Permit (133) CITY OF TIGARD
i y,�,, � ,,,,,, . , D EVELOPMENT SERVICES PLUMBING PERMIT
� X11) PERMIT # r PL M97 -0044
!-1+L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/10/97
PARCEL: 2S115BA -00101
SITE ADDREC.: : J6200 SW PACIFIC HWY #0
SUBDIVISTflm :... a ZONING: C -G
BLOCK.....,..... LOT....._ .
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: e
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:B FLOOR DRAINS...... 1 TRAPS • 0
STORIES • 0 WATER HEATERS 1 CATCH BASINS • 0
FIXTURES - - - - -- -- LAUNDRY TRAYS.....: 0 SF RAIN DRAINS • 0
SINKS • 2 URINALS • . 0 GREASE. TRAPS • 0
LAVATORIES • 2 OTHER FIXTURES • 4
TUB /SHOWERS • 0 SEWER LINE,(ft)...: 0
WATER CLOSETS..: 2 WATER LINE (ft) ...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Tenant modification
Owner : FEES --
MCFARLANE PARTNER LP type amount by date recpt
144 MARKET ST PRMT $ 133.00 B 03/10/97 97- 291459
STE 2100 PLCK $ 33.25 B 03/10/97 97- 291459
SAN FRANCISCO CA 94111 SPCT $ 6.65 B 03/10/97 97- 291459
Phone #:
Contractor: -.
PSSOCIATED PLUMBING CO
P 0 BOX 301362
PORTLAND OR 97230 - - - - ---
Phone #: 331 -0582 $ 172.90 TOTAL
Reg #..: 57890
REQUIRED INSPECTIONS
This per•ait is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top-out Insp
applicable laws. All work will be done in accordance with RP /Backf low Prey
approved plans. This pereit will expire if work is net started Final Inspect i o n
- within 180 days of issuance, or if work is suspended for lore
than 180 days.
Permittee Si/ature: ell441 ,-,,i
/ .
Issued By: / ; , ►^.- — -
Call for inspection - 639 -4175
z -2.(C,
CITY OF TIGARD Plumbing Application Recd By V• K"Sl) MA t�
13125 SW HALL BLVD. Commercial and Residential Date Recd Z - 10 -- q "+
TIGARD, OR 97223
Date to P.E. Z -- i z-- 71
(503) 639 -4171
Date
to se PI- M411- cot-ill
Print or Type Relat t: Rq - 0
Incomplete or illegible applications will not be accepted called 0-' 447
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Job
Sink 2. 9.00 , g."
Lavatory 9.00 ce
Address Street Address Suite (Q'
16200 SW ( t; F ;( / 0 Tub or Tub/Shower Comb. 9.00
I Bldg * City/Stat9 I Zip Shower Only 9.00
_ T A/G1 i 0 i 97223 Water Closet 9.00 fi
Name n� r j
r 1 Far 1Cv1 p Pei r 1 d e- Lf Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
1
114 i l -ktl l St, 2100 Washing Machine 9.00
ISta Zip d Phone Floor Drain 2' I 9.00 9.00
F An (15(o IOW 3' 9.00
Marne I- �
Tilt Or'cj'n0J1 C)n; Lk 13d. 4- - 9.00
Occupant Mailing Address 1 Suite Water Heater 1 9.00 9.0c) )62,00 S IA) 9a t i F C C b( w7 0 Laundry Room Tray 9.00
City/S a Zip Phone - Urinal 9.00
T Of. Q7ZZ3 _ Other Fixtures (Specify) 9.00
N
550C-41/ed MUM ID n floor- Sink - 3 9.00 0 /77,v0
Contractor Mailing Address Strfte Seri/ ;Et S;nK 1 9.00 9..00
PO l3*X 30134Z 9.00
City /stj�tte Zip Phone
Portlan Ott ¶72f4 331 050), 9.00
Oregon Const. Cont. Board Lic.>X Exp. Date 9.00
Misch Copy of 76c10 II - 9 7 9.00
Current Plumbing Lic. s Exp. Date Sewer - 1st 100' 30.00
q6 - 412. P6 io -31 -11
Sewer -each additional 100' ( 25.00
COT Business Tax or Me * Exp. Date
