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9055 SW MOUNTAIN VIEW LANE i '+ -- NI M3IA NId1NnOW MS 5506 e Lo 1 z r Z �L a A o. f ac 3 a� c� W J 9055 SW MOUNTAIN a IEVi LN CI)rYY OF TIGARD BUILDING SNSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ` BUP d/ r t Date Requeste ) (y 'AM PM — l BLD Location �1U�J S�✓ /17 E1L� '� L) 4✓ L w Suite MEC C-, Contact Person _ Ph ✓?� Yd G PLM Contractor Ph 3WR BUILDINO Tenant/Owner _ ELC Retaining Wall 11.R — ss: Footing Acce Foundation I FPS — Ftg Drain SGN Crawl Drain Inspection Notes: -�— Slab SIT Post&Beam Ext Sheath/Shear L ___-- Int Sheath/Shear Framing Insulation Drywall Nailing _ —__.. -� - --------- ------- Firewall Fire Sprinkler --— ---------- -- - Fire Alarm Susp'd Ceiling �-�--�"�� a -• ------ Roof �1 O.R'��.(' 1 -.L 1\ el —.. Misc: _ - --- Final — PASS PART FAIL ----- — ---- -------- -- PLUMBING _ Post&Beam Under Slab - Top Out Water Service Sanitary Sewer — Rain Drains Final RT FAIL __-- MECHANIC ; n,t& Beam -- Rough In Gas Line - Smoke Dampers in SS ART FAIL CAL --- -------- - e• ServiceIt H Rough In — - N UG/Si�-!) --- - -- — _--.�-_ --- ----- _ — LrwVoltage Fire �� ------ - — J Fire Alarm -. -- Final PASS PART FAIL ----- J SITE — --- -- --- - — Backfill/Grading - Sanitary Sewer Storm Drain [ J Reinspection fee of$ _ _—v 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 Dwe }t`j Inspector Ext Other -- — — Final PASS PART FAIL DO NOT REMOVE this inspectio record from thm lob site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 6394171a,( -- BUP 1 Date Requested_ AM PM BLD Location— (.(J Lt'.�C �^ Suite ', MEC Contact Person ALL 41-,1,3. YPh �A y y ff6)_ PLM -� �'Oy�0'7 Contractoe Ph __ SWR BUILDING Tenant/OwnerCLC Retaining Wall ELR Pouting ACCe33: �� '7 Foundation FPS Ftg Drain �- Crawl Drain Inspection Notes: SIGN - Slab SIT Post R Beam Ext Sheath/She.rr _ Int Sheath/Shear - Framing _ A_ Insulation Drywall Nailing _ Firewall Fire Sprinkler —_- -_ - Fire Alarm Susp'd Ceiling —_— Roof Misc Final PASS PART FAIL — NG Post&Beam �" — ------ - Under Slab TOD Out a er Servi�� Sanitary Sewer - Rai:i Drains A PART FAIL MECHANICAL Post&Beam --–— --- ---- — - - Rough In Gas Line ----- - --- --- _ -- Smake Dampers Final - — PASS PART FML ELECTRICAL -- -- ----_--� — - - -- 4. Service Rough In I- UG/Slab Low Voltage - --� - Fire Alarm 'j Final m PASS PART FAIL W SITE J Backfill/Grading �-"-� - - - -----------__ _ Sanitary Sewer Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ( ]Please c II for reinspection RE: ( ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Other Date inspector � �Ext Final _ PASS PART FAIL O NOT REMOVE this Inspection record fnm the Job s1te. CITY OF T I G A-R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT 0: PLM2000-00307 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: PARCEL: 2S1 I lAB-00301 SITE ADDRESS: 09055 SW MOUNTAIN VIEW_N SUBDIVISION: ZONING: R4.5 BLOCK: LOT: 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: It WATER CLOSETS: WATER LINE: 140 It r)ISHWASHERS: RAIN DRAIN: It RF