Permit CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT # • PLM97 -0239
J i J.- j 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06/23/97
PARCEL: 2S1O2CB -00302
SITE ADDRESS...: 13285 SW PACIFIC HWY
SUBDIVISION • NORTH TIGARDVILLE ADDITION ZONING: C —G
BLOCK • LOT •33 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..:M FLOOR DRAINS • 0 TRAPS • 0
STORIES • 0 WATER HEATERS • 1 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 electric water heater
Owner: FEES
G?AYUM, ABDUL & ISMAT type amount by date recpt
18245 RIVER EDGE CT PRMT $ 25.00 B 06/23/97 97- 296297
LAKE OSWEGO OR 97034 5PCT $ 1.25 B 06/23/97 97- 296297
Phone #:
Contractor
GEORGE MORLAN PLUMBING & APLIANCES
12585 SW PACIFIC HWY
CCB (EXP 6/2002)
TIGARD OR 97223
Phone #: 624 -6895 $ 2 TOTAL
Reg #..: 000027
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 wore
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 OIJNC by calling
(503)246 -1987.
Issued By: g c'� P ermittee Si nature: %
Y 9
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
.:ITY OF TIGARD Plumbing Application Rec'd By D
13125 SNV HALL BLVD. Commercial and Residential Date Recd lD - 2 -5 -` ��
1 0 3 2 3 l/Q ` 0 Date to P.E.
TIGARD, OR 97223
Date it to
# D
Permit �l �
(503) 639 -4171 7 - QL
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Job Sink 9.00
Address Street Address 111--7 Suite Lavatory 9.00
/ 77.-" r, ),u✓ /n�i Z _ / �l it Tub or Tub /Shower Comb. 9.00
Bldg # City /State Zip Shower Only 9.00
7 v./ (2 G �Zz 3 Water Closet 9.00
Name /� / 4tite4A S p I • Dishwasher 9.00
Owner Mailing Addre ' Suite Garbage Disposal 9.00
/ 3/ ( FS ' .ft. s /641 ( II WII Washing Machine 9.00
/State Z4 ? z2 ? c 2 � _ 1- f/ I Floor Drain 3' 9.00
•�ri! a 3' 9.00
N me S•(' 4• 9.00
Occupant Mailing Address Suite Water Heater I 9.00
Laundry Room Tray 9.00
City/State Zip Phone Urinal 9.00
Name /f �/� f Other Fixtures (Specify) 9.00
�) . G'7 . , i44 9.00
Contractor Mailing Address / fj S 9.00
/2S / rii✓ AliAl f 9.00
(Prior to issuance Ci /State }I ::::
applicant must d 2 Z 3 6,2 741 9.00
provide all Or6gon Const. Cont. Board Lie* Exp. Date - 9.00
contractors ( 734/ r--/q-R? 9.00
■
license Plumbing Lic. # z 6,,e) l Exp. Date Sewer - 1st 100' 30.00
information 3I/ Sewer - each additional 100' 25.00
for COT COT Business Tax or Metro if Exp. Date Water Service - 1st 100' 30.00
database).
Name Water Service - each additional 200' 25.00
Architect Storm & Rain Drain - 1st 100' 30.00
Or Mailing Address Suite Storm & Rain Drain - each additional 100' 25.00
Mobile Home Space 25.00
Engineer City/State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Describe work New 0 Addition 0 Alteration 0 Repair 0 Residential Backflow Prevention Device' 15.00
to be done: Residential 0 Non - residential 0 Any Trap or Waste Not Connected to a Fixture 9.00
Addition l description of work +
� n� / �6"k /./7 �� /�(,r 61.-1•24/' Catch Basin 9.00
�
i
PV /44C419/1 q 64-t rnpbyyl Insp. of Existing Plumbing 40.00
per/hr
xisting use of Q Specially Requested Inspections 40.00
5uilding or property /t e.$444 fYY.IJ7t per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property .c 140/0 QUANTITY TOTAL
Are you capping , moving or replacing any fixtures? Ye No o Isometric or riser diagram is required if Quanity Total is > 9
(If yes see back of form) *SUBTOTAL
I hereby acknowledge that I have read this application, that the information 5% SURCHARGE
given is correct. that I am the owner or authorized agent of the owner, and
that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date PLAN REVIEW 25% OF SUBTOTAL
,�` CO JJ 'Gf Required only if fixture qty. total is > 9
TOTAL Z.25
Contact Person Name /J // Phone
f • � /, ne
�! / V L, 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
f' C Prevention Device. which is $15 + 5% surcharge
I: \plmapp.doc 12/96 (dst)
PLEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
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: \plmapp.doc 12/96 (dst)
CITY OF TIGARD BUILDING INSPECTION DIVISION
a 5 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: e ot --q. . 7 A.M. P.M. MST:
Location: ye t a - sw ` / pa " C A-4c BUP:
Tenant: PAPA M u l2 P 7 '5 Suite Bldg: MEC:
Contracto Phone: (0,.24 -- 6 g)473-- c� 7 PLM: ! / -Qa3 9
Owner: - -C Phone: 4) 37 /6 /5 ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMB I. MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam 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 MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved A Approved Approved Approved
Appr /Sdwlk Not Approved o r pproved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
Cl Call for re's • .. tioi
/, ' O inspection Rein • = ti '. fee of required before next inection Cl Unable to inspect
Inspector: /A ' �� �, , [�/ �
4 Date: 17 Page of
. _ .