Permit 4 ► , CITY OF TIGARD PLUMBING PERMIT
91 DEVELOPMENT SERVICES PERMIT #: PLM2003 -00129
��'JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 -4171 DATE ISSUED: 4/7/03
SITE ADDRESS: 07100 SW SANDBURG ST PARCEL: 2S101 DD -00300
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B 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: Install commercial 3/4" doublecheck valve.
FEES
Owner:
Description Date Amount
HAYTER FAMILY LIMITED PARTNERSHI
23643 SW STAFFORD HILLS DR [PLUMB] Permit Fee 4/7/03 $72.50
WEST LINN, OR 97068 [TAX] 8% State Tax 4/7/03 $5.80
Total $78.30
Phone :
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD, OR 97223
REQUIRED INSPECTIONS
P RP /Backflow Preventer
Phone : 5O3 - 639 - 5296
Final Inspection
Reg #: MET 00001703
LIC 2439
PLM 34 -29PB
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 -0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699.
Issued By: 4,444_ Permittee . U l C! e�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Wia, WESTERN PLUMBING 5036649016 04/03/03 06:10pm P. 002
a
FO OFFICE USE ON � `
Plumbing Permit D Received Plumbing
Date/By:�7 -Q� it Permit No.:�
APR p 3 20 ( - 2O /c
Planning Approval Sewer
City of Tigard OF TIG • RD Date/By: Permit No.:
13125 SW Hall Blvd. I Plan Review Other
Tigard, Oregon 97223
CITY Date/By: Permit No.:
Post -Review Phone: 503 - 639 -4171 Fax: 503 ( eview Land Use
DI %� =rS ' ;;. Post -R y: Case No.:
Internet: www.ci.tigard.or.us ,_ i Contact Juris.: ' ® Sec Page 2 for
24 -hour Inspection Request: 503- 639 -4175 - M Name/Method: _- Supplemental Information.
TVP; E'OF WORT •• :'::.' `'; 3 Yi '.. °' ° ...: FEE* SCHEDiJL`E'.('o'e specialInfo ttiatiop: iis'e. iteeldist) .•
❑ New construction ❑ Demolition Description I Qty. ( Fee(ea.) , Total
dition/alteration/replacement ❑ Other: ... i'' • ': ' ?slew .1. &"2- family''th elliiigs'
( .: i. cludeslO utlt ty t
� � : iu" � O' ft:'�oreach' ' i ost ection) • ,•...CA`1'EGORY OIF, •:;:.;.. .. SFR I) bath 249.20
❑ 1 & 2- Family dwelling Commercial/Industrial SFR (2) bath 350.00
❑Accessory Building ] Multi- Family SFR (3) bath 399.00
❑ Master Builder ]'Other: _ Each additional bath/kitchen 45.00
' :JOB:SITE'INr1ORMATION and:LOCATION ,:..: Fire sprinkler - sq. ft.: Page 2
Job site address: 7i00 SA/ ....C7/470 : :. : J ` ' , :':" .. ,:Site: ;CJtilitiC$;;;;. s• : .
Catch basin/area drain 16.60
Suite #: Bldg. /Apt. #: - Drywell/leach line/trench drain 16.60
Project Name: [`Azey , C// _ Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities 110.00_
Manholes 1 6.60
— 20 2 ^f sal�L <' Rain drain connector 16.60 _ ,
Sanitary sewer (no. linear ft.) Page 2
Subdivision: I Lot #:
Storm sewer (no. linear ft.) Page 2
Tax map /parcel #: i fl) :Ar Iteiiiia;.; ! • ': ?:... ,--. - . •-
Water service (no linear Page
' • i • insetuP'tION OF WORK' Absorption valve 16.60
, , % I/Oe C Backflow preventer 1 Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
PROPPRT ;OWN'FR' . :' ;{ ❑ TENANT.:::::: •..: , j :; .' Ejectors/sump 16.60 ,
Name: 4 n604401 L.//.:62 29 Expansion tank 16.60
. t44 4 , E ,
Address: 2/ 00 ��J'••.�� Fixture/sewcr cap 16.60
,9 .i� ' .' .., Floor drain/floor sink/hub
City /State /Zip: <,, ~rte cs� �' "'' Garbage disposal . 16.60
Phone: (603 —fir.? Fax: Hose bib 16.60 '
APPLYCAIVT •;•:' '• . • d CONTAC':'PERSON :. . Ice maker 16.60
Name:
Interceptor /grease trap 16.60
Page 2
Medical gas - value: $ Pa 8
Address: Primer 16.60
City /State /Zip: Roof drain (commercial) 16.60
Phone: I Fax: Sink/basin/lavatory 16.60
E -mail:
Tub /shower /shower pan 16.60
16.60 GO
Urinal ;, ;. CONTRACTOR:. ' 1 . 0
�/ �/ Water closet 16.60
Business Name: �,/fS /h Water heater
Address: y5/E70 S/ / 7 fi S(//if OM Other .
City /State /Zip: 17 J O� 9 ?,,2,Z3 Other:
� ; ��'�: Pl<uul Petrmit;v� +i4,:i� :� ; �, i; ; , .
Fax: , ,.' : ; ;,,,
Phone: r �.T` "' "= - Subto $
CCB Lic. #:,„7-07 Plumb. Lic. #:..7,21/ Minimum Permit Fee $72.50 $ 7al ••e'
Authorized • •g"f' Residential Backflow Minimum Fee $36.25
Signature: � -e" - �' "�' �` - Date: 9/-)1 Plan Review (25% of Permit Fee) $
4 /941/64.7S State Surcharge (8% of Permit Fee) $ —
(Please print name) TOTAL PERMIT FEE $ 73; le
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
*Fee methodology set by Tri -County Building Industry Service Board.
is \Dsts \Petmmit Forms \PlmPcrmitApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION t Business Line: (503) 639 -4171 MST
• BUP
Received Date R nested - � AM PM BUP
Location 7 / o p Suite MEC
Contact Person r Ph ( ) l P 3q S?- PLM 3
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: - SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing f
Firewall /1 o f /.( e i e / G) /1J-t-
Fire Sprinkler I i l '
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P T FAIL
AT
LUMBING
am
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F F i
ART FAIL
NICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date I I/ � 0 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL