Permit CITY OF TIGARD
PLUMBING PERMIT
0 I DEVELOPMENT SERVICES PERMIT #: PLM2000 -00005
.- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/10/00
SITE ADDRESS: 14936 SW 109TH AVE PARCEL: 2S110AD -90049
SUBDIVISION: CANTERBURY WOODS CONDOMINIUM ZONING: R -12
BLOCK: LOT: 049 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 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: Replace electric water heater in single family dwelling.
FEES
Owner:
Type By Date Amount Receipt
14936 SW 109 , C PRMT GEO 1/10/00 $50.00 00- 321057
14936 SW 109TH 5PCT GEO 1/10/00 $4.00 00- 321057
TIGARD, OR 97224
Total $54.00
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING
9806 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 624 -6895 Top -out Insp
Reg #: LIC 000027 Final Inspection
PLM 26 -60BP
ORIGINAL
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 copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: - 2'14 a-a-z_eti
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JAN-06-2000 13:18
I T urr I lump.L, I 11164111,01111•11 • ••••••••,. • •
125: SW HALL BLVD. Commercial and Residential RECEIVED
3ARD, OR 97223
33) 638-4171 . JAN 0 7 2000
Print or Type
Incomplete or Illegible applications will not be accepted t a i llialliftliMOPM ENT
•L'°/C)4 /66(1 pz. m2000 - 0 0 , : ,.. ‘ ,5
•
Name of Development/Project r f IXTURESAiitetbritiUalr4,..T4 .Arig.. ..,,,,. ift3iCk
Job i\i n n 1\10 4_ a-n d Sink 11.50
11.50 •
Address Street Address , , it, Suite Lavatory
ILI 93(.0 30 109''1-2 Tub or Tub/Shower Comb.
11.60
Bldg* CINState Zip _, Shower Onty - 11.50
T fl Q a rd,Cr. ( ---)70,)(L,
1
_ I Water Closet 11.50
Name
Noun Wo Carl d Dishwasher -._
11.60
Owner Melting Address Suite Garbage Disposal 11.50
/ k,Stt) /Cr .
"- Washing Machine 11.50
WStatie Zip Phone
Floor Drain/Floor Sink 2
1 " 11.60
" I iar(10 7.'D„)(1 .
,
3' 11.50
Name .
•
Occupant Mailing Address Suite Water Heater 0 conversion X like kind 11.60 ii SO
_ Gas piping requires a separate mechanical permit. ) // -
City/State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
NATI° ' Other Fixtures (Specify)
("'" e0 - rn or 1 c»' Pt itatbi n 15.00 ,
Contractor Palling Add. Suite
q w
ROL W S
Prior to permit CityfState -Zip Phone Sewer - 1 et 100' 38.00
1841-1anca a copy - 1 -- ] (ard, g . 7,A-.).3 (DDLf -G2 0 Sewer - each suldtuonal 100' 32.00
of all licenses are Oregorf Come, Cont. Board Licit Exp. Date
0 73 tit , d - W - err' - - - s• I"'
c;)(p / , ., iCS MI I .7 V I vtt 38.00
required if
expired in COT Plumbing Lk.. t ..kcp. Dete )-' Water Service - each additional 200' 32.00
database c.2(,, - C D to P6 0 co/ 0 c Storm & Raln Drain - 1st 100'
38.00
Name Storm 8 Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00
Pollution Device
Engineer CITY/State Zip Phone Residential Bacefiew Prevention Device" 19.00
(Irrigation timing devices require a separate
Describe welt to be done: restricted energy permit.)
Nevi 0 Repair 0 Replace with like kind: Yes )4 No 0 Any Trap or Waste Not Connected to a Fixture 11.50
Ftesklentlal}k Commercial 0 Catch Basin 11.50
4dditional description of work: .. Imp of Existing Plumbing 50.00
• r p 1 a-e_e, el e_c+1 lc c i ) s - 4 - ex hear permr
Specially Requested Inspections 60.00
kre you capping, moving or replacing any fixtures? per/hr
Yes 0 No 0 Rain Drain, single family dwelling 45.00
f yes, see back of form to Indicate work performed by ,
Grease Traps 11.50
rixtuna. FAILURE TO ACCURATELY REPORT FIXTURE •
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the Information Isometric or riser diagram Is required X Quantity Total Is > 9 ...'.. :•;:•..„.:::.:..,:. :.
!Nen Is correct. that I am the owner or authorized agent of the owner, and ° SUBTOTAL :'... _": -?. cr o
itiat plans submitted are In compliance with Oregon State Laws. .:;:g:t* ' a -
;Igna of •rlAgent Date c cr'' 4% SURCHARGE
-1
or e 'omen Name Phone **PLAN REVIEW 2.5% OF SUBTOTAL ,:..-a.::...::::,=:
) -;..iP0 ( VI . • .ati-(0. • Required only f flduro qty. total it '
••••: -, - TOTAL . ,.,-. ;,-;:. co
,•:-:-.....,:.- - ., , - n.f..v.,:-..:
-Minimum permit foe is $50 • 5% surcharge, except Residential Backnow
4;Vei
.,.. i .,. • ..;, ,,::i .......ir -..: ;3. . • pl.> 44'4-P3'4n: Prevention Device, which is S25 4 ' 5% surcharge
•;:4-•
1a.;,...,.).1. ,:-.)::::zt::,1,...-.:',.......,;...c;m:P4Igailu. All New Commercial Buildings require plans with Isometric or riser diagram
and plan review
swoon motto app. ooq 512,5/911
TOTAL P.01
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested c S/5/00 AM K PM BLD
Location I L 7 ( 1O [ . Suite MEC
Contact Person Dekb1 e Ph (p Z '7 - 00 PLM ZOO - 000 6
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall • ELR
Footing Access:
Foundation r. , 9 I 3/ 3 FPS
Fig Drain k � SGN
Crawl Drain Inspect' n 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
PASS T FAIL
TBLU
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewqr
Rain Drains Cl.)
otini
PART FAIL
CHANICAL
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 �j
Approach /Sidewalk Date.../ 6 ( Inspector
Other � � Ext3
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.