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Permit CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT F'ERM I T # PLM97 -0235 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06/20/97 PARCEL: 1S134DC -03000 SITE ADDRESS...: 11130 SW TIGARD ST SUBDIVISION ° CHERRY HILL ACRE TRACTS ZONING: R -4.5 BLOCK LOT :1 JURISDICTION: TIG CLASS OF WORK..:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE -CMS WASHING MACH 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP.. :E1 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)...: 1 WATER CLOSETS.: 0 WATER LINE (ft)...: 1 DISHWASHERS 0 RAIN DRAIN (ft)...: 0 Remarks: INSTALL FIRST 100 FEET OF WATER & SEWER SERVICE FOR NEW MODULAR BUILD., Owner: FEES TIGARD— TUALITIN SCHOOL DIST. type amount by date recpt 13137 SW PACIFIC HWY PRMT $ 60.00 GEO 06/20/97 97- 296259 TIGARD OR 97223 5PCT $ 3.00 GEO 06/20/97 97- 296259 Phone #: Contract or GORMLEY PLUMBING & HEATING 1715 LAFAYETTE AVE PO BOX 117 MCMINNVILLE OR 97128 Phone #: 503 -472 -4101 $ 63.00 TOTAL Reg #..: 000484 REQUIRED 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 Water Service In applicable laws. All work will be done in accordance with Misc. Inspection approved plans. This permit will expire if work is not started Final Inspection 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: /hl ++++++++++(( ��+++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ 06.118.'97 16:53 V503 684 7297 CITY OF TICARP 0002/003 CITY Or TIGARD Plumbing Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 97223 Date to P.E. (503) 639 -4171 Date to sr Permit - - 7_ 0 235 Print or Type Related SWR a Incomplete or illegible applications will not be accepted Caned Name of Development/Project FIXTh1 individual .•... " 1 - QTY ; . .'PRICE ' • _ . Job Aft“) /41 vNiC/-12 8ti11W /� /&, Sink _ 9.00 Address Street Address Suite Lavatory 1J13o 36J t/l.?l,eo sr 9.00 Tub or Tub /Shower Comb. 9.00 Bldg* City /State Zip Shower Only 9.00 T6•eD, (7/2 9 Name - Water Closet 9.00 - 7 /174,BD "TiAL/r /Af .0 /6T. Zr 7 j Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 1 / 3 7 S L 046w/ l/y Washing Machine 9.00 City/State Zip Phone i/ITA'0 aR 972Z 42o - /‘:.2p Floor Drain 2" 9.00 Name 3 9.00 FoLU[e/2 /o /DDLt loo/ 4- 9.00 1 Occupant Mailing Address Suite Water Heeler _ 9 00 S /o' s 3IAJ lit/AL/vu Laundry Room Tray 9.00 City /State Zip Phone 774 pe 9 722- _ 68Y- ZLYq Urinal 900 Namea,,„„„ ,3'p en, d,S4 Other Fixtures (Specify) 9.00 6 Pl u w16i.vj 4 himthve, - 9 Go Contractor Mailing Address Suite 9 00 J7/5 LAMy Ave- 9.00 (Prior to issuance City/State Zip Phone _ applicant must An4/p✓ww,llc, 02 97/ e' X 72 - WC / 9 00 provide all Oregon Const. Cont. Board Llc S Exp. Date gm contractors O J 9 ! e l / 3 017 7 Minor Labels 10 100 00 license Plumbing Lic. # Exp..Dale information '3 C •- 2.2. P8 , / /9 7 Sewer- 1st 100 i 30.00 30.00 for COT COT Business Tax or Metro # Exp. Date Sewer - each additional 100' 25.00 - database) hAargo b (awl, 12 4:7 /nl 1117 Water Service - 1st 100' 30,00 3o • op Name A Water Service - each additional 200' 25.00 Architect nv /l4 Storm & Rain Drain - 1st 100' 30.00 Or Mailing Address Suite Storm & Rain Drain - each additional 100' 25.00 Mobile Home Space 25.00 Engineer Gb /State Zip Phone Commercial Back Flow Prevention Device or And- 25.00 _ Pollution Device Describe work New ! Addition 0 Alteration 0 Repair 0 Residential Backrlow Prevention Device" 15.00 to be done: Residential 0 Non - residential f3 Additional description of work - Any'Trap or Waste Not Connected to a Fixture 9.00 7J /00 Pr or ()f rein k?.J 0 Catch Basin ` n f 9.00 ,SQ /' aceWCG Foe /�JL(,U WD/�LIu is g4.4 /0)/ Insp. of Existing Plumbing 40.00 per /hr Existing use of Specially Requested Inspections 40.00 building or property per /nr Rain Drain, single family dwelling 30.00 Proposed use of Grease Traps g 00 building or property /VFW IMODULAe- G/ft652o0wr f C.1 QUANTITY TOTAL Are you capping , moving or replacing any fixtures? Yes 0 No O. Isometric or riser diagram is required d 0 uomty Toisi is > 9 ' (If yes see back of form) *SUBTOTAL I hereby acknowledge that I have read this application. that the information 6o. or - given Is correct, that I am the owner or authonzed agent of the owner, and 6% SURCHARGE • that plans submitted are in compliance with Oregon State Laws. ' 3. • Sign 2 7 . Owner /Agent �� Date PLAN REVIEW 25% OF SUBTOTAL G %" v .v�/ 9/y7 Required only If Ordure qty, total 4 ? s TOTAL Coma arson Name Phone 4 6 3, or D � 0 _ -minimum permit fee is $25 + 5% surcharge, except Residential Badcflow 97Z y /0/ Prevention Device. which Is $15 + 5% surcharge 1. ldsismpImepp.doc 5197 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 97?719 AM PM BLD Location /,/30 771 L� s Suite MEC Contact Person Ph PLM '/ /� ? — O 3 Contractor Ph SWR BUILDING Tenant/Owner j4a / �T 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 /' r /J A ' Drywall