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Permit CITY OF TIGARD PLUMBING PERMIT *0 4I> DEVELOPMENT SERVICES PERMIT #: PLM2002 -00143 - I� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/15/02 SITE ADDRESS: 15900 SW 116TH AVE PARCEL: 2S110CD -00105 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: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: A3 FLOOR DRAINS; 8 TRAPS: STORIES: 1 WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS: SINKS: 4 URINALS: GREASE TRAPS: 1 LAVATORIES: 1 OTHER FIXTURES: 3 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing tenant improvement for new restaurant. FEES Owner: Type By Date Amount Receipt UNITED STATES NATIONAL BANK PRMT CTR 5/15/02 $378.40 27200200000 REAL ESTATE MGMT DIV -T3 PLCK CTR 5/15/02 $94.60 27200200000 PO BOX 8837 5PCT CTR 5/15/02 $30.27 27200200000 PORTLAND, OR 97208 Phone 1: Total $503.27 Contractor: BUD'S PLUMBING 605 NW 22ND STREET BATTLE GROUND, WA 98604 REQUIRED INSPECTIONS Phone 1: 360- 687 -9226 Rough -in Insp Top -out Insp Reg #: LIC 147300 PLM 147 RP /Backflow Preventer 0 0 Final Inspection 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: ' ( , t -�� Permittee Signature: X �i / Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day .'! S 8 oz Plumbing Permit Application Date received: 4 5 So Q p Permit no.: L,K' _ /q3 o , of Tigard i and (r1 'I �_ `J , g Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 �. City of Tigard Phone: (503) 639 -4171 Project/appl. no.: date: Fax: (503) 598 -1960 43 Date issued: By - Receipt no.: Q Land use approval: Case file no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement 0 ❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: a 4 7 , ` �P i J �-p r. \ ' ( " f _ Description Qty. Fee(ea.) Total r `� New 1- and 2- family dwellings only: Bldg. no.: I Suite no.: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: IBlock: Subdivision: s SFR (2) bath t Project name: p p "0 A1A IA 0 v-vi■cylr ( SFR (3) bath City /county: \,; . _ i. r \... , e.4 t i I ZIP: - ` ? Each additional bath/kitchen Description and locatio f *brk on premises: Site utilities: � � � C - 4 ! " C , SDI -7aS -S lib? � Catch basin area drain Est. date of completion/inspection: Drywells/leach line/trench drain PLUMBING CON Footing drain (no. lin. ft.) c. t Manufactured home utilities Business name: IW � �hw+� `� Manholes : Qt Address: (pd 5 AJ A). h Rain drain connector l- City: p, c) s' A kQ (' vr u Stat ZIP: r \, Sanitary sewer (no. lin. ft. -� I d1/� I _` is r ( ft.) _ w Phone: 03-577 1 120p I E -mail: Storm sewer (no. lin. ft.) CCB no.: ! 41 -30 Fax: I Plumb. bus. reg. no: boz 1(b0 (O Water service (no. lin. ft.) City /metro lic. no.: : 1 Fixture or item: A ' a Absorption valve O Contractor's representative signature: Back flow preventer i Print name: 1 `u'' AO t � Date: —3 0 -02 Backwater valve O :_+CON'TACT PERSON Basins/lavatory Name: Clothes washer — 1 Dishwasher Address: Drinking fountain(s) — City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank . - — Fixture/sewer cap --- (print) Floor drains/floor sinks/hub h/ 5 .?„"Fe) .?