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Permit CITY TIGARD PLUMBING PERMIT • I, DEVELOPMENT SERVICES PERMIT #: PLM2000 -00190 `'` '� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/7/00 SITE ADDRESS: 15900 SW 116TH AVE PARCEL: 2S110CD 00105 SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: ADA update of water closet, lavatory and water heater. FEES Owner: Type By Date Amount Receipt UNITED STATES NATIONAL BANK PRMT DEB 6/7/00 $50.00 KING CITY REAL ESTATE MGMT DIV -T3 PO BOX 8837 5PCT DEB 6/7/00 $4.00 KING CITY PORTLAND, OR 97208 Total $54.00 Phone 1: • Contractor: MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone 1: 691-6166 Top -out Insp Reg #: LIC 87906 Final Inspection PLM 34 -250PB 09\G\N\L 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. Yo - -' • in copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Iss ed B ►l� -4 a I' i'• Permittee Signature: , AA_ . ,Ade Call (503) *49-4175 by 7:00 P.M. for an inspection needed the next busi ess day 1 JUN - 06 - 00 TUE 03:26 PM City of King City FAX:503 639 3771 PAGE 2 CITY OF TIGARD' . ' Plumbing Permit Application Plan ck . 13125 SW HALL BLVD. Commercial and Residential Rac By TIGARD, OR 97223 Date Recd '7roO (503) 639-4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit* Related SWR # Called Name of Develo ment/Pro ect �s ' dfi tdual i`; 41 ;;if "°CR;R , ,c`w;, tiii' . =:iF IC NOV p 1 ,��7�;�1R�S+_?g?(i� • - ): �' r It ±l4,.,,a,,��, �_.....,. ...:.......... � ,,. �';P�..;., � �.� Job QL..S 2 /,., J Sink 11.50 , Address Street Address �?�� Suite lavatory 11.50 �j (-01.1 . O Tub or Tub/ Shower Comb. 11.50 Bldg hit CitaState 1 Q Zip Shower O 11.50 1 �� r ! 0/ Wale Closet/ 'nal (Specify) 11.50 Name ��JJJ , . Dlshwas er 11.50 Owner Mailing Address Suite - Urinal 11.50 Garbage Disposal 11.50 City /State Zip Phone Laundry Tray 11.50 Name / Washing Machine /Laundry Tray (Specify) 11.50 S ' 1 3 . V"Q..._ Floor Drain /Floor Sink 2 11.50 Occupant Mailing Address Suite _ 3" 11.50 . • 4" 11.50 City /State Zlp Phone Water Heater 0 conversion 0 like kind a 11.50 Name Gas piping requires a separate Mechanical permit. f �� `� \X-0.--)1') MFG Home New Water Service 28.00 �� dd ! r- S ite MFG Home New San/Storm Sewer 28.00 Contractor M ailing Address Suite _ 1710 (-■` )j Hose Bibs _ 11.50 • Prior to permit City /State Zip Phone , Roof Drains 11.50 Issuance, a coPY L.. ph t _p , . -44_j 61,- et/04n- 6 t/6 Drinking Fountain 11.50 a all tican.ses are Ore a Co tCoo. Board Lic,# Ex p. Date - required if f .0 b G Other Fixtures (Specify) 15,00 expired In COT Plumbing tic_ e Da r database ; `( - 75 , C) -- '- Name Architect _ Sewer-let toe' 38-00 or Making Address Suite Sewer - each additional 100' 32.00 Water Service - 1st 100' 38.00 Engineer City/State Zip • Phone g Water Service - each additional 200' 32.00 Descri work to be done: Storm & Rain Drain - 1st 100' 38.00 New Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Resi ential 0 Commercial - Commercial Back Flow Prevention Device 32.00 Additional description of work: �7 cr �T,u "� ■ p 1�-� � + l ^ Residential 6adcflow Prevention Device 19.00 Nt(\ Pt. e L LAO-4 6j e A t ll-" \ Catch Basin . 11.50 Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50,00 Yes 0 No 0 Inspections per/hr If yes, see back of form to indicate work performed by r Rain Drain, single family dwelling 45,00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps , WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL. I hereby acknowledge that I have read this application, that the Information lsoetric or riser diagram Is required if Ouaruhy Total Is > 9 given is correct, that I am The owner or authorized agent of the owner, and m " SUBTOTAL ^ ' "'dam hat • lans submitted are in : re mpllance with O, on State Laws - ;:;:; O fr , t t / / 0 8% SURCHARGE Is S25 ^ nt oryNama $ h 6 / - PLAN REVIEW 25 °k OF SUBTOTAL e , - , lU ( � Required only If fi qty. total la> g : 'i' H, ± � : '', . ' r } s'Ni r ;1 k " ' ' S r ; TOTAL ' ' ' , 0 fe. t2 a . s . '.,,� . . I ' :: S' a w i 3 � q ,,, i a q. 5; ' i i ./ Th : . , O . ;04 .s lumblw k ",'t$),::iPt '�";44„', "'1:�r ?, 1fi� ,/li: ":: "Minimum permit fee is $50 + 8% surcharge, except Residential Bac is ee Inclu ; l # p e li nd`tho first:' i k:now Prevention ,, W«fff St�ilf' 8. 01 k ,� �: r ' +k 4 1';�un Device, which 4•894 surcharge �.i� ..wti�. x:. 35th °' ��' """ "" "'' '� "All Now Commercial Buildings require plans with isometric or clear diagram and plan review. r'ldsts formslpfumapp. 1011,99 - CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 /_ w ,rv� BUP Date Requested (p /l S AM PM BLD Location / S q °C I I Suite / MEC Contact Person JAVAN1 Ph L '/ K.4 PLM G - 001 9O Contractor I < � Ph SWR a CJ BUILDING Tenant/Owner > et-1" \.J-- ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: 1(�-(,,f rtk+ et Slab U �I SIT Post & Beam ( t � A / Ext Sheath /Shear ) /�' -�/�• Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PAS5_ FAIL Post & Beam Under Slab <Top OLD Water Service Sanitary Sewer Rain Drains Fin A 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 Approach /Sidewalk Other Date lL Inspector Ext Y Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION ST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • [[�� BUP Date Requested �—� AM/ Y7PM BLD Location /4570 d Ste/ /7 ' ( Suite ` ME Contact Person (S ` 1 O v I ( Co r �l Ph �fl — 4.( c �O PL 2®VU G v / j� U Contractor Ph / SWR BUILDING Tenant/Owner. 7 1/V ELC Retaining Wall ELR Footing Access: Foundation G9 2 / G (( 6,1( FPS Ftg Drain Q % ( SGN Crawl Drain Inspection Notes: 4,�A-�c4-e, � Slab VV77 �� SIT Post & Beam Ext Sheath/Shear ' 11 Int Sheath /Shear . , t V v Framing Insulation �/� r O Drywall Nailing Fire wall r^� r, Fire Sprinkler � U ,r \ \ O Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL c etiMBING -1 os &Beam Under Slab (∎t Top Out Water Service Sanitary Sewer, R -i* •rairf 440 PART FAIL NICAL 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 J� \ b v Inspector v LA / Ext Other p Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Buoiness Line: 639 -4171 r ) BUP -X Date Requested -7-, AM PM BLD Location 1 .5 t' 6 ' S ' / L Suite MEC Contact Person Ph (; PLM � i'C Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation ] 3 / C , C /( / . FPS Ftg Drain / / / �t" Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall Fire Sprinkler Fire Alarm /� /0. A T Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer R in Drains Final VA PART /F�(IL 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk - 17, Other Date / ♦ I Inspector Ext, Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.