Permit CITY OF TIGARD
! I � I 1, DEVELOPMENT SERVICES PERMIT ES LUMMBING PERM
1 Hall Blvd., Tigard, OR F'LM98 0308
DATE ISSUED: 10/19/98
PARCEL: 2S110CD -00114
SITE ADDRESS...: 11755 SW QUEEN ELIZABETH ST
SUBDIVISION • KING CITY N0. 2 ZONING:
BLOCK LOT . JURISDICTION: KIN
CLASS OF WORK..:NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH 1 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:B FLOOR DRAINS • 0 TRAPS • 0
STORIES • 0 WATER HEATERS • 1 CATCH BASINS • 1
FIXTURES LAUNDRY TRAYS : 0 SF RAIN DRAINS • 0
SINKS 6 URINALS • 0 GREASE TRAPS • 0
LAVATORIES OTHER FIXTURES 1
TUB /SHOWERS...: 1 SEWER LINE (ft)...: 100
WATER CLOSETS.: 2 WATER LINE (ft)...: 100
DISHWASHERS • 0 RAIN DRAIN (ft)...: 100
Remarks: Plumbing shell — USA sewer permit required, not COT jurisdiction for
sewer.
Owner: FEES
KIM, MOOKI & SANGWON type amount by date recpt
132 POPLAR CT PRMT $ 225.00 GEO 10/19/98 98- 310105
MCMINVILLE OR 97127 PLCK $ 56.25 GEO 10/19/98 98- 310105
5PCT $ 11.25 GEO 10/19/98 98- 310105
Phone #: PRMT $ 225.00 GEO 10/19/98 98- 310105
Contractor
FINNEY & SONS PLUMBING
20010 NE GLISAN
PORTLAND OR 97230
Phone #: 666 -2839 $ 517.50 TOTAL
Reg #..: 000945
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Rough—in Insp
applicable laws. All work will be done in accordance with Underfloor /Under
approved plans. This permit will expire if work is not started Top—out Insp
within 180 days of issuance, or if work is suspended for more Top—out Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules Craw l Dr a i n
adopted by the Oregon Utility Notification Center. Those rules are Rain Drain Insp
set forth in OAR 952 -0001 -0010 through OAR 952- 0001 -0080. You may Drinking F o u_t n t a i
obtain copies of these rules or direct questions to OUNC by calling Final Inspection
(503)246 -1987. Final Inspection
Issued By: -� � Permittee Signature: �i �2��C /I
y �1.! j 9 / / � U
+ + + + + + + + + + + + + + + + + + + ++ +++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application Plan Check #e) 6 7 - 0(' C
13125 SW HALL BLVD. Commercial and Residential Rec'd By G$
TIGARD, OR 97223 R01� • a vo /e ,SEE 4 roT9 Date Recd q 'tb
(503) 639 -4171 I �. Date to P.E. -/ " t 1 qrj
Print or Type �. Date to DST /0'15 8
Incomplete or illegible applications will not be accepted Permit# 01y14-0'11
o weii Amer ✓ota£,b 05 Related SWR
"ail z.5 PS re4rM 17. /.asP'• Called /
Name of Development/Project FIXTURES'(indivldual) < QTly, , PRICES 1AMT
Job 2110,,12 7.WiL 9EV) 1 , //eAc,v- , Sink - 16 9.00
Address Street Address pg0', Suite Lavatory -- Z 9.00
//75' ? W� f) 1J4 ; Tub or Tub /Shower Comb. 9.00
Bldg # City/State Zip
�,�/ OR Shower Only 9.00
Name N' Y Water Closet I/2 9.00
IMI / VA:11779X 140 Dishwasher 9.00
Owner Mailing Address -Suite Garbage Disposal 9.00
Washing Machine , 9.00
City /State Zip Phone ' Floor Drain/Floor Sink 2" 9.00
Name 3" 9.00
4"
9.00 •
Occupant I Mailing Address Suite Water Heater 0 conversion flil like kind 9.00
Gas piping requires a separate mechanical permit. i
-
City/State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Name
>/iiiiiA 0 elDNS / • . . Other Fixtures (Specify) 9.00
Contractor Mailing Address / d wt �f , P/L /Af /G/,(/,4 f :OPA) �j / 9.00
2010 of✓k �i/Oi¢/ cm go - /I 3 , A 9.00
Prior to permit Ci /State Zip P �1 Sewer - 1st 100' / 30.00
issuance, a copy Q,0j, d/- 9t,Q A/ 7
q
Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date -
required if 9L,r� d//A /GQ Water Service - 1st 100' / 30.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' ! 25.00
database . 4 «vI f a/ �f� Storm & Rain Drain - 1st 100' 3C.00
Name / / Storm & Rain Drain - each additional 100' 25.00
Architect ei e-/li+,7z' Y Mobile Home Space 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- • 25.00
✓ycg , V /d /0'Y Pollution Device _
Engineer
Ci /State Zip Phone Residential Backflow Prevention Device' 15.00
B iv: evz 92 ,7 •3>9 (Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New JIB Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 1
R 0 Commercial 0 Catch Basin / 9.00 � �
Additional description of work: Insp. of Existing Plumbing r 40.00
_ j per/hr
i Specially Requested Inspections ; 4U.UU
per/hr
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes 0 No IIK Grease Traps 9.00
If yes, see back of form to indicate work performed by QUANTITY TOTAL ..ve
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is > 9 -s
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL aaS,c
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 5% SURCHARGE l!, X`
that plans submitted are in compliance with Oregon State Laws.
