Permit •
.... CITY OF TIGARD
„
,, DEVELOPMENT SERVICES PLUMBING PERMIT
�a��
•!•1 '� I 13125 SW HaII Blvd., Tigard, OR 97223 (503) 6394171 PERMIT # • PLM97 -0442
DATE ISSUED: 04/08/98
PARCEL: 2S115BA -00600
SITE ADDRESS...: 16105 SW PACIFIC HWY
SUBDIVISION • ZONING:
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 1 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 4 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRP..:R1 FLOOR DRAINS • 10 TRAPS • 0
STORIES • 0 WATER HEATERS • 4 CATCH BASINS • 4
FIXTURES LAUNDRY TRAYS • 2 SF RAIN DRAINS • 0
SINKS • 4 URINALS • 0 GREASE TRAPS • 0
LAVATORIES • 79 OTHER FIXTURES • 1
TUB /SHOWERS...: 74 SEWER LINE (ft)...: 100
WATER CLOSETS.: 79 WATER LINE (ft)...: 0
DISHWASHERS • 1 RAIN DRAIN (ft)...: 700
Remarks: Building /site plumbing for Best Western Motel — does not include any
swimming pool related plumbing (separate permit from pool contractor).
Owner: FEES
KCM ASSOCIATES LLC type amount by date recpt
10895 SW FIFTH PRMT $ 2627.00 JSD 04/08/98 98- 304760
BEAVERTON OR 97005 PLCK $ 656.75 JSD 04/08/98 98- 304760
SPCT $ 131.35 JSD 04/08/98 98- 304760
Phone #:
Contractor
TIKKA PLUMBING
15619 NE CAPLES ROAD
#67
BRUSH PRAIRIE WA
Phone #: 360 - 690 -4334 $ 3415.10 TOTAL
Reg #..: 111675
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Line Insp
applicable laws. All work will be done in accordance with Water Service In
approved plans. This permit will expire if work is not started Fire Supply Line
within 180 days of issuance, or if work is suspended for wore Rough —in Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules PLM /Underfloor
adopted by the Oregon Utility Notification Center. Those rules are Top —out Insp
set forth in OAR 952 -0001 -0010 through OAR 952- 0001 -0080. You eay Storm Drain Insp
obtain copies of these rules or direct questions to OUNC by calling Rain Drain Insp
(503)246 -1987. RP /Backflow Prey
Final Inspection
Final Inspection
Issued By: Permittee Signature:
+ + + + + + + + + + + + + + + + + ++ +' ++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++ + + ++ + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
. 0404 (LL_____
CITY OF.ITIGARD Plumbing Application hie Recd B
13125 SW HALL BLVD. Commercial and Residential
Recd //� -'3/ c9 7
TIGARD, OR 97223 JD. Date to P.E. / hi. "j
r Date to DST MEV
(503) 6394171 Permit* / -+f 9 7- tx/Slz
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called -/2 F
Name of Development/Project
Job Best Western FIXTURES (Individual) QTY :' PRICE: ANIT
Address Street Address ' Suite Sink 4 9.00 36.00
16105 S.W, Pacific Hw✓. Lavatory 79 9.00 711.00
Bldg # City/State Zip Tub or Tub /Shower Comb. 73 9.00 657.00
King city, OR 97224 �y
Name Shower Only 1 9.00 9.00
KCM Associates LLC Water Closet 79 9.00 71100
Owner Mailing Address Suite ,Dighwasher 1 9.00 9.00
10895 S.W. Fifth Garbage Disposal 1 9.00 9.00
City/State Zip Phone Washing Machine
Beaverton, OR 97005 643 -5421 4 9.00 36.00
Name Floor Drain 2' 9 9.00 81.00
KCM Associates LLC 3' 0 9.00 0.00
Occupant Mailing Address Suite 4' 1 9 9.00
10895 S.W. Fifth Water Heater 0 conversion 0 like kind 9. 00
City/State Zip Phone 4 36 - 00
L aundry Room Tray Beaverton, OR 97005 643 -5421 y 2 9.00 18.00
Name Urinal 0 9.00 0.00
Tikka Plumbing Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 1 (1 1 7 2" Floor sink 1 9.00 9.00
15619 N.E. Caples Roai #67 7 u t o
(Filar to Issuance City/State Zip Phone .V . /6 e free X £ 9.00 d, '°11
4PAcentffalg Brush Prairie, WA - 340--842-529-5 _ 9.00
provide all Oregon Const. Cont. Board Lic.# Exp. Date L 9.00
contractors 111675 �'v",��a
Information if 9.00 • license Plumbing Lic. # Exp. Date 9 a Sewer - 1st 100" 1 nn 30.00 l(1 D0
expired Sewer - each additional 100' 25.00
in COT COT Business Tax or Metro # Exp. Date Water Service - 1st 100' 30.00
database). IBC - 702 6/30/98 Water Service - each additional 200' 25.00
Name
Architect Charles C. Hagel Storm & Rain Drain - 1st 100' 30 0
Of Mailing Address Suite Storm & Rain Drain - each additional 100' 25.00
11580 S.W. 67th Mobile Home Space 25.00
Engineer City /State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
9• Tigard, OR 97224 620 -3825 Pollution Device 2 50.00
Describe work New OX Addition 0 Alteration 0 Repair 0
Residential Backfiow Prevention Device* 15.00
to be done: Residential 0 Non - residential 0 Any Trap or Waste Not Connected to a Fixture 9.00
Additional description of work Catch Basin . . 9.00
Insp. of Existing Plumbing 40.00
per/hr
New construction - 73 unit motel Specially Requested Inspections 40.00
Existing use of per/hr
building or property Vacant lot Rain Drain, single family dwelling 30.00
Proposed use of
Grease Traps 9.00
building or property 73 Unit motel
QUANTITY TOTAL 1045 .