marks: 140 Ft. water service F��s _ Owner: FEES By Date Amount Receipt WOODWARD, ERIC E + CHARLOTTE M PRMT JMT 8118/00 $70.00 0004579 9055 SW MOUNTAIN VIEW LN 5PCT JMT 8/18/00 $5.60 0004579 TIGARD, OR 97224 Total $75.60 Phone 1: Contractor: BRUNER PLUMBING rO BOX 23035 TIGARD, OR 97281 REQUIRED INSPECTIONS Phone l: Final Inspection Reg#: LIC 81837 PLM 26-445PB a ac U) L m This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. W Specialty Codes and all other applicable laws. All work will be done in accordanoe with approved plans. J 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. J Issued By: _ I ( )y Permittee Signature: _ -- Call (503 639-4175 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 eyc ' TIGARP, OR 97223 Date Reel. (503) 639-4171 Date to P.E. Frint or Type Date to DST Incomplete or illegible applications will not be accepted Rermill�>Xao-3o7 Related SWR _ -- ---- Called - Name-of Clevetopment/Prolect FIXTURES (Individual) QTY PRICE AMT Job Sink 11.50 Address Street Address Suite Lavatory 11.50 J Tub or Tub/Shower Comb 11.50 Bldg* City/Stale Zip Show^r Only -�� 11.50 Name Water Closet 11.50 CC__ Urinal 11.50 Owner iv %ling Address }� �uifie Dishwasher 11.50 (r I7 S S S [A) Mew til' V 01) �I`r Garbage Disposal 11.50 4 City/State Zip V l one �9 p Laundry Tray - - -- 11.50 Name �0 / Washing Machine/laundry Tray 11.50 Fluor Drain/Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11.50 _ - t" 11.50 City/Slate Zip Phone Water Heater O conversion O like kind 11.50 Names Gas piping requires a separate mechanical permit. MFG 4ome New Water Service 32.00 Contractor Mailing Address l/C 'Osuite) MFG Home New San/Storm Sewer 32.00 p O, t6"X e 3 7 F�;- Hose Bibs 11.50 Prior to permit City/State Zip Phone Roof Drains 11.50 issuancr,,a copy cw, 72-b' bLo/ 'Pro Drinking Fountain Fountain 11.50 1f all licenses ereOreg Const.Cont.Board Lic.# Ex to - required f1 I a Other Fixtures(Specify) 15.00 expired in COT Plumbing 1-Ic.0 Exp.Path database 2 G y y S_ 31 0 I Name Architect Sewer-1st 100' 38.00 or Mailing Address Suite Sewer-each seditional 100' 32.00 City/State Zip Phone Water Service-1st 100' (� 38.00 Engineer Water Service-each additional 200' 32.00 Describe work to be done: Storm&Rain Drain-1st 100' 38.00 New O Repair es Replace with like kind: Yes O No O Storm 6 Rain Drain-each additional 100' 32.00 Residential O Commercial O Additional description of work: _ Commercial Back Flow Prevention Device 32.00 Residential BeckBow Prevention Device" 19.00 Catch Basin 11.50 Q. Are you capping,moving or replacing any fixtures? Insp.of Existing Plumbing or Specially Requested 50.00 Yes O No O Inspections perfhr If yes,See back of form to Indicate work performed by Rain Drain,single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 H WORK COULD RESULT IN INCREASED SEWER FEES. --- QUANTITY TOTAL r 1 hereby acknowledge that I have read this application,that the information Isometric or riser diagiarn is required M Quantity Total Is >9 given Is correct,that I am the owner or authorized agent of the owner,and that plans submitted are In compliance with Oregon State Laws. 'SUBTOTAL OD , 0 Signature of Own ant Date - -- -- - W �l.g! _��, 8 v ,, 8%SURCHARGE Contacy Person Narrp _ Phone L v G S/ r ,� ,1 � "PLAN REVIEW 26%OF SUBTOTAL Requked only N nature qty.total Is>9 1 BATH HOUSE 1178.00 _ `, ! TOTAL 2 BATH HOUSE$260.00 3 I,ATH HOUSE$285.00 t Js fee Includes all plurnbin -Minimum permit t ae is$50+8%surcharge,except Re~sI Baekfknv Prevention teAt 01 senkary amt dt0 Device,which Is$25+8%surcharge "All New Commercial Buildings require plans with isomeW or rfw disgram and pian review. I Mtslformslplumspp doc 11118/99 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink Lavatory — 'rub or Tub/Shower Combination Shower Only Water Closet Urinal Dishwasher Garbage D:-tposal Laundry Room Tray 4 Washing Machine Floor Drain/Floor Si 2" Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: a m — --- 5 W NepvonnNpkrrupp.doctvteroo CITY OF TIGARD, MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2000-00392 13125 SW Hall Blvd.,Tigard,OR 97223 (503) 639-4171 DATE ISSUED: 1012100 PARCEL: 2S 111 AB-00301 SITE ADDRESS: 09055 SW MOUNTAIN VIEW LN SUBDIVISION: ZONING: R-4.5 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR. FLOOR FURW EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOIL.EHS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE !� 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15-30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 -50 HP: Wir,)"'TOVES: GAS PRESSURE: 50+ HP: CLL' r -'ERS: FURN < 100K BTU: AIR HANDLING UNITS TS: OTHER UNITS: FURN >=100K BTU: <= 10000 cfm: 1 GASER UNITS: > 10000 cfm: Remarks: Installation of air h,...idling unit and heat pump. Placement of heat pump unit must comply with standard setback requirements. Ower: _ FEES WOODWARD, ERIC E + CHARLOTTE M Type By Date Amount Receipt 9055 SW MOUNTAIN VIEW LN PRMT CTR 1012100 $72.50 2720000000 TIGARD, OR 97224 5PCT CTR 1012100 $5.80 2720000000 Phone: Total $78.30 Contractor: AIRE-FLO HEATING+ AIR CONDITI 1601 SE RIVER RD HILLSBORO, OR 97123-5040 REQUIRED INSPECTIONS Mechanical Insp Phone:640-3607 Heating Unt Insp Reg#:LIC 00052098 Final Inspection a at I— J_ m W This permit is issued subject regulations contained in the Tigard Municipal Code, State of Ore.Specialty Codes _J and all other applicable laws. will be done in accordance with approved plans. This permit will expirk if work is not started within 18% days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9180. 156ue By: �� Permittee Sigreiure: r - Call (503)63941751 by 7:00 P.M.for inspactions needed the next business day Mechanical Permit Application Date received: /o Permit no.:"f e� do (City of Tigard Project/appl.no.: Expire date: Otvo/T%xard Address: 13125 SW Hall Blvd,Tigard,OR 97223 �� Phone: (503)639-4171 Date issued: /0 9 - B Receipt no.: Fax: (503)598-1960 Case file no.: Payment type: ' and use approval: _ Building permit no.: ;LU1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement w construction U Addition/alti-ra(ion/replacement U Other: dress; 0 55 E v "N J:e') l n.