Permit •
CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT # • PLM97 -0240
. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06 / 25 / 97
PARCEL: 1S125DB -08000
SITE ADDRESS...: 07080 SW SHADY CT
SUBDIVISION : SHADY DELL NO.2 ZONING: R -4.5
BLOCK. - LOT °53 JURISDICTION: TIG
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SF WASHING MACH 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS 0 TRAPS : 0
STORIES ° 0 WATER HEATERS • 0 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...: 2 SEWER LINE (ft)...: 0
WATER CLOSETS.: 1 WATER LINE (ft)...: 0
DISHWASHERS : 0 RAIN DRAIN (ft)...: 0
Remarks: add new value for tub /shower and replace shower and water closet
Owner: FEES
MARY JANE MATTLOCK type amount by date recpt
7080 SW SHADY COURT PRMT $ 27.00 GEO 06/25/97 97- 296390
TIGARD OR 97223 PLCK $ 6.75 GEO 06/25/97 97- 296390
SPCT $ 1.35 GEO 06/25/97 97- 296390
Phone #:
Contractor --
POWER PLUMBING CO
P 0 BOX 23144
TIGARD OR 97281
Phone #: 244 -1900 $ 35.10 TOTAL
Reg #..: 000523
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the PLM /Underfloor
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top—out Insp
applicable laws. All work will be done in accordance with Final Inspection
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 -YJ"J1 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: Permittee Signature.' 4 . 4
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13145 SW Hall Blvd. Permit #P6/1/ ql -o0yC-)
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Name of Oesetoyment . New Single Family Residences Only
A°dref � y ❑ 1 BATH HOUSE $140.00 1:1 2 BATH HOUSE $195.00
7 80 w
Job ` ,Y ❑ 3 BATH HOUSE $225.00
Address city......) f.) ,tat zo Fee includes all plumbing fixtures in the dwelling and the first 100 feet
C,a. ( l J ra (' %� of water service, sanitary sewer and storm sewer. See fees below.
Name (or name of Buameu) FIXTURES QTY PRICE AMT
Sink 9.00
Maim Address Rhone Lavatory 9.00
Owner Tub or Tub/Shower Comb. MOr, Nrc&Ar_. j 9.00 y' ,M
ON/State ZIP Shower Only Rep I - 1 9.00 9
Water Closet T"�^._ e "' I 9.00 1,°!.. bums.) Name (or name of bums.) Dishwasher �'" 9.00
Garbage Disposal 9.00
Occupant Meg Address Phone Washing Machine 9.00
Floor Drain 9.00
Cn /S1f1e Zip Water Heater 9.00
Laundry Room Tray 9.00
Name ` Urinal 9.00
�p Net c \ k,,, �` Other Fixtures (Specify) 9.00
Mang Address 1 Phone 9.00
Contractor
Ro &7C 03\y `i 9.00 _ ..._ .
City /State zip
9.00
\ G4AI ' oy(N Sewer 1st 100' 30.00 Retan No. rykyro Gay Bus. Tax Na. Sewer - ea. Addit. 100' 25.00
sa - 18 /g6T- Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm
& Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
�� r' -z4 -ct ) Back Flow Prevention
Devi ce or Anti - Pollution Device 9.00
Sigmas era Oats Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new Q addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential non - residential 0 Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00 /hr
Existing use of
building or property es �.C� Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of
building or property e.S ■,Jv..Q. e
°(Except residential backflow
prevention devices)
NOTICE . *Minimum Fee $25.00 SUBTOTAL ."� °d
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 3-5:-
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE ., ��
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS "TS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL
■S IO
Special Conditions
Date issued by
•
RECEIVE
JUN 257997
COMMUNITY DEVELOPMENT
5/19/99 - Activities for Case #: PLM97 -00240
2:08:06 PM •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA799 Final Inspection VLN 9/17/98 Inspection request for research
to Hap W. 9/18/98.
PLMA003 Application received 6/25/97 6/25/97 TAT 6/25/97
PLMA005 Create Permit 6/25/97 6/25/97 TAT 6/25/97
PLMA725 Top -out Insp 6/25/97 7/1/97 MS PASS J *H 7/18/97
PLMA050 (F) Issue permit 6/25/97 GEO PASS TAT 6/25/97
PLMA799 Final Inspection 9/22/98 RB FAIL VLN 1/29/99 Inspection card left on site:
"Please make arrangements to
provide for a plumbing final
inspection of the above listed
permitted installation of a
tub /shower replacement and
w /doset installation. Your
cooperation is very much
appreciated."
PLMA799 Final Inspection 9/23/98 RB PASS VLN 1/29/99
PLMA800 Case Finaled 2/3/99 MS PASS MRS 2/3/99 already finaled by Rick Bolen
Page 1 of 1
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639-4171
` ... S Xl°61 BUP
Date Requested { 7- ?, A MPM BLD
Location 7 n z� < S Y'� Ir �c ) , L ,74 1 -5 Suite MEC
Contact Person Ph PLM 9 7 •-0 aU
Contractor { PPh SWR
BUILDING Tenant/ nee �j f 7 / - 6��I 3 ELC
Retaining Wall ELR
Footing
Foundation FPS
Ftg Drain NOT REQUESTED SGN
Crawl Drain FOUND DURING RESEARCH „� SIT
Slab NO INSPE IN FILE
Post & Beam '
Ext Sheath /Shear
Int Sheath /Shear -
Framing
Insulation
Drywall Nailing
Firewall
Jl
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PAS RT FAIL
UMBI
earn
Under Slab
Top Out
Water Service
Sanitary Sewer
R.' - ins
arr
SS 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 I:
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 9/L3/ r Other
Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION •
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: A.M. P.M. MST:
_
Location: • i �i L!• _■ .i __ tf/ •L ./ 1 BUP:
•
Tenant: Suite: . Bldg: MEC:
Contractor: --c,c 3--e---‘ __ p, Phone: 4 / 1 -1 – /7 00 PLM: 9' - 7-0 .
Owner: / // Phone: • ELC:
i . ) � { L U e, P e p ' Z c — l r v l P . , 1 - j 9 2 o w of _+ 0 CJ ELR:
J SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE .
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler '•.,
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump • Low Volt
Approved p rye Approved Approved Approved
Appr /Sdwlk Not Approved it Approved Not Approved Not Approved Not Approved
FINAL • 1 FINAL FINAL FINAL
,.t lam_ / L ! . i.ra� _...h `�/ Ofa aA : ■A G r ., - %' 1 _�
L I . ...iL.% ' _ . _ _ ! .
Aorpr fz,,7 , /7 " ._, ,o r i 7 .
. ........ _
___ .
. •
. .
O Call for reinspection 0 Reinspection fee of $ )equired befor next in ction / 0 Unable to inspect
'' / '•� / Date: 75 7 Page ( of /