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Permit , CITY OF TIGARD PLUMBING PERMIT a:'r^ DEVELOPMENT SERVICES PERMIT #: PLM2000 -00152 r• ' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/16/2000 SITE ADDRESS: 12220 SW SWEENEY PL PARCEL: 2S103A6 -05200 SUBDIVISION: WALNUT GLEN ZONING: R -4.5 BLOCK: LOT: 010 JURISDICTION: TIG CLASS OF WORK: ALT 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: Install a residential backflow prevention device. FEES Owner: Type By Date Amount Receipt GREGG HYMAN, LAURA PRMT GEO 05/16/200C $25.00 0002209 12220 SW SWEENEY PLACE SPOT GEO 05/16/200C $2.00 0002209 TIGARD, OR 97223 Total $27.00 Phone 1: 503 - 620 -0653 Contractor: OWNER REQUIRED INSPECTIONS Phone 1: RP /Backflow Preventer Reg #: 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 the e rules o •irect questions to OUNC by calling (503) 246 -1987. r Issued By: " ��„ ��� ittee Signature: ��a dA £t 1 — Call (503) • •• 175 by 7:00 P.M. for an inspection needed the next buss i s ' CITY OF TIGARD Plumbing Permit Application Plan Check# 1 3125 SIN HALL BLVD. Commercial and Residential Rec'd By TIGARD, OR 97223 Date Rec'd (503) 639 -4171 t Date to P.E. Print or Type Date to DST Yp Permit IR M e 2 - CMG /rjR Incomplete or illegible applications will not be accepted Related SWR# Called • Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job I AIGI/lu G Ie,--1 Sink 11.50 Address Street Address Suite Lavatory 11.50 /2ZZO SW Swee/!c, PI Tub or Tub /Shower Comb. 11.50 Bldg # City/State Zip Shower Only 11.50 Name I I J r � / h la ` cl i Water Closet 11.50 6 f ppq /4 t/1 Urinal , 11.50 Owner Mailing Addres Suite Dishwasher 11.50 I ZZ26 SW S v✓een1'j PI Garbage Disposal 11.50 City /State Zip Phone Laundry Tray 11.50 I;yar,e1,09- g 7ZZ 3 620 - 454 , 5 3 Name Washing Machine/Laundry Tray 11.50 5 44h e G,S 6L✓//e r Floor Drain/Floor Sink 2° 11.50 Occupant Mailing Address Suite 3° 11.50 4" 11.50 City /State Zip Phone Water Heater 0 conversion 0 like kind 11.50 Name Gas piping requires a separate mechanical permit. N one- 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 None 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 Water Service - each additional 200'_ 32.00 Describe work to be done: Storm & Rain Drain - 1st 100' , 38.00 New 0 Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Residential » Commercial 0 Commercial Back Flow Prevention Device 32.00 s Additional description of work: p (S pro >V l e( y5 +em) Residential Backflow Prevention Device' 19.00 2 =jiciAll (eS 6e, +(4 e _foW re ve*o, 1 � vx[e Catch Basin 11.50 Are you capping, moving or replac any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 Yes 0 No Inspections per/hr If yes, see back of form to indica a 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 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 00 that plans submitted are in compliance with Oregon State Laws. ZS Signet of Owriq/Agent Dat o �f 0141 5 b 8 /o SURCHARGE Z p�1 Contact Pe n afhe Phone 6 ( o y yvll' ,- bZo -ot. 5 3 **PLAN REVIEW 25% OF SUBTOTAL 1 BATH SE 78.00 Required only if fixture qty total is > 9 ,,0 2 BATH HOUSE 3250.00 TOTAL Zl - 3 BATH HOUSE $285.00 - (This fee includes all plumbing fixtures In the dwelling and the first •Mlnlmum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention 100 feet of sanitary sewer storm sewer and water service) -tlevlce which is $25 + e% surcharge **Ali New Commercial Buildings require plans with Isometric or riser diagram and plan review. I:tdstsVormstplumapp.doc 11/18/99 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: I: dstsformsVlumapp.doc 11/18/99 • 8/21/00 Activities for Case #: PLM2000-001 52 3:37:23 PM s • Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMA003 Application received 5/16/00 GEO RECD No Hold GEO 5/16/00 >► PLMA005 Create Permit 5/16/00 GEO DONE No Hold GEO 5/16/00 PLMA750 RP /Backflow Preventer 7/18/00 MRS FAIL No Hold MRS 7/18/00 require 24" depth PLMA7g9 Final Inspection No Hold GEO 5/16/00 PLMA050 (F) Issue permit 5/16/00 GEO DONE No Hold GEO 5/16/00 PLMA055 (F) Reprint Permit 8/15/00 ZZZ DONE No Hold ZZZ 8/15/00 , . f Page 1 of 1 CITY OF TIGARD 24 -Hour 'a 44 BUILDING Inspection Line: (503) 639 -4175 • INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested / ' 30 ~ o Z PM BUP Location /' 2- Z 2 0 S • cy , c e 5 J Suite MEC Contact Person Ph ( ) PLM Z 0 oo '° oo /4 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: • Ftg Drain /� ELR Crawl Drain u — — rw.�� Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing �) � /�5 � � ! /I /p S 71PS °��s' Insulation � ``__ �� Drywall Nailing 67 e/ .-�N ('e Qv04K -e ic., Fire Sprinkler � 7i O /id 'I 4 y 9 rot/ Sleti'� VP? flit-- Fire Alarm � -e _/� �� , v Susp'd Ceiling Roof i 47' h: S 9/-a /d a (07. -1✓e1QA Other: Final PASS PART FAIL J /,/, 1-rf ell„, A PLUMBING Post & Beam Under Slab �f Rough -In „J=2-e_ f7 e/ Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan _� 1 y€O ' 1 4 ) / 019p# , -e c �� j Other:�1 -P /0u 1�°✓i d e "ASS 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Date / 1a O - Inspector Z G die, Ext A pp oach/Sidewalk p Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested I —� AM PM BLD Location /ZZ 2d 54 " ' / Suite MEC G�vv r f Contact Person 1 1 Ph 53 -6w 6 ) 3 PLM �.�Ua - oo /S l�' 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 i Fire Alarm Susp'd Ceiling /11r L� _ �L ��40f = -� � Roof Misc: Final / PA FAIL ,PLUMBIN / / i_ ii ���/` 4°. 40 P os Beam Under Slab �� IS � Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART L MECHANICAL 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 [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ I Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date Inspector Other _ 1 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.