Are you capping , moving or replacing any fixtures? Yes p No7�3j Isometric or riser diagram is required if Duanity Total is > 9
(If yes see back of form) *SUBTOTAL 2�Zf co
?b�@0
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 131.10 131-3 Q
tha • . r • - • . - _ . • ' . nce with O - • • e Laws.
gnayure of Owner /A• : Date - PLAN REVIEW 25% OF SUBTOTAL
/ Required only if fixture qty. total Is > 9 0
. `i��� :if, 4 10/29/97 TOTAL
o •
ct Perso , ame Phone *Minimum permit fee is $25 + 5% surcharge, except Residential Backflo 0
ndrew Ilg 643 -5721 Prevention Device, which is $15 + 5% surcharge
I:'dststplmapp.doc 5/97
PLEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I: Wstslplmapp.doc 5/97
^� Accumulative Sewer Tally
Tenant Name: .Oc"Y G(./E$/Z This SWR#
Address: /6 /01 Stv ct t, 1-4G.1 y This PLM#: 97- O'/S/Z
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4 73 292
- JacuaiNVhirlpool 4
Car Wash - Each Stall 6
- Drive Through 16 `
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 / y
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2 / j 20
-3inch 5
- 4 inch 6 / (O
- Car Wash Dm 6 •
Garbage Disposal 16
- Domestic (to 3/4 HP) / /
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
Ice Machine/Refrigerator Drains 1
Oil Sep (Gas Station) 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2 / 2
Sink - Bar/Lavatory 2 ' 79 /ski
.
- Bradley 5
- Commercial 3 9 / Z
- Service 3 2 6
Swimming Pool Filter 1
Washer - Clothes 6 4 1 2 j
Water Extractor 6
Water Closet - Toilet 6 7 9 y 9 [
Urinal 6 T
TOTALS
Total fixture values: divided by 16 = EDU
HISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
iadstsl`swrtay.doc
.. i :' '.. .- - . :.. ... .... .. ....: -:. ... .... . `a >..._... .; .,'_.. K .......
• • • "
.f
11411/ KING CITY
:1b300 SW. 116th Avenue, King City, Oregon 97224 -2693 -
Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
•
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard.
Building Department for the following project: /611 ( 1
•
located at: 9q
g d„,_.\.4) ,
King City Representative
I:'DSTS.KCI\sT.DOC
Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0442
KCM ASSOCIATES LLC
16105 SW PACIFIC HWY
01/08/99
Action Description Req/ Schd/ End/ . Action Notes Disp By Update Upd
Code Sent Done Done Date By
. PLMC003 Application received / / / / 10/31/97 PASS DRA 11/05/97 JD
PLMC005 Permit Created / / / / 11/05/97 PASS JSD 11/05/97 JD
PLMC007 Plans routed to Plans Examiner 11/05/97 / / 11/05/97 PASS JSD 11/05/97 JD
PLMC008 Plans Approved /Routed to DST / / / / 03/25/98 Contractor will need sewer permit from PASS TLP 03/25/98 J *H
USA to obtain this plumbing permit.
PLMC015 DST Post Review Complete / / / / 03/26/98 DONE DLH 03/26/98 DLH
PLMCO50 (F) Issue permit / / / / 04/08/98 "Ready ", per Dianna PASS JSD 04/08/98 JSD
PLMC705 Sewer Inspection 03/25/98 / / 06/08/98 Main sewer lateral from exterior PASS TLP 11/05/98 TLP
building to manhole.
PLMC710 Water Line Insp 03/25/98 / / 07/14/98 PASS TLP 11/05/98 TLP
PLMC712 Fire Supply Line -FPS 03/25/98 / / 05/20/98 Interior riser stub up /thrust block for PART TLP 05/22/98 J *H
• 6 -inch fire line.
PLMC712 Fire Supply Line -FPS / / / / 06/11/98 Main supply line fdc to vault 200 # test PASS TLP 11/05/98 TLP
required OK
PLMC720 Underfloor /Underslab / / / / 05/15/98 Underslab approved PASS TLP 05/18/98 J *H
PLMC725 Top -out Insp 03/25/98 / / 07/14/98 PASS TLP 11/05/98 TLP
PLMC725 Top -out Insp / / / / 09/28/98 Test on all tubs for entire bldg. PASS TLP 09/29/98 J *H
Interior rain drain leaders.
