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Permit (157) CITY OF TIGARD .., ... u, °,.,,, DEVELOPMENT SERVICES PLUMBING PERMIT �n �� I/ PERMIT # : PLM98 -0103 - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 04 / 0 / 98 PARCEL: 25115BA -00101 SITE ADDRESS...: 16200 SW PACIFIC HWY #0 SUBDIVISION • ZONING: C —G BLOCK • LOT JURISDICTION: TIG CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE -COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:B FLOOR DRAINS • 2 TRAPS • 0 STORIES . 0 WATER HEATERS • 1 CATCH BASINS • 0 FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS : 0 SINKS • 1 URINALS • 0 GREASE TRAPS • 0 LAVATORIES • 1 OTHER FIXTURES • 0 TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 1 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Kit's Camera — Tenant improvement to add 1 sink, 1 lavatory, 1 water closet, 2 -2" floor drains, and 1 water heater. Owner: FEES KITS CAMERAS type amount by date recpt 16200 SW PACIFIC HWY PRMT $ 54.00 DLH 04/20/98 98- 305080 SUITE "0" SPCT $ 2.70 DLH 04/20/98 98- 305080 TIGARD OR 97223 Phone #: Contract or ANCTIL PLUMBING INC 16900 SW MERLO RD BEAVERTON OR 97008 Phone #: 503- 642 -7323 $ 56.70 TOTAL Reg #..: 000241 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Rough —in Insp 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 1: 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- 0001-1080. You lay obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issued By: Permittee Signature: /yf} /LE7'" +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD RECEIVEglumbing Application Rec'd.By .. 13125 SW HALL BLVD. Commercial and Residential Date Recd ' /2o /s, - TIGARD, OR 97223 Date to P.E. (503) 639 -4171 APR 1999 Date to DST I Permit #, / 9,P -0 /03 • CO. ;t UNITY DE EIO"t.^ENT Print or Type Related SWR # Incomplete or illegible applications will not be accepted Called Y� /9P / Name of Development/Project On back Indicate Work Performed by fixture. Job / (tA _ i - I/ FIXTURES (Individual) QTY • PRICE ' AMT . Address Street Address Suite Suite 1 /0 " Sink / 9.00 F AO i,_ /!� A /• w_ Lavatory / 9.00 Bldg # E'State / 2Ip Tub or Tub /Shower Comb. 9.00 Name ,/ f ` pie Shower Only 9.00 Water Closet / 9.00 Q 0 0 Owner Mailing Address Suite Dishwasher 9.00 Garbage Disposal 9.00 City/State Zip Phone Washing Machine 9.00 Name Floor Drain 2' x0 0 ti, 2 ? -©/Jr 3' 9.00 Occupant Mailing Address Suit 4' 9.00 Water Heater 0 conversion 0 like kind 1 9.00 C; O, City/State Zip Phone / Laundry Room Tray 9.00 Name \ ■ Urinal 9.00 � r` ...4-"4 Other Fixtures (Specify) 9.00 Contractor Mailing Address _ /JI 9.00 ��6 .� (J Oi?.Cp 9.00 Prior to permit pity/State Zip / q Phone issuance, a copy i/T / 2 054 ( '2 -233 9.00 of all licenses are Oregon Cost. Cont. Board Lic.# p. ate / 9.00 required if !� /g r�/ /70 Sewer - 1st 100" 30.00 expired in COT Plumbing �Lic. # p. ate database ,Plumbing - ( , 2 /2/2 (.. 30 . 5 , - t/ Sewer - each additional 100' 25.00 Name Water Service - 1st 100' 30.00 Architect Water Service - each additional 200' 25.00 Of Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00 Storm & Rain Drain - each additional 100' 25.00 Engineer City/State Zip Phone Mobile Home Space 25.00 Commercial Back Flow Prevention Device or Anti- 25.00 Describe work New 0 Addition] Alteration 0 Repair 0 Pollution Device to be done: Residential 0 Non - residential Residential Backflow Prevention Device* 15.00 Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00 Catch Basin 9.00 Insp. of Existing Plumbing 40.00 per/hr Existing use of Specially Requested Inspections 40.00 building or property _ per/hr Rain Drain, single family dwelling 30.00 Proposed use of Grease Traps 9.00 building or property