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Permit 41+, CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PE DEVELOPMENT PLM2000 -00302 .,`"""IJI DATE ISSUED: 8/17/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12442 SW SCHOLLS FERRY RD 200 PARCEL: 1S134BC -00401 SUBDIVISION: ZONING: C -N BLOCK: LOT: JURISDICTION:, TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES • LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 4 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Tenant Improvement FEES Owner: Type By Date Amount Receipt SISTERS OF PROVIDENCE IN OR PRMT JMT 8/17/00 $69.00 0004553 BY STEVE FOSTER 5PCT JMT 8 /17 /00 $5.52 0004553 PO BOX 13993 PORTLAND, OR 97213 Total $74.52 Phone 1: Contractor: MYERS + SONS PLUMBING 6024 SW JEAN RD, BLDG F LAKE OSWEGO, OR 97035 REQUIRED INSPECTIONS Phone 1: 684 -6602 Rough -in Insp Reg #: LIC 00040389 Final Inspection PLM 26 -305PB • 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 these rules or direct questions to OUNC by•calling (503) 246 -1987 _ n Issued By Permittee Signature: i A, - c t) Call ( 03) 639 -4175 by 7:00 P.M. for an inspection nee 1, the ne t b siness day / or, 30 2 CITY c 2 F TIGARD Plumbing Permit Application Plan Check # 1312SW HALL BLVD. Commercial and Residential Rec'd By) TIGARD, OR 97223 Date Re 9 / - 00 (503) 6394171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Related WR Permit # SWR# �OOPc� # lzEF 13u 0 - cto3Th Called Name of Development/Project FIXTURES (individual) QTY PRICE I AMT Job ' ' Sink y 11.5G il�oo Address Street Address Suite Lavatory 1 11.50 i So 12442 SA/ .M1 -I0LLS if eD 7 Tub or Tub /Shower Comb. 11.50 Bldg # City /State Zip 116A2I Shower Only 11.50 Vme Water Closet I 11.50 I I SD V2/31/i Da J-1 A L,1N SVIE.W1S Urinal 11.50 Owner Mailing Address Suite Dishwasher 11.50 Garbage Disposal 11.50 City/State Zip Phone Laundry Tray 11.50 Name Washing Machine /Laundry Tray 11.50 I AN I'? Floor Drain/Floor Sink 2° 11.50 Occupant Mailing Address Suite 3" 11.50 4" 11.50 City /State Zip Phone Water Heater 0 conversion 0 like kind 11.50 Name Gas piping requires a separate mechanical permit. AhVa_S E Snit] S OLU1 AA g 1 A.ie MFG Home New Water Service 32.00 Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00 L3 24 S■/U J Ie Al F I' o Hose Bibs 11.50 Prior to anco a cop y � Ae City/State Is ,': / Zip jlLa5 Phone _' ! Z Roof Drains 11.50 issuance, a copy LN L�]IIUtz ` 1 `t CXl Drinking Fountain 11.50 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date required if LIQ I I - l0 Other Fixtures (Specify) 15.00 expired in COT Plumbing Lic. # Exp. Date database 'Lb - 3DsPB - 7-21 Name Architect Sewer- 1st 100' 38.00 Or Mailing Address Suite Sewer - each additional 100' 32.00 Water Service - 1st 100' 38.00 Engineer City /State Zip Phone Water Service - each additional 200' 32.00 Describe work to be done: Storm & Rain Drain - 1st 100' 38.00 New 1)3( Repair 0 Replace with like kind: Yes O No 0 Storm & Rain Drain - each additional 100' 32.00 Residential 0 Commercial 14 Additional description of work: Commercial Back Flow Prevention Device 32.00 .��. _ Residential Backflow Prevention Device' 19.00 TEIJNIAIJT I M r ! �YOk/ENllt� T' Catch Basin 11.50 Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 ' Yes 0 No 1 Inspections per/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 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL o D I hereby acknowledge that I have read this application, that the information Isometric or riser diagram Is required if Quantity Total is > 9 U 6 given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL v� that plans su miffed are in compliance with Oregon State Laws. 6 9 of ner /Agen Date o ll 8 - 1 - 7 - 8% SURCHARGE _ 5 Contact Perso ame Phone 12 MY✓QS 684 _6c2. "'PLAN REVIEW 25% OF SUBTOTAL 1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9 2 BATH HOUSE $250.00 TOTAL .� 52 3 BATH HOUSE $285.00 (This fee Includes' all plumbing fixtures In the dwelling and the first 'Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention ` 100 feet of sanitary sewer storm sewer and water service) Device, which Is $25 + 8% surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review. I:\dstsVormstplumapp.doc 11/18/99 - - 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 Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Floor Sink 2" 3" 4" • Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I: ldstsVormstplumapp.doc 11/18/99 - - CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 ' Business Line: 639 -4171 BUP Date Requested /0 AM PM BLD Location / Z if q Z Sw s V7 // Suite �� MEC Contact Person / Ph Ci KY Z PLM 2, LJL -GU 3e, 2— Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation '�/� FPS Ftg Drain i Notes: - e G Crawl Drain Inspectio SGN 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 PLU st :earn / % Under Slab //X o Top Out Water Service Sanitary Sewer Rain 675' • S. PART FAIL • ANICAL Post & Beam o1 Rough In / Line i (/L Smoke Dampers Final PASS PART FAIL �p ELECTRICAL \A! Service I f V 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 I �/y� Approach /Sidewalk D 1 ti Inspector 4v " Ext Other J � (� Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested q" r ° AM PM BLD Location /?-- get & 3 w - /i / ' e "-7 A9" Suite o MEC Contact Person / Ph co t'L( G 4' 6 Z- PLM . 26ir - - 00 3 L 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 PART FAIL PLU Post & Beam Under Slab ater Service Sanitary Sewer Rain Drains tg r2' 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 Other Date 6 Inspector Ot! Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.