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Permit CI TY - OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2001 -00524 --- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/13/01 SITE ADDRESS: 15785 SW 116TH AVE PARCEL: 2S110CD 07600 SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: 37 BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: M FLOOR DRAINS: 4 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 4 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: 100 ft Remarks: 37 washers, 4 floor drains, 1 water heater, 100 ft. ea. water service and storm /rain drain, 1 backflow prevention device. Other fixtures: tray primers. FEES Owner: Type By Date Amount Receipt TOBIAS INVESTMENT CO PRMT CTR 11/13/01 $920.00 27200100000 300 SE SPOKANE ST 5PCT CTR 11/13/01 $73.60 27200100000 PORTLAND, OR 97202 PLCK CTR 11/13/01 $230.00 27200100000 Phone 1: Total $1,223.60 Contractor: SOUEL WELDING 21140 NW NICHOLAS CT.#L HILLSBORO, OR 97123 REQUIRED INSPECTIONS Phone 1: 503 - 617 -2972 Water Service Insp #: L IC 133602 Rough -in Insp Reg Final Inspection PLM 34 -390PB 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 Notifi - - • -r. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. Y. may obtain cops- of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: , I ■ f :;1 � ! 1 �t. , I�' Permittee Signature: Call (503) 639 75 by 7:00 P.M. for an inspection needed the next business day 1 CleanWateer Services Our commitment is clear. SANITARY 155 N First Avenue, Suite 270 pcorretrit 0 Hillsboro, Oregon 97124 SURFACE WATER (503) 846 -8621 CONNEt:'t IC)N PERM/I ISSUE DATE 110/01 EXPIRATION DATE 050602 EC EXP DATE PERM l I STRUCTURE ADDRESS 15/85 PROJECT STRUCTURE STREET SW 116TH AVE LOT BLOCK TYPE CONNECTION- EXIST OF TYPE INSTALLATION- (5 ) INTERNAL/TENANT IMPROVEMENT TYPE OCCUPANCY"- (4 ) COMMERCIAL CAL PARCEL. 2S1 10CD 7600 QTR SEE 4617 MH 6296 OWNER FAMILY COIN LAUNDRY ADDRESS 15785- SW 1161 H AVE TREATMENT PLAN'( )DURHAM KING CITY OR 97224 PHONE 503 -•629 -0353 WATER LISIRJC1 TIGARD FIXTURE EQUIVALENT DWELLING RESTriF:NTTAI. UNITS 202 SERVICE 11NIrs 0.0 UNITS SERVICE UNITS CONNECTION FEES SURFACE WATER DEVELOPMENT FEE SEWER CONNECT CON 20060.00 WATER QUALITY 0.00 LESS CRED1:1 < 0.00:: WATER QUANTITY 0.00 LESS CREDIT < 0.00> EROSION CONTROL SUBTOTAL 20060.00 SUBTOTAL 0.00 TO1AI. 28060.00 APPI.. NAME. .INKWON LEE PHONE m._._._........_....__.._ AFFIL.LIATI:ON REP REMARKS TI KING CITY LAUNDRY; DEMO LAMBERT HOUSE l -�-- S 1?+ian i dr1ditfdms: 'F pe ap i . a•s o ,• ply. all fhe rules and regulations of.Clean Water Servkey, L4cdrid1Ag thcie rp4arLiiFu itosion control. A 24 -hour notice is required for all inspections. The inspection request number is (503) 846 -8444. When calling for an inspection, please refer to the permit, project and lot numbers. The Permit expires one hundred eighty (180) days from the date of issuance. The District does not guarantee the accuracy of the location of side sewer laterals. Revised 6/01 White - USA, Blue - Accounting, Green - Inspection, Yellow - Customer Plftm in Permit Application u�,. Date received: 'Vol (� Permit no.:a�7 • QDj .4=s,- II' cic° L s. t`,•- b g � ;' City of Tigard — .44 '4 11 Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 - 1960 Date issued: ByW. Receipt no.: "L �`,, II Land use approval: � 60 - oo 3 ,AI Case file no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family 