Permit r; ,
CITY TIGARD PLUMBING PERMIT
o DEVELOPMENT SERVICES PERMIT #: PLM2000 -00305
'`� r'f II 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED:
SITE ADDRESS: 09830 SW VIEW TERR PARCEL: 2S111 BA -02100
SUBDIVISION: INGEBRAND HEIGHTS ZONING: R -3.5
BLOCK: LOT: 006 JURISDICTION: TIG
CLASS OF WORK: GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 1 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Water Service
FEES
Owner:
Type By Date Amount Receipt
KURTZ, JOSEPH F + MARCIA C PRMT JMT 8/18/00 $50.00 0004576
9830 SW VIEW TERRACE SPOT JMT 8/18/00 $4.00 0004576
TIGARD, OR 97223
Total $54.00
Phone 1:
Contractor:
CHRISTIAN PLUMBING
23172 SW STAFFORD RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone 1: 503 - 638 -8231 Final Inspection
Reg #: LIC 00042671
PLM 3470PB
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: // t _ ! Permittee Signature: 777
Call (503) X 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Plumbing Permit Application Plan Check #_________
13125 tW HALL BLVD. Commercial and Residential Recd B
TIGARD, OR 97223 \761 Date R c'6 5?"
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit # -pp303--
Related SWR #
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job Sink 11.50
Address Street Address Suite Lavatory 11.50
/Q"' 305Ga Vi'ul TRW- Tub or Tub /Shower Comb. 11.50
Bldg # City /State Zip Shower Only 11.50
Na Water Closet/Urinal (Specify) 11.50
0 er 4 2._ KC N 1 - 3 Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
a S 1.4i Vi tW "•' Washing Machine/Laundry Tray Zip Phone g ry Y (Specify) 11.50
`-1--6 o,;,Q 7 77 -. 6;-0 )7,' Floor Drain/Floor Sink 2" 11.50
Name 3" 11.50
4" 11.50
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit.
City/State Zip Phone MFG Home New Water Service 28.00
MFG Home New San/Storm Sewer 28.00
Name
c 5 h.,,' , n eo_ Ctf CW Pi i4 Hose Bibs 11.50
Contractor Mailing Address Suite Rain Drains 11.50
3 se" Rif-&4-et g Drinking Fountain 11.50
Prior to permit Cit S tate � Zip Phone Other Fixtures (Specify) 15.00
issuance, a copy Cr 146 972-06 77/- 9vy9
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if ya ( / 06- C3.-
expired in COT Plumb' Lic. # Exp. Date
'.,,
database P (3 vgo - O
Name Sewer - 1st 100' 38.00
Architect Sewer - each additional 100' 32.00
Or Mailing Address Suite Water Service - 1st 100' 38.00
}
Engineer City/State Zip Phone
Water Service - each additional 200' 32.00
Storm & Rain Drain - 1st 100' 38.00
Describe work to be done: Storm & Rain Drain - each additional 100' 32.00
New I Repair 0 Replace with like kind: Yes 0 No 0 Commercial Back Flow Prevention Device 32.00
Residential It Commercial 0 Residential Backflow Prevention Device' 19.00
Additional description of work:
N € w 34 v-tnc, Catch Basin 11.50
Insp. of Existing Plumbing 50.00
Are you capping, moving or replacing any fixtures? per/hr
Yes O No Iiil Specially Requested Inspections 50.00
If yes, see back of form to indicate work performed by per/hr
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain, single family dwelling 45.0
WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50
I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL
given is correct, that I am the owner or authorized agent of the owner, and lsometnc or nser diagram is required if Quantity Total is > 9
that plans submitted are in compliance with Oregon State Laws.
*SUBTOTAL w
Signature of Owner/Agent Date 56 6
Contact Per) n Name Phone V% SURCHARGE y t3it
77 /- 9 yy 9 ""PLAN REVIEW 25% OF SUBTOTAL
,1Wkl HOUSE 8.00 " r;,•" N:A� ° ;r `N °• ` Required only it fixture qty. total is > 9
2yBATH HOUSE 250.00 "'` w, "` aR` z F TOTAL �
BAT HOUSE 28 4 0 74,0 r ° , * 7
(This fee Includes all plum f xtu es in "the and the first '
"� 'Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention
0 feet efrani
0fal�r sewerb8to` , sewer end W 4; /lCe) ; _' , £ , Device, which is $25 + 7% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
plan review
1 \dsts\forrns\piumapp doc 7/19/99
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
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
1 \dsts \forms\plumapp doc 7/19/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171
BUP
�y7 Date Requested ?I �Z� —gyp AM PM
A I r BLD
Location q g ?) V) -ho l i'c1L Suite MEC
Contact Person a Q kir - Ph PLM RED --ere - FDs'
Contractor aim Ci��(ia -� Ph 7'7 / gy4/9 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
Roof
Misc:
Final /-5'
PASS PART FAIL _ - _-arAlrt��� / 1 . 1146 r
AMMUNG
Post & Beam
Under Slab /%It,/■al e . W �ra�
Top Out - —
Sanitary Sewer /
Rain Drains
Final
S PART FAIL
HANICAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk S
Inspector Ext )4)
Other Date I
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.