Permit •
CITY F T I GA R D PLUMBING PERMIT
PERMIT #: PLM1999 -00193
,� y n DEVELOPMENT SERVICES DATE ISSUED: 6/23/99
--I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12625 SW SNOW BUSH CT PARCEL: 1S133DA-08500
SUBDIVISION: AMART SUMMERLAKE NO. 2 ZONING: R -7
BLOCK: LOT: 145 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: 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: Installation of residential backflow prevention device.
FEES
Owner:
• Type By Date Amount Receipt
PAUL DRAKE
12625 SW SNOW BUSH CT PRMT DEB 6/23/99 $25.00 99- 316345
TIGARD, OR 97223 MISC DEB 6/23/99 $1.25 99- 316345
Total $26.25
Phone 1:
Contractor:
NATURES PATH LANDSCAPING INC.
10623 NE FOX FARM ROAD
DUNDEE, OR 97115 -0000 REQUIRED INSPECTIONS
Phone 1: 680 -6040 RP /Backflow Preventer
Reg #: LIC 6174 Final Inspection
PLM 1204.1
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.
Issued By: / Permittee Signature:
Cal (503) 639 -4175 by 7:00 P.M. for an inspection needed e next business day
(l4q,(a--e_e____ L/ed
•
•
CITY TIGARD � t � ! PLUMBING PERMIT
AVM 19
PERMIT #: PLM1999 -00193
y4, DEVELOPMENT SERVICES. DATE ISSUED: 6/23/99
1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12625 SW SNOW BUSH CT PARCEL: 1S133DA -08500
SUBDIVISION: AMART SUMMERLAKE NO. 2 ZONING: R -7
BLOCK: - LOT: 145 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; 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: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
PAUL DRAKE
12625 SW SNOW BUSH CT PRMT DEB 6/23/99 $25.00 99- 316345
TIGARD, OR 97223 MISC DEB 6/23/99 $1.25 99- 316345
Total $26.25
Phone 1:
Contractor:
NATURES PATH LANDSCAPING INC.
10623 NE FOX FARM ROAD
DUNDEE, OR 97115 -0000 REQUIRED INSPECTIONS
Phone 1: 680 -6040 RP /Backflow Preventer
Reg #: LIC 6174 Final Inspection
PLM 12041
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 - 008
You ay obtain • •pies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issu :. By: 1 _ 2 4,4 . _4 , , A ik _ �� -' Permittee Signature: - _ f _
r r
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next usiness day
CITY OF TIGARD Plumbing Permit Application Plan Check -
13125 SW HALL BLVD. Commercial and Residential R ec'd By.l �� .
TIGARD, OR 97223 Date Rec'd G/ 'A ` " ° q V
(503) 639 -4171 ` ‘ Date to P.E. -
Print or Type (4-1,,R.35,,,i, Date to DST
Permit #It.F - i(ERt1 ?'00/9
Incomplete or illegible applications will not be accepted
Related SWR # -°
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
•
Job PA, J L - ORA g- Sink 11.50
Address 1 Street Address s � 1 ,43 R vS Suite Lavatory 11.50
r..7 Tub or Tub /Shower Comb. 11.50
Bldg # City /State Zip Shower Only - 11.50
7764 O
Name Water Closet 11.50
Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
Washing Machine 11.50
City /State Zip Phone Floor Drain/Floor Sink 2" 11.50
Name 3" 11.50
4" 11.50
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit.
City/State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
Name
IAA g _ l � T r I GN Other Fixtures (Specify) 15.00
1.24 Kg 5 ),4- -T /.A, - scAP /,-)r-,
Contractor Mailing Address Suite
(obZ3 s Nf I�'X )21 fit -
Prior to permit City/State Zip Phone Sewer - 1st 100' 38.00
issuance, a copy -- 0‘.7,�g f el q7 1 / s 1,81 ( to
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date Sewer - each additional 100' 32.00
required if / -74 / l/5/)45 Water Service - 1st 100' 38.00
expired in COT Plumbing Lic. # / 24,4/ Exp. Da Water Service - each additional 200' 32.00
database / 03 / / 95 Storm & Rain Drain - 1st 100' 38.00
Name Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00
Pollution Device
Engineer City/State Zip Phone Residential Backflow Prevention Device' 19.00
(Irrigation timing devices require a separate J /g
Describe work to be done: restricted energy permit.) /
New Repair 0 Replace with like kind: Yes O No 0 Any Trap or Waste Not Connected a Fixture 11.50
Residential p- Commercial O Catch Basin 11.50
Additional description of work:
L. A (,,.. A.7 Insp. of Existing Plumbing 50.00
/ jJ S'V4 /i . gr4Cf( f2-0 a) PR', - S per/hr
Are you capping, moving or replaci g any fixtures? Specially Requested Inspections 50.00
Yes 0 No per/hr
R ain Drain, single family dwelling 45.00
If yes, see back of form to indi ate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
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 o' ..... that plans submitte are 'n compliance with Oregon State Laws.
Signature of NA ent �/G Date , 9 5% SURCHARGE A , 2 y
Contact Perso Na e Phone "PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total Is > 9
1 BATH HOUSE $178.00 . TOTAL Ai ,
_2 BATH HOUSE $250.00 . - . _
3 BATH HOUSE $285.00 'Minimum permit fee is $50 + 5% surcharge, except Residential Backflow
(This fee includes all plumbing fixtures In the dwelling and the first Prevention Device, which is $25 + 5% surcharge
100 feet of sanitary sewer storm sewer and water service) "'All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I: ldstsVornslplumapp.doc 6/2/99
•
r"
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
N ;.
ew' . Moved . Replaced . ;:Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:tdstsformslplumapp.doc 6/2/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
QQ BUP
"'ZS' l
Date Requested G "'� I AM PM BLD
Location �1n(���")�b,,��_. Suite MEC
n/
Contact Person I ° e( vl 1 Y\ Ph U gO°{Q (S PLM ) q qq - 0D / C
Contractor Ph SWR
BUILDING Tenant/p ecuv Dw,ae.e., ELC
Retaining Wall ELR
Footing Access:
Foundation I /� �/� ! /� FPS
Ftg Drain ,/
Crawl Drain Inspection Notes: // ,^, ^ 11 �, SGN
Slab 1.� S[ �1.�, SIT
Post & Beam ��
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm �j�
Susp'd Ceiling 11��`- 111
Roof
Misc:
Final
PASS PART FAIL
-- Post & Beam 19ack l
Under Slab
- Top Out
Water Service
Sanitary Sewer
Rain Drains
F' =.
) PART FAIL
171ELHANICAL
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 �°dF Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.