Permit K
A CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2000 -00218
�v DEVELOPMENT SERVICES DATE ISSUED: 6/15/00
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 08610 SW SCOFFINS ST 057 PARCEL: 2S102AD -00400
SUBDIVISION: MANCHESTER APARTMENTS ZONING: CBD
BLOCK: LOT: 018 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: 1 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: Connect floor sink to main drain.
FEES
Owner:
Type By Date Amount Receipt
THOMPSON, J RONALD + PRMT KJP 6/15/00 $50.00 0003020
A I TRS 5PCT KJP 6/15/00 $4.00 0003020
8610 S
8610 SW SCOFFINS #26
TIGARD, OR 97223 Total $54.00
Phone 1:
Contractor:
REQUIRED INSPECTIONS
1: Misc. Inspection
Phone
Reg 1 . Final Inspection
ORIGINAL
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 -1 7.
4e/,
Issued By � l ✓ Permittee Signature] . _� /L jam 1 �I
Call (503) -4175 by 7:00 P.M. for an inspection needed the next busi - - s day
•
CITY OF TIGARD Plumbing Permit Application Plan Check#
13125.6W HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#
Related SWR #
Called
Name of Development/Project //�� FIXTURES (individual) . QTY PRICE AMT
Job M,.& e_he -S T1"4. Sink 11.50
Address Street Address L Suite Lavatory 11.50
�( n SIUj Se.o i V1S q T - 57 Tub or Tub /Shower Comb. 11.50
Bldg # City /Sttattey -� OR Zip Shower Only 11.50
• T "`' "' / �1` / �� Water Closet 11.50
Na pie I ,
� ,PP� Q) 1. „J� n, .. 5�- Urinal 11.50
Owner o Mailing Adddres �� Suite Dishwasher 11.50
pipit cs V Lo p VI Ei,ts Sat. Garbage Disposal 11.50
City/State c ip Pho e c�LAI Laundry Tray 11.50
I . Washing Machine /Laundry Tray 11.50
N me S • yam �� `� T" _ D Si 2° 11.50
Occupant Mailing . dr ` es c � > S y, 3" / 11.50 /�
%)n ND Ft 1 its S1- • 4" 11.50
Ci fate Zip 6 117 43 Pho a ' J tl T: /�
lJ Q� � 4 r-9 'r/ Water Heater 0 conversion 0 like kind
N Gas piping requires a separate mechanical permit. 11.50
Oft n 4.42 MFG Home New Water Service 32.00
Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00
• Hose Bibs 11.50
Prior to permit City/State Zip Phone Roof Drains 11.50
issuance, a copy Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if
Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date
database
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
9 Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 41k Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial Di Commercial Back Flow Prevention Device 32.00
Additional description of work:
•
no Flop' �,�� tA� e L dam" Residential Backflow Prevention Device" 19.00
1• o. Q 4 Catch Basin 11.50
Are you capping, • ving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
`Q� o No Inspections per/hr
If yes, see bbdk •f • rm 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
I hereby acknowledge that I have read this application, that the information SO S
given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required if Quantity Total is > 9
that plans submitted are in com•liance with Oregon State Laws. "SUBTOTAL
S , 1 . ture of Owner / g w ) Date / 8% SURCHARGE
Contact Pers j Name Ph. ne
T L. "NAM 6241_/650 *'PLAN REVIEW 25% OF SUBTOTAL
1 BATH NO $178.0f) : ; . .. - :. ,_i. , Required only k fudure qty. total Is > s TOTAL
BATH
"2 BATH HOU q $250.00` + <ri: ,� � .° - �
HOUSE $285.01141; r ', } , , '' t� ' °_' � .
. is fee Inct tid all plumbing jI ctu In the dwelling an the fust ,, ` -Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
100 of san taty sewer storm sower andlNatel service) �;;' Device, which is $28+ 8% surcharge
"'All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
ttdstsVormstplumapp.doc 11/18199
•
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:
•
1 : ldstsVorms\plumepp.doe 11/18/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested :P �/C0 AM X PM BLD
Location g(4' /0 S( '1) S Suite S1 MEC
Contact Person 14L,YI, 0 Ph (P 7.6r7Z S I q PLM 0021 g
Contractor U 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
LUMBINt
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Drains
agn
PART FAIL
HANICAL
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 , v Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.