0 Tenant improvement G ❑ New construction Li Addition/alteration/replacement 0 Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special inforu ation use checklist) Job address: / jiji t i, r r / t� f '1 (/` Description Qty. Fee(ea.) Total Bldg. no.: // l Suite no.: C. / New 1- and 2- family dwellings only: Tax map /tax lot/account no.: (includes 100 ft. for each utility connection) SFR (1) bath Lot: I Block: I Subdivision: SFR (2) bath Project name: �m / '4) Vic. ? /,, Aa4rilCl!"l SFR (3) bath /,<I' f),. i / City /county: �`,) I ZIP: 2 Each additional bath/kitchen Description and locatjgt of w k on premi s: 7_ Site utilities: fi t r," /wt- Catch basin/area drain Est. date of completion/inspe4(on: Drywells/leach line /trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) '-1 {.. Manufactured home utilities Business name: ' f 71 PA r f ' , Manholes Address: ' • 4 �� i c j L•_ Rain drain connector City: /l 54? State. (A ZIP: 27/ jil Sanitary sewer (no. lin. ft.) Phone: •ll 6 I : • E jf Z I E -mail: Storm sewer (no. lin. ft.) CCB no.: / 33 O 2_ Plumb. bus. reg. no: f _ 3 /23 Water service (no. lie. ft.) Q City/metro lic. no.: Fixture or Absorption valve i tem: �7 / • - Contractor's representative signature: - v _ -- fiaelklow preventer Print name: r Date: Backwater valve Basins/lavatory l ot e la h hes washer Name: r J��,� � �� Clothes as — 4? �N/` ` Dishwasher Address: Q7) _ t C p/e)' ',.///./.. P ,s 41 -?3f Drinking fountain(s) City: - , , i! State: : ZIP: R ' Ejectors/sump k Phone . 'Ji i i gi E -mail: Expansion tank O:1 NI:R Fixture/sewer cap Name (print): _ZAW PV `L Floor drains/floor sinks/hub Mailing address:2 `J" � ' i.�, j < Garbage disposal l f f � f Hose bibb City: /' iJ / s // p.. I State: 27/ V Ice maker Phone: 3 ' - , > I Fax: I E-mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENGINEER Tubs/shower /shower pan Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ Notice: This permit application ❑ Visa ❑ MasterCard Plan review (at _ %) $ expires if a permit is not obtained Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440 -4616 (b)n /COM) PLUMBING PERMIT FEES: - - PRICE TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection) One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE Dishwasher 16.60 ^ PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL - Laundry Tray 16.60 Washing Machine 3 '7 16.60 Litt 2 L Floor Drain /Floor Sink 2" 16.60 3" 16.60 PLEASE COMPLETE: 4" e/ 16.60 6/^ , y U Water Heater 0 conversion 0 like kind 16.60 l� Quantity by Work Performed Gas piping requires a separate mechanical G' Fixture Type: New Moved Replaced Removed/ % / I ,� yp p permit. / ((S1 Capped MFG Home New Water Service 46.40 Sink MFG Home New San /Storm Sewer 46.40 Lavatory Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures (Specify) 16.60 Dishwasher / r-cy ' r wt-e-i. y ; ( ; VC. Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Sink: 2" Sewer - 1st 100' 55.00 3 „ Sewer - each additional 100' 46.40 4" Water Service - 1st 100' / 55.00 ,j - Water Heater Other Fixtures Water Service - each additional 200' 46.40 (Specify) Storm & Rain Drain - 1st 100' 55.00 "c Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device / 46.40 yG ./v Residential Backflow Prevention Device* 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per /hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram is required if (_pr