-�_ Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: value of all mechanical materialb,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ Lot: Block: I Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: Description and location of work on premises: -Ll. ., We N�•�lR✓ �•,J IJ.�t Pa, r+ �n1 s, t. .rt+ctL Fee(ea) Total Est.date of completiontinspection: I() Dent Res.only Res.only Tenant improvement or change of use: Is existing space heated or conditioned?01 Yes U No rMndlin CFM_^ con urn,. 'elanrequired) Is existing space insulated?A Yes U No I trenoT 'ir HVACsyatem millail� or er comptearors Business name: State boiler permit no.: HP —Tons BTU/H Address: loo 1 c.nar A, i smo e damprii7ductsmo a detectors City: IA i U ba-b State: (, 7 ZIP: 12 _ eat pump 3 s le plan re ur ) Phone:to 110-3 h 0Fax: E-mail: nate rrp ace umac umer Including ductwork/vent liner U Yes U No _CCB no.: -0 nste replac re ocateheaters--suspen , City/metro lic.no.: wall,or floor mounted Name(pleaseprint): 6 n o D 3 0 o ti- ent fora iance other than furnace e erat , Absorption units BTU/H Name: pn Fe'Nn Chillers_, ___ HP Address: I(o 0 i (�;J tf( Compressors A HP Favironmentalex amt a vesnt toe: City: III.Ls c rD State:QC ZIP: 1 2 3 Appliance vent Phone: Lot)0- to Fax: E-mail: erex aust — s,Type res. itc a azmat n hood fire suppression system Name: /�t L v'�}t W O o(► 3-, Exhaust fan with single duct(bath fans) _ IL Mailing address: Q T S ,t ;�w r,e_ Exhaust a stem a art F-5mfiie nor AC F City: i �� Stale:0 f ZIP: 4 7 2 2 I Fluel T e:piping a LPG NG nd distribution p to outlets) U) Phone: 8 - o Fax: E-mail: y Ort uc l m eac a rt one over outlets rocesa pipftg(schematic requi ) -� Name: Number of outlets m t appy or egndpmcn�: (5 Address: Decorative fireplace y _ W City: State: Z1P: Insert--IM, Phone: Fax: E-mail: Woodstovc/pellet stove Applicant's signature te: )0-2--2,, r' Name (print): Not all jurisdictions accept credit cards,please call jurisdiction ra mare intarrrtarlat. Permit fee.....................$ _ O Visa U MasterCard Notice:This permit application Minimum fee................$ 7A;317` expires if a permit is not obtained &G credit card number_ _ / / Plan review(at __ %) $ ,_:,T. Expires within 180 days after it has been State surcharge(896)....$ _ Name or cardholder as sttown on credit card s accepted as complete. 7 TOTAL _ . • Cardholder signature Amami 11041617(6+KIWOM) Commercial Schedule 1R2 Family Dwelling Schedule ASSUMED VALUATIONS PER APPLIANCE04111100 ----- -- --- Furnace to 100,000 BTU Table IA Mechanical Cott _ - - oty Prk* Tota includingducts R vents 955 t)Ftlmxe M 100.640 RTU !c tx p duds 6 vents --- ---- -14.00 _ FUmaod>100,000 BTU 2) Funace 100.000 BTU- Ox" TU• Oxlud_in�duds 6 vents 17.40 _ includind ducts&vents 1,170 )MoeFurnace wM 1400 floor fum ce 4) suspenel"hen«.wall healer --- -- - including nt 955 or am"101N1+"`r NOW -- 14 00 suspended eater,wall healer 5)vont flat tnotuded h aP1niance pemNt_ _ e:90 or floor mOu ted healer 955 a anb _ 12.15 Vent not incl ed in appliance unit 445 014`6 s1"apgy � � Heal Ak- PP Pe Fo.Mems 7-10.Mee a PwM Coad Gly Pane Total 1"Umles 1.2 Repair units 605 7)<a140-:bseeb inti to -- <3 hp;absorb It 100K BTU _( _ 14.00 - 5)3-15 t1P:absorb will - l0 1 GOk BTU 955 took to 5"BTU __ _ 25,40 3-15 hp;ahsorb.un 9)15-90 Hr.