Permit CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
Wi PERMIT T # • PLM97 -0040
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02 / 1 1 / 97
PARCEL: 2S1O2CC -01000
SITE ADDRESS...: 13660 SW PACIFIC HWY
SUBDIVISION • ZONING: C -G
BLOCK • LOT
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •MF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R1 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: INSTALL WATER HEATER (IN KIND REPLACEMENT). LOCATION NOT
YET DETERMINED. CHECK WITH MANAGER FOR ACCESS AT 639 -7779.
Owner: - FEES
FIR GROVE APTS /MORRIS & STVNS type amount by date recpt
520 SW 6TH #400 PRMT $ 25.00 JMH 02/11/97 97- 290261
5PCT, $ 1.25 JMH 02/11/97 97- 290261
PORTLAND OR 97204
Phone #: 223-3171
Contractor: -•- EXP
GEORGE MORLAN PLUMBING �-
5529 SE FOSTER RD
PORTLAND OR 97206
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 02734
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rough-in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Top -out Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Final Inspection
than 180 days.
Permittee Signature: jb,it) Issued B y % /' j i
Call for inspection - 639 -4175.
a
CITY ' 3ARI5 Plumbing Application Recd By 912/1-----
13125 IALL BLVD. Commercial and Residential Date Recd Z - / 1-97
TIGAF 1 97223 Date to P.E.
;503) E 71 /UZ_ Q UP Date to DST
Permit FL/1497
Print or Type Related SWR s -e--
Incomplete or illegible applications will not be accepted Called
` Name of Development/Project , Vet4i,/, JRES (Individual) QTY PRICE AMT
• Job -/I- r it9 - r,,: ti - , . 71... -, 4 erred ' " 9.00
Address 'dress D /� Suite Lavatory 9.00
/3 Sl i Ark i Tub or Tub /Shower Comb. 9.00
Bldg s City/State ' Zip Shower Only 9.00
VIAr 177. ,/ oe Water Closet
9.00
Hame 6,00d W/4 Dishwasher 9.00
Owner Mailing Address /' /� Suite Garbage Disposal g 00
3Ote ati ,4 ij RI Washing Machine . 9.00
City/State Zip Phone Floor Drain 2'
,; cir &X ri C172Z 3 G1 -77711 3• 9.00
•
N�arfie 9.00
4 9.00
Occupant Maling Ad dress / Suite Water Heater ' 9.00
Laundry Room Tray 9.00
City/S Zip I Phone Linnet 9.00
Name Other Fixtures (Speofy) 9.00
� /f�
G -(• ��!� r/aA7 9.00
Contractor Mailing Address Suite 9
/ C rc S ) ki'' H w
9.00
City/State ,, Phone
- 7 - 7/44/ ( c 172- 2 3 Zt-1 -7 71 9.00
O on Const. Cont. Board Lic.f Exp. Date 9.00
i Meech copy of h Z7 3Gl G//4/47 9.00
Current Plumbing Lic. C Exp. Date Se ?s o •�yw3 30.00
Licenses 7, /V �c 1 30/4 7 Sewer - e. - :' dtfttf I 25.00
COT Business Tax or Metro s Exp. Date
Water Service - 1st 100' 30.00
Name Water Service • each additional 200' 25.00
Architect Storm 8 Rain Drain - 1st 100' 30.00
or Mailing Address S Storm 8 Rain Crain - each additional 100' 25.00 I
Mobile Home Space 25.00
' Engineer C' to Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Cevice
Describe work New 0 Addition 0 Alteration 0 Repair O Residential Backflow Prevention Device' I 15.00
to be done: Residential 0 Non - residential O
Any Trao or Waste Not Connected to a Fixture I 9.00
I Additional descripuon of work Catch Basin 9.00
1 Insp. of Existing Plumbing I ( 40.00
::::: use o f Specially Requested Inspections 00
.sicOng or property Rain Drain. single 'amity dwelling I 30.00
Proposed use of Grease Traps I 9.00
I building or property
QUANTITY TOTAL
i Are you =aping . moving or replacing any fixtures? Yes a No a Isometric or riser diagram required if Cuanay Total is > 9
(It yes see back of form) 'SUBTOTAL
I hereby acknowledge that I ha read this application. that the information
given .s correct. ;hat I am the cwner or authorized agent of the owner. and 5% SURCHARGE
:•iat clans submitted are in comoliance with Oregon State Laws.
Signature of Owner/Agent Date PLAN REVIEW 25% OF SUBTOTAL
4eaueed only R fi x t u r e city. :atm is > 9
-��-, 4 / i 4 1 TOTAL
contact Person Name Phone C
'Minimum permit fee is S25 • 5% surcharge. except Residential Backflow
1A .-/1/4/./7 62q-730/ Prevention Device. which is S15.5% surcharge
i:ldststplmapp.00c 9/96
,
PLEASE COMPLETE AS APPROPRIATE TO PROJECT: `
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
i / ,
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal \,`
Washing Machine
I
Floor Drain 2"
3"
1 \ _
I
4"
Water Heater I \ , \ / \ _
L
\ /
aundry Room Tray
Urinal
Other Fixtures (Specify)
_________--) 1
COMMENTS REGARDING ABOVE:
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Fir /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line l Appr /Sdwlk Reins.
Other: �!
Date: _5 /1 b ( 5 A.M. P.M. Entry:
-
Address:
Tenant: Ste: MST:
/ ^ BUP:
Con /Own: f d- - 39S MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
1 /
•
deM-__%/
Inspector :i Date: gite2
_APPROVED ISAPPROVED /CALL R REINS CF CO