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) •
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