The URL can be used to link to this page

Permit - C ITY OF TIGARD PLUMBING PERMIT l� DEVELOPMENT SERVICES PERMIT #: PLM2002 -00033 s`" ��I II 13125 S W Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/7/03 SITE ADDRESS: 08530 SW PFAFFLE ST PARCEL: 1S135DA -01000 SUBDIVISION: METZGER ACRE TRACTS ZONING: C -P BLOCK: LOT: 020 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: 2 FIXTURES • LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 0 ft WATER CLOSETS: WATER LINE: 0 ft DISHWASHERS: RAIN DRAIN: 150 ft Remarks: Site utility work, redirect storm drainage from existing CB and new parking lot FEES Owner: Description Date Amount DAVE DALTON 17930 SW MCEWAN [PLUMB] Permit Fee 2/25/02 $134.60 TUALATIN, OR 97062 [PLMPLN] Plan Review 2/25/02 $33.65 [TAX] 8% State Tax 2/25/02 $10.77 [PLUMB] Investigation 1 1/7/03 $134.60 Phone : 503 267 - 4419 Total $313.62 Contractor: CR WOODS TRUCKING INC PO BOX 1488 SHERWOOD, OR 97140 REQUIRED INSPECTIONS Phone : 503 Storm Drain Insp Final Inspection Reg #: LIC 123973 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 a‘C Issued By: / � _/ Permittee Signature: 'd% Call (503) 639 -4175 by 7:00 P.M. for an inspection neede the next business day ,- ' &4v� ez/ 04- a L r Plumbing Permit Application " _ 1 I �� Date received: - A� Permitno.: a.- w�e ,g� �.,.�; y Ci ty of Ti! anRE� , ` J g Sewer permit no.: Building permit no.: - - Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 - 4171 ;r _ 4 26i12 Project/appl. no.: Expire date: Fax: (503) 598 - 1960 Date issued: By: Receipt no.: __9 CM OF TIOARD Land use approval: 3UTL,D1Nf nivisioN Case file no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory Commercial/industrial ❑ Multi- family 0 Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Food service 0 Other: JOB SITE INFORMATION FEE SCl1El)Ul E (for special information use checklist) Job address: 6.✓ " -- X43' Ye . , i ,s +, ----17• a r O q Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: I Block: I Subdivision: SFR (2) bath Project name: L.)ak \-tor A rr..C"€ (1' . :V 1 SFR (3) bath City /county: '• c 0. r! I at: 9 `�d Pe. p - Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est. date of completion/inspection: Drywalls/leach line/trench drain r PLUMBING CONTRACTOR Footing drain (no. lin. ft.) _ Manufactured home utilities Business name: MIIMWMPIP - Manholes Address: Rain drain connector City: I State: I ZIP:,.. Sanitary sewer (no. lin. ft.) Phone: #5r I E -mail: Storm sewer (no. lin. ft.) s CCB no.:,3.r I Plumb. bus. reg. no: Water service (no. lin. ft.) City /metro lic. no.: Fixture or item: Contractor's representative sigma _ e: ■ \ Absorption valve ark flow presenter Print name: _ . �� _ ;( Date � ackwater valve CONTACT PERSON Basins/lavatory Name: l v ■ C. p e , t' /1L? Clothes washer Dishwasher Address: Sri„rnQ qS v t"_', s ;°,, Drinking fountain(s) City: ' I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank Fixture/sewer cap _ Floor drains/floor sinks/hub Name (print): bql. O \-o Garbage disposal Mailing address: 1793 p 5( 4g'icF',Net Rol. Hose bibb City:` -u ,. I State:0(k. I ZIP: et" , 0, :-- Ice maker Phone: . te,, c, , -121 i I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump Tubs/shower /shower pan - Urinal Name: t i Cr1 c : =� j i , p.e , ILI ; l'''' Water closet Address: pp ,,.,x avm,ti Water heater City: 'r; 5G f r` I State: Qti• I ZIP: cl 1 2.91 Other: r Phone: 503 •tv2w• 2.0134o I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information Minimum fee $ Not This permit application Plan review (at _ %) $ 0 visa ❑ MasterCard expires if a permit is not obtained Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440.4616 (6/I0/COM) • PLUMBING PERMIT FEES: .. I .. PRICE TOTAL New 1 and 2- family dwellings. only: FIXTURES (individual) ' " ' ' •QTY (ea) ' AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. - QTY ,(ea),'i - AMOUNT Lavatory 16.60 for each utility connection) One (1) bath $249.201 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE . Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL I_ Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 16.60 3" 16.60 PLEASE COMPLETE: . 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 • Quantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced - Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home New San /Storm Sewer 46.40 - Lavatory Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures (Specify) 16.60 Urinal - Dishwasher _ Garbage Disposal Laundry Room Tray • - Washing Machine . Floor Drain /Sink: 2" Sewer - 1st 100' 55.00 3" Sewer - each additional 100' 46.40 t Water Service - 1st 100' 55.00 Water Heater ' Other Water Service - each additional 200' 46.40 (Specify) Fixtures Storm & Rain Drain - 1st 100' 150/.14 I 55.00 . 5560 Storm & Rain Drain - each additional 100' l r 46.40 46' 7 ('O Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device* 27.55 • Catch Basin Z 16.60 33, ao Inspection of Existing Plumbing or Specially 62.50 • Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps • 16.60 QUANTITY TOTAL . Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL c 5 60 . 8% STATE SURCHARGE / ✓ /�, ' 77 - **PLAN REVIEW 25% OF SUBTOTAL (O S Required only if fixture qty. total is > 9 TOTAL $M, av * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $38.25 + 8% state surcharge. . ** AII New Commercial Buildings require 2 sets of plans with isometric or riser diagram for plan review. / is dsts\forms\plm- fees.doc 12/26/01 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested /0 AM PM BUP Location cS 3 0 Su N P &C fF Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: J v' Final PA FAIL `PLUMBIN am Under. Slab Rough -In a",(///-■ Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower P i■_ AS • 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line PnW Approach/Sidewalk Date raft Inspector Ext P Other: Final DO ''OT REMOVE this Inspectlo record from the Job site. PASS PART FAIL