Permit CITY OFTIGARD
�f ,a ,.; 1 DEVELOPMENT SERVICES PLUMBING PERMIT
!+� -'� 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # • PLM98 -0039
DATE ISSUED: 02/11/98
PARCEL: 1S136AD -02600
SITE ADDRESS...: 07027 SW PINE ST
SUBDIVISION : VILLA RIDGE ZONING: R -4.5
BLOCK • LOT •005 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:R3 FLOOR DRAINS • 0 TRAPS : 0
STORIES • 0 WATER HEATERS • 0 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: Add residential backflow prevention device to an existing single family
dwelling.
Owner: FEES
KEVIN FLOYD type amount by date recpt
7027 SW PINE ST PRMT $ 15.00 GEO 02/11/98 98- 303220
TIGARD OR 97223 5PCT $ 0.75 GEO 02/11/98 98- 303220
Phone #:
Contractor
MICHAEL ALLENS NURSERY INC
696 HAWTHORNE NE
SALEM OR 97301
Phone #: 503- 581 -8688 $ 15.75 TOTAL
Reg #..: 000061
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other RP/Backf low Prey
applicable laws. All work will be done in accordance with
approved plans. This peruit 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 - 0801-0010 through OAR 952 -0001 -0080. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
'`
Issued B • ! Pe tt n • .hif*Af
!
y .// � /_/ � �_ �i� _ Permittee ee Sig atur�►.�i /a..i u.
+ + + + + + + + + + + + + + + + + + + + + + ++ ++++++ + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++ •+• + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + ++
. ■ rt
CITY OF TIGARD Plumbing Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
Date to DST
(503) 6394171 Permit # 6G /// %$. - 00 3 F
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back Indicate Work Performed by fixture.
Job FIXTURES (Individual) QTY PRICE AMT
Address Street Address - ` Suite Sink 9.00
7 " 2- 7J7A" ( in'� IJ4 _ Lavatory 9.00
Bldg # City/State / Tub or Tub /Shower Comb. 9.00
��' -A � NanikShower Only 9.00
Narge I VliN Gnat., Water Closet 9.00
Owner -�OZ1 f � t Suite Dishwasher 9.00
City/State � Z Zi ip Phone Garbage Disposal 9.00
Washing Machine 9.00
Na a Floor Drain 2' 9.00
rr/v`(� 3' 9.00
Occupant Mailing Address Suite 4' 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Name ( ��,,� Urinal 9.00
c4 a e `� r � 14,,,,e,,,.6. �`5 Other Fixtures (Specify) 9.00
Contractor ai ri Aiciress Suite -
/. s TEi I LA ��)�l(L 9 9.00
Prior to permit C' t e m Zip P pp 9.00
issuance, a copy G. QII�O Y 4 0 1 , -C6 p 6 9.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 9.00
required if Sewer- 1st 100" 30.00
expired in COT Plumbing L,ic. # E.x� / Date Sewer -each additional 100' 25.00
database t_ ((A ‘i be Lc13 la q0c) 7/ G /� Water Service - 1st 100' 30.00
Name
Architect Water Service - each additional 200' 25.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City/State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 Pollution Device
to be done: Residential 0 Non - residential 0 Residential Backflow Prevention Device' 15.00 1
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL _
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quanity Total Is > 9 •
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that • lans submitted are in compliance with Oregon State Laws.
Sigh at re of Owner/ • , ent Date 5 % SURCHARGE
a Noe
a'u�L.4u.: • PLAN REVIEW 25% OF SUBTOTAL
Contact e Person Name Phone Required only if fixture qty. total is > 9
I J C Lcvera4- ve 3�,�' `� TOTAL
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
I:ldstslplmapp.doc 5/97
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New . � . . Moved Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I: ldstskplmapp.doc 5197
3/6/00 Activities for Case #: PLM98 -00039
9:43:20 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 2/11/98 GEO RECD PHN 2/11/98
PLMA005 Create Permit 2/11/98 GEO DONE PHN 2/11/98
PLMA740 Misc. Inspection 2/11/98 PHN 2/11/98
PLMA750 RP /Backflow Preventer 2/11 /98 2/8/00 MRS PASS AKJ 2/8/00
PLMA050 (F) Issue permit 2/11/98 GEO PASS PHN 2/11/98
PLMA800 Case Finaled 2/8/00 AKJ DONE No Hold AKJ 2/8/00
Page 1 of 1
,. CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
• Date Requested AM PM BLD
Location b' l et 1 ,n 2 Suite ME
Contact Person Ph 42:0' C R 'bO 39
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Ai NOT REQUESTED
Foundation FOUND DURING + — FPS
Ftg Drain
Crawl Drain In; NO INSPECTION(s) IN FILE 15-- n r SGN
Slab SIT
Post & Beam V%4 b
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Addll
Ms. 'up, t -
i
Final
PAS • _ RT FAIL
Post & Beam i i %.
Under Slab
Top Out
Water Servi
Sanitary Sewer
Rain Drains ■
n - Iv
S PART 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
Other Date 0 Inspector `% Ext ,3&)
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.