Permit •
t CITY OF TIGARD
OR/ GI N PLUMBING PERMIT
DEVELOPMENT SERVICES PE RMIT #: PLM1999 -00290
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 A ATE ISSUED: 10/13/99
SITE ADDRESS: 15660 SW PACIFIC HY A -6 PARCEL: 2S110DC -02200
W
SUBDIVISION: WILLOW BROOK FARM ZONING: C -G
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS: 7 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 7 URINALS: GREASE TRAPS: 2
LAVATORIES: 1 OTHER FIXTURES: 7
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 2 RAIN DRAIN: ft
Remarks: Plumbing TI work. Other fixtures: ice maker, tea /coffee brew, ice water dispenser, make up air, hot food well,
and 2 woks.
FEES
Owner:
Type By Date Amount Receipt
TIGARD CENTER LP PRMT DEB 10/13/99 $346.50 99- 319034
9777 WILSHIRE BLVD #607 PLCK DEB 10/13/99 $86.63 99- 319034
BEVERLY HILLS, CA 90212 5PCT DEB 10/13/99 $24.26 99- 319034
Phone 1: Total $457.39
Contractor:
PENINSULA PLUMBING
PO BOX 16307
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Phone 1: 761 -0500 Sewer Inspection
Water Service Insp
Reg #: LIC 2244
P Top -out Insp
LM 26 -64P6
Storm Drain Insp
Rain Drain Insp
RP /Backflow Preventer
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
Notifica i Center. Those rules are set forth in OAR 952 - 0001 -0010 throu.. e • 952 -01. -0080.
Yo ay obtain .opies of these rules or direct questions to OUNC by c g '503) • 9: .
o e A
Issue • By: �� ��:�� ' t ack,a, Permittee Signatur' : 4ims■ �
Call (503) 639 •175 by 7:00 P.M. for an inspection nee • - :..• : • usiness day
09/09/99 11ill 10:51 FAA 503 598 1900 C I •I'Y U1" r 1 GARD Igi UUZ
F-56r
,CITY OF TIGARD • Plumbing Permit Application Plan Check 8 ,-.) C
13125 SW HALL BLVD. Commercial and Residential Reed By ‘013
Date Redd laNFAF di
TIGARD, Oft 97223
(503) 6394171 Date to P.E. All:MAU -
Date to D - HIM
i ,
Print or Type pen it • Afrif.- •Gasio
incomplete or illegible applications will not be accepted Ratted SWR 0 j 19- nfnot ,e,A,
•
c /0-/9- /a '5"0
Name of Development/Project
1 .
Job WU's Open Kitchen Sink Mill 11.5o P 0. I
Address sub y r 1_
Mt Pa c HiElhwa Lavatory
Tub or Tub/Shavier Comb. • 1 1 1.50 1.51
11.50
Bldg 8 I Qv/State Zip Shower Ordy 11.50
Water Close:Mind (Specify) 11.50
Name
• Dishwasher Z 11.50 .5 . U
.
Owner Mang Address Suite Urinal 1 11.50 1 5
Garbage Disposal 11.50 • .
Cty/State ZIP Phone Laundry Tray 11.50
• Washing Machine/Laundry Tray (Specify) 11.50
Name • Fiber Drain/Floor Sink 2" fp 11_50 , 1 . I)
•
Occupant Ma Address Suite 3 1
* 4" 11.50
CityrStale Ey Phone 11.50
Water Heater 0 conversion 0 like kind%
Gas piping mann a separate mechanical permit.
• JIVAinsula Plumbing Co MFG Horne New Water Service 28.00
MFG Hanle New San/Stonn Sewer 28.00
Sae
Contract f ) 6307 11.50
. Hose Bibs
Mimi° Plered RAVI and Dndris .s
issuance, a copy 9/ 9 2 7%1'10500 Roof
• prinldng Fountain 11.50 /0 ' ' 42
del licenses are emit%:44st. Cat Board Uc.8 Rat g1e
Other Fbdures (Specify) fr i 7 15.00 imiraii•
expked in COT rtsrnbleptis.ff
base 5EMMO
didcr
UgagIVANNWITMALEIME MI
Name
Architect Sewer- 1st 1W 38.00
or Mafing Address Suite Sewer - each add5one1100' 32.00
- . Water - 1st 1W 38.00
• Engineei °IT/State Zifi Phone
Water &nee - clads addlional 2B0. 32.00
Storm 8 Rain Drain -1111100/ • 38.00
Describe mak to be done:
New 0 Repair 0 Replace with like kind: Yes 0 No 0 acmes a Rah Drain -each additional 100 32.00
Residential 0 Commercial 0 - Commercial Back Raw Prevention Device 82.00
AddEonal description af warfc moo
Residential Baddlow Prevention Device'
catch Elaski 11.50
.
