Permit .xI
'or CITY OF TIGARD
PLUMBING PERMIT
I DEVELOPMENT SERVICES PERMIT #: PLM2000 -00368
a �,L '�J �! 13 125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/29/00
.ti
SITE ADDRESS: 15350 SW SEQUOIA PKWY 140 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Plumbing TI.
FEES
Owner:
Type By Date Amount Receipt
PACIFIC REALTY ASSOCIATES PRMT CTR 9/29/00 $99.60 27200000000
15350 SW SEQUOIA PKWY #300 -WMI 5PCT CTR 9/29/00 $7.97 27200000000
PORTLAND, OR 97224
Total $107.57
Phone 1:
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone 1: 236 -4152 Rough -in Insp
#: L IC 172 Top -out Insp
Reg Final Inspection
PLM 26 -83PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR..
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. c You ob a opies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issu B : I I. i i 1 Permittee Signature: X il '
Y
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY,OF$TIGARD Plumbing Permit Application Plan c
131'25 SW HALL BLVD. Commercial and Residential Recd r�a '
TIGARD, OR 97223 Date Recd - ,` -- ; - -9 - 0 0
(503) 639 -4171 Date to P.E.
Date to OSA
Permit# t-0 09-04)30g
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project FIXTURES (individual) Qty Price Total
Job C.DMN1/40A/ S ivy Sink 16.60
Address Street Address SE QMoI A Suite Lavatory 1 16.60 /b
/ 535a S •J Pi4w y Jit P *7 Tub or Tub /Shower Comb. / 16.60 96
Bldg # City /State Zip Shower Only 16.60 l
/4,444 ®j-. c1'7 ,L �.
Na e i Water Closet / 16.60 /
P A-, la , s Urinal 16.60
Owner Mailing Address Suite Dishwasher 1 16.60 J&
153 56 Sim SFcrjU � u Garbage Disposal 16.60
City /State Zip Phone
72446We q7,2: toA4 i 0 . Laundry Tray 16.60
Name Washing Machine 16.60 �
CO O,, 5 ---se_ Floor Drain/Floor Sink 2" / 16.60 /�
Occupant Mailing Address Suite 3" 16.60
Y.rot. 4" 16.60
City / - Zip Phone
Water Heater 0 conversion 0 like kind 1660
. C -* Name Gas piping requires a separate mechanical permit. J ih
Q EAI, 44 r e 0 v , 01-86; MFG Home New Water Service 46.40
Contractor Mailing Address Suite MFG Home New San/Storm Sewer 46.40
"3 t t i$ g l 3 Hose Bibs 16.60
Prior to permit py/StatejAi a Zip Phone Roof Drains 16.60
- uance, a copy i / 7 a 36_4116
II licenses are Oregon Const. nd Lic.# Exp. ate Drink Fountain 16.60
required if l -7a. 1a Iasi o1 Other Fixtures (Specify) 21.75
expired in COT Plumbing Lic. # Exp. Date
. database a 83 f B 03 /
Name
Architect Sewer- 1st 100' • 55.00
Or Mailing Address Suite Sewer - each additional 100' 46.40
Engineer City/State Zip Phone
Water Service - 1st 100' 55.00
Water Service - each additional 200' 46.40
Describe work to be done: Storm & Rain Drain - 1st 100' 55.00
New Repair 0 Replace with like kind: Yes No 0 Storm & Rain Drain - each additional 100' 46.40
Residential 0 Commercial
Additional description of work: Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 72.50
Yes No Inspections per/hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 65.25
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 16.60
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 correct, that I am the owner or authorized agent of the owner, and `SUBTOTAL �� � U
that plans submitted are in co pliance with Oregon State Laws.
Sign Owne cent Date / al/
09 8% SURCHARGE 7 .r
C ontact Person Name .....
rij-L, EA/iv •� Ei 5 23& -1•/ ( I 5" '"'PLAN REVIEW 25% OF SUBTOTAL
1 BATH HOUSE $249.20 Required only if fixture qty. total is > 9
4TH HOUSE $350.00 . TOTAL y _
ATH HOUSE $399.00, ,,; „ , .
(This fee.Incl plumbing fixtures In the 'dwelling the first lling and th
� � �� -v ..� , a ll �- 'Minimum permit fee Is $72.50 + 8% surcharge, except Residential Backflow Prevention
4 100 feet olf, 4nitary atom sewer and water servlce)N rr ';,,_ m Device, which is $36.25 + 8% surcharge.
"All New Commercial Buildings require plans with isometric or riser diagram and plan review.
Wststorms%plumapp_rev.doc 9/8/00
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved 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:
•
tdsts tormstplumapp rev.doc 918100
ti r—
CITY OF TIGAR[ PLUMBING PERMIT
s l� DEVELOPMENT SERVICES PE
DEVELOPMENT PLM2000 -00368
Iry 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/29/00
SITE ADDRESS: 15350 SW SEQUOIA PKWY 140 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Plumbing TI.
FEES
Owner:
Type By Date Amount Receipt
PACIFIC REALTY ASSOCIATES PRMT CTR 9/29/00 $99.60 27200000000
15350 SW SEQUOIA PKWY #300 -WMI
5PCT CTR 9/29/00 $7.97 27200000000
PORTLAND, OR 97224 —
Total $107.57
Phone 1:
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone 1: 236 -4152 Rough -in Insp
Top -out Insp
Reg #: LIC 172
PLM 26 -83PB Finallnspection
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 •• - o • a opies of these rules or direct questions to OUNC by calling (503) 246 -1987.
a
Issu - By: . - Permittee Signature: /l
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
BUP - Building Permit ELC - Electrical Permit
I Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical fmal
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing � Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
•
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PL M - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm fmal Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final f /C el/a z-7-2.
Sprinkler supply lines % / / /7 /d1D
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils I Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639 -4175 Bus injss.Line: 639 -4171
4 + • . BUP
Date Requested /0 ' / O AM PM BLD
Location /5 5 S C✓ apr - -S. ga,c / a, Suite NO MEC
Contact Person Ph 2 j 4 W-> Z PLM 2€,/,/1 - o 036,f(
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
(:ELUMHIUG—
Post & Beam
Under Slab
(Top_Out
ater Service
Sanitary Sewer
Rain Drains
Fi
AS PART FAIL
•
CHANICAL
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 lb\ Other Date 1 Inspector Exty
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITT OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 171
BUP
Date Requested / / AM PM BLD
Location / 5 5 Sw Se /A.01 a / Suite NO MEC
Contact Person Ph 23, 4l 3 Z PLM 7, ve ov 3 (o F
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
=ear
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
- PART FAIL
CHANICAL
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 (1/(7 �j Approach /Sidewalk Date en Inspector h/i� Ext Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.