contact Person / 3 es pa.C4,a� 9 '
Ph PLM / 9-to Z ?
Contractor Ph SWR
BUILDING Tenant/Owne `� (-% I ! /! - ELC
Ay
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation Q Drywall Nailing I _.i��I - o /Iii _ _.
Firewall .� � �
Fire Sprinkler -• / /Id__: - i /
Fire Alarm 4 :
Susp'd Ceiling / - /�� . � A -
Misc: i_� ` _/• �� i ' i
Final %
PA�_, FAIL
cialTi 1 V) , ,r • % /' -
Post & Beam / ` r
Under Slab , / / � �
Top Out /
Water Service 1
Sanitary Sewer
Rain Drains --if —I_11 �� �/ / %!
Final f �(
PASS PART k-
MECHANICAL /
Post & Beam `
�..,.
narrifir i Rough In - - i /� /: ��/
Gas Line 4
Smoke Dampers , �✓. r � / i . a '
Final 'e
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage % /l..f
Fire Alarm ,. b.� � A � I
L (�7� ��I
Final /I /�'a�I 511 PASS PART FAI A ���
SITE . /, i�/ f Ii r
Backfill /Grading ? W �// 1
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 1
Approach /Sidewalk n )/� Z
Other Date 2 Inspector 1 2 2' 2 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 --2 ) - 1/ -/ AM PM / BLD
Location I r I S S (�ZC / Suite g -`7 MEC
Contact Person OCtira Ph Z?9'j2,7o PLM 'l q - apa3B
Contractor Ph SWR
BUILDING c' Owner al c , 4 -CSSC6 S 4 dIANASELc
Retaining Wall ELR
Footing Access:
Foundation FPS
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
<PLIMAIMFM
Post & Beam
Water Service
Sanitary Sewer
Rain Drains
PART FAIL
MEC ICAL
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 3 ,/ '
Inspector Ext
Final
PASS • PART FAIL DO NOT REMOVE this inspection record from the job site.