Permit .., CITY OF TIGARD
PLUMBING PERMIT
,a ,�i�;� DEVELOPMENT SERVICES PE R MI ISSUED: O7/18i97 -0283
PARCEL: 2S11OCC -13100
SITE ADDRESS...: 16055 SW QUEEN VICTORIA PL
SUBDIVISION • ZONING:
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK..:ALT 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: install /change water heater to gas from electric
Owner: FEES
PAUL MCFARLAND type amount by date recpt
16055 SW QUEEN VICTORIA PRMT $ 25.00 TAT 07/18/97 KING CITY
KING CITY OR 97224 SPCT $ 1.25 TAT 07/18/97 KING CITY
Phone #: 639 -2796
Contractor
ABLE MECHANICAL, INC.
PO BOX 7176
BEAVERTON OR 97007
Phone #: 503 -640 -4141 $ 26.25 TOTAL
Reg #..: 000691
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Service In
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gas Line
applicable laws. All work will be done in accordance with Final Inspection
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 _, ��
4 1 -
Permitt Si gnat�_ire: ,e. /� f
+ + + + ++ ++ +- + + + + + + + + + + + + + + + + + ++ +++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
JUL- 17 -'97 THU 13:56 ID: FAX NO: #246 P01
s d By_T
CITY OF- TIGARD Plumbing Application Re Re c Recd 7- _ 7 __
13125 SW HALL BLVD. Commercial and Residential Date to P.E.
TIGARD, OR 97223 Date to DST - 2
(603) 639 -4171 Permit >r J
Print or Type Related SWR a
Incomplete or illegible applications will not be accepted called
I
•
I
FIXTURES . {Individual)' S k ; k• •. '•:''�'': �. '. QTY PRICE . AMT '
Name of Development/Prefe Sink 9.00
Job .. .---- Lavat 9.00
Address S treetAddress Suite 9 .00
ySS ti ce ' Tub orTub/ShowerComb.
�,tJ �N
Bldg a City/State Zip Only 9.00 P ' 9.00 •
Water Closet
- Name _ Oishwater 9.00
eta, m� f2 C iarriage Disposal 9.00
Owner Mailing Address Suite 9.00
,) 60-.5-S V c� 4, Washing Machine $� C��POn �
City /Slate Zap Phone Floor Drain 9.00
if
a s
6'. • - 9.00
Name' a"
9.00
c 'sRin� -�' 9.00
Occupant Mailing Address Water Healer
s Suite '
p Laundry Room Tray 9.00
9 "00
City /State Zip Phone Urinal
Omer Fixtures (Specify) 9.00
Name g9,00 {; \Q\c n' e 1 ,O.r: iint 9.00
Contractor Mailing Address Suite 9.00
P t) 4 1171. - 9.00
� Ci t t ,� Zip Phone
kOR 9/6 c .7440-1i' 9.00
Oregon Const, Cont" Board LIc.# Exp. Date 9.00
Attach Co of � 9
Copy u p mbi fJ c. � Date Sewer - 1st 100
Current Plumbing Uc. - 30.00
Licenses Sewer •each additional 100' '
COT Basin , ax or Metro is Exp. 'ate water Service • 1st 100' - 25.00
11 1 Water Service - eatn additional 200' 30.00
Name Storm es Rain Drain - 1st 100' 25.00
Architect , S torm & Rain Drain -each additional 100' 30.00
Or Mailing Address ' Suite �-
Mobile Home Space 25.00
C ity /State ZJP
Commercial Beck Flow Prevention Device or anti- 25.00
Phone
Engineer Pollution Device
Residential Backtlow Prevention Device" 15.00
Descr wort Ne w 0 Addition o A lteration • Repair O Any Trap or W aste Not Connected to a Fixture 9
to be done: Residential a Non - residential 0 y 9.00
Additional description of work Catch Basin
�'`�a`�V f h' Insp. of Existing Plumbing 40.00
_ per hr ,
(' ���. r - },1 64 rt- 40,00
� Specially Requested Inspections _ per 0
Existing use of 30.00
tit/Doing or property Rain Drain, single family dwelling
Grease Traps 9,00
Proposal use
buildln or property of QUANTITY TOTAL ?� 4.....4'' ' •4 `
9 requires ir Chan Tatd la .9 "'114; ..k• . t.
Isomeuic ornserdi-' fe rssl .- µ...�
Are ou cappin• an fixtures? Yes ■ No • *SUBTOTAL � ? = "
I hereby acknowledge that I have read this application• that the information
given is correct, that I am the owner or authorized agent of the owner, and 6% SURCHAR 5 ' .'
that plans submitted are In compliance with Oregon State Laws. •
Signature of Owner /Agent Date PLAN REVIEW 25% OF SUBTOTAL •
�T , l A � '- n 1 Required only if fixture Qty, total is x• 9 `_
J�A "{'` ` L',ca,�F• TOTAL 1ar,J�J
Con of Parsee Name Phone
'i,,,�i,� ` �\‘' o , � -minimum permit fee is $25 + 5% surcharge. except Residential 8ackflow
, Prevention Device, which is $15 + 5% surcharge
iAdstskpimapp•doc 8/98
8/16/99 Activities for Case #: PLM97 -00283
5:11:58 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 APPlication received 7/18/97 7/18/97 TAT 7/18/97
PLMA005 Create Permit 7/18/97 7/18/97 TAT 7/18/97
PLMA737 Gas Line 7/18/97 7/22/97 RAB PASS J'H 7/22/97 •
PLMA799 Final Inspection 7/18/97 7/22/97 RAB PASS J'H 7/22/97
PLMA050 (F) Issue permit 7/18/97 TAT PASS TAT 7/18/97
PLMA800 Case Finaled • 7/22/97 RAB PASS J *H 7/22/97
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: - ) A. M. P.M. MST:
Location: /0055 '0055 9aW? / "t/ .3 .. 6'I .C.Q _ ��.
/ / BUP:
Tenant: Suite: Bldg: MEC: .
Contractor: Ci.�i � , Phone: / T � PLM: 9 7-023
Owner: Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) LUMBIN MECHANICAL ELECTRICAL SITE
Site Post/Beam o eam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved pproved Approved Approved Approved
Appr /Sdwlk Not Approved o oved Not Approved Not Approved Not Approved
FINAL INAL FINAL FINAL FINAL
•
•
O Call • - -O Reinspecti • of $ required before next inspection 0 Unable to inspect
i-
Inspect. I i ! i I r4' _. / . Date: 7-._ z --- 9 7 Page of