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Permit CITY OF TIGARD • ^ ' 4'111 DEVELOPMET SERVICES PLUMBING # TM UMBING PERMIT — 13125 SW Hall Blvd., Tigard, (503)639-4171 F'ERMI 98 0473 DATE ISSUED: 12/30/98 PARCEL: 1S135BD- -01200 SITE ADDRESS...: 09800 SW SHADY LN SUBDIVISION • ZONING: C —G BLOCK • LOT JURISDICTION: TIG CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:M 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...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 100 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Repair less than 100 feet of water line. Owner: FEES DON BURDICK type amount by date recpt 434 RIDGEWAY RD PRMT $ 30.00 DEB 12/30/98 98- 311832 LAKE OSWEGO OR 97035 5PCT $ 1.50 DEB 12/30/98 98- 311832 Phone #: Contractor JACK CORMAN PLUMBING, INC 7483 SE JOHNSON CREEK BLVD PORTLAND OR 97206 Phone #: 788 -6947 $ 31.50 TOTAL Reg #..: 000008 REQUI RED INSPECTIONS This permit is issued subject to the regulations contained in the Water Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection 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-ml-10 through OAR 952-01-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-1987. i - Permittee By: F er ^mittee Signature +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ 12/30/98 WED 12:09 FAX 503 598 1960 CITY OF TIGARD (J002 CITY OF TIGARD Plumbing Permit Application Plan , _.- - 1.3?25 SW HALL BLVD. Commercial and Residential Recd . . 1!P , " TIGARD, OR 97223 Date Recd /9-- r (503) 639 -4171 Date to P.E. '----- - Print or Type - Date to DST Incomplete or illegible applications will not be accepted it it X 73 Related SWR e Called Name of Development/Project -:� M ft Job ?goo S sNaD NN Sink 9.00 Address Street Address / Suite Lavatory 9.00 Tub or Tub/Shower Comb. 9.00 Bldg & I City Zip Shower Only 9.00 - Name 6-,4-eD Water Closet 9.00 0Ai 3 vebic./( . Disinvasher 9.00 • Owner ailin ssss Suite Garbage Disposal 9.00 AT n• 14) 4' Washing Machine 9.00 - Cjty/State Zip Phone Floor Drain /Floor Sink Y 9.00 K6 �' Sul ,.j 63s 393 s Name 3' 9.00 • 4' 9.00 • Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00 Gas piping requires a separate mechanical permit City/State Tip Phone Laundry Room Tray 9.00 Urinal 9.00 Name //�� Other Fatures (Specify) 9.00 �AC�C_ 0A 7ri - L abial _J -, .„2 -ivG. 9.00 Contractor Mating Address Suite Pr lEwAgeZ G2e.8[ t 9.00 Prior to permit City/State Tip Phone Sewer - 1st 100' 30.00 . Issuance, a copy ?e 97a•962 lee-69417 - Sewer - eaaradditionai .100' 25.00 of all licenses are Oregon Cant Cont. Board Lic.# Exp. Date - - required if g$-3 // Water Service- 1st 100' /OD 30.00 ga expired In COT Plumbing Lk. # Exp. Date Water Service - each additional 200' 25.00 database .3- / 98 Storrs & Rain Drain - 1st 100' - 30.00 Name Storm & Rain Drain - each additional 100' 25.00 Architect Mobile Home Space 25.00 or Mailing Address Suite Commerdal Back Flow Prevention Device or Anti- 25.00 Pollution Device Engineer citY/State Zip Phone Residential Badcflow Prevention Device* 15.00 Desaibe wort to be done: restricted energy.permlL) New 0 Repair 0 Replace with like kind: Yes, No 0 Any Trap' or Waste Not Connected to a Fbdure 9.00 Residential " Commercial A Catch Basin 9.00 Additional description of oak. Insp. of Existing Plumbing 40.00 peri rr Specially Requested inspections 40.00 per/hr Rain Drain, single family dwelling 30.00 Are you capping, moving or replacing any fixtures? Yes 0 No 0 Grease Traps 9.00 If yes, see back of form to indicate work performed by QUANTITY TOTAL . • - .-.*:"'" "� fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram Is required 8 Quantity Total Is > 9 i,7.- u "' . WORK COULD RESULT IN INCREASED SEWER. FEES. *SUBTOTAL - '` ` r ' 1 hereby acknowledge that I have read this application, that the Information i±- '`4 � : � n given•is coed, that I am the owner or authorized agent of the owner, and e. - tY that plans submitted are In compliance with Oregon 6% SURCHARGE r ' z ' : X =k3: ` p tegon State Laws. sx -: / i re of; . _, Agent Date "PLAN REVIEW 25% OF SUBTOTAL _ t=_ 2.e� . /a - 30 -98' } y ' . Required only a fixture qty. form is > 9 " t _ ' TOTA Y : - • ��.r p Person Name Phone y r *- � . 5 MA,e/c A /Q_ i Hgg^6 9 y . •Minimum permit fee is $25 + 5% surcharge, except Residential Baddiow "I / Prevention Device, which is $15 + 5% surcharge ~Ail New Commercial Buildings require plans with Isometric or riser diagram and plan review • Lidsts1pkirriepp.doo 7/1/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 8: 60 BUP /4/ / . /.Date Requested / / /,) AM XX PM BLD Location ifver ') SUJ �� fix v _ Suite MEC Contact Person Ph PLM 9J-e4,77_3 Contractor Ph 71d SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: / Slab /d P_XT Ida- SIT Post & Beam // Ext Sheath /Shear Q 6/1 -f-p Int Sheath /Shear i Insulation Framing 661/..a.57 / JS<S/9 � �' �� /9/)1 d' cep -k wa-t _Slr u - 6 1. 7 Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Drains 1 4 1 ! PART FAIL ANICAL 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 _ . Inspector Ext 3 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 //5(1q:9 AM PM BLD 1 / Location r/v _iL Suite MEC Contact Person Ph PLM Contractor t!. .4_A 4i ■ , ; _ / _ _ __ Ph -7(?-8v q7 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 E Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof f , //J Final PASS PART FAIL PLUMBING `l /j ftifr f.1// Post & Beam Under Slab ' Top O r, ater Se Sanitary Sewe Rain Drains Fi- ‘ PART FAIL ECHANICAL 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 , Inspector Other Date p 7 Ext Final PASS PART . FAIL DO NOT REMOVE this inspection record from the job site.