13578 SW HILLSHIRE DRIVE-1 I
h�
rA
W
U1
v
OD
2
H
r
r
Ln
a:
H�77
lam]
H
I
i
13578 SW HTLuSHIRE DRIVE
w�
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Busiress Line: 639-4171
OUP _
_Date Requested / I� AM PPA BLD _
Location 6-k�kl -e_� _ Suite MEC
Contact Person �l✓l t:t_[ 4��-- Ph PLM 1 �- O0 3S
Contractor Ph ��: -��.��/ ��-- SWR
6UILDING _ Tenant/Owner ELC _
Retaining Wall — ELI _
Footing Access:
Foundation FPS
Ftg Drain SIGN
Crawl Drain Inspection Notes: ' --
SI&b -------—�XrL_� � Sir
Post& Beam --"
Ext Shealh/Shear
Int Sheath/Shear
Framing .---
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fi,a Alarm
Susp'd Ceiling _
Roof
Misc. —
Final
PASS PART FAIL ------
Post & Beam
Under Slab
Top Out
Water Service _
Sanitary Sewer
Ram' Drains
ASS PART FAIL
MECHANICAL
Post&Beam --
Rough In
Gas Line - —-------- - --
Smoke Dimpers
Find; —
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab —
Low Voltage
Fire Alarm _ _ —
Final
PASS PART FAIL —SITE
BackfillZrading
Sar.tary Sewer
Storm Drain [ ]Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hm'l Blvd
Catch Basin ( j Please call for reinspection RE: _ ( j Unable to inspect-no access
Fire -pply Line
ADA
A roach/Sidewalk
Otiher Date —Inspector �LI - Ext!
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
/�. CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM1999-00'57
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED:
SITE ADDRESS: 13.78 SVV HILLSHIRE DR PARCEL: 2S104CD-02900
SUBDIVISION: HILLSHIRE ESTATES 'ZONING: R-7
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW. PREVNTRS: 1
O!'CUPAVI'Y GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: C HER FIX' ORES:
Tl1BISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DR�,'N: ft
Remarks: Installation of a residential backflow prevention device.
` FEES _
Owner: — !,a
--'---- Type By Date Amount Receipt
JOHN HOWELL PRMT I)ST 10/29/199 $25.00 99.319419
13578 SVV HILLSHIRE DR
TIGARD, OR 97223 SPOT QST 10/291199S $2.00 99-319419
Total $27.00
Phone 1:
Contractor:
OWNER
REQUIRED INSPECTIONS
RP/Backflow Preventer
Phone 1: Final Inspeciion
Reg #:
0 \ I A L
This permit is issued subject to the re.40ations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work wil 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: . '' Permittee Signature�� ,1 r �
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Plan Check#
CITY OF TIGARD Plumbing Permit Application
13125 SW HALL BLVD. Commercial and Residential Recd By.
TIGA,RD, OR 97223
(503) 639-4171 "` Date to P E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#-Related SWR#
Called_____.__
i Name of Development/Project FIXTURES (individual) — QTY PRICE AMT
Job Sink 11 50
Address Street Address Suite Lavarory — _ 11.50
13h-l2 %t.w Htw)HIPC P,rJE Tub or Tub/Shower Comb. 1150 _I
Bldg# City/State Zip Shower Only 11 50
P VA k6) f 71--3 `Vater Closet/Urinal (Specify) 11 50
Name —
,�F, ljew�C� Dishwasher _ _ 11.50
Owner Mailing Address Suite Urinal 11.50
ti E- 1" R ayrnis Garbage Disposal 11 50
City/State Zip Phone Laundr/Tray 11.50
Name Washing Machine/Laundry Tray (Specify) 11 50
Jr ,l /,,/ tic �e t4— Floor Drain/Floor Sink 2" 11.50
Occupant Mailing Address Suite 3" _ 11.50
,,AHu A•, Atk'L'E'
4" 11.50
City/State Zip Phone —
Water Heater O conversion O like kind 11 50
Name Gas t 'ng requires a separate mni
echaralrm
peit. _
MFG Hc:ne New Water Service _ 32 00
MFG Home New San/Storm Sewer 32.00
Contractor Mailing Address 5vite
Hose Bibs 11.50
Prior to permit City/Slate Zip Phone Roof Drains 11.50
issuance,a copyF
Dr11 50 inking ountain
of all licenses are Oregon ronsl,Cont Board Lic# Exp.Date 15.00
required it Other Fixtures(Specify)
expired in COT Plumbing Lic.# Exp Dale _
database
Name
Architect _ _ Sewer-isl 100' I
38 00
Or Mailing Address Suite Sewer-each additional 100 i 3200
Water Service-1st 100' — 3800
Engineer City/State Zip Phone —
Water Service-each additional 200' 00
Describe to be done — Storm 8 Rain Crain• 1st 100' 38.G
e
Ne ep ' O Replace with like kind. Yes O Nn O Storm&—Rain D ain-each additional 100' 3200.
Residen tat 0, Commercial O Commercial Back low Prevention Device 3200
Additional description of work j -- 19 00
Residential Backflow Prevention Device' 1
Catch Basin v 11 50
Are you capping,loo,;ng or replacing any fixtu:es? Insp of Extsting Plumbing or Spatially Requested 5000
Yes J No O Inspectionsper/hr
If yes, see back of form to indicate work perform,,d by Rain Drain,single fancily dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT Fl�TURE Grease Traps 11.50
_WORK COULD RESULT IN INCREASED SEWER FEES. _ QUANTITY TOTAL
I hereby acknowledge that 1 have read this application,that the information Isometric or riser diagram is required d Quantity 1'otal is >s _
(liven is correct that t am the owner or authorized agent of the owner,and -- --"SUBTOTAL
that plans submitted are in compliance with Oregon Slate Laws pC 7
Signature of OV1) r/A nt Date -- —
f� 8% SURCHARGE
Contact Pers n Name Phone — — '--
�clltJ „JctL 5 24 "PLAN REVIEW 25% OF SUBTOTAL I
1 BATH HOUSE$178.00 R^ ”" J only A fixture qty tote is�-9
2 BATH HOUSE$250.00 TOTAL
3 BATH HOUSE$285.00 —
(This fee Includes all plumbing fixtures In the dwelling and the Hrst *Minimum perrolt fee Is$50+8%surcharge,except Residential Backflow Prevention
100 feet of sanitary sewer storm sewer and wale,service) .. Device,which is$25+8%surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
plan review
I%dsrslformslplu napp doc 10/8/99 -
PLEASE COMPLETE:
Fixture type Quantity by Work Performed
NgW Moved Replaced Removed/Capped
Sink
Lavatory—____- —_— ---- - -
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Urinal---- --- - —
Gaibage Disposal
Laundry Room Tray
Wa!,hing Machine
Floor Drain/Floor Sink 211 _—
411
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I V.1slsVormslplumFpp,cv:101Hf?