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Permit CITY OF TIGARD 4� , -; � DEVELOPMENT SERVICES PLUMBING PERMIT PERMIT # PM98 -0371 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/09 PARCEL: 2S110CC -11900 SITE ADDRESS...: 15935 SW QUEEN VICTORIA PL SUBDIVISION • KING CITY NO. 3 ZONING: BLOCK LOT •032 JURISDICTION: KIN CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE -SFA WASHING MACH : 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:R1 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: Water heater Owner: FEES FUMICO WHEELOCK type amount by date recpt 15935 SW QUEEN VICTORIA PL PRMT $ 25.00 B 10/09/98 KING CITY KING CITY OR 97224 5PCT $ 1.25 B 10/09/98 KING CITY Phone #: Contract or COMFORT ZONE HEATING & COOLING 3204 SE KELLY PORTLAND OR 97202 Phone #: 236 -4655 $ 26.25 TOTAL Reg #..: 46238 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 Final Inspection 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 -9001 -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: e 1' v�� Permittee Si nature:( �I( 0 '� — I uC Y 9 �P +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ _ - :."OCT- 09 -'98 FRI 15:07 ID: FAX NO: ••' „. #077 POS CITY OF TIGARD Plumbing Permit Application Plan Check* 13125 SW HALL BLVD. Commercial and Residential Rec'd By /2. TIGARD, OR 97223 Date Reed /0 1- 7 1: 4 - C -- t7 - 5 -4 t (503) 639 -4171 Date to P.E. Print or Type Date to DW3� Incomplete or illegible applications will not be accepted Permit ft Related SWR at Called Name of Development/Project �` ' : ., . ( . C c { + : l , , ! t. i t Job • Sink 9.00 Address Street Address �f uit Lavatory 9,00 l fSW q t Li 'j t FL • Tub or Tub/Shower Comb. 9.00 Bldg ity/ late Zip Shower Only 9.00 Name f ( Cc � Water Closet 9.00 i_4 t J wt. ( CO G /1 -e - - k Dishwasher Mil 8•00 Owner Mailing Address Suite Garbage Disposal 9.00 5 Washing Machine - 9.00 City /Stale Zip Phone Floor Drain/Floor Sink 2' 9.00 Name , g.00 (9•yy4...Q..r 4' 9.00 Occupant Mailing Address Suite Water Heater 0 conversion :: like kind Mil 9.00 - Gas piping re• titres a separate mechanical • = it. City /State Zip Phone laundry Room Tray -- 9.00 Urinal . 9.00 Ngme 62 to (9• Other Fixtures (Specify) . 9.00 Contractor Mailing Address - -p suite " ' •9.00 Mil 7 Se- ge-i , y 0.00 Prior to permit Ciy /State 1 Zip PhOne Sewer - 1st 100' 30.00 issuance, a copy p p vt,' stow ell Zdl-, 2.1 G `�'6 Sewer each additional 100' 25.00 of all rues are Oregon 4 2 46 ' and Lk.* Exp. Dag required if ct [Y 9 Water Setvioe -1st 100' 30.00 MI expired In COT Plumbing Lie. 1! a - ii. Date Water Service - each additional 200' 25.00 database 2.6-s 7 i l 14 J 5-- 77 Storm & Rain Drain - 1st 100' 30.00 Name Storm & Rain Drain - each additional 1W 25.00 Architect Mobile Home Space 25.00 Or Mailing Address Suite commercial Back Plow Prevention Device or Anti - 25.00 - Pollution Device Engineer City /State Zip Phone Residential BacklioW Prevention Device" ■ 15.00 ■ (Irrigation timing devices require a separate Describe work to be done: restricted ener• permit. New o Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial 0 • Catch Basin 9 .0 0 Additional description of work: Inap, of Existing Plumbing - 40,00 - •:r/hr Specially Requested Inspections - 40,00 - • er/hr Rain Drain, single family dwelling 30.00 Are you capping, moving or replacing any fixtures? Grease Traps 9.00 • Yes NoO If yes, see back of form to indicate work performed by QUANTITY TOTAL - n .• ;+ 1 ; ' fixture. FAILURE TO ACCURATELY REPORT FIXTURE IsomElAc w riser diagram Is required N' Quantity Tore) is > 9 o il : WORK COULD RESULT IN INCREASED SEWER.FEES. 'SUBTOTAL '""" " S'"+ I hereby acknowledge that I nave read this application, that the information a +1 I r ` Z- given is correct, : =1 t:: , that I am the owner or authorized agent of the owner, and 6% SURCHARGE 4i i ,;',,'.,5,::' 2,c- that arts submitted are In compliance with Oregon State Laws. `: , r ' / SI a re w er! nt / Date �[/ °PLAN RE1/iEW 26% OF SUBTOTAL . I :( / d e S � ' b , � R: • uired o n x fatuie • l . total is 2. 9 5 4 �` ' TOTAL r 7,=11.,!;:••• c �,14� nta a ,.n = me Phone y - � : k __, 1 �� ! r ' ) (e ' 6 fi 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow (j-0 --j / Prevention Device, which is $15 + 5% surcharge **All New Commercial Buildings require plans with isometric or riser diagram and plan review l: tdeteblumapp.doc 7/298 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location / 3.5 & (,(��( �C,�c i,�, Suite MEC Contact Person Ph PLM / � 6 ,3 - 7/ Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: j �� Foundation W ' FPS Ftg Drain Crawl Drain NOT REQUESTED SGN Slab FOUND DURING RESEARCH SIT Post & Beam Ext Sheath /Shear NO INSPECTION(s) IN FILE Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof � j ✓ %rte Misc: Final PASS PART FAIL PLUMBING Post & Beam / Under Slab / Top Out i Water Service Sanitary Sewer Rain Drains Final PART FAIL MECHANICAL Post &Beam (/I_J 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 I f/ Inspector I J // Other Ext- 317 PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 e BUP Date Requested /-) I AM PM) ' BLD Location / J� 9 35 (Q (.62e--frt Suite e- ,V' '7 — 00 S7 Contact Person �u �C2 U.)\ 1t LO C.J( Ph `7 - 603 7 ` / Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: C , 1nn^ �.. Foundation al �u / tce FPS Ftg Drain Crawl Drain NOT REQUESTED SGN Slab FOUND DURING RESEARCH SIT Post & Beam Ext Sheath /Shear NO INSPECTION(s) IN FILE Int Sheath /Shear R 1 Framing Insulation Drywall Nailing '' // /n� (, ,1 ,( ^-� Firewall `L/•l IV G`C� r V a.A /s — O V �i'� /)—,1g)( V 1 4-f i m Fire Sprinkler Fire Alarm `� Susp'd Ceiling 46b \ L ` 0 VV3 1 >-� l `� _ "1 Roof Misc: Final PASS RT FAIL MBING hu Yk5 Post & Beam Under Slab Top Out Water Service Sanitary Sewer Drains N � ASS PART FAIL C-I4 ANIC k Post & Beam Rough In Gas Line Smo a Dampers in PART FAIL RICAL Service Rough In UG /Slab Low Voltage Fire Alarm Ili 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 1 n nS p Approach /Sidewalk Date t / Inspector �� j� / - Ext l e) Other Final PASS PART FAIL DO NOT REMOVE .this inspection record from th job site.