„"Fe) MName ing address: Garbage disposal N Hose bibb City: I State: I ZIP: Ice maker l Phone: I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) Z 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) 4/ Owner's signature: Date: Sump °` ENGINEER Tubs/shower /shower pan — Urinal — Name: Water closet Address: Water heater 1 City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total r^. op . ") 1 Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ Notice: This permit application Plan review (at — %) $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Credit card number: / / State surcharge (8 %) .... $ Expires within 180 days after it has been TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440 -4616 (6/00/COM) PLUMBING PERMIT FEES: * - y PRICE TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) , - , QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink ' 16.60 r/'4a9', the dwelling and the first100 ft. QTY (ea) AMOUNT 1 6.60 for each utility connection) Lavatory /ij 1) 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 /4 /, SUBTOTAL Urinal 16.60 8% STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray /IO, Sehd.-. / 16.60 /f, 4» Washing Machine 16.60 Floor Drain /Floor Sink 2" 16.60 /32,g0 PLEASE COMPLETE: Fs .‘,/ 3 .. -- 16.60 ro " 4" 16.60 Water Heater conversion 0 like kind 16.60 Quantity by Work Performed prpit g7equires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. /4/6 G, �` 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)14,. s . fi 16.60 /4,4 Q Dishwasher (2) P/.wt c•cs _ ? ZO 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 Water Heater Other Fixtures Water Service - each additional 200' 46.40 (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device f 46.40 y(, W Residential Backflow Prevention Device* 27.55 Catch Basin 16.60 , Inspection of Existing Plumbing or Specially 62.50 Requested Inspections per /hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 /,,, / A QUANTITY TOTAL Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL -:> 8% STATE SURCHARGE 3L -'- * *PLAN REVIEW 25% OF SUBTOTAL 9q4 Z) Required only if fixture qty. total is > 9 TOTAL sa3•Z7 * 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 12/26/01 CleanWater Services Our commitment is clear. 155 N First Avenue, Suite 270 SANITARY p errnm o uil Hillsboro, Oregon 97124 SURFACE WATER (503) 846 -8621 CONNECTION PERMIT ISSUE DATE 051402 EXPIRATION DATE 111002 EC EXP DATE PERMIT 122554 STRUCTURE ADDRESS 15900 PROJECT 9999 STRUCTURE STREET SW 116TH AVE LOT BLOCK TYPE CONNECTION - EXIST OF TYPE INSTALLATION- (5 ) INTERNA.L /TENANT IMPROVEMENT TYPE OCCUPANCY- (4 ) COMMERCIAL PARCEL 2S1 10CD 105 QTR SEC 4617 . MH 6297 OWNER JUNO INC ADDRESS 15900 SW 116TH AV TREATMENT PLANT DURHAM TIGARD OR 97224 PHONE 503 - 705 -5467 WATER DISTRICT TIGARD FIXTURE EQUIVALENT DWELLING RESIDENTIAL UNITS 27 SERVICE UNITS 0.0 UNITS SERVICE UNITS • CONNECTION FEES SURFACE WATER DEVELOPMENT FEES PROCESSING 25.00 WATER QUALITY 0.00 LESS CREDIT < 0.00> WATER QUANTITY 0.00 LESS CREDIT < 0.00> EROSION CONTROL SUBTOTAL 25.00 SUBTOTAL 0.00 TOTAL 25.00 A ?PL NAME KATE PHONE A?FILLIATION REP RZMARKS TI FOR MASHITA TERIYAKI SEGNATURE t G't A ISSUED BY GROSSM Permit conditions: The applicant agrees to comply with all the rules and regulations of Clean Water Services. When calling for an inspection, please refer to the Permit Number. 