Permit .. CITY OFTIGARD
.
DEVELOPMENT PERMIT SERVICES PLUMBING PERM
PLM97- 033
DATE ISSUED: 02/20/97
PARCEL: 251 12DA- 01300
SITE ADDRESS...: 06640 SW REDWOOD LN
SUBDIVISION • MLP96 -0002 ZONING: I -P
BLOCK ° LOT •
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH 0 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRP..:B FLOOR DRAINS • 5 TRAPS • 3
STORIES • 0 WATER HEATERS • 8 CATCH BASINS • 0
FIXTURES . -- LAUNDRY TRAYS 0 SF RAIN DRAINS 0
SINKS : 28 URINALS 0 GREASE TRAPS • 0
LAVATORIES.....: 8 OTHER FIXTURES • 13
TUB /SHOWERS 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 8 WATER LINE (ft) ...: 300
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Providence clinic interior plumbing
Owner: FEES
PACTRUST REALTY type amount by date recpt
15350 SW SEQUOIA PKWY PRMT $ 730.00 JSD 02/20/97 97- 290689
PLCK $ 182.50 JSD 02/20/97 97- 290689
TIGARD OR 97224 5PCT $ 36.50 JSD 02 /20/97 97- 290689
Phone #:
Contract or: --
PENINSULA PLUMBING
PO BOX 16307
PORTLAND OR 97216
Phone #: 761-0500 $ 949.00 TOTAL
Reg #..: 002244
REQUIRED INSPECTIONS
This pervit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Line Insp
applicable laws. All work will be done in accordance with Top-out Insp
approved plans. This pervit will expire if work is not started Storm Drain Insp
within 180 days of issuance, or if work is suspended for more Rain Drain Insp
than 180 days. Misc. Inspection
RP/Back fl Prey
• Final Inspection
Perm ittee Signa• eE ��
7r
Issued B ��`
AP
Call for inspection - 639 -4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
j.3128 SW Hall Blvd. Permit # PL Ai q7- 17033
Tigard, OR 97223 SovR _00
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
C�a d d 2- I'1' 7
NaAe or D0V010tmmant New Single Family Residences Only
PROD /tof.nlel ( 44/ it e4,?f
Address ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job [JA& Ai0 S,w, 9 a:A4,00A ILA., ❑ 3 BATH HOUSE $225.00
Address = zip Fee includes all plumbing fixtures in the dwelling and the first 100 feet
�],a Q I2.�_ of water service, sanitary sewer and storm sewer. See fees below.
rma. n. FIXTURES QTY PRICE AMT
- PRO v,'1f.wcf. i4E4i /l Sy(4- s,Avas Sink / i�8 9.00 152 °'D
Mang Addy... Phan. Lavatory / O 9.00 110
Owner 4 /k OS N.F. es I I /4,a Tub or Tub /Shower Comb. 9.00
City /State TIP Shower Only 9.00
r- 13(2.4- La n uf. 97213 Water Closet R- 9.00 11,00
NaAe (o ` mane of tininess) r Dishwasher 9.00
Occupant V; INeK)cr Q�
4eA141a /Z>c Garbage Disposal 9.00
"'a"o Addre.. Pismo Washing Machine 9.00
O 6/0 S, w: at 6 kno),S Floor Drain l S 9.00 45 9.
City/State Water Heater g 9.00 1Z,da
j DYL6 Laundry Room Tray 9.00
Nema Urinal 9.00
PFi1. S wila 19_ IA.m..ON/ rU LA Other Fixtures (Spec ) fiBSL /16 ti . 9.00 ?36p oC Mona
,,
Contractor � a � tvur a .S; cJ IC S _ ? 9.00 21 m
f ' 0. QO I.. 1( 30 7 - Roo & `lea , ru .� 2 9.00 t i •O0
Ci"'Sta1e ZIP Ovf t2 G /ox a A c Z- , 9.00 1$ ao
Q024 -/ 4..,.1, t c 9 7Z f f - 0307 , Sewer 1st 100' 30.00
Stale R° n No. ec,i3 e , Z_ Z q 7 city BM Ta■ No. Sewer - ea. Addit. 100' 25.00
4'
0 O2 Z /pplie.hn 4� 10 11" ' 9 1 ) 000/ qf0 i( Water Service 1st 100' i 30.00 730,
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' I 25.00 1j 90
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
S 5KAA0a Z- /,p 97 Device or Anti- Pollution Device 1 9.00 ( g a0.
Sq,.hae cam or agent) Date Any Trap or Waste Not ).6
Connected to a Fixture bRA1,� ( 3 9.00 z l dG
Describe work new g addition 0 alteration 0 repair 0 Catch Basin 9.00 .