Nailing M' vb j.r.2 7JIZ �7 j '�7/ ' 0 - Firewall Fire Sprinkler r � /'S e / YJ t /l4 4 / Fire Alarm Susp'd Ceiling / . �1 ./ 9dd-117 l /� Roof l� O�+' �4 41 -e.C) - e /Z'� % / t f Misc: Final PASS____EAT FAIL ING eam Under Slab Top Out (2/ Water Service L&Z/ Sanitary Sewer Rain Drains (}Ar l — PART FAIL ANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab 6.) Low Voltage \I . II 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 7/7/q/ Inspector Ext /' / Xi Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 3 0 0V CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 v \ A p DD ate Re uested 'JA AM PM BLD / / /3 v SG() ( I ke,- I Suite MEC D Contact Person Ph `� 9 7 - d 3 Sj Contrac Ph SWR i NUR% Tenant/Owner ELC c all CELR) / - C3/ ' 3 0 Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab D I6 ,6 Post & Beam Ext Sheath/Shear Ina mingth /Shear ThA q L ` 3 0 , Framing � `" �i' `7 CO Insulation 514)(Z..9')- O �7 J 5 • , _ . W/ , 99 S Drywall Nailing Firewall C-.-ti �� 7 _ D � 5 / 2// /4-9 Fire Sprinkler L:. (/r \ Fire Alarm Susp'd Ceiling Roof Miscue anal ART FAIL Post & Beam A.(9 Under Slab 11/1 Top Out G�i Water Service i Sanitary Sewer Rain Drains PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS P T FAIL ECTRIC Service v Rough In UG /Slab a i °� Low Voltage Fire Alarm , 0,5 4- in PASS PART FAIL RE Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk p Oth D Inspector Ext 1 S PART FAIL DO NOT REMOVE this inspection record from the job site. '1, /C6 CIT - OP TIGARD BUILDING INSPECTION DIVISION 24 -Ho r Inspection Line: 639 -4175 Business Line: 639 -4171 Cn uP' 17— CV Date Re uested AM PM q 770. BLD Location l (l O (fV \ r Suite MEC Contact Person Ph ` i C ? — Ova- 3S Contractor Ph SW 97 0 3 Tenant/Owner ELC Retaining Wall 4101 q 7 - S Footing Foundation Access: & �i r c S FPS Ftg Drain SGN Crawl Drain Inspection Notes: / 6 Slab Oc IT / 7 - 0 Post & Beam Ext Sheath /Shear Ina Sheath /Shear ��� ' /` ��� Framing f [. O ! Insulation r _1 Drywall Nailing AV "(., � lit r 0 (V g ' Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mis Final ) PASS RT FAIL Post & Beam Under Slab Top Out \`i V Water Service Sanitary Sewer Rain Drains anal SS 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 (TE2 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 Ap oac/Sidewa k l ✓ th r o ar c o h t k, flu.... Date - Th/ "i/ Inspector v Ext inaV w PASS PART FAIL DO NOT REMOVE this inspection record from the job site. N Date: /L(/ i iii ,�� �w�I1Ct : n 1 N. CITY OF TIGARD OREGON Address -_) Permit # To Whom It May Concern: RESEARCH iA 1�h1 1ti1 �,/ rCfv The permit listed above is currently inactive in our file and apparently went un- noticed, either by never being inspected or it failed and was never re- checked by one of our inspectors. Whether or not this be another attempt to make the required inspection, or the first attempt, {or} creating a new permit, it is the responsibility of the owner to make the necessary arrangements to obtain compliance and complete the inspection process. Therefore, you are hereby advised to make these arrangements as early as possible, but no later than 10- working days. I would be most please to assist you in any way that I can, but you must contact me to do so. You may reach me at 639 -4171 ext. 319 between the hours of 08:00 through 09:00 and at 3:00 through 4:00. If an emergency should arise you may page me at 955 -5665 during the remaining hours. Issue Date: /4/47 Original Notice Date: 7//-1/6 (See Inspection Card) Th / e following procedure shall apply: This is your - YFirst Notice- Make the necessary arrangements as mentioned above; Call 639 -4175 or for work without a permit(s) call 639-4171 Ext. 310 (Jeanne). _ Second Notice- Without consideration to the contents of the first notice, a re- nspection fee shall be assessed in the amount of $ , AND an investigation fee shall be assessed in the amount of $ . The investigation fee shall be 100% of the permit fee. All fees shall be thereafter doubled. TOTAL DUE: $ _ Third Notice- All fees mentioned above are payable before any inspection can be made. If arrangements are not made within 10- working days from the day of this notice, the City of Tigard Code Enforcement Agency will be notified and a Civil Infraction notification will be delivered to the principles in ownership of the above noted address. All prior fees shall be carried over and doubled and not withstanding any fees assessed by the Civil Infraction Notice. 2 NOTICE: DUE $ (2) = TOTAL DUE $ It is with my deepest appreciation, that you help in any way that you can to bring closure to this permit {or} lack of. If you wish to speak with me, please do not hesitate to call. Thank you for your patience and pro attention regarding this matter. Rick Bolen City of Tigard Inspector II • d. Tigard, OR 97223 ( 639 -4171 TDD (503) • `f I jp i2Y zr _ r. # . ":►�+':';� -- - - - - -- - `' _1_'° $ se..