Permit r CITY OF TIGARD
PLUMBING PERMIT
,rA DEVELOPMENT SERVICES PERMIT #: PLM1999 -00287
r � l II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/14/1999
SITE ADDRESS: 12635 SW PRINCE EDWARD CT B PARCEL: 2S109DD -90122
SUBDIVISION: ZONING:
•
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: '
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
.LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Water heater ,
FEES
Owner:
Type By Date Amount Receipt
GILL COFFMAN PRMT BON 09/14/199E $50.00 KING CITY
12635 SW PRINCE EDWARD CT SPOT BON 09/14/199E. $3.50 KING CITY
KING CITY, OR 97224 Total $53.50
•
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING + APLIANCES
9806 SW TIGARD STREET
CCB (EXP 6/2002) REQUIRED INSPECTIONS
TIGARD, OR 97223
Phone 1: 624 -6895 Misc. Inspection
Reg #: LIC 000027 Final Inspection
PLM 026 -60PB
ORIGINAL
•
•
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: l Permittee Signature: i 9 _ ma
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day ) Y P Y
SEP -13 - 99 MON 11:21 AM City of King City FAX:503 639 3771 PAGE 2
CITY OE TIGARD - Plumbing Permit Application Plan Check g
13125 SW HALL BLVD. • Commercial and Residential Recd By
TIGARD, OR 97223 Date Reed 9 -t3 -40 -Iti M
(503) 639 -4171 Date to P.5_
• Print or Type Date to DST q.- I2 -4q 9 4 f - 9j
Incomplete or illegible applications will not be accepted Permit P4vt1949 -00 7
Related SWR *
Caned
Manse at ll , iJT1�111: �:•;w <. :•s.2 C c�. <';
Job $ hlit 11.50
Address Q Adams Cam _ _ 1 Y f /n /+„ � � B , T lAvatory 11.50
a or Tub/Shower Comb. 11.50
l , . . U • / d! ' . 9 Shower Only - -- - -- - -_ . 1 •
1Varne Water Closet 11.50
lZ/ l/ CorP marl Dlshlrasher . 11.50
Owner Malting Addree 0 - y Garbage DIsposai 11.50
/ / • •. / d _ �' Winning Machine 11.50 -~
Cl •
be • Z)p Fbor Drain/Floor Sing 2 11.50
w a 49 9 ...Z..% ,
ems 3' 11,50
a ' 11.50
Occupant Malting Add1asa SUite Water Heeler O conversion it like kind / 11.60
Gas piping requires a aaderele mochas ic&l permit
ry/State Dp Phone Laundry Room Tray `�
My/State 11.50
I
' Urinal 11.50
r • / /I I y� fir tan PLu rn b i n ► Other Halms (Specify) 15.00 -
Contractor Addre a
LBOIP -"• ark St. _
Prior to perms s h` • to Phone Sewer • • 151 100' 98.00
ssuanoa, a copy W r I pi Or _ - 0 . -•-, - r I Q Sewer - each additional 100' 32.00
,f all ea are Oreg • Cent Hoard tic fi I p.
required if - ., e 011 Water S e r v i c e - 151, IG0'. _ _ _ . . . . . . . 3 5 • 0 0 ... 38.00
expired In COT pi imj Lk. 0 Em a Water Service - eadi additional 200 32.00
database �p - (() P6 Qe5 4 saw a Rain Drain - 1st 100' 38.00
Name Storm & Rain Drain -midi additional 100' 92.00
Architect Motilo Home Space ' 32.00
or Malunp Address i Sults Commerdal Back Flow Prevention Device or Anil- ' 82.00
Pollution Devlee
Engineer City/State 27p Phone Residential Orator prevention Orrice' 19.00
OMgetlon•dmind deices require a separate
ascribe wort to be done: restricted energy pent) _
ew 0 Re air 0 Replace with like kind: Yes XI No 0 Arty Trap or Waste Not Connected to a FM 11,50
eeldenttel ; Commercial 0 . Cstdl Basin ' 11.50 .
