Permit +! ' CITY OF TIGARD PLUMBING PERMIT
M I P, DEVELOPMENT SERVICES PERMIT #: PLM1999 -00395
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/22/1999
SITE ADDRESS: 12447 SW 69TH AVE PARCEL: 2S101AA -TTOOC
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOC JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
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: Install commercial backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
TIGARD CORPORATE CENTER LP PRMT KJP 11/22/199E $50.00 99- 319963
15400 SW MILLIKAN WAY SPOT KJP 11/22/199E $4.00 99- 319963
BEAVERTON, OR 97
Total $54.00
Phone 1:
Contractor:
NORTHWEST LANDSCAPE INDUSTRIES
16075 SW UPPER BOONES FERRY RD
TIGARD, OR 97224 REQUIRED INSPECTIONS
Phone 1: 684 -1450 RP /Backflow Preventer
Reg #: LIC 7030E Final Inspection
1Th rr.C!c:r`r
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 through OAR 952- 0001 -0080.
You may obtain co ies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature:.
all (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I ( os\ d 2era ptrt . 4 no g? -
Gin Of TIGARD RECEIVED Plumbing Permit Application •
Plan agar
1i125 SW HALL BLVD. Commercial and Residential Reed By
TIGARD, OR 97243v 1 9 1999 Date Rec'd
(503) 639 -4171 '`�u Date to P.E.
Print or Type Date to DST
COMMUNITY DEVELOPMENT peal** Pi-M/ y
Incomplete or illegible applications will not be accepted Related SWR S
Called
Name of DevetopmenVProject G � /'yam Oo is - r.. «•. «..:_. -:a• -
.: :y'c- .fit- .:i= 1:.__a�r3F.23�TiS� -: o. r.. . r a. -.'54-''
Job T s:IL (_ 31 p • f Sink •
Lavatory 11.50
Address 2. 4 '7 S W 64 +'4 Tub or Tub /Shower Como. 11.50
Bldg s City/State Zip shower Only "
11.50
Ti aid r oR 4 7 z z 3 Water 1 (Specify) 11.50
Name
'Ti 4c A l et1 ptnci4 l"D,v..44 -A.- Dishwasher 11.50
Owner I it aaS S Lo l o ow Fl vrt sorts Disposal 11.50
- t red 0.44, a R q p Phone
i ZZ 3 • Laundry Tray 11.50
Name Washing Madfdne.ALundry Tray (Spedfy) 11.50
T CtAti (A Cs k. Floor DralnlFbor Sink r 11.50
Occupant (,Z Address roc 44 ��C Suite 3- 11.50 �y Zip Phone 4' 11.50
a o.A P r Ok Tt ? 22.3 Water Heater O conversion 0 lice kind 11.50
1 e Gas piping reghdres a separate mechanical permit
„,toes+ � Shd LL MFG Home New Water Service 28.00
Contractor Mailing Address h .. _ MFG Home New San/Storm Sewer 28.00
l bG 15 S W U j&r 4c 1...7.....:
Pr j Hose Bibs • • 11.50
•
Prior to pmt �� Zip I Phone • Roof Drains 11.50 • .
Issuance. a copy -r, a , OR 97 22 y LIM .114S-0 Fountain 11.50
of ell pongee are Oregon Cont. Copt Board Uc.o eqh. tlter Fbduras (Specify) 15.00
cif *7 n3O Li O
3 0 E IT database 1 So $ 3D /DO . .
Name
Architect L R. S A-A.e g Sewer - ist 100' 38.00
or >! Ad
dr ss G AI M O O Sewer - each additional 100' 32.00
Engineer � DP Phone - water SenAce -1st 100• 88.00
Pad-lead 1 OR 4 7 20 5' Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New X Repair O Replace with lice kind: Yes 0 No 0 Storm & Rah( Drain -each additional 100' 32.00 •
Re131deN1at O Comrrerdel ]lif Commercial Back Row Prevention Device 9 2.00
30.
Additional aial description of work: `0 4 ) .
�Q �f+ Residential Beddow Prevention Device' 19.00
t dS
° A,, y Catch Basin 11.50
Are you capping, Yes moving ing or placing any fixtures? Insp. of editing Plumbing or Specially Requested 50.00
Inspections per/hr
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
WORK COULD RESULT IN INCREASED SEWER FEES. QUANI ITY TOTAL i`; L�; = =0/ =''
1 hereby acknowledge that I have read this application, that the information 1 - • . .:ii r_fri_ :hi
given Is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required it Quantity is > 9 1 ,., ;. ;, - ss: ••; `-
.. ,. . -.
that plans submitted are in Hance with Oregon State Laws. *SUBTOTAL : a t_ - ii to
Sign: D rill 1 8% SURCHARGE _ _=_ _ _-- -
Costa • rso •' ' ame Phon _ �r to
"PLAN REVIEW 25% OF SUBTOTAL _ " _' :'
__..._..__.. °„ "'� . - � _ r _ Required only if fixture qty. total is > 9
a Ti r - 4Si - - e -L f -. P 22:2 u^ tars- ._;?.: _ -
r -- i, '- -=' -se! �>` _ ii = 0/i , : 7_ TOTAL -- :.:--: :
- , .- s', .r { . �: a y '` - Mt _ - _
7riikiJ°_S „rRT4 :ii _- _ ; = ' . _ ' S�'/
:A.:z:� dE :il _-- -, a (c7G,° arzlic:gi sari
.
` e1 t ' _ � I! 0 / 'Minimum permit fee isk50 +8% surd except ResiidentialBaddlow Pr do
� - n roc
�r ` _ . ` .,,_�....�..s.�....._..� ��_�°�- _'. :�� : 1'_ rr� Device, which is $25 +8% surcharge
- 'All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
I:ldstsvonmstpumepp.doc 10/1/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2// J ( AM PM X BLD
Location AV. Suite MEC
Contact Person Ph / c ?9 n S
Contractor Ph ar j - col7
BUILDING Tenant/Owner � ' e
ELC
Retaining Wall ELR
Footing NOT REQUESTED FPS
Foundation FOUND DURING RESEARCH
Cr awl l Drain NO INSPECTION(s) IN FILE —' SGN
Crawl
Slab &Beam Ae i / `
P SIT
Post QG�G q
Ext Sheath /Shear 1 ! [ -/ -' 07 5 /
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
P SS PART FAIL
LU
Post & Beam
Under Slab /
Top Out
Water Service / /
Sanitary Sewer
Rain Drains
, �'-:
PART FAIL
MECHANICAL
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 7(
Approach /Sidewalk Date / 6-6 I nspector Ext-
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site