*bomb _ wM.5-1 m1 BTU95.00 101k to 500k BTU 1700 10)30-96 No. un4 1-1.75 loll BTU 52.20 15-30 hp;absorb.unit I+)>5a+P.absorb una>+75 nA ATU - -- 501 k to 1 mil.BTU 231 ---- �7 _ 721 AN MnAMq unX to 10,000 C,FM 30-50 hp;absorb.unit - 10.00--. 19)is n.ndlh0lmlt 10.000 M. 1-1.75 mil.BTU -- 00 17.20 >50 hp;absorb.unit 14)tdaara!+abh er.peune aDekr 10.00 >1.75 mll.BTU 5725 15)Vent tan emmled to a skVM dud -- - __ ease Air handling unit to 10,000 dnh 656 +5)vuw4af on`iyat«n notincluded in n.0e1 - Air handling unit>10,000 dm 1170 17)aooWsen by nadlankuust al eM --- -_ I 11 - Non-portable evaporate Collor 656 1e oe,.wsnc k.�x,ernmi---------- 10.00 _ 1 vent fan connected to a single dict 446 17.40 - -- - Ven19)Commwdd of l dustr4l type hcIm"Mor t syst.not Included in appliance 656 59.95 Hood served by mechanical exhaust _656 20)otrb`w ks,wK*Adk10 WOW.+ores 10.00 000 - Domestic Incinerator 1170 21)Gas Pd11n9one is fim-ankh` - - 5.10 Commercial or Industral In-------- 4590 22)%4m,than 44W ouan teidt) I Other unit,Including wood stoves serts,etc. _ Mlntmwn Penna Fea 72.50 --- SUBTOTAL Gas plping 1 outlets M 3 -�0%. oe Each additional ouUel 63 PUN REVIEW 25%oAI. Raqulred Mr Alt.commemlaJy \ tkhsr Mpenoo4 sM Fen: 1 kopecYaw siaftls of,-,w bunt.is,nus(-*Yeum dw9e4aro ho-►6) 172 at per haw 2 tnapr/ons Im WWI M 100 h sp ANESM Ob"601("W* en r!mllehse lnul s7:soo«how 2 Aaesar Pyr w.4n+wree+Y aanMs.aeM1:n.M"rlsbrt.n Mr+(R+Nn.nn 12 IlOpt _ _ ____ \it;C�p1YaAel P41s=C*fv IMM�aisgired d $I.QOtoS5000.00 Minimum$72.50 ___.. ---- -� ^�'A'Cr0au"of plan "°"°'"'"." "1dI. � � 55,001.00 to 510, .00 � 572.50 for the first 55,000.00 end 51.52 for � each additional$100.00 or fraction thereof, i to and including$10,000.00 m $10,001.00 to 525,000.00 $148.50 for the first$10,000.00 and 51.54 a for each additional S100.00 or fraction J thereof,to and including$25,000.00 $25,001.00 to S50,000.00 -� $379.50 for the first$25,000.00 and$1.45 for each additional$100.00 or fraction thereof,to and including$50,000.00 550,000.00 and up 5742.00 for the first$50,000.00 and$I. for each additional$100.00 or fraction dtereof r I a 0 z 0 U1 n. f- a� sa��055 Sw ►�+� �;�,, L�rv_ CITY OF TIGARD DEVELOPMENT SERVICES PLUMBING PERMIT 13125 SW Hag 81vd.,Tigard,OR 97723 (503)63y4171 PERMIT #. . . . . . . c PL.M9A--Q11.77171 1.77 DATE ISSUED: 06/19/98 PARCEL: ?S 1 i l Ata-oo.i01 Tr raDnR''SG. . . : 09055 SW MOUNTAIN VIEW LN In IVISTON. . . . : ZONING: R 4. S SCK. . . . . . . . . . . I.-OT. . . . . . . . . . . . . : J(JRISDTCTION: TIC; ":^C OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME JPACCS. : 0 "'Pr OF ll.SF. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 1 "rlJ�'ANC1' GRE'. . : R3 F(..OGR T.mAT.NS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . . 0 'ORIF . . . . . . . . : 0 WnTER HEATERS. . . . . : 0 CATCH BASING. . . . . . . : 0 XTURES--.-•-- ---- --- - LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 lNKS. . . . . . . . . 1 0 l►RINAI..S. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . : 0 :VATORIES. . . . : 0 OTHER rIXTURCS. . . . : 0 '.iS/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 WOT17R Cl..Oi9C'7S. - 0 WATER LINE (ft ) . . . : 0 T.,SHWASHF'RS. . . . : 0 RAIN DRAIN (ft ) . . . : 0 Remar-ks : Arid residential backflow pr•eventinn device. Fnpv,: .____-_...-._-_.._._...._---.-_.---__--__-_..-_____-----.-.....,...._._..._..._-_-_...___ FEES TICK W(IODWARD type amount by date rvcpt ��155 SW MOUNTAIN VIEW LN PRMT 15. 00 GEO 06/1.9/9R IiS-306710 ' .SARD OR SPc'r s 0. 75 GEO 06/ 19/98 98-306710 +oy'e #: ,WN Tn E-ARTIA '!RpmnTION .775 SW r-,PrTFIr.. HWY CARD OR 972-2..� -.a.. .�� rine fie 3 15. 75 TOTnl g tk. . . ��Q10�17r"Tc: RE0.1.11 RED INSPECTIONS - s permit is issued subject to the regulations contained in the RP/Backflow Prev .ard Municipal Code, State of (ire. specialty Codas and all other Final 1nst-rer_t ion 1icable laws. All work will be done in accordance with -oved plans. This permit will expire if work is not Started "lii� 180 days of issuance, or if wo)-1 is suspended for more n 1.80 days. ATTEt,'TpN. Oregon, las+ rs-9dreo you to follow rules ;;ted by the Oregon Utility Notificatio r Center. Tense rules Ar? fc t► in OAR 952-0@01-f0le through OAR 952-INI--OO8O. You may 'alr copies of these rules or ei-prt questions to OX by Calling X3)246-1987. _ Per,mittee Signatur er �/L +++++ I r }•f-+++-t•++- F.+44 +++++4.4- -+4++-I.-!-4•++++++-r++-t+4-+++4-++++4++++++++++++-++++-I-+4- Call 63t3-4175 by 7:0+0 p. m. fnr' an inspection needed tilp nPxt bi_r5iness day �_.f 4.f.+ ++4.4,4.+++++4-++•+-F-+•++++++-+4+++++++++++++.++++•I•++++.*++++++++++++++++'•+i•++++.F..;. CITY OF TIGARD !Plumbing Permit Application PlRn check 0 13125 5W HALL BLVD. Commercial and Residential Recd By _ TIGARD, OR 97223 Date Recd _ (503! 639-4171 Date to P E. Print or Type Dale to DSS In .ornplete or iHogible applications will not be accepted Relate F:elated SWR f Name of Development/Project On back IndlcaLs Work Perfor reed by fixture Job r: OQCTURESltondMdua ,;i;4°3 ;�c QTY>t. PctICR;R . Address Street Address Suite Sink 900 i Lavatory 9.00 Bldg 9 Clhr/8taft ZIp i� 9-7-2-1 y Tub or Tub/Shower Comb. 9,00 Name Shower Only 9.00 Water Closet 9.00 Ov fne f Mailing Address _ Dishwasher 9.00 ' City/State ZIP Garbage Disposal 9.00 Iq Washing Machine 9.00 Name Floor Drain 29.D0 3' 9.00 Occupant Mailing Address Suits 4, — 9.00 City/State ZIP Phone Water Heater O conversion O like kind 9.00 Laundry Room Tray —9.00 Nameq Urinal _ -hr Uh 9.00 Maitl Other Fixtures(Specify) 9.00 Contractor ng Address Suits - 9.00 rt Prior M permit City/State Zip Phone 9.00 issuance,a Copy 1 ,o f "77Z �y r� DU Sewer-1st 100' 3000 of all licenses are Oregont.Cont.Board LIc.9 Exp.Date. C Sewer-each additional 100' - 2-.00 required it ; �'�)� E)-� / ii Water Servks-1at 