Permit CITY OF TIGARD
•:��" •II� DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT # F'LM98 -0423
Tigard, 13125 SW Hall Blvd., OR 97223 (503) 639-4171 DATE ISSUED: 1 1 / 16 / 98
PARCEL: 2S103DA -04500
SITE ADDRESS...: 10600 SW PARK ST
SUBDIVISION FANTASY HILL ZONING: R -3.5
BLOCK • LOT •002 JURISDICTION: TIG
CLASS OF WORK..:OTR GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH - 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 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: Replace existing water heater.
Owner FEES
TERRY WEESE type amount by date recpt
10600 SW PARK STREET PRMT $ 25.00 GEO 11/16/98 98- 310819
TIGARD OR 97223 SPCT $ 1.25 GEO 11/16/98 98- 310819
Phone #:
Contract or
JACOBS HEATING & A/C INC
4474 SE MILWAUKIE AVE
PORTLAND OR 97202
Phone #: 234 -7331 $ 26.25 TOTAL
Reg #..: 1441
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspect ion
Tigard Municipal Code, State of Ore. 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- 0801- 'w.:'. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: // /_! ice Permittee Signature:
/V
+ + + + + + ++ -+++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
a
CITY OF TIGARD R Plumbing Permit Application Plan Check a
13125 SW HALL BLVD. 31998 Commercial and Residential Recd By
• TIGARD, OR 97223 W.'0 . 1
Date Redd
(503) 6 39 -4171 Date to P.E. •
CO;. ".� " "��ItY D�CVELOP�'IEtV
Print or Type Date to DST
Incomplete or illegible applications will not be accepted • ' Pemuls
Related SWRf
i A called
■ Name of De velopment/Projed FIXTURES";int11918 F n,a" ` ;. 1 3 r .
Job - � ,.. .��
Sink gm
Address IOb ss QG� I(- I Suite Lavatory 9.00
n Tub or Tub/Shower Comb. g 00
fi 1T i C�ft�1� t ZIP Shower 9.00 -
-+«r L 3 Disler Closet h r 9.00
Dishwasher 9.00
Owner Mang Addres " Suite Garbage Disposal 9.00
.S(4.v2 Gt
aty/State Zip Phone Washing Machine 9.00
j W9-0 193P Floor Drain/Floor Sink 2" 9.00
Name 3' 9.00
. 4 " 9.00
Occupant Mailing Address Suite
p Water Heater conversion 0 Eke kind 9.00 G, DD
City/State Zip Phone Gas piping requires a separate mechanical permit.
Laundry Room Tray 9
Urinal g 00
fi ..: Other Fixtures (Specify) 9.00
Contractor Mailing Address Suit 9.00
�� S� ( Vi iJA . 9.00
Prior to permit qty to Zip ];hgne, 71 2� Sewer -1st 100' 30.00
&
Issuance. copy f O R C o�F_
• of all licenses oenses am Sewer - each additional 100' 25.00
required H Grego _ tro�ei Cont Board Uc.r Exa. Date �► ,
' �Al 1 I l�q� • o water Service - 1st 100' • 30.00
expired In COT Plumb Uc. � to _ A Water Service - each additional 200' 25.00
.. database �(� _5 f c i- , '/ 31 /C dNG Storm & Rain Drain -1st 100' 30.00
Nam Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space YS_00
' Or Matting Address Suite Commercial Back Flow Prevention Device or Anti- - 25.00
•
_ Pollution Device
1 Engineer City/State Zip Phone Residential Baeldlow Prevention Device' 15.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New O . Repair 0 Replace with Me kind: Yeses No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential ! - Commercial 0
Additional description of work: Catch Basin 900
Insp. of Existing Plumbing 40.00
per/hr
Specially Requested Inspections 40.00
per/hr
Are you capping, moving or replacing any fixtures? Rain Drain, singtc fay - 14 uweiiing 30.00
Yes O No O Grease Traps 9,00
• If yes, see back of form to Indicate work performed by
QUANTITY TOTAL Is Quantity t .: ,
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric f , :
WORK COULD RESULT IN INCREASED SEWER FEES. ° its« diagram diagram is required 1 antity Taal > 9 T ��
'SUBTOTAL r ; :: -
I hereby acknowledge that I have read this application, that the information
, n l�
given Is caned. that 1 am the owner or authorized agent of the owner, and a r; . SURCHARGE - _ -'-
that plans submilted are In compliance with Oregon State Laws. 6 /e SURCHARGE , %:? l - ;N=- = : -;:: •:-• 1
Signature of OwnerfAgent Date "PLAN REVIEW 25% OF SUBTOTAL - - !'? . ; f :`
G ✓�R. r C C-✓Yl te-(r 1 II/If/' 1 Required only s Rdure qty. totals > 9 4 ' '1•,
Contact Person Name Phone ±�� �,:,���. TOTAL
i /'�� � , n�'IO.t� + /�CA n;,Q rnCMt .r� _ 753) 'Minimum permit fee is $25 * 5% surcharge, except ReSkfential8a_� ckfl aw
Prevention Device, which is $15 * 5% surcharge
"All New Commercial Buildings require plans with Isometric or riser diagram
and plan review
tlds8s1pItenapp.doc 72/98
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7/25/99 Activities for Case #: PLM98 -00423
6:24:22 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp: Level By Updated Notes
PLMA003 Application received 11/13/98 GEO MAIL GEO 11/16/98
PLMA005 Create Permit 11/16/98 GEO DONE GEO 11/16/98
PLMA799 Final Inspection - 12/4/98 TLP PASS J *H 12/7/98
PLMA050 (F) Issue permit 11/16/98 GEO PASS GEO 11/16/98
PLMA057 Issue plumbing signature form 11/23/98 JMT RECD DST 11/23/98
PLMA800 Case Finaled 12/4/98 TLP PASS J *H 12/7/98
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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
�i BUP
3 /53 Date Requeste � 2 - 4- - c AM CP BLD
Location /0600 � (V e PA-4( S/ Suite MEC p `— _ _ . Contact Person /� /e(. /E Ph PLM i i C �3
Contractor vf1-6,04 Hr6/-' Ph SWR p
BUILDING Tenant/Owner 7 li(J ELC q0 -QG�/ I) p
7
Retaining Wall ELR
Footing
Foundation Access: / L� j AS J �+/13t5 FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab = .. m 1 • SIT
Post & Beam .P If / 77 PUP
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceil g Cc Sel �.
Roof
Misc:
Final =
FAIL
. PLUMBING J
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
rains
Fi • -
i FAIL
- : I. CAL
Post & Beam j.).,
'• • 0 ,
Smoke Dampers i
'Final
FAIL
TRICA
Service
Rough In
UG /Slab
Low Voltage
F, fi nal 3n
PART FAIL
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
Approach/Sidewalk Date 1'0,4 _ ' 9
Other / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.