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.