lenlonnl datalpdon of wont: Insp. of EalsOng Plumbing 60.00
r�eplae e uXcker hC � r
. _ per/hr ,
re you capping, moving or replacing any natures _ Specially Requested Ins 60.00
Yes 0 No 0 Rein _ 4 6
yes, aee back of form to Indicate work performed by praln, single faintly dwelling , 45..00 00
1
Mire. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
Mo
'ORK COULD RESULT IN INCREASED SEWER FEES, QUANTl7Y TOTAL `'�.„ .i: -
`= " " " 11::
iereb acknowled a Mal I Have reed ells Ilradan, trial the Information •'',': °" '; coned, Mat em the owner or sPp hornet/1e or la required d Cuan Towel V s 9 �� 4
a o authorized agent of the owner. end diagram r°R' tlb : H-m-Fi
, en Le o ne
: ubmitted are k Cfm - Rance with Ore • on Slate Laws. 'SUBTOTAL S ^ fi �- �;. co
at • tans
•
a , ' . toad _ •r ■ u,6 .:K os a r
r7 SURCHARGE rR ' W�.
• .K6 ...e -te,
I � � � .I
.....1 .....:y44.1 3 ._..
et P ra • Nemo - FLAN REVIEW 26% OF SUBTOTAL yr fe1�la�pp�.d.11p�'' ire„x- x
•.Io (AV
iiM aa.14 Ar. °4r•
i . � / • Required and A Mum 4h. rout N a a -i
Y •re ' f, ' • T ' („ :4" ::;:;:;":;::::','",j - 1 1 = " > .• JC?•!')'•\i." .t ..th .,.e
• �Za�jj �ti x, <' 4 TOTAL ,. .:. .,. ��t� Q
7 7 � r� a Z . �+ T ' { ,� 3 9 '.:,A�.tt�� xi:: e .. ..:�� • - '''���..���.�
" r .� , t t , r a �, x 'Minimum portnh too is 550+ 5% surcharge, except Residential Beddow ^A' . . '�Y.�:�".Y ^ 'R s cF` ', . s Z a •+^ ` + `t t
, '' + n a ' t ' i �: i -, � 4y , t l, a . Y' 1 > t
) . L� 1. Prevention Device, which Is 525 r 5% surcharge
'. y3` ) v4 1 { ?._, • f f \r'. ; "t d '' ` - AU Now Commercial Buildings require ,..1.lr n. ,.,. \J, � +. ice �� ,e.y�_..): " , _ :.,.:.. �,. .,:, ,_ •::. :. ;:.: F. < .:. < ;; Ofnm lei ng Quire plans with Isometric or Isar diagram
and plan review
OThev .nsce.ex MC,
TOTAL P.02
03/29/2000 Activities for Case #: PLM1999 -00287
1:07:47 PM
■
Assigned Hold Updated
I Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMD003 APPlication received 09/14/1999 BON DONE No Hold BON 09/14/1999
PLMD005 Permit Created 09/14/1999 BON DONE No Hold BON 09/14/1999
PLMD740 Misc. Inspection 09/14/1999 09/14/1999 No Hold BON 09/14/1999
PLMD799 Final Inspection 09/14/1999 09/14/1999 03/28/2000 TLP • PASS No Hold AKJ 03/28/2000
PLMD050 (F) Issue permit 09/14/1999 BON DONE No Hold BON 09/14/1999
PLMD050 (F) Issue permit 09/14/1999 BON DONE No Hold BON 09/14/1999
PLMA055 (F) Reprint Permit 11/23/1999 GEO DONE No Hold GEO 11/23/1999 -
PLMA800 Case Finaled 03/28/2000 AKJ DONE No Hold AKJ 03/28/2000
•
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 - Hour Inspection Line: 639 - 1175 Business Line: 639 - 4171
/ BUP
Date Requested 3/ 3 00 AM PM BLD
Location I 2 3$ fr r a et Saite MEC
Contact Person . -J Y.�l P, Ph l02.1' PLM / 9 Q9- 0027
Contractor 610)- fi 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 / /Ad '�'r� f-�Q 2 ,
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
�PttiMBI J
Pos Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains GO t
air
q a 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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date / . v p ector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.