Permit .
y A , CITY OF TIGARD PLUMBING PERMIT
PI4 DEVELOPMENT SERVICES PERMIT #: PLM1999- 00324.
c- I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/11/1999 •
SITE ADDRESS: 15340 SW ROYALTY PKWY PARCEL: 2S110CD -00102
SUBDIVISION: KING CITY NO. 2 • ZONING:
BLOCK: LOT: 002 JURISDICTION: KIN
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
• SINKS: 1 URINALS: 1 GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Upgrade to A.D.A. requirements.
. FEES
Owner:
Type By Date Amount Receipt
C V MCCANN PRMT BON 10/11/199c $69.00 KING CITY
BY 'S PHARMACY 5PCT BON 10/11/199c $5.52 KING CITY
15685 85 SW SW 11 116TH
KING CITY, OR 97224 Total $74.52 .
Phone 1:
Contractor:
MARXMEN PLUMBING INC
9665 SW 163RD AVE
BEAVERTON, OR 97007 REQUIRED INSPECTIONS
Phone 1: 579 -2200 Top -out Insp
Reg #: LIC 00102432 Final Inspection
PLM 34 -161 PB
ORIGINAL
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 throw - •AR 952 - 0001 -0080. 4 .
You may obtain copies of these rules or direct questions to OUNC by c.11ins I ) 246 987.
Issued By: ,� AL t Permittee Signature . 4 1
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the I TIF iness day
OCT -11 -99 MON 09:08 AM City of King City FAX:503 639 3771 PAGE 2
CITY,OF TIbARD Plumbing Permit Application Plan Check*
13125 SW HALL BLVD. Commercial and Residential . Rec'd By
TIGARD, OR 97223 �� Date Rec'd /b -1/-f
(503) 639 -4171 b0 - • Date to P.E.
Print or Type . P I q S 1 Date to DS'r /0-ii-4
. ce Permit# LM 14'79 _00
Incomplete or illegible applications will nog accepted Related SWAB nr.,-
• Called 19///// S c ya0 IL-0e
• II ito Aw,
•
Name of Develo ment/Prolect /� :.:t . . s 1jllt; .tvI Ua1) .'' " ,` : y I ;.OT''( "PRICE;, :WIT::::
Job _ _ west' 4%1 aJK - Sink 2 11.50
Address Street Suite Lavatory 11.50
)5 3 g o 5(.0 . ` 2 o v i. ai 11442. Tub or Tub /Shower Comb. 11.50 •
Bldg B City /Stale J Zlr Shower Only 11.50
y ■
- (fir u� W.A.' - Wat Closet/Urinal (Specify) 1 w1lf..) till Z 11.50
■ Name /I v e /1 Q ry Dishwasher 11.50
•
Owner Mailing Address • 1, Suite l Urinal 11.50
t 5 So P5 SO I i, fa Garbage Disposal 11.50 .
City /Slate Zip Phone Laundry Tray 11.50
l Al �. T� O(Z �f 72�! � _ Washing Machlnellaundry Tray (Specify) 11.50
Name Floor Drain/Floor Sink 2' • 11.50 •
M ailing Address Suite 3' • 11.-50
Occupant _ •
•
f a" • 11.50 •
ClfylSlele Zip Phone Water Heater Crconversion 0 like kind 11.50
• - Gas piping requires a separate mechanical perMit. /
Mld12�(rr�N l�lIh11P !� • MFG Horne New Water Service • l 32.00
Mailing Address Suite MFG Home New San/Storm Sewer 32.00
Contractor q(daSS W• i b 3 Hose Bibs 11.50
Prior to permit City /State Zip Phone Roof Drains 11.50 •
issuance, a copy Bawer bh ci X'o7 $ 1 1 - 7340 Clunking Fountain 11.50
of all licenses are Oregon Cont. Cont. Board Llc,$ Exp. Date , Other.Fbrtures (Specify) 15.00 _,
required If / (02 43 Z t•(-OZ U 3 • •
expired In COT PluntWg - Uc. # Exp. Date I - .
database 3 i61p !/•3 iY .
