Permit CITY TIGA PLUMBING PERMIT
PERMIT #: PLM2000 -00451
s � �l� DEV w HO B r SER V I CES ) 639 -4171 DATE ISSUED: 1/25/01
SITE ADDRESS: 12730 SW WATKINS AVE PARCEL: 2S1026C -04200
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R -4.5
BLOCK: LOT: 031 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 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: 300 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of 300' of water service for development of minor land partition.
FEES
Owner:
Type By Date Amount Receipt
SAMUEL A GOTTER JR. PRMT CTR 12/12/00 $101.40 27200000000
12925 SW PACIFIC HWY 5PCT CTR 12/12/00 $8.11 27200000000 '
TIGARD, OR 97223
Total $109.51
Phone 1: 503 - 639 -1111
Contractor:
PERKINS PLUMBING
14060 SW 98TH AVENUE
. PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone 1: 503 - 684 -0905 Water Service Insp
Reg #: LIC 145776 Final Inspection
PLM 34 -379PB
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 calline 503) 246 -1987.
Issued By: i Permittee Signature: ' 4 G /` 1 , `'��
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Call (5 3) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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. Datctoceived: /a -moo Permit no.: clr o -:10 571
7 City of Tigard Sewer permit , Mates permitno.:
. ,� .�r d Address; 13125 SW Halt Blvd, Tigard, OR 97223 Projeet/agnLao.: Expired= ro
Cityof lgsai Him: (503) 639 4171
Fax: (503) 598 - 60 Date issued: By: 1 Reoeapto°.:
Land use approval; 1 ` a 6000 —0000 7 . cause file ao.: Pasaneat type: , a
a I th 2 family dwelling or accessary G Commesoialiindustrial 0 Multi-family . 0 Tenantiaaprovement
O New oonatztrodon . O Addition/atte /repIacrnent U Food service CI Otber
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PLUMBING PERMIT FEES:
' PRICE ' TOTAL New 1 and 2- family dwellings only: ' • '
FIXTURES (individual) QTY - (ea) AMOUNT ; (includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the first100ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection) '
One (1) bath $249.20
Tub or Tub/Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL •
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: ` New . - Moved ' "Replaced Removed/
permit. r Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
Hose Bibs 16.60 Tub or Tub /Shower
Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Fixtures (Specify) 16.60 Dishwasher
Garbage Disposal
Laundry Room Tray •
Washing Machine
Floor Drain/Sink: 2"
Sewer - 1st 100' 55.00 3"
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' ' 55.00 Water Heater
Water Service - each additional 200' ^ 46,40 Other Fixtures
U" (Specify)
T
Storm & Rain Drain - 1st 100' 55.00 N6/,q0
Storm & Rain Drain - each additional 100' 46.40 .
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL ' i '
Isometric or riser diagram is required if
Quantity Total is > 9
*SUBTOTAL ` • /01-ii/6
8% STATE SURCHARGE f yr
i Lb 5
**PLAN REVIEW 25% OF SUBTOTAL • f . _ :
Required ony if fixture qty. total is > 9 - - • _ •
TOTAL - ' t-141752";
i
* Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow
Prevention Device, which is $36.25 + 8% state surcharge.
** AU New Commercial Buildings require plans With Isometric or riser diagram and
plan review.
i:.dsts\forms\plm- fees.doc 10/10/00
ea tool
CITY OF .T�ARD BUILDING INSPECTION DIVISION '' ' '
24 -Hour Inspection Line: 639 -4175 •• Business L' . . • • 17 MST
BUP
C-05 Date Requested / g'
' ! A ) v i / p " M BLD
Location $ • r t '3 Lc) ciatreIA/S Suite MEC
Contact Person Ph t) — —77V 410 .td2O — 019.-
Contractor Ph SWR
BUILDING Tenant/Owner , ELC
Retaining Wall • ELR
Footing Access:
Foundation FPS
Ftg Drain . ) At " SGN
o
Crawl Drain Inspection Notes: —306 (�
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear r
Framing _ —1 -L —
Insulation 11
Drywall Nailing ✓ SS LA/Li2e,
Firewall l.(!
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS RT FAIL
PLU B
ost & Beam , t
-- Under Slab
:. Top Out
a
r:}-/ /
ter e
ant ary Sewer
Rain ! ains ` I
to -± 1
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 l Cr/61 , n -
Other Date / Inspector v �^ Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.