Permit CITY OF TIGARD PLUMBING PERMIT
41 AA I , DEVELOPMENT SERVICES PERMIT #: PLM1999 -00230
A. '�I I- ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/28/99
SITE ADDRESS: 09645 SW SATTLER ST PARCEL: 2S111CA -13600
SUBDIVISION: DARMEL ZONING: R -3.5
BLOCK: • LOT: 013 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: . BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 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 a new water heater.
FEES
Owner:
Type By Date Amount Receipt
BRYAN HANSON PRMT GEO 7/28/99 $50.00 99- 317206
9645 SW BATTLER 5PCT GEO 7/28/99 • $3.50 99- 317206
TIGARD, OR 97224
Total $53.50
Phone 1: 503 - 639 -1608
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Contractor: .
COLUMBIA HEATING + COOLING INC
PO BOX 230397
8900 SW BURNHAM ST STE E -110 REQUIRED INSPECTIONS
TIGARD, OR 97281 -0397
Phone 1: 624 -2704 Final Inspection
Reg #: LIC 00000763
PLM 34 -175PB
ORIG INAL
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 may obtain copies of th rule r direct questions to OUNC by calling (503) 246 -1987.
Issued By: / /,..- ,- ----*1 Permittee Signat• e: ` ,��f , �,��� /_;/ v
C Call (503) 63 75 by 7:00 P. . for an inspection n - • - • • - next bu - ess day
CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGAgb, OR 97223 Date Rec'd
(50:4) 639 -4171 <‘ Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit #P n ( 9 -- ao23d
Related SWR #
Called
Name of Dev lopment/Project FIXTURES (Individual) QTY PRICE AMT
Job Z- orison Sink 11.50
Address tr (o // 46- ,,,,t) ��//� Suite Lavatory 11.50
` 6 0 ' �t r/ J Tub or Tub /Shower Comb. 11.50
Bldg # Ci /State r� Zip Shower Only 11.50
. /
e
lard nom" 7 /7 a q Water Closet 11.50
R Rang, Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
9/0 c5a Wei- Washing Machine 11.50
7 C' /State / Zip Phone 67.2 - Floor Drain/Floor Sink 2° 11.50
oa o/? 99a q 639-�larXf 3° 11.50
,50-n I 4° 11.50
Occupant Mailing Address Suite Water Heater •Conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit. i i0
City /State Zip Phone Laundry Room Tray 11.50
Mai (� �[ Urinal 11.50
7 h� a- )4ea /► g Other Fixtures (Specify) 15.00
Contractor ailing Address Suite
.a. xa30397
Prior to permit City/State Zip Phone ,..-v3 - Sewer - 1st 100' 38.00
issuance, a copy 1 ; card Ode q 9a 13 /,,,
of all licenses are Ore .46n Const. Cont. Board Lic.# Exp. ate Sewer - each additional 100' 32.00
required if . 7 /O 3s id- oa - 9 q Water Service - 1st 100' 38.00
expired in COT Plumbing Ic. # Exp. Date Water Service - each additional 200' 32.00
database 3 -/75 r Jo-3/-91 Storm & Rain Drain - 1st 100' 38.00
Name Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
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or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device' 19.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No O Any Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commercial 0 Catch Basin 11.50
Additional description of work: Insp. of Existing Plumbing 50.00
per/hr
Are you Ca in mo n or replacing an fixtures? Specially Requested Inspections 50.00
Y PP 9. f 9 Y per/hr
No )( Rain Drain, single family dwelling 45.00
If yes, see back of form to indicate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram Is required if Quantity Total is > 9
given is ��,, that I amt .caner or authorized agent of the owner, and *SUBTOTAL •
that Va 1 min are i , liance with Oregon State Laws. ,0
SI . T' • ner /A ii Date 7% SURCHARGE
Bn,�it,� 7 ' - q 3<50
Person ✓ N eme c) rA Phone563 - "PLAN REVIEW 25% OF SUBTOTAL
a/ r w of /U rid / ao -g 7 Required only if fodure qty. total is > 9
1 BATH HOUSE $178.00 TOTAL
2 BATH HOUSE $250.00 .3,
3 BATH HOUSE $285.00 'Minimum permit fee is $50 + 5% surcharge, except Residential Backflow
' (This fee includes all plumbing fixtures In the dwelling and the first Prevention Device, which is $25 + 5% surcharge
100 feet of sanitary sewer storm sewer and water service) . "All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I:tdstsVormstplumapp.doc 6/16/99
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved I - Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
t: ldstsVonmslplumapp.doc 6/16/99
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8/30/99 Activities for Case #: PLM1999 -00230
4:59:15 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 APPlication received 7/28/99 GEO RECD No Hold GEO 7/28/99 .
PLMA005 Create Permit 7/28/99 GEO DONE No Hold GEO 7/28/99
PLMA799 Final Inspection 7/28/99 7/28/99 8/10/99 RB FAIL No Hold AKJ 8/10/99 1) seal penetration in found wall
at gas line-
2) install drip legs
appliance not installed at this
time •
PLMA050 (F) Issue permit 7 /28/99 GEO DONE No Hold GEO 7/28/99 •
PLMA799 Final Inspection 8/22/99 8/22/99 8/20/99 . MS PASS No Hold AKJ _ 8/22/99
PLMA800 Case Finaled 8/22/99 AKJ DONE No Hold AKJ 8/22/99
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 �, ,r� Business Line: 639 -4171
BUP
Date Requested [� � -q 9 AM x PM BLD
Location 9(10 " S , c� c1 !-(l mil Q/L Suite MEC ]tietq''Oo Li
Contact Person LS A j)1/\, Ph (42)/-2/70q PLM 1 ?' ! —6■61Z&J
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
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
laai tNgi)
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
S PART FAIL
411EC
Post & Beam
Rough In
Gas Line
Smoke Dampers
PA . S PART FAIL •
CTRICAL
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 Q�
Approach /Sidewalk Date / 2� Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.