Are you capping, moving or replacing any fixtures? insp. of Erdsling Plumbing or salty Requested .50.00
Yes 0 No 0 inspections perthr
If yes, see back of form to indicate %rock performed by Rain Lein. single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps - 2 11.50 . II 0
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY "itam. _ • ' r
rig g A . ■ ' . ' .
i hereby acknowledge that I have read this application, that the informadon - - • • • and M 47 ..:EQ:
Isometric or riser diagram is ' n ' ' Tabli b . 9 - ..7, - ,er --L 4. 4-
is carved, that I am the owner or authorized agent of the owner,
*SUBTOTAL i" Lf9fititgl 31../tp •-'
that plans submitted are in compliance with Oregon State Laws. •
Date Wr a40
7% SURCHARGE .?...4:Fei ri:Alia0a-
tte.G.4 ' z --. ...L. j.z. oN 7 a a
Coatect Person Name r Phone .:;..:,-.5r garte-L; i ■ ‘10 --)
"PLAN REVIEW 25% OF SUBTOTAL . ;:-,v,.1F.:t. - .g u
, Frowned . frtidure • . Mal le 9 '-fl 77
-- ----77 - i: -. 4, 5 gr_77. •17. 4 -•:::;ir=rg-f.i7-.:a- -2 1:-"it..ti.M - TOTAL tt, 11 57 - 3
•
i.-Til? -,,,,-; -1-E.- rfft:.:f.:::5 kiroi...a. :-
f. ..;, , , :fr.- : - t'.:,, Lf • ' :--
*Enid= penalties is go . 716 menage, except Residerdia eadziew Prevention
`- .I - Thr - r -- `• -, M7 - ,: ---- , -- h'7.. ; ., 7:- . 7. f _ ,F 1 ..T.: ; •
'•.',!:' V...]",:tc-..:;r11,=-----k.2.1:':',-,:::.!-4-T:tt=*:' • ;_. Device, which Is 125. 7% matharge
- All New Cora ramead ClondinP Moira Plana arm isceneddc or riser diagram and
plan review. .
LidstsVormatpsorepp.doc EtC20/39 .
--:.
09/09/99 THU 10:52 FAX 503 598 1960 CITY OF TIGARD 003
•
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PLEASE COMPLETE: •
. r,� f_- - — ace�;1 _": .r1,J_ ._ :. Q , y•3 a� ._ =� -.:. uz
r Ev Z � 6 r r �1'ic� Fs. = _5 =;�_y .,dlY `.r•F' k •" ,� '
sue.' fl •�
F'•n':�".;�3.1' -1.';' :rT"`' � ti -ze = .n�'gUtr.h4.n .144;1,4 rs �;{�'r�i.fh rl .Lr. 1 y!I r � 1 !- wr S •hL!'a�.'
Sink 7 /
Lavatory 1,/ _
Tub or Tub /Shower Combination
Shower Only
Water Closet •
Dishwasher . 2
Urinal 1
Garbage Disposal '- 1:
Laundry Room Tray •
Washing Machine •
Floor Drain/Floor Sink T (01 � 1
3' ./
4"
•
Water Heater
Other Fixtures (Specify)
Items #9, # 4 0 , #41, #42, # 51
#59(2) #73 #74 #75
2 Grease Traps
•
COMMENTS REGARDING ABOVE:
,
• •
CA
I ,,,. _ Accumulative Sewer Tally
•
Tenant Name:1 ) ,�CN` Th is SWR# �(°
Address: I S L O rA This M#: ('L / 1199 - OD ft9
� i(() & LC 1 y G PL
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
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 d 5
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain /sink - 2 inch 2 3 ✓
- 3 inch 5 / ,/ 45-
- 4 inch 6
- Car Wash Dm 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32 ( / 39
- 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
Sink - Bar /Lavatory 2 / o / _
- Bradley 5
- Commercial 3 7 . ✓ ? - 1
- Service 3
•
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6
Urinal 6 i • ,/ (D
TOTALS ( al O / 0 u ; g
Total fixture values: a g 9 divided by 16 = 1 g• ° EDU N /g 'Du
HISTORY G' ' 5 "Du
PLM# 96-6 2-79-, EDU# /3 SWR# 9G -000a c PLM# 96- 6;o/O EDU# !o SWR# 99 -c e 3
PLM# % -ova3O EDU# ,'i SWR# 94- oo p PLM# 94,- y EDU# . SWR# Q5- &53 /'
PLM# 96- 61°333 EDU# 9 SWR# Y‘ /9 PLM# EDU #Aigk, SWR#
PLM# 96)-oa677 EDU# 7 SWR# 9e-coo' PLM# EDU# SWR#
i:klsts%swrtaly.doc
•
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12/17/1999 Activities for Case #: PLM1999-00290
2:08:44 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 09/14/1999 GEO RECD No Hold BON 09/17/1999 •
PLMC005 Permit Created 09/17/1999 BON DONE No Hold BON 09/17/1999 Letter from Wash. Co. Health
. Dept. on file with the building •
permit.