100' 70.00 expired In COT Plumbing Lic,0 Exp.Date database p Water Service-each additional 200' 25,00 Name Storm&Rain Drain-tat 100' 30.00 Architect Storm&Rain Drain-each additional 100' 25,00 or Mailing Addreus Suite Mobile Home space 25.00 _ Commercial Bacl,Flow Prevention Device or Anti- 25.00 Engineer City/State Zip Phone Pollution Device �/ Residential Barkllow Prevention Device' 15.00 Describe work New O Addition O Alteration O Repair O Any Trap or Waste Not Connected to a Fixture goo to be done: Residential O Non-reskienoml O Catch Basin 9.00 Additional description of work: Insp.of F_xlstktg Plumbing 40,00 per/hr L Specialty Requested Inspections 40,00 lh Rain Drain,single family dwewling 30•0Q Existing)u e of �J / p - /J _ building er property !"rLJG,.^j--P )U J -40-Yr�-4 Grease Traps — 900 Proposed use of QUANTITY TOTAL building or property Isomealc or riser diagram b required If Ou*y Total is >9 'SUBTOTAL I hereby acknowledge that I have read this application,that Me Infornallon given is correct,that I am the ner or authorized agent of the cotter,and 6%SURCHARGE that lana submitted are 1n Co fleece With re$on to Laws. Signature of Ownrlr/A ant Date —PLAN REVIEW 26%OF SUBTOTAL I Requirod only M flours qtv.total is>9 Cat TOTAL Contact arson Nar4 vF Phone 'Minimum permit fee is$25+5%surcharge,except Reskier"Rack1low /F neventlon Device,wMch is$IS+5%surcharge "All New Conrrrwrelal Buildings require glens with Isometric cr riser diagram and plan review I%dstftphxnbpp doe SMM PLEASE COMPLETE: Fixture Type uantity b Work ork Performed New Moved Replaced Removed/Capped Sink y _ Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4" _ Water Heater _ Laundry Froom Tray i Urinal Other Fixtures (Specify) COMMENTS REGARDI ABOVE: CITY OF TiGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639.4175 Businexa Line: 639-4171 — --- /��(�rl p BUP Date Zequested fid' " 3 qa AM PM _ -- BLD Location1Suite 5 � _ MEC Contact Person �� 1J1�0 �Z�P.{/7�tr!I[T Ph �/� � _ rLM _ Contractor Int`Vli'►J Tt; Iz�' C� -i'1 p� Ph sWR _ BUILDING Tenant/Owner ELC _ Retaining Wall ELR Footing Access: Foundation FPS _ Ftg Drain SGN r Crawl Drain Inspection Notes: --- Slab _ _ Post&Beam SIT - Ext Sheath/Shear Int Sheath/Shear Framing � U 1 — Insulation Drywall Nailing nrewal! Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PA2L-fNT FAIL — — — -- MEIN � Post& Beam — - Under Slah Top Out Water Service Sanitary Sewer - LujiftPrains ` in - APT FAIL � — MECHANICAL Post& Beam ---- Rough In Gas Line - - -- Smoke Dampers Final ---- -- -- - -- PASS PART FAIL ELECTRICAL IL Service Rcughln 0 UG/Slab Low Voltage — - ---- - _----� Fire Alarm Final PASS PART FAIL J SITE Backfill/Grading Sanitary Sewer Storm Drain [ )Reinspection fee of$ -required before next inspec+ion. Pay at City HAII, 13125 SW Hall Blvd Catch Basin [ )Please call for reinspec.•tion RE:______ _ _ [ )Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk Other Da!e a " InapsCtOr.�.� Ext Final PASS PART FAIL .0O NOT REMOVE t' H Insprvction record from the Job site. i