V. Quantity Total is > 9 *SUBTOTAL 9 Zo 8% STATE SURCHARGE 3 l9 7 * *PLAN REVIEW 25% OF SUBTOTAL - "3® - Required only if fixture qty. total is > 9 TOTAL $/2 7-N e (45... * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. ** All New Commercial Buildings require 2 sets of plans with isometric or riser diagram for plan review. is \dsts \forms \plm- fees.doc 08/29/01 O� TI G ARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 • Wi INSPECTION DIVISION Business Line: (503) 639 -4171 MST - c (o o Sat T� / I Received Date Requested c 3 ( AM PM BUP Location /57g5 / 4, 'AN- A U'e— Suite MEC Contact Person Ph ( ) g Lj gg Lig sCi) Contractor . Ph ( ) c O l ‘ SWR BUILDING Tenant/Owner ELC Footing Foundation ELC ess: Ftg Drain Ac J c / / ELR Crawl Drain 7� �rt� c` 4 K4,64 Slab Inspection Notes: ; c t/ S SIT Post & Beam Shear Anchors C U / ' / 40/7- z �y 7 z Ext Sheath/Shear J f-Q 1 W -e e i; Ina /Shear Framing Insulation ��-R f•- 1/ �' Drywall Nailing _ O Z=''' �'� • Firewall ' • i f Z 1 �( Fire Sprinkler '/ erv; Fire Alarm jT Z/A // t• �, / / r� P s Susp'd Ceiling Roof Other: -y� /�� Final fiti J 441) / 6 ec (,� /� ' - p `f • PASS PART FAIL 1 / ✓ PLUMBING i / /iea.g "rj Post & Beam Under Slab r' s i c"< . 70 r Rough -In (03 9 - 9 7 / C;(1 * Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole P o k 1)/5,1 c ,� / `� pu1 U � 6 .c� Storm Drain `"'YY"" �i' r Shower Pan r: Fi SS PART FAIL MECHANICAL �19ti - W. si,./4' M Post & Beam /67.e.7 Rough-In (0 Gas Line Smoke Dampers Final 3 7& PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date / —� Q -2 Inspector ' Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 1 1 — -? AM r, f BLD Location / . 7 ..s / 16o •-� Suite 6-e Z— MEC Contact Person Ph 7 g 7 (, L S PLM ,tea q Contractor Ph SWR BUILDING Tenant/Owner 7 ELC Retaining Wall ELR Foun dation Access: k� FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing 1 ) ?re fr4 o e`e 6 /lc a A> , c 0'2r > S Firewall [' s-� Fire Sprinkler �J� a� u c � u -� S s � � S + //!'mss: e r g Fire Alarm Susp'd Ceiling d i1 9 It Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Top Out Water Service Sanitary Sewer Rain Drains Final PASS FAIL MECHAN Post & Beam �� Rough In Nt97/4, ' /' lic /S /4 / /Gt 1 / L /- /(vc I 4 '7,.i Gas Line Smoke Dampers 1A9 , S /CrGI / a r � 4 - , 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 7/6/ // Z / 7L/ p , Ext Other Date Inspector / Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.. N CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST � J BUP // Date Requested ! r --� / 0 AM a' PM BLD Location / 5 7 jW i/b / Suite MEC Contact Person //•P.,,/1 Ph 3 �S 7 V - PLM 0W12/- Contractor Ph SWR BUILDING Tenant/Owner / j t etA ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: r A 7 Slab � I �1 SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing X /) ! hr¢.. i of 1 ht wn frr , e•,, / y 4 ,,. Insulation / /' Drywall Nailing /�/`u %N (Ar ( 6a� e 8,,✓ CAf O e t7L�41, g t is t oe- Firewall Fire Sprinkler Q V�r f / L : kQ % S /� ' FA-J, �-e - 7 /e--/,/ Fire Alarm ` ) /� it 4 Susp'd Ceiling / 7 40 l��'[ -� �`Q e &if •rah / AI vv� K 4 w. /U 4r./ 7‘-• S Roof 7 c ? V1/. Misc: j ) - r /' �j j Final PART FAIL (s"' 4 Q / 72 —e- �S y dd ) /k �- / L / ` K u! , e !�( 1- e.t ot, ,,-1 K O -e 7 i1 ^ de Post & Beam d mil) Top Out � 7 �D V �G�-� T�� r'r • K �-� j.,t.. 44."4.4 , ,�-� r . 