Sign Owner /Age t Date * *PLAN REVIEW 25% OF SUBTOTAL �540. c s5
o-9 9l p Required only if fixture qty. total is > 9
7 TOTAL S D
Conta Person ame Phone 5
-_.4-2./4 y ,/ / ��,v �O, 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
' Prevention Device, which is $15 + 5% surcharge
*'All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I:Wstskplumapp.doc 7/2/98
■ i, : tu:... :ie9
,
.,i v {i4 .,:F
•
PLEASE COMPLETE:
Fixture Type :Quantity by Work Performed
New <. Moved Replaced:; Removed /Capped
Sink &
Lavatory A •
Tub or Tub /Shower Combination
Shower Only / ,
Water Closet 2
Dishwasher
Garbage Disposal
•
Washing Machine f
Floor Drain /Floor Sink 2"
3"
4 "
Water Heater • / _
Laundry Room Tray
Urinal
Other Fixtures (Specify)
•
Pi/,v /e.
COMMENTS REGARDING ABOVE:
•
I: \dsts\plumapp.doc 7/7/98
I
z
•
se vier SAN ITARY• D o L
155 N. First
• Ave., Sui Hillsboro, Or, 97124 SURFACE WATER
503 648-862.
CONNECTION PERMIT
ISSUE DATE 101998 EXPIRATION DATE 041799 EC EXP DATE 101800 PERMIT 115778
STRUCTURE ADDRESS 11755 PROJECT 9999
STRUCTURE STREET SW OUEEN ELIZABETH
LOT BLOCK
TYPE CONNECTION- NEW OF
TYPE INSTALLATION- (18) EROS CON /SDC
TYPE OCCUPANCY- (4 ) COMMERCIAL PARCEL 2S1 10CII 114
QTR SEC 4617 MH 629E
OWNER LANDMARK DEV CONSTRU
ADDRESS 15075 KOLL PARKWAY TREATMENT PLANT DURHAM
BEAVERTON OR 97006
PHONE 646-3016 WATER DISTRICT TIGARD
FIXTURE EQUIVALENT DWELLING RESIDENTIAL.
UNITS SERVICE UNITS 0.0 UNITS SERVICE UNITS
CONNECTION FEES SURFACE WATER DEVELOPMENT FEES
WATER QUALITY 0.00
LESS CREDIT < 0.00;
WATER QUANTITY 0.00
LESS CREDIT 0.00`
EROSION CONTROL
INSPECTION 88.00
FLAN CHECK 57.20
SUBTOTAL 0.00 SUBTOTAL 145.20
TOTAL 145.20
APPL NAME JIN CHONG PHONE
AFFILLIATION REP
REMARKS EC ONLY FOR NOOKI DENTAL LAP SEE PERMIT
*24 HOUR NOTICE FOR EROSION CONTROL INSPECTIONS REQUIRED
* * *** Number to cQIJ. f .. NSPECTION-- 844 -8444 * * * * **
SIGNATURE ISSUED BY HUMPHREJ
r C�
Permit Conditions: The applica . grees to comply with at rules and regulations of the Unified Sewerage Agency, including :hose regarding erosion control.
