Permit CITY OF TIGARD
� ,., DEVELOPMENT SERVICES PLUMBING PERMIT
-i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # PLM96 -0380
DATE ISSUED: 12/19/96
PARCEL: 15134BC- 00300
SITE ADDRESS...: 12220 SW SCHOLLS FERRY RD
SUBDIVISION • ZONING: C —G PD
BLOCK • LOT •
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:M FLOOR DRAINS 0 TRAPS : 0
STORIES ° 0 WATER HEATERS • 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 0 URINALS • 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS • 0 SEWER LINE (ft)...: 0
WATER CLOSETS..: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: REPLACE WATER HEATER
Owner: FEES
HOWARD'S MARKET type amount by date recpt
12220 SW SCHOLLS FERRY ROAD PRMT $ 25.00 JSD 12/19/96 96- 288008
SPCT $ 1.25 JSD 12/19/96 96- 288008
TIGARD OR 97223
Phone #:
Contractor:
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
PORTLAND OR 97206
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 02734
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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.
Permittee Si ■'' i . X . /./
Issued '•. a
• Call for inspection — 639 -4175
12/16/96 09:11 '$503 684 7297 CITY OF TIGARD (j0O3 /00
b).� lqg
cm? oF TIGARD Plu Application Redd By 4"
13125 SW HALL BLVD. Commercial and Residential Data Reea
TIGARD, OR 97223 Date to P.E. -
(503) 639 -4171 Date to OST
Print or Type °e'^"` s L o
Relateo Incomplete or illegible applications will not be accepted caned _ ____ Y
Name of Development/Proleq . FIXTURES (Individual)
Job Sa QTY PRICE AIAT
9.00
Address Street Address Suite L" avatory 9.00
/w 2c) fJ SC.) 5,1111 X I Tub or TubrSh OmD.
Bldg t I State Zip 7 3 Shosar Only 9.00
t hl
Water Closet
Nam /WA-von/5 C✓& -Chol1S r hw
Oisaslsar 9.00
9.00
Owner milling Address Suite Garbage Disposal 9.00
!Z� o Sw ■E_ X, Wasnmg Machine -
7 � � eg 7 22 3 $g o -Aw Floor Drain r.-----. 9.Q0
/� ' ' 900
. �d�nG 4• _ 800
(*Cupant medal Adorns ` Suite Water Neater I 9.00
Laundry Rai= Tray
- � ZP `Phone Ur--- 9.00
9.00
Marro ar - < a ��driiii Other Fixtures (Specify) 9.00
Contractor M Address suite -- 9.00
1 Z sirs Sw A tik /A./ e.00
CltyrSute LO Phone .. 9.00
r'_at✓ Ore q7) -3 G ZV - 7j g-/ �� 9.00
�� Oregon Cosec. Cont. Board Ues Exp. Date - -_ 9.00
6U Copy of
Current - -1'7 -
Cu Lioness. Plssn ing lie s Exp. Date Sever - 1st 100'
9.00
Q 3 6 -1 4 1 -0
30.00
Sewer - east additions( too* 25.00
COT Business Tax or Metro t
Exp. Date
/l" Coil p - 1- cr 7 Water Service -1st 100• I 30.00
Narrts Water Service - eatn additional 200 - 23.00
■ Architect stones Rain Drain - 1st 100• 30.00
Or malting Address s t. Stone b Rawl Drain - tacit additional 100 25.00 j
Mobile Noma space 23.00 I
Engineer Chi Zp Phone Commereat Bactt Flow Prevention Device or Anti-
Poduoon COWS
23.00
ry
•
Oeea reert Vew fd' Motion O ,alteration 0 Repair O Resieendal Backlog. Prevention Device' l
No be done: Residential 0 Non-resiaentral 15.00
. stelio tel descnpoon of wont
Arty Fixture y Trap or Waste Not Connected to a f 9.00 '
- Caum aasan 9.00
Inep. of Existing Plumorng f ao.o0 a
i
penny
Exs7 use Specialty Requested Inspesaons 40.00
aularg or property oanhr
PropOeed use of Rain Cram• single family dweiling 30.00
I budding or properly
Grease Traps �� 9.00
QUANTITY TOTAL '
r Are you capping , moving or replacing any !mires? Yes Q NO ❑ Isometric s tuersiror ni Is review f Cvanay Tout is • s
(Miss see back of tornil "SUBTOTAL
Z S
I hereby acknowledge mat I ha.e read oils appOcadon. that the information
re -
given s correct that I am the owner or authorized agent of the owner. and S% SURCHARGE 1
hi $
that mans suemmrrted are in compliance with Oregon State Laws.
Signature Cl OvwmeNa • ent
J /- Data PLAN REVIEW 25% OF SUBTOTAL I
ort
1"--1--2---,„, /2-//0 Rewires owe lbws rev. tees if 9
Contact Person Name Phone TOTAL I
- Mlnlmrun pent fee is 525 • 5% stoma:ge. except Residential Bae
Prevention Cenci% %viten is 515.5% surcilarge
•tistbiinapp.doc 3196
3/8/00. Activities for Case #: PLM96 -00380
3:02:30 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 APPlication received 12/19/96 JSD PASS JD 12/19/96
PLMC005 Permit Created 12/19/96 JSD PASS JD 12/19/96
PLMC799 Final Inspection 1/6/98 MS FAIL ST 2/17/00 heater needs to be strapped in
2 places
2/17/00- inspection request to
Hap
PLMC740 Misc. Inspection 12/19/96 5/21/99 JMT JT 5/21/99 inspection request (research)
• sent to Hap
PLMC060 (F) Issue permit 12/19/96 JSD PASS JD 12/19/96
PLMC90 Expired by limitation • . 2/21/00 HAP DONE No Hold AKJ 2/21/00
•
•
•
Page oft
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location ? Z 2,0 "� • I : /. MEC
Contact Person Ph , PLM NCO 0° 3 Q d
Contractor Ph SWR
BUILDING de Owner , L ,7 7 ' L ELC
Retaining Wall ELR
Footing Access: �l FPS
Foundation l
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
•
Framing
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
Final
PASS PART FAIL
MECHANICAL
Post & Beam EXPIRED
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 t
I
Date Inspector Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.