Permit • CITY OF T I GA R D PLUMBING PERMIT
-• ,4, DEVELOPMENT SERVICES PERMIT #: PLM2000 -00157
�! �I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/18/00
SITE ADDRESS: 12564 SW QUAIL CREEK LN PARCEL: 2S104DA -00500
SUBDIVISION: QUAIL HOLLOW - EAST ZONING: R -4.5
BLOCK: LOT: 042 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 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: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
DON MORISSETTE HOMES INC PRMT DEB 5/18/00 $25.00 0002273
4230 SW GALEWOOD SPOT DEB 5/18/00 $2.00 0002273
LAKE OSWEGO, OR 97035
Total $27.00
Phone 1: 790 -6456
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 00006136 Final Inspection
PLM 11558 •
O
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 m- • •taln •ies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued ' Permittee Signature: h.
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/06 / 99 TUE 10:57 FAX 503 598 1960 CITY OF TIGARD IZI 0 02
CITY OF TIGARD Plumbing Permit Applicatiapc EIVED Plan Cr. -
13125 SW HALL BLVD. Commercial and Residential nc Redd i
_
TIGARD, OR 97223 Date Re* 5-'579 0
-
(503) 639-4171 MAY 1 5 2000 D W
• Print or Type Date to D3T --
Incomplete or illegible applications w111:9MneVi• ' Permit .1. Pt./18090 -100 /57
1 Caved
SWR*
( 0
Name of Daveiopment/Projec: *F A...ir':1 .- F i lMg 1AIAT.:;-=
Job au-&a- 4oll.cno Sink 11.50
Address Street Address - I Suite Lavatory 11.50
I aS(40 SLi) OILCUIL, C.re 11 Tub or Tub/Shower Comb. 11.5C '
. • ' Bldg 4 - - City/State I .
. . Zi p . - - - .. --. Shower Only 11.50
Name
T cutct_ ok 9 1»L Water Closet 11.50
I
ban
_ frerei 35 e..- liarne.S Cishwasher I 11.50
. . .._. _ ..... .. _
Owner Maling Address Suite Garbage Disposal 11.50
L-/Q30 Stv Gelicwooct_ Washing Machine 11.50
City/State Zip Phone
Lake bStuccic. Ok., 79o- by 5.40 Floor CraINFloor Sink 2° 11.50
Name\ 3" 11.50
•
4" 11.50 - I
Occupant Melling Ad . ss Suite Water Heater 0 conversion 0 like kind 11.50
' Gas piping requires a separate mechanical permit
City/State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
. 1 -P -rIC I Sci P 4- Wr Grass lizrvisze, Other Fixtures (Specify)
• 15.00
. i
Contractor Mailing Address Suite . I
al I s PA) lOnftntut
Prior to permit City/State Zip Phone 1I - Sewer - 1st 100' 38.00
issuance. a copy 1/...›ii Sdn Wile.. Ok.97070 1,4140 an Sewer - each additional 100 32.00
of ad licenses are Orego Conet. Cont. Board tic.* Exp. Date
required if CD)31, • if)C.) . Water Service -1st 100' 38.00
expired In COT Plumbing Lie. C Exp. Date Water Service - each additional 200' 32.00 . .
database I Storm & Rain Drain - 1st 100' 38.00
Name ' ' -
Storm & Rain Drain - each additional 100' 32.00 I
Architect Mobile HOMG Space . 32.00
or - Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00
' - Pollution Device
Engineer 1 City/State Zip Phone Residential Bacidlow Prevention Device* 19.00
(irrigation timing devices require a separate 4 .
Describe work to be dcne: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commerdal 0 Catch Basin 11.50
Additional description of work:
Insp. of Existing Plumbing 50.00
• per/hr I
Specially Requested Inspections • 50.00
Are you capping, moving or replacing any fixtures? per/if
Yes 0 No 0 Rain Drain, single family dwelling 45.00
If yes, see back of form to indicate work performed by Grease Traps 11.50
fixture. FAILURE.TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. -
QUANTITY TOTAL
I hereby acknowledge that i have read this appkation . the:the information Isometric cr riser dagram Is required If Quargily Trial is > 9 1 :1;:f ;' •',', 1 Z
given Is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL i.
that plans submitted are in compilance with Cregon State Laws. L.F.2,.",:jill:
=ref,,Svntent
! 1C , r, IS.% SURCHARGE
-- • - ;z- - 4 1 ::;. i
Contact Person . Phone "PLAN REVIEW 25% OF SUBTOTAL i:::.;:.,;.,....„;?,W;.".5&
Requi:ed 3rdy ti fixture qty. total Is > 9 : . :,'..iit:0,!: , ! ; ::- . ?4 , 11 •
rt;tn.fggkRI.4EN.rgXWV-iiggg-:-2P-::.1*:*MI'tgt;--ag.FAF,Sgr-LI.-52;.:EA TOTAL •
I NIMONOILsEN 00.:§telji,:r:Attliail.R41;;:e:f1-11.117.--itittil ___:. - ::: :•._, 96
.. ... . . ........ 1
r t- - M, $. .0e .1StPAN-9;437,F7?-747,g,,,ii.EFAI:kractf .:T.74-7,1illst:::€. 'Minimum permit fee is $50 + 5% surcharge, except Residential Backflow
rOf!...---15:41_ttilF3WRY-fiafta:0_11110/3.4,fifliir4.5/WitigOtfiVitikek-0 -..A Prevention Device which is + 5% surcharge
1-€1.0tatii.:6kiiatiiiii0LidifietttofrifirprW.41.1101.2.15...ff1-4-*0 "All New Commercial Buildings require plans with isometric or riser diagram
and plan review
BdstsVuins‘eiumapp.dc: 52199
•
05/26/2000 Activities for Case #: PLM2000 -00157
1:24:39 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 APPlication received 05/15/2000 DEB MAIL No Hold DEB 05/18/2000
PLMA005 Create Permit 05/18/2000 DEB DONE No Hold DEB 05/18/2000 Delay in creating due to
understaffing.
PLMA750 RP /Backflow Preventer No Hold DEB 05/18/2000
PLMA799 Final Inspection 05/18/2000 MRS PART No Hold AKJ 05/18/2000 submerged in water
PLMA050 (F) Issue permit 05/18/2000 DEB DONE No Hold DEB 05/18/2000
PLMA799 Final Inspection 05/19/2000 MRS PASS No Hold AKJ 05/21/2000
PLMA800 Case Finaled 05/21/2000 AKJ DONE No Hold AKJ 05/21/2000
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 264c)0 - 07)0 5
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5f I i io J AM PM BLD
Location ) 25L o I Q. a,i' ( (�n A- Suite G a MEC
Contact Person T l Ph 1A 1- c7 b 3 I PLM d o 0 -c 7/ s7
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGT
Slab 0 SIT
Post & Beam Ext Sheath /Shear �(�/ Vi
Int Sheath /Shear
Framing
Insulation
Drywall Nailing =.
Firewall
Fire Sprinkler ■ _AY
Fire Alarm
Susp'd Ceiling � 1Y'
Roof
Misc:
Final
PASS PART FAIL
S P BI
Post &Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
na —�
ASS` FAIL
T aY101
Post & Beam
Rough In
Gas Line
S Dampers
ej� PART FAIL
CTRICAL
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
3/
•
Approach /Sidewalk Date I 14 Inspector A Ext
Other
Final
PASS PART FAIL D • NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST lo -600
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 51/ I AM BLD
Location 1 Z S ` -( Q IA.4A : I CAVAL Suite MEC
Contact Person T I - Ph 1.-0 - / ' 1 PLM jDO - DO I S
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: �J� v
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof P/
Misc:
Final
PASS PART FAIL
gN111"IIBIN��
Pos t O
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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 Dat , Inspector Ext�
•
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.