QUANTITY TOTAL I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quanity Total is > 9 (9 ..yt given is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL that plans submitted are in compliance with Oregon State Laws. Signature of Owner /Agent ) Date r / 5% SURCHARGE Contact Person Name n e PLAN REVIEW 25% OF SUBTOTAL /' Required only if fixture qty. total is > 9 �-y /�� (/IL/1 Y / lU _3 TOTAL J 6, 0 it *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge I: \dsts\plmapp.doc 5/97 PLEASE COMPLETE: Fixture Type Quantity. by Work Performed New Moved . Replaced RemovedlCapped Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: 1:ldstslplmapp.doc 5/97 • Accumulative Sewer Tally ' • Tenant Name: A/ TS C»I ' /1,9- This SWR# _S w 29P— 00 7G Address: /6..200 s e x ) / / f u ) y S 7E' D " This PLM#: Pe-t/ gr9 — 0 / 0 3 Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New Value Capped off value added # added #s total Count off #s count value values Baptistry/Font 4 • Bath - Tub/Shower 4 - JaauzziNVhirlpool 4 Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher - Commercial 4 - Domestic 2 Drinking Fountain 1 Eye Wash 1 Floor Drain/sink - 2 inch 2 2 Y -3inch 5 - 4 inch 6 - Car Wash Dm 6 Garbage Disposal 16 - Domestic (to 3/4 HP) - Commercial (to 5 HP) 32 - Industrial (over 5 HP) 48 - Ice Machine/Refrigerator Drains 1 -- Oil Sep (Gas Station) 6 — - Rec. Vehicle Dump Station 16 _ Shower - Gang (Per Head) 1 - Stall 2 Sink - Bar/Lavatory 2 / 2 - Bradley 5 - Commercial 3 3 - Service 3 Swimming Pool Filter 1 Washer - Clothes 6 Water Extractor 6 Water Closet - Toilet 6 / ( Urinal 6 ' • TOTALS 3a 9 y / Total fixture values: 5/ j/ divided by 16 = 02/ , -5 EDU '_` a ' ) Et lL C2,2 /T HISTORY fe � , r,J / C,2E6 , r /LE j /} - 7 (/ //�(•- PLM# �P - a 0 / EDU # .z / WR# 91 000-Z PLM# EDU# SWR# PLM# -037y EDU# 020 SWR# 97 -03 Sp PLM# EDU# SWR# PLM# F2 -670yy EDU #a,, SWR# 92-00 yd PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# indsts swrtay.doc 4 /28 /99 • Activities for Case #: PLM98 -00103 10:02:46 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. — Level By Updated Notes • PLMC003 Application received 4/20/98 DLH RECD DLH 4/20/98 PLMC005 Permit Created 4/20/98 DLH DONE DLH 4/20/98 PLMC799 Final Inspection 5/12/98 TLP PASS J *H 5/13/98 PLMC715 Rough -in lnsp 4/20/98 4/23/98 WA PART DGW 4/23/98 Top out waste and vents only. No water piping installed. Reschedule rest of top out • when water piping installed. PLMCO50 (F) Issue permit 4/20/98 DLH DONE • DLH 4/20/98 PLMC720 PLM /Underfloor 4/23/98 WA PASS DGW 4/23/98 Underslab waste & vents. PLMC725 Top -out Insp 4/28/98 TLP PASS DGW 4/29/98 Water line pressure test okay. • Top out already passed for DVVV. PLMC800 Case Finaled 5/12/98 TLP PASS J *H 5/13/98 • • • • Page 1 of 1 Page No. 1 CASE HISTORY FOR CASE NO.: PLM98 -0103 KITS CAMERAS 16200 SW PACIFIC HWY Unit: 0 09/02/98 Action Description Req/ Schd/ End/ Action Notes - Disp By Update Upd Code Sent Done Done Date By ---- - -- -- - - - - -- - -- PLMC003 Application received / / / / 04/20/98 RECD DLH 04/20/98 DLH PLMC005 Permit Created / / / / 04/20/98 DONE DLH 04/20/98 DLH PLMCO50 (F) Issue permit / ./ / / 04/20/98 DONE DLH 04/20/98 DLH PLMC715 Rough -in Insp 04/20/98 / / 04/23/98 Top out waste and vents only. No water PART WA 04/23/98 DGW piping installed. Reschedule rest of top out when water piping installed. PLMC720 PLM /Underfloor / / / / 04/23/98 Underslab waste & vents. PASS WA 04/23/98 DGW PLMC725 Top -out Insp / / / / 04/28/98 Water line pressure test okay. Top out PASS TLP 04/29/98 DGW already passed for DWV. PLMC799 Final Inspection / / / / 05/12/98 PASS TLP 05/13/98 J *H PLMC800 Case Finaled / / / / 05/12/98 PASS TLP 05/13/98 J *H