Permit A CITY OF TIGARD PLUMBING PERMIT
'"Ir'� DEVELOPMENT SERVICES
PERMIT #: PLM2000 -00298
II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED:
SITE ADDRESS: 15660 SW PACIFIC HWY A -4 PARCEL: 2S110DC -02200
SUBDIVISION: WILLOW BROOK FARM ZONING: C -G
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Tenant Improvement
FEES
Owner:
Type By Date Amount Receipt
TIGARD, CENTER LP PRMT RCP 8/14/00 $50.00 0004455
9777 WILSHIRE BLVD #609 SPOT RCP 8/14/00 $4.00 0004455
BEVERLY HILL, CA 90212
Total $54.00
Phone 1:
Contractor:
WOLCOTT PLUMBING CONT. INC
PO BOX 2007
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Phone 1: 667 -1781 Water Service Insp
Reg #: LIC 00023847 Rough-in out I
Top --out Insp
sp
PLM 26 -208P6 T
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 By: Permittee Signature: !
Call (50 ) 639 -4175 by 7:00 P.M. for an inspection needed the nex business day
06/02/00 12:20 '8`503 684 7297 CITY OF TIGARD UJ002 /003
c1TYIYF TIGARD Plumbing Permit Application Plan /3125 SW HALL BLVD. Commercial and Residential Recd B 4-
TIGARD, OR 97223 ec'e By ��yyv(i
1503) 639-4171 Date 8-1 V -
' Date to o p P. .E.
Print or Type Date to DST -
Incomplete or illegible applications will not be accepted Permit* Pc,��D - °Dag4
-- - 8C °C Called
SWR N�
caned
Name of Development/Ptbbct ' FDCTURES Qndividuaq'
Job .QTY PRICE ; AllltT
>v V.►. Sink '
■ 11.50
Address beet • _ •s9 1.,. - CI . Lavatory I 11.50 lb SO
glag City/State • Tub or Tub/Shower Comb. 11.50
Zip Shower Only
11.50
Name Water Closet
1 11.50 11,61:i
Urinal 11.50
Owner Mailing Address Suite Dishwasher
11.50
Garbage Disposal 11.50
_
Laundry Tray 11.50
fl (i Washing Machine/Laundry Tray 11.50
. Floor Drain/FloorSink ' 2' �` 1 1.50
Occupant Meiling Ad Suite �1 .
3 ' 11.50
City /Stale Zip Phone 4' 11.50
Water Heate 0 conversion 0 like kind 11 .E ,,. 5d
Nam requires a separate mechanical permit. I
f� ` ��' �� ` D MFHome e N New Water Service 32.00
Contractor ,e�aaahg Address Suite MFG Homew San/Storm Sewer 32.00
t f 0 ■�( a ooh Hose Bibs
Prior to permit City /State ZIP Phon 11.50
issuance, a copy Yy'7a1n. OK. c. i10 - 0 (o� I - Roof Drains 11.50
'fall licenses are Or : • and LPG Exp. pate Drinking Fountain 11.50
required if 3 y 1 __ - 3 `_ 0 _ Other Fixtures (Specify) r_ ,,.� 15.00 t a r
expired in COT Plumbing .# Q Q Exp. Date
b � I
database o C. � . `
lie
Architect
Or Mailing Address Sewer-1st100'
38.00
Salle Sewer -each additional 100'
32.00
Engineer City/ : - L 1 Ph
Water Service • 1st 100' 38.00
I Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace with Ike kind: Yes 0 No 0
Residential 0 Commercial 0 Stbrm a Rain Dram -each additional 100' 32.00
Additional description of work: ' Commercial Bade Flow Prevention Device ' 32.00
Residential Badtflow Prevention Device' 19.00
Catch
Are you capping, moving or replacing any fixtures? Basin 50.00
Yes 0 No 0 Insp. of Existing Plumbing or SpedaUy Requested 50.00
Inspections per/hr
If yes, see back of form to indicate work performed by Rain Drain. single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps
WORK COULD RESULT IN INCREASED SEWER FEES. 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 Is or Td is requisd if Ouanury Toot is > 9 • f '`-
that plans submitted are in corn. lance with 0 : • on State Laws. *SUBTOTAL /
Signs • re of CwneAAgo ..., _
1.--- ∎. wi - 10•- Op
8% SURCHARGE • ���/// ��
COMMA P '
Co • n Name Phone e•/.
