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Permit CITY OF TIGARD PLUMBING PERMIT r PERMIT #: PLM1999 -00431 fjli DEVE H B r S o E RV 2CES 639 -4171 DATE ISSUED: 12/16/1999 SITE ADDRESS: 10330 SW SCHOLLS FERRY RD PARCEL: 1S134A6 -03300 SUBDIVISION: ZONING: R -12 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing TI work, installation of (2) new lays, (2) new toilets, (1) new drinking fountain, replacement of (1) like kind water heater. Capping (2) showers, (1) washing machine and (1) laundry room tray. FEES Owner: Type By Date Amount Receipt MUSLIM EDUCATION TRUST ISLAMIC PRMT KJP 12/16/199E $69.50 99- 320488 PO BOX 283 5PCT KJP 12/16/199E $5.52 99- 320488 PORTLAND, OR 97207 Total $75.02 Phone 1: Contractor: CARROLL MECHANICAL CO 2305 SE 50TH AVE PORTLAND, OR 97215 REQUIRED INSPECTIONS Top -out Insp Phone 1: 231 -3842 Reg #: LIC 00033043 Insp existing /capped fixtures PLM 26 -250pb 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 these rules or direct questions to OUNC by calling (503) 246 -1987. / _ Issued By: ` Permittee Sign. Ire• " '� Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busi 4s day CITY OF TIGARD Plumbing Permit Application Plan C eck# 13124 SW HALL BLVD. Commercial and Residential Rec'd TIGARD, OR 97223 Date Rec'd a -a-99 (503) 639 -4171 Date to P.E. Print or Type Date to 14T -- Incomplete or illegible applications will not be accepted Permit # r.M1999-a Related S s ,f � �� &AP r e 9 - b05// Called 4V/. /d(vtf57 Name of Development/Project FIXTURES (individual) QTY PRICE AMT J _ Sink 11.50 Address Street Address Suite Lavatory A 11.50 25,00 /03.7 Sw S'chOlS c Tub or Tub /Shower Comb. 11.50 Bldg # City/State Lip Shower Only 11.50 c OR Name �� Water Closet/Urinal (Specify) 11.50 aa ®Q S c Ct, S Gt.0 i>"C Dishwasher 11.50 Owner mailing Address pp Suite Urinal 11.50 Po �OO( ,-9 3 Garbage Disposal 11.50 City/State Zip Phone Laundry Tray 11.50 >ll/a,4 06Z 9 v 8 -375 Name Washing Machine /Laundry Tray (Specify) 11.50 /2/), Floor Drain /Floor Sink 2" 11.50 Occupant M i ng Address G� Suite 3" 11.50 - o o'.XC °`Z? 4" 11.50 G o %1 l Q Zip c9 7 - Water Heater 0 conversion like kind _ 11.50 /Name Gas piping requires a separat mechanical permit. / �� `Gl� IL Co#1) >s (A..CfoZr r, -Tl C MFG Home New Water Service 28.00 Contractor Mailing Address Suite MFG Home New San /Storm Sewer 28.00 _ S' -E C0 1-11- Pt V‹- Hose Bibs 11.50 Prior to permit City /State Zip Phone �i /, q Roof Drains 11.50 issuance, a copy ,) o I S �'2 ' f O `/-C `/� 7�` Drinking Fountain / 11.50 ii, 5 of all licenses are Oregon Const. ont,Board Lic.l #.. Exp. Date required if .?4C7( 5 /a3 / Other Fixtures (Specify) 15.00 expired in COT Lic. # M Ex Daje database - 950 AS 4p,,5p / (�Q Name Architect 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 0 Commercial 0 Additional description of work: Commercial Back Flow Prevention Device 32.00 Residential Backflow Prevention Device' 19.00 Catch Basin 11.50 Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 Yes 0 No 0 Inspections per/hr If yes, see back of form to indicate 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 // w , I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required d Quantity Total is > 9 Cl/ given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with Oregon State •S UBTOTAL Laws. /09,5E Signature of Owned, • ent Date 8% SURCHARGE ConUct Pers ' n amen Phone t o .ice ,_.)0..\\Q-ck ^ 6 , 8 30°.0 "PLAN REVIEW 25% OF SUBTOTAL ` 1 BATH HOUSE $178.00 , ; y,: Required only if fixture qty. total is > 9 TOTAL o-� @� 2 BATH HOUSE $250.00 ,' , ;; - 75' 3 BATH HOUSE $285.00 .- ' - `- 4 ... + ' . (This fee includes all plumbing fixtures in the dwelling and the first *Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention 100 feet of,sanitary sewer storm sewer and water service) -'s;: Device, which Is $25 + 8% surcharge "All New Commercial Buildings require plans with Isometnc or riser diagram and plan review I 1dsts1formskplumapp doc 1011/99 - - PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed /Capped Sink ' - Lavatory & Tub or Tub /Shower Combination Shower Only a_ Water Closet Dishwasher Urinal Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Other Fixtures (Specify) - - 1 . 4 _ 4 1 , 4 , 1 6)1-e nrrel COMMENTS REGARDING ABOVE: • I %dstsUormslplumapp doe 10/1/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 c / BUP Date Requested is /o 9 AM PM BLD Location ( 6 33 0 Sr,J S 1 ( . 0 (1S 0c,/ Suite MEC Contact Person OD h f id( I U-C CAArk ,t v Ph 2 5/ - 3 & "74 ? - PLM /5 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 Fire Alarm Susp'd Ceiling Roof Misc: Final PART FAIL PLUMING) Post & Beam Ia' eThZA `" (/)L — op Out Water Service Sanitary Sewer Rain Drains Final S, PART FAIL 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 [ ] 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 0 Other Date Inspector Ext Final PASS PART FAIL D • NOT REMOVE this inspection record from the job site. iqc 9 -c6f1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Vi Requested O 0 AM PM BLD Location 16330 3 t1 t2A S 'Ce uite MEC 1 7'1 - c:O5 I / 0 Contact Person Ph i, ► i l e N -C)() y 3, Contractor Ph SWR BUILDING Tenant/Owner \ US A 1-4 - VCXAL4A,\ i 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 Fire Alarm 1 / . 7 - Susp'd Ceiling I Roof ' effr? • Misc: / Final 0 ' PASS PART FAIL f „�, ” .. N� fir", Post & Beam Under Slab Top Out Water Service Sanitary Sewe Rain Drai : 4 : 2 -`S PART IL HANI Post & B eam „. '� i, ,. 0% Rough // ,, •• 0 Gas Line W%p Smoke ? . - r$ N' PART ECTRICAL Service Rough In \ UG /Slab ( 7 Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading _____--Y 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 t I Date Inspector Other Ext Final PASS PART FAIL DO NO REMOVE this Inspection re ord from the job site.