PLMC007 Plans routed to Plans Examiner 09/17/1999 BON DONE No Hold BON 09/17/1999
PLMC008 Plans Approved /Routed to DST 10/01/1999 10/01/1999 10/11/1999 MS SENT No Hold MRS 10/11/1999 one lay moved
two grease traps added
PLMC120 Plumbing Undersl 10/01/1999 10/01/1999 10/14/1999 MS PART No Hold DGW 10/14/1999 Call back for reinspection. Test
on floor sink and floor drain OK.
PLMC725 Top -out Insp 10/01/1999 10/01/1999 10/25/1999 TLP DONE No Hold TLP 10/25/1999 kitchen area
PLMC750 RP /Backflow Preventer 10/01/1999 10/01/1999 12/07/1999 TLP DONE No Hold TLP 12/07/1999
PLMC799 Final Inspection 10/01/1999 10/01/1999 12/07/1999 TLP DONE No Hold TLP 12/07/1999
PLMC040 (F) Ready to issue 10/12/1999 DEB DONE No Hold DEB 10/12/1999 Must pay sewer fee prior to
issuance.
PLMCO50 (F) Issue permit 10/13/1999 DEB DONE No Hold DEB 10/13/1999
PLMC725 Top -out Insp ' 10/28/1999 10/28/1999 10/28/1999 MS PASS No Hold MRS 10/28/1999
PLMC725 Top -out Insp 11/01/1999 11/01/1999 11/01/1999 TP PASS No Hold VT 11/01/1999
PLMA800 Case Finaled 12/17/1999 JMT DONE No Hold JMT 12/17/1999
•
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Page 1 of 1 .
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /6/15 _ AM PM BLD
Location /S(D ( PO 2ZC( n C, Otal Suite 4 MEC
Contact Person P Ph 7 (0l ' 4 . Z . PLM 1 q 9
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Insp��tipp fVgt �/�,d -� C / ` �� C /.
Slab ` '7D�� -�C 'TlJ /at, !� �C��/t� 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
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
AID
PART FAIL
CHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
Low V b
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
Apppp S nspe
roach /Sidewalk Date Inspector Ext (.3
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1 *1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST �C
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
0-3j p BUP glfj C����-� "
(,, � Date Requested [ AM PM BLD
V /
Location / S (o 6 C) f c/4 .- uite , -�o MEC 9q l l C/
Contact Person h -7g / - 3/ 73 PLM f elg166 :�
Contractor Ph .swir i3oP (qq q - b014 (d Z
D Tenant/Owner LC) (,(1i ELC 09
ing Wall LR
Footing Access: �� ' ! FPS
Foundation � . 11 9 60 57 - • 1 oc, � � 7 � 3
Ftg Drain
Crawl Drain Inspection / SGN
ection Notes:
P
Slab � � : � �, '�'�;:��' � r� °•��
SIT
Post & Beam
Ext Sheath /Shear r1' '17,04//q
Int Sheath /Shear [[
Framing . l�R� - e,c
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
(7P (5 L
Susp'd Ceiling
Roof
Misc:
• ° RT FAIL
r
:earn
Under Slab
Top Out
Water Service
Sanitary Sewer
R -in Drains
v et`,
PART FAIL
L
Rough In
Gas Line
Hoke Dampers
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 L2 / 7 / c/7 Inspector (0/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record. from the job site.