A 24 -hour notice is required for erosion control Inspections. The inspection request number is 8444444. when caning for an Inspection, please refer to
the permit, project and lot numbers.
The permit expires one hundred eighty (t 80) days from the date of issuance. The Agency doe: not guarantee the accuracy of the location of side sewer lateral.
7/93 WHITE - USA, BLUE - Accounting, GREEN - Inspection, YCLLOW - Customer
•
TO 96667938 P.02
•
OCT -19 -1998 10:47 FROM
u A 4 nine SANITARY i� c � - - ' 9-11, ewerage
agency
i
105 N. hirst Avo., Suitc 270, Hillbburti. SURFACE WATER t!
SW 648.8641
_ L
CONNECTION PERMIT
1SSUE DATE 101998 EXPIRATPA DATE 041779 Ec FXP DATE 1o;.B00 PERMIT 115777
• CTRUCTURF ADDRESS 11755
•
STRUT' I URE STREET SW QUEEN ELLZABETW PROJECT 4944
•
Tt'NE CONNECTION.- NELJ LOT BLOCK
OF
TYPE INSTALLATTnN -. ti?) BLI! SWR /ERO cONisDc
TYPE OCCUt'ANr.r- t•a COMMERCIAL
F 11 F 7 2S1 ".n.n 114
O TR se c 46th f4H 62?8
OWNER LANDMARK DEV CONSTRIJ
ADDRESS 15077: KOLL PARKWAY
BEAVERTON I TREATMENT PLANT DURHAM S� 7k '7006
PHONE 646 -5016
• -- _, WATER DISTRICT T1GARD
FIXTURE EQUIVALENT DWELLING RE +
UNITE 43 SLKVICE UNITS 3.8 UNITS
BERVICF IINI T 5 0
CENNEC!J.UN FEES SURrACF. WATER DEVELOPMENT i-LF_S
LINE TAP -SANI Ii00.00 WATER QUALITY
SEWER CONNECTION .6210.00 LESS X900
ES5 I:hEDT.T 0.
OQ.>
WATER QUANTITY 1102.00
LESS CREDIT < 0,0
ERUSLUN CONTROL
SUBTOTAL 6410,00 SUBTOTAI •
1904.0E
TOTAL 0310.00
APPL NAME .JTN CHONG PHONE
AFrILLIATTnN REP
REMARKS MffKI. DENIAL LAB CONNECTION F•FRM11
*24 HUBS NOTICE FOR EROSION CONTROL INSPECTIONS PFl1JIR ll
* * *** Numtler• O « 4, 1 f� 'NSPECTION - -A44� -13444 *k: * ***
SIGNA I VF'+E , r , � e......Q.1._
ISSI•IEJ ey HUMRHREJ
Pa uli; CcntSlllnne• I MG 10th n cs to comp:y with ie rv!es ane rppula6rns ct the Unload Fonver
ea' Acef tir% irdurnng m,sP raga. -Srtg erosion aontrot.
A e a,notko iv requnod for erosion cuntot Inxtwrtlax. The;; apection risque number ix s
Ise Oroioet are lot numbers. When eetrrr� for en hRpEC00n• Dr2asre rate► to
The permit orniree ono hurdl+cd cig'lt. (100) day, :1;rn Me (Um n' . ssuance. ?ec ^,panty docs In.i yuaran■pa 1110 Prcuroey of t'r 'caution of site st'v r lateral,
703 1tttITE — IICA- BL'JL Atcau:tiir:
y, GittiSN - InApprti:On, Y:LLOF - Cut Lomer ,
. .
KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224-2693
immosNomm Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be.returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
b Department project: ? /LG /12,2 M
Building De artment for e following ro ec �r/ a
located at: //75 -
../.. • _, ,.,e i - /'- irtz./.
King Ci Representative
I'DSTS DOC
Page No. 1 CASE HISTORY FOR CASE NO.: PLM98 -0308
FINNEY & SONS PLUMBING
11755 SW QUEEN ELIZABETH ST
03/02/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
PLMC003 Application received / / / / 09/02/98 RECD GEO 09/04/98 BON
PLMC005 Permit Created / / / / 09/02/98 DONE B 09/04/98 BON
PLMC007 Plans routed to Plans Examiner / / / / 09/04/98 SENT B 09/04/98 BON
PLMC007 Plans routed to Plans Examiner / / / / 09/18/98 MUST HAVE USA SEWER PERMIT PRIOR TO SENT HAP 10/09/98 J *H
•
ISSUANCE.