• I b_e - 9 -1 - 91 Water Service - 1st 100' 30.00
Name
Water Service - each additional 200' 25.00
/� n Storm & Rain Drain - 1st 100' 30.00
Architect f 1 ;C 0.E 6. far all
M Storm & Rain Drain - each additional 100' 25.00
Or Mailing Address St..te re
20 5 E. r -la, A 20 S Mobile Home Space 25.00 I
Engineer , C f ity/Sta 00
te Zip Phone Commercial Back Flow Prevention Device or Anti- 25. pp
I ft i �I5 bOr0 O k q7123 6f0 4217 Pollution Device I �i'
i Describe work New A Addition 0 Alteration 0 Repair 0 Residential Badkflow Prevention Device' I 15.00
to be done: Residential 0 Non - residential p Any Trap or Waste Not Connected to a Fixture I 9.00
" Additional description of work Catch Basin 9.00 I
. Insp. of Existing Plumbing I 40.00
oerihr
=xisonq use of Specially Requested Inspections I 40.00
• 3uidinq or property Co rtMer•Cic�1 oerrhr
Rain kraut. Sangre family dwelling I 30.00
Proposed use of II Grease Traps I 9.00
I building or property ac5 /a.UranT 1`
QUANTITY TOTAL
Are you capping , moving or replacing any fixtures? YesX, No Q Isometric or riser diagram is required a Cuanay Total is > 9 4
(H yes see back of form) 'SUBTOTAL /33C4)
I hereby acknowledge that I have read this application, that the information
given s correct, 'slat I am the owner or authorized agent of the owner. and 5 SURCHARGE ,106
that Clans submitted are in compliance with Oregon State Laws. (p
Signs are oil Owner/ nt Date PLAN REVIEW 25% OF SUBTOTAL I 33, 9•5-
- � Reaui d f6
ed only dure my. total is >_ 9
I / K Z-10-9> TOTAL I in.cQ
Parson lime Phone
II_ 'Minimum permit fee is S25. 5% surcharge, except Residential Beddow C l')u.( Lu. roa✓l/1 331 05431 Prevention Device, which is 515.5 %surcharge
Odstskplmapp.doc 8/96
•
PLEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2" 1
3 „
4"
Water Heater f Laundry Room Tray
Urinal _
Other Fixtures (Specify)
ZOMMENTS REGARDING ABOVE:
Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0044
MCFARLANE PARTNER LP
16200 SW PACIFIC HWY I. t: 0
03/20/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By -
PLMC003 Application received / / / / 02/10/97 RECD B 02/12/97 BON
PLMC005 Permit Created / / / / 02/12/97 PEND B 02/12/97 BON
PLMC007 Plans routed to Plans Examiner / / / / 02/12/97 PEND B 02/12/97 BON
PLMC008 Plans Approved /Routed to DST / / / / 02/25/97 PASS MS 02/25/97 MRS
PLMCO50 (F) Ready to issue / / / / 02/28/97 INCREASE OF 1 EDU'S - PAY SEWER PRIOR TO PASS DRA 02/28/97 TAT
ISSUANCE.
PLMC060 (F) Issue permit / / / / 03/10/97 PASS B 03/10/97 DST
PLMC120 Plumbing Undersl 02/25/97 / / 04/01/97 waste only PASS MS 04/01/97 MRS
PLMC710 Water Line snap 02/25/97 / / / / 02/25/97 MRS
PLMC725 Top -out Insp 02/25/97 / / / / 02/25/97 MRS
PLMC750 RP /Backflow Preventer 02/25/97 / / / / 02/25/97 MRS
PLMC799 Final Inspection / / / / / / 02 12 97 BON
PLMC800 Case Finaled / / / / 03/06/98 Per Hap, project withdrawn at tenant's CLOS JDA 03/06/98 DST_
request. No refund
due. See letters from PLM contractor and
general contractor in file. Note last
improved inspection.
CILL64 4111
6115-1L)