PLMC730 Storm Drain Insp . 03/25/98 / / 04/22/98 60 - ft. storm line and manholes 3 & 4 PASS TLP 04/23/98 J *H
appproved.
PLMC735 Rain Drain Insp 03/25/98 / / 04/28/98 NE corner rain drain. Perimeter Rain PART TLP 04/29/98 DGW
drains and south and SW raindrains.
PLMC735 Rain Drain Insp / / / / 09/28/98 Interior rain drain leaders. PASS TLP 09/29/98 J *H
PLMC737 Gas Line / / / / 07/07/98 Install gauge outside of building where FAIL TLP 07/08/98 J *H
meter to be set.
PLMC740 Misc. Inspection / / / / 04/16/98 Consultation w/ Jerry Bennett. MTG WA 04/17/98 J *H •
Plans call for cleanouts every 100 feet
on storm drain between manholes.
Plumbing codes says clean outs are not
required between manholes if not over
300 feet in length, with no offsets -
verify with engineer.
PLMC740 Misc. Inspection / / / •/ 04/21/98 Conference only. MTG TLP 04/22/98 J *H
PLMC750 RP /Backflow Preventer 03/25/98 / / 12/17/98 PASS TLP 12/18/98 J *H
Page No. 2 CASE HISTORY FOR CASE NO.: PLM97 -0442
KCM ASSOCIATES LLC
16105 SW PACIFIC HWY
01/08/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
PLMC799 -Final Inspection 03/25/98 / / 12/17/98 PASS TLP 12/17/98 TLP
PLMC800 Case Finaled, / / / / 12/18/98 PASS TLP 12/18/98 J•H
•
•
1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 p Business Line: 639 -4171 B UP `�
/1") /5�I Dat Requested �.2��7 AM PM BLD �(��
Location f& /05 e4P/' . Suite MEC
Contact Person =. Ph
6 Z -/ 7 7— D
Contractor Ph SWR
BUILDING Tenant/Owner ik,QZaIi..) ELC
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 c 4"('
/ �"
Roof
Misc:
Final
P RT FAIL
<PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
• • rains
W O PART FAIL
ANICAL
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
O /2 � 7-9 if other Date O Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .
6,59
DV
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 6 - ) 0 - F A.M. P.M. MST:
_`
Location: , 2 SCE ) /i. t i') / U5,-. BUP:
Tenant:
.�r �t1��► c��- Suite: Bldg: MEC: `/
Contractor: , I7/� Phone: . 70 -/ 7�,0 PLM: 7 7 0 44 7
Owner: • Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) , PLUM 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 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 Approved
Appr /Sdwlk Not Approved oved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
rr!_-.ar . O f - / / 4 / /I
4' 4C L /17g,Ai ,, /G r ,
II Call for re', :.= ' • D Reinspection fee of $ required bef e next ' spection O Unable to inspect
Inspector: /.4.-411 - Date: (� / 7 Page of
L —
1 110
CITY OF TIGARD BUILDIN INSP ION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / � -Fr A.M. P.M. MST:
Location: f&/05 / r ei. e /).7 ,f F. BUP:
Tenant: .(J A.....1 Suite: Bldg: MEC:
Contractor: /� A A � Phone: .7 PLM: 7-04/4/0---
Owner• Phone: ELC:
T —
—Led C ?-'I ,P j ELR:
SIT:
BUILDING BLDG (con't) ' LUMBING) MECHANICAL ELECTRICAL CIT�
Site Post/Beam i Post/Beam Cover /Service Sew torm
Footing Roof UndFI/Slab Rough -In Ceiling Water 1
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Furnace Temp Service MISC.
Masonry Ceiling Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approve ) Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
24441 "104- t V / 4 / / 572:7&' s‘,...ecit .)
O Call for reinspection einspection fee of $ required before ne inspection 0 Unable to inspect
Inspector: Date: e-7.2,2. (/ Page of
` CITY OF TIGARD BUILDING INSPEC ION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: .41- . ,5? - 9" M. P.M. MST:
!
Location: /6905 3-60 -,Pa....a
-Burr-c?
Tenant: p "— Suite: Bldg: MEC: / �/
Contractor: � Phone: 7 0 p O - 9O PLM: 7 7 7 y
ear: cIV -2A O/a� Phone: ELC:
(f 4€ - a nd L - ELR:
4 700p o -'' I'Am '/ i 7srr: �T
BUILDING BLDG (con't) PLUMBING MECHANIC U ELECTRICAL � G�?rl�n-
Site Post/Beam Post/Beam Post/Beam Cover /Service ewer /:. v
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 Approved Approved Approved roved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not pproved
FINAL FINAL FINAL FINAL FINAL
r
. fevei Al ,e7 ',iv / /Li ar?ot2/A.-5 f 5 6(1 ,
r
C (oicZ 4 f /9 / /j47/,
0 Call for rein- s • tion O Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: ...4111411■- Date: Page of
•