Name '
Architect Sewer - 1st 100' 38.00
or Mailing Address • Suite ' Sewer • each additional 100' 32.00
Water Service -1st 100' 38 .E
Engineer City/State Zip Phone Water Service - each additional 200' 32.00
Describe work to be done: Storm B Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace Ilth like kind: Yes' V No 0 Storm & Ram Drain - each additional 100' 32.
Residential . Commercial Ql Commercial Back Flow Prevention Device • 32.00
Additional description of work:
Residential Backtlow Prevention Device' 19.00
tAcp G At TO AD' 4 , Catch Basin 11.50
Are you capping, mootf g or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 Inspections permr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE ' Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL ;;-
; _ 1;,
Isometric or riser diagram is required it Quantity Total Is > 9 • : Xd;i : c,
I hereby acknowt- - - that I have read this application, that the Information
given Is core- h m the ow n er or authorized agent of the owner, and 'SUBTOTAL ;'_: �• ? , '-. � ` •
that pia s su•4 to re in co•-�-nce with Oregon State Laws.
`; � ..
t • of �$ ne +gen � Ito B% SURCHARGE ,,: :': . '
C rtaa erao • " ' Phone • ""PLAN REVIEW 26% OF SUBTOTAL -I Z
M A n !J � ,22D'O su
is US . eg Re q uired only H 16Aure qty. total Is > 9 ' _ '',;
; .y A ,: < , W!1 'ggF71 ; r I E °� , '�•�*t - r ; '+ TOTAL ! �J
• . E 1 � , � � ti g .�Y� 0
g �,�fi. - i t. tit: rR �Nr� 7f+ lit . F:: . ::.. , .,..:::..::: . . �� .; � �C+,
k ; - d.s,4� "` "1 [:, Wa - t . �}�" J (a - y ': •y
' r e i : F 4 � � it fee 6 + 8% . except Residendel Baeldlow Prevention
Dev
@ __ .. ., . '� m. r� ? ' ' . • , ' 4 ' N., •• S . i � Ylnlmum perm SSO su tdlar8e pt
s 0 S.M *M - R.Srvi1 + V•:A.'tiSJ,S 41 - ` :_S -.,e {l
ry lbe, wink!! o, re orge
••AH New Commercial Buildings require plans wan isometric or riser diagram end
Plan review.
hagsvormslplumapp.doc 1018183 - - -
02/17/2000 Activities for Case #: PLM1999 -00324
2:50:10 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 10/11/1999 KJP RECD No Hold • KJP 10/11/1999 •
PLMC005 Permit Created 10/11/1999 KJP DONE No Hold KJP 10/11/1999
PLMC725 Top -out lnsp 10/11/1999 10/11/1999 No Hold KJP 10/11/1999
PLMC799 Final Inspection 10/11/1999 10/11/1999 10/12/1999 MS . PASS No Hold JS 10/12/1999
PLMC040 (F) Ready to issue 10/11/1999 KJP DONE No Hold KJP 10/11/1999
PLMCO50 (F) Issue permit 10/11/1999 BON DONE No Hold BON 10/11/1999
PLMC120 Plumbing Undersl 10/12/1999 10/12/1999 10/12/1999 MS PASS No Hold JS 10/12/1999
PLMA800 Case Finaled 10/14/1999 JMT DONE No Hold JMT 10/14/1999
PLMCO55 (F) Reprint Permit 11/23/1999 GEO DONE No Hold GEO 11/23/1999
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 39 -4171
f�Gj BUP
Date Requested 10'12//q l / AM PM BLD
Location 1 5 - & ( --I D P�Gt��Suite MEC G
Contact Person Ph S7 ? 2L') PLM i qq t43 324
Contractor Ph ;1 Sig SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: I
Foundation / 5 r /6. 3 FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: CYX
Slab SIT
Post & Beam J 4a D
Ext Sheath /Shear (',(`"0 P � i/ 1 t �
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
QCOMI§M
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
• PART FAIL
MECHANICAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
•
ADA X11
Approach /Sidewalk Date r,
v Inspector / i/ I Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.