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 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP e' % Received * Date Requested �9 AM PM BUP Location uite cat Zo d . 00111 Contact Person Ph ( ) 7Z 3 5 % 7 PLM g a a ( (/3 Contr Ph ( ) SWR BUILDING Tenant/Owner d� - _-6U: 7�`V L ELC Foundation ELC Ftg Drain Access: �'} ELR Crawl Drain C/ Slab Inspection Notes: SIT Post & Beam Sr Anchors Sheath/Shear Ext eah/hear Int Sheath/Shear r /� Framing C / S '/�/� l� Insulation Drywall Nailing Firewall Fire Sprinkler ° -- Fire Alarm Susp'd Ceiling Roof Other: • :T FAIL G Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: S P A PA SS PART FAIL NICAL — Pos Rough -In Gas Line Smoke Dampers inai ART FAIL ICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: Unable to inspect – no access Fire Supply Line ADA Approach /Sidewalk Date 7 / © Inspector / Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OFIIGIRD 24 -Hour . _ ,_ - ` BUILDITG Inspection Line: (503) 639 -4175 EtSl9- . INSPECTION DIVISION Business Li // ne: (503) 639 -4171 Received Date Requested AM PM BUP S f�rlJ Location � , Suite , MEC Contact Person Ph ( ) 20 - PLM Contractor >_ Ph ( ) / SWR BUILDING Tenant/Owner _MQ -s"c 4 / -e4/�/ to `C�t ELC Footing Foundation s.%w.1, ELC Ftg Drain ELR Crawl Drain Slab Inspect! n N SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear /) �. _j,� rY i " T it S 'k+' to ar_ ' / "` Insulation ace P-00/-)-- d /2 C f J1 —vd> Drywall Nailing Firewall 0766)-do,?- O d / 3 , (77/e z //vs' 4- 41a1(--2-10 ‘c-;19) Fire Sprinkler / , Fire Alarm &XI a--ad ?-- d C) f 7 3 ( 7---77)— 4' /,vlcj / - LaN I LvjL Roof Ceiling �� �� ] S �� Roof G! ��jy� - v c Other: /- b _ Q � � / -'? / Q Final /-�-2_ ("Vt., ,i2/V") ,i2/V") Cif! 5 c� ki -mod �c (�-,,. ,SLX PASS PART 42) I / / ■ 1 i / f l PLUMBING c ) '9/'T chit „c- g)2-,-r,jS . X / � u Post & Beam ��o a- ^ d Under Slab /J Z- ( rfo5 5 w., 3dQ Sf�,-L_ Rough -In fe.-2. .� V 90 5:2- % � � "". _ ' Y _ c,C S S Water Service (� �� Sanitary Sewer 1.* l I ' /55 i . O') • Rain Drains Catch Basin / Manhole 3) NC3 (2,......„,p4„,w,.., O _4) re_ �.. 4v.- l. ( .1-, ' Storm Drain Shower Pan C V )0e cy—) 71-- 4 eZ.#A / Ir • Other: Final (.10�i t'//� LI.J C--1- PASS PART FAIL �! MECHANICAL S.) J-� 1.-✓1...i G 4 --- C---e ,, wit �`-" c • Post & Beam / • 1 1f 3 , /J„ ,( _� C Rough -In (a J // �''r!1 1�►� �'1�.1P S` y � � Smoke Dampers Gas Line ,2� (c.-,•� `n CZ-- 72 � L Final I _ • PASS PART FAIL `�' 12-e-1 ELECTRICAL V 61) ^ ��'—. _ c _- Service f � &� Rough -In �- 2 1 C-40 S Lk.J 4 -- a i �- 2-- C.`.- . UG/Slab JJ Low Voltage 9 L1 .�( a 3 7 ��,fi� �� kJ D le-e-e r e _ c f- r...d-k Fire Alarm 9 /3 v)C-e 5 51- .4-0-4 s�..- -2-y /' <...-4-..---7 /het 4 _ 1v F PASS PART FAIL ❑ Reinspection fee of $ required before next inspection. Pay at Ci Hail, 13125 SW Hall `� SITE 111 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA / � Approach/Sidewalk Date 13 , / Inspector Y .. Ext " Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY -OF TIGARD 24 -Hour _ BUILDING Inspection Line: (503) 639 -4175 �/ / ` „ INSPECTION DIVISION Business Line: (503) 639 -4171 �11� MST `:'•' Zoie - do // Received Date R uested 7 - - 5 - 6 AM •' /f / PM BUP . Location /570 t . 