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr I
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of nn l C q
building or property y11r)k. ( ` etTacOf/ 1 a
'(Except rest Sal backflow
prevention devices)
NOTICE "Minimum Fee $25.00 SUBTOTAL I?0,
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE 36 50
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL / iZ5° \
TOTAL
Special Conditions 0 4
J
Date issued by
17ki5 ro 114
Pl b1 sg- ey r,
L)!> , E i,I L._
TA►D,
Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0033
PACTRUST REALTY
06640 SW REDWOOD LN
05/13/98
•
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
PLMA711 Water Service Insp / / / / 06/27/97 PASS MS 07/09/97 J *H
PLMA715 Rough -in Insp / / / / 06/27/97 Reduced Pressure Device to go outside. PASS MS 07/09/97 J *H
PLMA725 Top -out Insp / / / / 06/24/97 PORTLAND CLINIC, DWV & WATER: FIRST PASS RAB 06/27/97 JDA
FLOOR ONLY
PLMC003 Application received / / / / 02/06/97 Plans were submitted on 01/21/97 to Mike PASS JSD 02/06/97 JD
Sheehan with an assurance by the
applicant that they were in response to
a plan review letter. Mike Sheehan
informed the applicant that an
• application would be required. The
application was received on 01/30/97
without any plans or note indicating
plans were already submitted. Ed Shock
of Peninsula Plumbing indicated the
plans were with Mike Sheehan. Mike
Sheehan was an vacation until 02/06/97
when he confirmed he had the plans.
PLMC005 Permit Created / / / / 02/06/97 PASS JSD 02/06/97 JD
PLMC008 Plans Approved /Routed to DST / / / / 02/14/97 The second application has the tenant PASS MS 02/14/97 MRS
approvements added to the permit
PLMC015 DST Post Review Complete / / / / 02/19/97 PASS B 02/19/97 BON
PLMCO50 (F) Ready to issue / / / / 02/19/97 Do not issue until SWR97 -0030 is paid! MEMO B 02/19/97 BON
Plumbers license expired and CCB will
expire 2/28/97.
•
PLMC060 (F) Issue permit / / / / 02/20/97 PASS JSD 02/20/97 DST
PLMC120 Plumbing Undersl 02/14/97 / / 02/14/97 trunk line only PASS MS 02/21/97 MRS
PLMC120 Plumbing Undersl / / / / 02/21/97 need to fill out industrial waste forms PART MS 02/24/97 MRS
PLMC705 Sewer Inspection 02/14/97 / / 10/23/97 PASS TLP 01/27/98 J *H
PLMC710 Water Line Insp 02/14/97 / / 06/27/97 PASS MS 06/29/97 J *H
• PLMC725 Top -out Insp 02/14/97 / / 06/23/97 lost test on dwv FAIL MS 06/25/97 J *H
•
PLMC725 Top -out Insp / / / / 06/24/97 PASS BRB 08/07/97 S *W
PLMC730 Storm Drain Insp 02/14/97 / / 10/23/97 PASS TLP 01/27/98 J *H
PLMC735 Rain Drain Insp 02/14/97 / / 06/30/97 No test on 1 rain drain and 1 overflow. FAIL RAB 07/01/97 J *H
NOTE: Have paperwork from MacKenzie
Engineering showing overflow
change to 4 -inch.
Page No. 2 CASE HISTORY FOR CASE NO.: PLM97 -0033
PACTRUST REALTY
06640 SW REDWOOD LN
05/13/98
Action Description Req/ Schd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
- - -- - -- -- - - - - -- - --
PLMC735 Rain Drain Insp / / / / 07/01/97 Roof drains, partial approval, overflow PART RAB 07/07/97 J *H
or scupper still to come on canopies.
PLMC740 Misc. Inspection 02/14/97 / / 07/11/97 Special inspection for overflow /acid PASS RAB 07/31/97 J *H
waste system drain on 2nd floor
(interior).
PLMC750 RP /Backflow Preventer 02/14/97 / / / / 01/27/98 J *H
PLMC799 Final Inspection / / / / 08/07/97 Not ready for inspection. Inspection not FAIL RAE 08/08/97 RAB
completed.
PLMC799 Final Inspection / / / / 08/11/97 Water heater needs to earthquake FAIL RAB 08/11/97 J *H
bracing.
PLMC799 Final Inspection / / / / 08/12/97 Partial approval for room numbers: PART RAE 08/15/97 J *H
102, 102, 131, 132, 133, 142, 144, 146,
135, 110, 108, 113, 137, 138, 139, 150,
151, 152, 161, 119, 117, 116, 120, 121,
122, 130, 128, 127
PLMC799 Final Inspection / / / / 09/12/97 Second floor restrooms and second floor PART RAB 01/26/98 J *H
mop sinks.
PLMC799 Final inspection / / / / 01/28/98 PASS TLP 01/29/98 J *H
PLMC800 Case Finaled / / / / 01/29/98 PASS TLP 01/29/98 J *H
•
•
•