Routed plans to LP2A for review at
1100hrs...hap
NOTE: please access double permit fee as
- work started 090198 without permit per
HAP 100798. Please release hold on
BUP98 -0109.
UPDATE: STILL NO RESPONSE FROM FINNEY
PLUMBING ON LP2A REVIEW. TOM TO REQUEST
REMAINING PLANS & PLAN REVIEW LETTER •
SENT BACK TO COT FROM LP2A.
COT TO FOLLOW THROUGH. 100898HAP /jh
PLMC040 (F) Ready to issue / / / / 10/14/98 needs copy of USA permit prior to DONE DEB 10/19/98 DST
issuance. Double feed per Hap's
instruction, working w/o permit on
9 -1 -98.
Received USA permit on 10/19/98, double
fee paid.
PLMCO50 (F) Issue permit / / / / 10/19/98 PASS GEO 10/19/98 DST
PLMC705 Sewer Inspection / / / / 11/02/98 Sanitary: 20 -feet of 3 -inch ABS PASS TLP 11/04/98 J *H
PLMC710 Water Line Insp 10/13/98 / / / / 10/13/98 TLP
PLMC715 Rough -in Insp 10/13/98 / / / / 10/13/98 TLP
PLMC720 Underfloor /Underslab 10/13/98 / / 10/20/98 PASS TLP 10/20/98 TLP
PLMC725 Top -out Insp / / / / 10/20/98 CALLED FOR TOP OUT INSPECTON - NOT YET PASS TLP 10/23/98 TLP
APPROVED - PLAN REVIEW NOT YET RECEIVED,
ETC. *(UPDATE 101998 - SCHEDULED FOR
102098)*
•
PLMC725 Top -out Insp 10/13/98 / / 10/20/98 PASS TLP 10/20/98 TLP
PLMC734 Crawl Drain 10/13/98 / / 10/13/98 11/05/98 TLP
PLMC735 Rain Drain Insp 10/13/98 / / 09/04/98 PASS TLP 10/23/98 TLP
PLMC735 Rain Drain Insp / / / / 11/03/98 RAIN DRAIN TO CATCH BASIN APPROVED PASS TLP 11/03/98 J *H
(NOTED ON SIT98 -0008
PLMC745 Drinking Fountain 10/13/98 / / / / 10/13/98 TLP
PLMC799 Final Inspection / / / / 10/20/98 AS PER HAP UNDERFLOOR AND TOP OUT MUST NOTE RC 10/23/98 TLP
BE INSP BY INSP AGENCY
PLMC799 Final Inspection 10/13/98 / / 02/22/99 PASS TLP 02/22/99 TLP
PLMC800 Case Finaled / / / / 02/25/99 - 02/25/99 JT
Page No. 2 CASE HISTORY FOR CASE NO.:PLM98 -0308
FINNEY & SONS PLUMBING
11755 SW QUEEN ELIZABETH ST
03/02/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
CITY OF TIGARD BUILDING INSPECTION DIVISION MST Of,
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP 40 " 411.
0
4 9 V /% Date Requested .il,? AM PM BLD
Location // 7 GG C /1 Q;4e Suite MEC
Contact Person -./ //2 Ph (-96 / 4o PLM rrf
■
Contractor Ph SWR
BUILDING Tenant/Owner i�� ,cS!'.0...e ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: jf �/ /.
Slab 6 c2X C / • SIT
Post & Beam p
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing \
Firewall N
Fire Sprinkler _
Fire Alarm ; `
Susp'd Ceiling
Roof !
Misc:
Final ���
PASS PART FAIL / ` .
MBI _
Post & Beam
Under Slab /
Top Out
Water Service \'
Sanitary Sewer —
Rain Drains
r0+y PART FAIL .•' /(/ \ 4 ° q L
ANICAL •. . C,
Post & Beam
Rough In -
Gas
Smoke e Dampers , - _
Final
PASS PART FAIL - __.
ELECTRICAL F
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: 0 [ ] Unable to inspect - no access
ADA ? fi /
Other
Approach /Sidewalk Date N Inspector ' - - ° Ext
Final
PASS PART FAIL _ DO NOT REMOVE this inspection record from the job site.