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Permit CITY OF TIGARD - h�,� DEVELOPMENT SERVICES PLUMBING PERMIT - 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 ,PERMIT # : PL M98 -1003 DATE ISSUED: 10/21/98 PARCEL: 2S102CA -00940 SITE ADDRESS...: 13520 SW VILLAGE GLENN DR SUBDIVISION. • VILLAGE GLENN ZONING: R -4.5 BLOCK LOT °040 JURISDICTION: TIG CLASS OF WORK.. :ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE °SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:R3 FLOOR DRAINS 0 TRAPS : 0 STORIES • 0 WATER HEATERS • 1 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)...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Convert existing water heater to gas. Owner: FEES CHINMAYA SHRIVASTAVE type amount by date recpt 13520 SW VILLAGE GLENN DRIVE PRMT $ 25.00 GEO 10/21/98 98- 310169 TIGARD OR 97223 5PCT $ 1.25 GEO 10/21/98 98- 310169 Phone #: 620 -3566 Contractor OWNER • Phone #: $ 26.25 TOTAL Reg #..: 9XXX REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection 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 'A4-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issued By: 4 / � Permittee Signature: 4rhI ++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++'++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Permit Application Plan Check # 13125 SW HALL BLVD. Commercial and Residential Rec'd By TIGARD, OR 97223 Date Rec'd (503) 639 -4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit #rc`� - �oQ 3 Related SWR # Called Name of Development/Pr jest :FIXTURES '- „ -,..:: !;?,t- iQTY ',PRICE AMT, Job j 3 5 54ii t4-till e 4--e_Rx4ixe. Sink 9.00 Address Street Address Suite Lavatory 9.00 Tub or Tub /Shower Comb. 9.00 Bldg # City/State G� % Zip Shower Only 9.00 Name y AP 3 Water Closet 9.00 L.!frfri1iiii 5/7 ,9 r,4cf1- Dishwasher 9.00 Owner Mailing Address Suite Garbage Disposal 9.00 `91, Washing Machine 9.00 , City/State Zip Phone Floor Drain/Floor Sink 2° 9.00 Name 3" 9.00 5/9",/1 � 4" 9.00 Occupant Mailing Address Suite Water Heater conversion 0 like kind 9.00 Gas piping requires a separate mechanical permit. City/State Zip Phone Laundry Room Tray 9.00 Urinal 9.00 Name Other Fixtures (Specify) 9.00 Contractor Mailing Address Suite 9.00 9.00 Prior to permit City/State Zip Phone Sewer - 1st 100' 30.00 issuance, a copy Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date required if Water Service - 1st 100' 30.00 expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00 database Storm & Rain Drain - 1st 100' 30.00 Name Storm & Rain Drain - each additional 100' 25.00 Architect Mobile Home Space 25.00 or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 Pollution Device Engineer City/State Zip Phone Residential Beddow Prevention Device* 15.00 (Irrigation timing devices require a separate Describe work to be done: restricted energy permit.) New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial 0 Catch Basin 9.00 Additional description of work: Insp. of Existing Plumbing 40.00 per/hr Specially Requested Inspections 40.00 per/hr Rain Drain, single family dwelling 30.00 Are you capping, moving or replacing any fixtures? Yes O No O Grease Traps 9.00 If yes, see back of form to indicate work performed by QUANTITY TOTAL - P"" ' -'= .- fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or nser diagram is required if Quantity Total is > 9 40'u ' '''';'.;• WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL ° t a l I hereby acknowledge that I have read this application, that the information .°s3�'' : �a given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE " a €', that plans submitted are in compliance with Oregon State Laws. Wah 1 4: f. pl Signature of Owner /Agent Date '"`PLAN REVIEW 25% OF SUBTOTAL Wt Required only if fixture qty. total is > 9 4- : TOTAL ..- n � �� . 3k ,'- o /' Contact Person Name Phone j, ' = , u" 'Minimum permit fee is $25 + 5% surcharge, except Residential Beddow Prevention Device, which is $15 + 5% surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review I:\dststplumapp doc 7/2/98 1 6 PLEASE COMPLETE: Fixture Type . Quantity by Work Performed New Moved 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: I \dststplumapp doc 7/7/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ,� BUP k D-41 - /3/' �' ( r Date Requested � AM PM BLD Location 1 3 J 2,0 V 1 t eZ C L C - MEC Contact Person er J 5 �� Ph C� G rPLM % - /0o3 Contractor,) ✓1. e L n 2 A j fV"\& P-4 r4 --� b d 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 PASS PART FAIL U , ' B ' t - - os =eam \, , Under Slab Top Out - Water Service Sanitary Sewe - Rain Drains IQ 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 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 Date f � � Inspector 1/ i ' Ext Other Final . PASS PART FAIL DO NOT REMOVE this inspection record from the job site. ? CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP ✓ K t j 7 Date Requested lot T 3 ' r� AM j1 PM BLD Location / 9 7 '5 -0 5W Vy�I • p& J.4 Suite MEC Contact Person .) � � �I1 n 1'P-( Ph PLM fb n `ld e 3 Contractor kkia 9Ief • _ Ph Oa t/ g &&D 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 PASS PART FAIL Post & Beam Under Slab Top Out Water Service Sanitary Sewer R Drains 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 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 f johl Inspector / , Ext Final b PASS PART FAIL DO NOT REMOVE this. inspection record from the job site. • •