25% OF SUBTOTAL r
'r - "' ::,v'•_.�:_- .. - .:�. _ _ RequYeeon total is a
�►(01 ' � REVIEW O T •�
, - -i -4 -� ;;:r - - - ') qty.
TOTAL
e
rr- 1 w a • is � sly,
-•.r d•- '::. : ; _,. 1. . Z . r ' 15..'.S .:,;., c.''.: D - Minimum
ev u w h i permit Is= + + 8 %surrharpe, exact Residential Bacrdlow Prevention � vV
-An New commercial Bu rta tngs � reooire plans with isometric or riser diagrwn and
prsn review.
t:%dstsvonnesplunapp.doo I1'1a59
06/02/00 12:21 $`503 684 7297 CITY OF TIGARD Z003/003
PLEASE COMPLETE:
Fixture Type ' •:Qt,aty. bY.Work'Perforxned° '
New Moved Replaced RemovediCapped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Urinal
Dishwasher _
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify) Cop L —
COMMENTS REGARDING ABOVE:
•
1:1d VarmsQWmepp.dOc 1111899
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested F- AM PM BLD
Location /,5 Seri / ?C r {/C i-A-7 Suite 4- e( MEC
Contact Person Ph _/ ��� PLM 7 - 0 0 2 �$
7
Contractor Ph SWR
BOIL Tenant/Owner 5 04 5 l ELC
Retaining Wall ELR
Footing Access:
Foundation Q G FPS
Ftg Drain ,7 SGN
Crawl Drain Inspection Notes:
Slab / i i IT
Post &Beam ' / , /
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: _
Final i� � � 1 /� ' � ,
P S PART FAIL _
PLUMB G 7 ' . 7
Post & Beam
I lndar Slab
(Top O u /
a er Service
Sanitary Sewer
Rain Drains
F
PART FAIL
HANICAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA Approach /Sidewalk Date 1 I Inspector ��� Ext 2
Other p
Final
PASS PART FAIL DO NO 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 v AM PM BLD
Location /5 frfr 5o1 fl?C f c Suite g ' (-( MEC
Contact Person I Ph 7 l 75/ PLM Au vv - DU °
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
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
BI
ost & Beam
U � la b
op
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART F IL
MECHANIC
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 /�
/4
Approach /Sidewalk
Other Date vl Inspector 4 Ext
Final
PASS PART FAIL O N OT REMO 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
1'4 3 3 6 Date Requested AM PM BLD
Location /CO %9 cie) ,Ac- / / y Suite — t MEC n)
Contact Person /A)a Ph & b7 /2s/ PLM RQ0-040a ��l
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation � � o ,,� FPS
Ftg Drain �-f` SGN
Crawl Drain Inspection Notes:
Slab j r / 1-1/7.? SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation 7
Drywall Nailing
Firewall
Fire Sprinkler PIWAP —
Fire Alarm
Susp'd Ceiling ����
Roof
Misc: •
Final
PASS PART FAIL
Post & Beam
U7&
Top Out
Water Service
Sanitary Sewer
Rain Drains
F'
PA PART FAIL
C
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 reinspectionRE: [ ] Unable to inspect - no access
ADA p 177-2‘-'2 Approach /Sidewalk
Other Date ` Inspector Ext G�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / -3 AM PM BLD
Location / 57, C o .SIN AC('( Suite A- t MEC
Contact Person Ph 3/3 ri 3/ 7 PLM 020w - 0 9r
Contractor Ph SWR
BUILDING Tenant/Owner 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
Roof
Misc:
Final
PASS PART FAIL
(LUMBI
ost & Beam
Under Slab
Top Out
Water Service / I
Sanitary Sewer /� ) 4�
.' 1 Drains /
' ART FAIL
CHANICAL
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 &g7, Other Date 6 '/ �� Inspector 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 / U �� AM PM BLD
Location w A cc f ( 1114-7 Suite 6 - L9 MEC
Contact Person Ph ‘4 PLM -e v 2 411- -
Contractor Ph SWR
BUILDING Tenant/Owner 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 4.•
Fire Alarm
Susp'd Ceiling
Roof
F
P al
PASS PART FAIL (3
CUMBI
Post & Beam
Under Slab / , � /_�_ °� � Jr _'� ..
Top Out
Water Service � l i i��
Sanitary Sewer
Rain Drains
rna
ASS PART FA
MECHANICAL
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
Other oach /Sidewalk Date j to Inspector 1 24,4 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.