4- erg.. ".Pr �' ..t �e Water Service ' 7 € �... ; rn-e . K U W i moo/ Sanitary Sewer Rain Drains Final PASS PART AIL 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 Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach/Sidewalk F /// I t Other her Date / nspeco G - /q ✓� • E xt Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY L ARD • 24 -Hour BUILD Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / � � AM PM BUP Location 1.S ?FS // 6 //,, 4 T-C Suite MEC Contact Person /x/ Ph ( S`)3) R-4- g a 4 9 PLM Contractor Ph ( ) W - 61 6 6 SWR BUILDING Tenant/Owner - ,.. _ ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear `1 yt1, ry . s .' .- S7 'ALL S Framing ' / v, ��c/! Insulation �7 "� Q a O / 0 0 3 5¢ C 7 )).e..1.- 0) Drywall Nailing `7i `� n 1 0� Firewall �Z PL e- 10 d� - o a a v1-q 4 - -{. T •J7 s �e.- cit-e- 0 Fire Sprinkler _// ^� ,/ Fire Alarm Mf'�i C.� o / - o 0 3 6 P 4-c o f -.. Qo s'° Susp'd Ceiling Roof "..e/c-',Y7 S . Other: ^ r _ (- c /' � f Final ��.0 . n 10 /_ 00 l 4' r� �Q it.,2_ S 4- d 7 e t-c.1 b) PASS PART FAIL �? PLUMBING �,�c 11'.GG4)04,0 // 16 - /6.‘As. WA AkU , C-Q-1 4--1"- Post & Beam Under Slab �� "V Rough -In ���Ain LAS 1 --V\ 1 Lb Water Service Tv Sanitary Sewer I / 0200 /--- 065 - as s, .. - Fto Rain Drains Catch Basin / Manhole l / 'r Y' v1 S' / — Aj0 Storm Drain Shower Pan / O d - i�4 Other: n �^ ,, Final a f . L. jJ ] -�2_4/ 7J ' LAZ PASS PART FAIL �% MECHANICAL C / 7 `/ ' 1? /�-C -t-r+ bGta - Post & Beam n� Rough -In / -- / ;et. Lle.- WJ ! - i c2 Gas Line ' ! /—r---t.7 \ Smoke Dampers �tJ� ./) Final PASS PART FAIL ELECTRICAL m & = (-i - c A ��T ) 4 t f Service ------ o / v ,_ _p 4.--.-„,f Rough -In '''r' 4.--.-„,f UG/Slab // Low Voltage 41 e /A-C∎C — 1—e �.. , y Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY CARD • 24 -Hour Or— BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested AM PM BUP Location Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear I 1 • Framing Insulation /J / N �jS (� � _ p S� �� ' Drywall Nailing Firewall �J U CA.) �� ✓I re r Fire Sprinkler Fire Alarm tit L� �� I— U 0 T rn Susp'd Ceiling Roof Ok > . L1c� - /J� � - � Q P " 4{) L-L Other: 9 ` Final -� S p (N �� !. L C?rZ) PASS PART FAIL PLUMBING 4. ) CJ •� /' !� '� Post & Beam ( s /v D f n S Under Slab Rough -In h/(J' S t�y.�.Q�� Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole ( C( � O f 0/0;1_ Storm Drain. ��� Shower Pan / L � G' � U J7Q-c ;P /• 00 DLLC_. . Other: Final PASS 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL • /pF • • ' "'t \ y�Q n Department of Consumer and Business Services FR'Xio 41 mE' c Building Codes Division A. Kitzhaber, M.D., Governor 1535 Edgewater Street NW John A 5 - PO Box 14470 • Salem, OR 97309 -0404 (503) 378-4133 FAX (503) 378 -2322 January 17, 2002 TTY (503) 373 -1358 http: // www.oregonbcd.org TOM TAYLOR TAYLOR BOILER & EQUIPMENT 9943 NE 6th DR. PORTLAND, OR 97211 Re: QUIK WATER DIRECT CONTACT WATER HEATER As per your inquiry as to whether the Quik -water direct contact water heater falls under the jurisdiction of the Boiler Safety Program. I have reviewed the manufactures data on this unit and it does not fall under the jurisdiction of the Boiler Safety Program. The unit can not develop pressure in any of the sections ( i.e. open to the atmosphere) therefor is not classified as a boiler. If you have any questions please feel free to contact me, 503- 373 -1216. , A0/ F. RAY I D R ACTING CHIEF BOILER INSPECTOR •