Permit y
` 4► CITY OF TIGARD PLUMBING PERMIT
A x � a DEVELOPMENT SERVICES 0 DATE PERMIT PLM2000 -00093
13125 SW Hall Blvd., T igard, OR 97223 (503) 639
SITE ADDRESS: 16345 SW ROYALTY PKWY 4/
PARCEL: 2S110CC -02700
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 006 4( JURISDICTION: KIN
CLASS OF WORK: OTR GARBAGE DISPOSALS: , MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft •
Remarks: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
COTTON, MARILYN T + KENNETH A PRMT DEB 3/22/00 $25.00 KING CITY
16345 SW ROYALTY PARKWAY SPOT DEB 3/22/00 $2.00 KING CITY
KING CITY, OR 97223
Total $27.00
Phone 1:
Contractor:
HIGHRIDGE CORPORATION, THE
21400 NW CHERRY LANE
HILLSBORO, OR 97124 REQUIRED INSPECTIONS
EXPIRE P /Backflow Preventer
Phone 1: 503 - 629 -0193 final Inspection
Reg #: LIC 00006221
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You obtain . •pies of these rules or direct questions to OUNC by calling (503) 246 -1987.
, _ / / 1-
IssuQd By: . J, /i , 7 l P ermittee Signature: / /,% , ,/ / J it , ,
I
Call (5 1 - 639 -4175 by 7:00 P.M. for an inspection needed the next bu mess day
MAR - 22 - 00 WED 10:04 AM City of King C' FAX:503 639 3771 PAGE 2
CITY OF TIGARD RECEIlit bing Permit Applicati� 1�� Plan Check �'
13125 SW HALL. BLVD. Commercial and Resident!*.
10 Reed ey"'‹ •
TIGARD, OR Rec'd S- -Cr;
) 639 -41717223 1 1 1 • 0 2000 ttr- V f�'‘ Date to PP T 'Z'.7-•'"100 COMM . In DEVELOPMEr>I� not or Type 6' fc Permit* Ill .r- 3
In • mplete or illegible applications will accepteed Related SWR*
L � ,t l 7 Called
Name of Developme t/Projod • TFlX i E$=,Ilildmdual).' "^ % f" ' 4 .' ;""15.r 't, ; f.01 "AMT •
Job V 1, ,' e r at) Sink '( 11.50
t reat • • d . s u1 - , Tub or Tub /Shower Comb. la iauy 11.50
/ r Lk.. / . V �/ , l�/f
Address '.^` `e� 11.50
�
Bldg a _ty /��Slppat•� I Zip �]. (C Shower Only 11.50
t om` I Water Closet/Urinal (Specify) 11.50
Na e lJ �
&h 1r t �� �,o+ Dishwasher 11.50 •
Owner Mailing Ad r � �\ S Urinal 11.50 • 1 b (,t Garbage Disposal 11.50 .
City/State • Zip - h • • e. Laundry Tray 11.50
`ti ' " �1 f, Washing Machine/Laundry Tray (Specify) 11.50
Floor Drain/Floor Sink Y 11.50 •
Occupant Mailing Address Suite 3' • 11,50 .
4- • 11.50
City/State . Zip Phone 11,50 ,
Water Heater 0 conversion 0 like kind •
Gas piping requires a separate mechanical permit
e , n ^ MF.G Home New Water SeMce . . 28.00 �T / MFG Home New SaNStoren Sewer • • 28.00 • •
-a. .� aifi 2 Ad'Su • :::m'a�. -.- ...... ... ... ...... • '11.50. . • • •
...... .. . .... '� ��� . Ho se Bibs � ; .. ...... ; •
issuarnce permit c y ; a p I , ` ^ i a. y � Root. Draing • .. 11.50
/- h n=
D jai P �' D rinking Fountain 11.50
of all HcenLses are Oregon Cons /. Cont. Board Lie* Exp. Dia {fie ,hr11 Other Fixtures (Specify) •
15
required rf f �- �c, L —vv
expired in COT Plumbing U9.11 . Exp. Data ' •
database , ' •
Name •
Architect Sewer -1st 100' 38.00
Cr • Mailing Address RED Sewer - each additional 100' 32.00
Water Service - let 100' . _ 38,00 • Engineer City /State Zip Phone Water Service - each additional 200' • 32.00 •
Desclibe work to be done: Storm & Rain Drain -1st 100' 38.00
New O Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain- each additional 100' 3 2. 00
' Residential 0 ; n lerciat O Commercial Baok Flow Prevention Device 32.00
Additional description of work: Residential Backflow Prevention Device' 19.00 I �
• Catch Basin 11.50 •
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested v 50.00
• Yes 0 No 0 Inspections p er/hr
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 1130
WORK COULD RESULT IN INCREASED SEWER FEES. read this application. I hereby acknowledge that I hav QUANTITY TOTAL rh ;:. I'.
e. cation, that the information ' "'" . =' `
given is correct, that I am the owner or authorized agent of the owner, and IeomeOfic or deer diagram Is required.il Quantity Total is !♦ . . .. =`: •
g "SUBTOTAL r� at��s':r� i
� fiance State Laws. f � '
that plans submitted are p with Oregon • • - • • • . � crf ir.'l V
slg mire of OwnerlAge t cape .. 8% SURCHARGE. psi N. "' =- .'h '
CAntacc Pers Name. ( ] hone n^ :. '^'PLAN REVIEW 25% OF.SUB.TOTAL e:::`= +:
_ r�l q.. Re9u o If may fatal W � 9 y ° "• •
i $ Qt ? .:, ± , , t TOT ��./.��^� D
� +.. fir :
., � '. r= ' "� , ,: . F y : g (meat Residential Beattow Priventton
`' M � °I It 1 - t d l`i''x+ ob o e u w � i,Id � � I sa r e % su e. •
ttletlo � ' ° ° " "Ali New Commeiclat Buildings require plans with Isometric or riser diagram and
• plan review.
imenrennsiOMnepP.dx 1011199 - -
•
MAR - 22 - 00 WED 10:04 AM City of King City FAX:503 639 3771 PAGE 1
•
lialt KING C ITY
15300 S.W. 116th Avenue. King City, Oregon 9724 Phone: 639.4062
A X C O S H E E T
2Z-
DATE :
TO ` - v. r P
•
ATTN : S
FROM : (1a `, CC
• MESSAGE:
•
This transmittal contains • . pages, including this Cover
Sheet. If you experience any problems, please contact:
City of King City (503) 639 -4082
Fax Number (503) 639 -3771
•
•
•
8/30/99 Activities for Case #: PLM95 -00263
9:09:32 PM •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received 9/19/95 CS RECD CTR 9/19/95
PLMA799 Final Inspection 9/19/95 - CS RECD CTR 9/19/95
PLMA050 (F) Issue permit 9/19/95 CS PASS CTR 9/19/95
PLMA730 Rain Drain lnsp 9/19/95 CTR 9/19/95
PLMA050 (F) Issue permit 9/19/95 CS PASS CTR 9/19/95
PLMA800 Case Finaled 10/6/95 MS PASS MRS 10/6/95
•
•
Page 1 of 1
- v CITY OF TIGARD BUILDING INSPECTION DIVISION MST •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/ Date Requested / ' / f Z AM PM BLD
Location / 6 35/5 w• ? ' // 7, 4]ySuite MEC
Contact Person Ph PLM es* — G an 53
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ' S ( � � ° �G/ f
Framing 4 11 -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
J : 11 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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /
Approach /Sidewalk Date / 1 / 0Z Inspector ) r / / " ' Ext
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.