Permit CITY I PLUMBING PERMIT
I DEVELOPMENT SERVICES PERMIT #: PLM2000 -00360
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/22/2000
PARCEL: 2S 109CB -EVOOF
SITE ADDRESS: TRACT 'F'
SUBDIVISION: EAGLES VIEW ZONING: R -7
BLOCK: LOT: OOF JURISDICTION: URB
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of 3 commercial backflow prevention devices.
FEES
Owner:
Type By Date Amount Receipt
VENTURE PROPERTIES 5PC2 CTR 09/22/200C $11.14 27200000000
4230 SW GALEWOOD ST #10 PRM4 CTR 09/22/200C $139.20 27200000000
Total $150.34
Phone 1:
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
RP /Backflow Preventer
Phone 1: 682 -6076 Final Inspection
Reg #: LIC 6136
PLM 11558
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 hrough 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: pT/ • 9 /
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
a-
OF TIGARD BUILDING INSPECTION DIVISION
MS T
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 AM PM BLD
Location Ea y P tl �✓ k"a' - Suite MEC
Contact Person Ph CrJ 8Z aO 7 G 2vG a Gv 3� G
Contractor Ph 1k 211 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
RT FAIL
PLUMB
& Beam C4v .
Under Slab /
Top Out ar 4c4)
Water Service
Sanitary Sewer
Rain Drains
Final •
S PART FAIL
— HANICAL
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 Date 1, ' i o / Inspector �(�/ Ext
Other I�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
09/14/f0 •1tnL 12:4/ Y.t.. gaud a.7o 17011 ,iii Li/ 11V.lt\L •-•
CITY OF TiGARD Plumbing P lumbin Permit Application Plan Check # _ ,
12126 SW HALL BLVD. Commercial and Residential Recd By 1Y/91 Date Recd 9/24/ _
fIGARD, OR 97223 RECEIVED a to P.E.
;503) 639 -4171 D ate to DSST
c Perni L
#E_ - )1340
1 A Print or Type SEP 2 �OOO Related SWR af • _ •
�. \f v Incomplete or illegible applications will not be accapted C alled
C OMMUNITY DE VELur
Na•ne of Developmen fPrcject ,FIXTURES: ,(individual) Qty Price. I - retail
1 `I Sink 16. 60. . 1
Job fi a i cS v/ etc !� - 16.60
�`t ctreet Address Sui a Lavatory _
A d d re , 4 L' / e` „ r � / Tub or Tub/Shower Comb. 16.60 ;
n1 16.so
A'U A 5ldg # C ity /Stal `! Zip -7 Shower Only l
144
I T(� GvrL l O]2 �� / a-3� Water Cicset J 16.60
Win ' ' n e. h S I 16.60
Mailing Address Suite 1 Garbage Disposal Dishwasher 16.60
Owner _ ,_ -c 30 Sw 6a.lewooc L� 10 _ 16.60
_
ity /State 3A " CP U Phone Laundry Tray 16.60 • X � Wasting Machine. 16.66
\ Floor Drain/Floor Sink T _ - 1 16.60
Occupant
' h1�' ing Address f Suite 3 16.60
4•
1:.6G
City ISi le Zip Phone - i6.6G
` l Water Heater 0 conversion O like kind
l ! _ Gas piping requires a separate mechanical permit. 11
i 46.4J
Name MFG Home New Water Service 111
Pro &rl��� Li
�lt.r1 i�SG «�('J MFG Hon Ne•.v San/Storm Sewer 46.40
Contractor Meiling Address � Suite
cc , ..,, l h c'rna, _ KD Hose Sibs i 16.63
��,�� � d'ttJ
Phone x -! 7 Roof Drains 16.63 l
Prior to permit City/State Zip
issuance, a copy l i-)i)c'C5y1 L j i f., 0 a o , C / T? i & - (00 Drinking Fountain 16.60
of all q ses are Oregon Copst./ 3 card Lic.# Exp. Date
required ! Other Fixtures (Specify) 21.75
squired If (/> 1 � E �
expired in COT Plumbing Lir_. # Exp. a te
. database
Name
Architect
Sewer - 1st 130' • 53.00
or
Mailing Address Suite Sewer - each additional 100' 45.40 I
_
Water Service - 1st 100' 55.00
C ity /State Zip Phone 43.40
Engineer Water Service - each additional
work to be done:
Storm &Rain Drain 1st 10G' I 55.00
New`0.. Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 45.40
Residential 0 Commercial •Commercial Back Flow Prevention Devl °.e a 46.40 )39. ;ad;
Additional description of work: Residential Dackflow Prevention Device' 27.55 ,
/) ,giq -C / d e-v/ Cat ch Basin i 113.60
Are you capping, moving or replacing any fixtures? Insp. of Existing Fl unbing or Specisily Requested Z 72.50
Yes 0 No 0 Inspections perhr
single family dwelling 55.25
If yes, see back of form to indicate work performed by_- 1___ R ain Drair. sin 9 --
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 16.60
WORK COULD RESULT IN INCREASED SEWER FEES. . QUANTITY TOTAL
hereby acknowledge that I have read this application, t'nat tha information
Isometric or r see eia7ram is required d ]uanry Totals > _ 9 3 /44i 401 - 1' �
!;
given -s coned, that I arri the owner or authorized agent cf the owner, and "SUBTOTAL.
that Glaris submitted are in compliance with Oregon State Lav:s.
I Signature of Own rlAgent Date 8% SURCHARGE :. ' I ' L!
Contact Person Na a Phone x t a ir! **PLAN REVIEW 25`/o OF SUBTOTAL
J! �S��U rr�v �ga �cl�
Reg ui-eG only i` fixture qty. total is > 9 _
SAT OU ,E 00 lei= .r`^ 4;e - ca f ss'.$Ty"- °''" r. TOTAL C� 7 c �
.r<mBA�OUSE��35 OQ r y a`-�"; s��i:• a.,:4' � �� T _ - - - -
3' ATti OUSES399.00 ., -, -ar " • `.
s ln
,i � - fee inelrid� at4�•ltunb(n . - xfures = n • 5Watac8A tha dw y n 1 a rs � � 3 ,: ••Mlnlrnurn permit fee is iT2..i0+ 8% surcharge, except Re..iden "a' bacdl7+v Pre�en�on
:IV. " lXt` a • aewe atonriih& F ry CG? .� '- ,a • Device, Nfriofi is Su .25 + 9°n surcharge.
"'All NewCcrnmertlat eultdings requ're plans with Isemetrieor rise. d'agam arc Wan reviex.
4°bVom:slpiumap1_rev.doc SdWOO