Permit CITY OF TIGARD
4
,�,. DEVELOPMENT SERVICES PLUMBING' PERMIT
'I� 13125 SW HaII Blvd., Tigard, OR 9722(503) 639 -4171 DATE I ISSUED: 12/ 16/ 98 -0463
3
PARCEL: 1S135CD -01701
SITE ADDRESS...: 11650 SW 98TH AVE
SUBDIVISION....:
GREENBURG HEIGHTS ZONING: R -4.5
BLOCK LOT.. ......... ..:002 JURISDICTION: TIG
CLASS OF WORK.. :OTR GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE. OF USE -SF WASHING MACH - 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP.. :R1 FLOOR DRAINS......: 0 TRAPS......... ..... 0
STORIES - 0 WATER HEATERS 0 CATCH BASINS - 0
FIXTURES LAUNDRY TRAYS 0 SF RAIN DRAINS.....: 0
SINKS - 0 URINALS - 0 GREASE TRAPS - 0
LAVATORIES....: 0 OTHER FIXTURES....: 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: • 0 WATER LINE (ft)...: 350
DISHWASHERS....: 0 RAIN DRAIN (ft)...: 0
Remarks: Install new water line.
Owner: -•- FEES
CHERYL VEZEY type amount by date recpt
11650 SW 98TH AVE PRMT $ 80.00 GEO 12/16/98 98- 311568
TIGARD OR 97223 SPCT $ 4.00 GEO 12/16/98 98- 311568
Phone #: 620 -4778
Contractor
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY
BEAVERTON OR 97005
Phone #: 643 -7619 $ 84.00 TOTAL
Reg #..: 000128
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line 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 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.
■
Issued By: _ Permittee Signature ��� __.
+ +++++++++++++++ i-++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
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CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 SIN HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type- Date to DST _
Incomplete or illegible applications will not be accepted Permit pZ_Hr 9Ss_6z,163
Related SWR #
Called
Name of Development/Project FIXTURES (ititlivldual).q : s ,� A
... _.,� � < �..,.. <�; <a, ._.._.. aTY . -PRICE MT ..
Job Sink 9.00
Address Street Address Suite Lavatory 9.00
1 i f00 StA) Q6AAd� Tub or Tub /Shower Comb. 9.00
Bldg it City/State / Shower Only .00
�t�4 /722'3 y
Name Water Closet 9.00
Li V�ZE--Y Dishwasher 9.00
Owner Mailing Address / Suite Garbage Disposal 9.00
1 «° SO Sri 'fir `' Washing Machine 9.00
CitvJState Zip Phone Floor Drain/Floor Sink 2" 9.00.
I t6iiirzs6 0IZ et72 � 0749" , c-ng
Name 3" 9.00
A
trayL tJZFy 4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00
L r rO L7 Su) `IE " iA - Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 9.00
116A4(20 Ca- c !70Z5 C.2d zr770 Urinal 9.00
Name
B.-.A t27DN 4.(/M t3 litJ 0 .-A- I L Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 9.00
1 396x) Scv 1 t - r . 9.00
Prior to permit City /State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy ve cZT0, 4 ) 61-13-7614
Sewer - each additional 100' 25.00
of all licenses (% ! s are Oregon Cons . C t. Board s Exp. Date
required if �S Water Service -1st 100' 30.00 3 6 °'
expired in COT Plum i �; # �� Exp. Date Water Service - each additional 200' Z 25.00
, 3 L
database Storm & Rain Drain - 1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device* 15.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes O No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial 0 Catch Basin 9.00
Additional description of work: .
--2...CW<C- -- • tAJAIEc2 SF -t.tl LE. Insp. of Existing Plumbing 40.00
per/hr
Specially Requested Inspections 40.00
per /hr
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes 0 No Grease Traps 9.00
If yes, see back of form to indicate work performed by , -,,,
fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL e- t a ,,
Isometric or riser diagram is required if Quantity Total is > 9 TAT G; ' t x
WORK COULD RESULT IN INCREASED SEWER.FEES. * SUBTOTAL M44-'''''''''''
I hereby acknowledge that I have read this application, that the information rt
given is correct, that I am the owner or authorized agent 5% SURC HARGE S; - *Pc Vi
9 ent of the owner, and 5 /o ti /
that plans submitted are in compliance with Oregon State Laws. -; 3 E0 '7
Signature of Owner /Agent Date * *PLAN REVIEW 25% OF SUBTOTAL r'`'= -1 n- _ F
r 1 \ y' / 4 ( C, q g Required only if fixture qty. total is > 9 gtr -
1 � �- t `t TOTAL ,K '1 L Ql/�I -
y ,-,- ( /
Contact Person Name Phone -" � F �� �
` b/4U (J b . Q.J G 6 c{s - 7 G f e' *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
* *All New Commercial Buildings require. plans with isometric or riser diagram
and plan review
I: dststplumapp.doc 7/2/98
PLEASE. COMPLETE:
. . . .
:-:•••••••
. . New Moved Replaced
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2"
3 „
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
lAdsts Iplumapp.doc 717/98
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line 639 -4171
BUP
/6h6 Date Requested
�i p /,, / 2 / 7 91 AM PM BLD
Location //&50 3(L ' 0 3�/V Suite MEC /, '/ U ,/-
Contact Person Ph A PL ' 5 O3
Contractor j/4 Q- Ph 643 " - 7& / A c� SWR
BUILDING Tenant/Owner /�� / /'�!�°"> ELC
Retaining Wall ELR
Footing r"`' •5i✓ �` i 2i r; cr� r..v " � i o �� ,�� ��. �..., t
Foundation x �. L 1 ` T1' . i �} #1 i�.
Ftg Drain ' ' s sf:`;`� C; �'" �r .��•} FPS
`a ,,�= C 6e1 o 1`. �•
r_`.ilA ?i.Q .i �.�'ti� -7P!y5 .`�.�'.f' = p�•`i�•
Crawl Drain Inspection Notes: SGN
. 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 -
PASS —PART, FAIL
<PLUMBING _} _ --
PoshBeam L \ •
Under Slab
top-Out- •
`Water Service
Sanitary Sewer
Rain Drains
Fi a
t P PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL _ p
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 f /J
Approach /Sidewalk Date / / / / 7<? Inspector / Ext
Other P
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.