5w // 4 v /1 c Suite MEC Contact Person Ph 70.5 7 PLM Contractor � Ph ( ) SWR tn/ !� BUILD Tenant/Owner r Y t 6 'C VI A \ Q (/)0. % ELC ooting Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear do ,/1 o Framing I' 0 1 Insulation 14# 2 O a �^ Q-C / Co Z / ' t o , a GO )e., Drywall Nailing !s UL--30d Firewall ''''''A' ' 4S - cf.- 6 /3 . 01 e7' -iP d Fire Sprinkler _ p Fire Alarm I� �/�,/� � I�i� Z Z U - 0 / "- l ( / -- /1 l/ � ) 'X, Susp'd Ceiling /� ' Roof C-- %s$�dJ / Z Cr ) — d � C�- • l er: �, ,( ( _ PASS P L k '1602_ - 6 0 / 4 3 1. T1- ASS PART / < PLUMBING ` � --��'' -4_9 ./ Post & Beam , X (. LC..v ? tea -z - v d 2 4 7 4 T r ) Under Slab Roug Service /4 cS - -7/3/° -2_ ` j Wate EC) 0 Le----- Sanitary Sewer ` )(g'k([ ) 7 a 2 00 / Z s ( /2_ 2 d ) Rain Drains Catch Basin / Manhole >• / £C //3/d _ 6 7 d Storm Drain Shower Pan i sj i'r !a.�..� / i 7 /7� AP _ Other: (; °V � S' Final // / � -- - _ - PASS PART FAIL MECHANICAL 491�f I flrst S s. , Ro & Beam 4 */),4 r k1 S d, l Rough -In Cdd.,, ---7„4- t Gas Line 4 A) — 66 Smoke Dampers c Q Y - Final / // PASS PART FAIL 3 `% A ELECTRICAL L•) ill l 4--e ro'� (A-4 ` — `7' 0 ' 01,/5/...../........../ Service Rough -In a' c-� e Low olt e ) ( c - Low Voltage 1 / � Fire Alarm 4-. ) ( 4 ew e /-1.) j�,J S ' 4. L 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 S d �� Inspector Ext Z / Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL / .2-- CITY OF TIGARD 24 -Hour _ A BUILDING Inspection Line: (503) 639 -4175 MST __ INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP Location Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear r ff / L Int Sheath/Shear 5 •) � Q'.■k / — t es ;S f "4C.�1 ■ e---,e L.4,1 Framing Insulation h f/C '4-- &etA/ . Drywall Nailing ) /�,J, t � // _ (....„:„ Firewall h.) rt G- � (-P ._ — ' 'e Fire Sprinkler Fire Alarm Cx- S , G -.-k y / Susp'd Ceiling Roof 0 r-e i Other: /� ,, �. Final .7 - ' S 3-'1.45 �� z (iJ GC- `�-/� l`.r.`.n f2 PASS PART FAIL a 5 , me-Q- N PLUMBING Post & Beam 0, J �! � y 5�F--e -, .- Under Slab Rough -In ) �ie ( 7 e Zel Water Service ! Sanitary Sewer C- ) .�� ( v J o � Rain Drains �"— Catch Basin / Manhole < ^ „ ', ` p 1 } �_ `L .� - Storm Drain ' n Shower Pan ,-../.--e , rY...&, A .a.. .L CX Other: Final PASS PART a MECHANICAL FAIL a,,, --o 1 `, << C Post & Beam 1 Rough -In � ./ C 1-- ✓ 1 / 4 . �-st.. 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 7 /s /c - z Inspector CZ Ext Z Y Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL 2— CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business (503) 639 -4171 MST / BUP Received Date Requested AM PM BUP Location 1 5 - q06 /l S -41/ ` Al Suite MEC Contact Person CLe2 Ph ( ) S 7 7 ( "0" 0-6 PLM d, / ( -7 1 7 Contractor Ph ( -) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection N / SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ■■•■/ Susp'd Ceiling Roof OAKAf Other: Final PASS PART FAIL PLUMBING 0 \V Post & Beam Under Slab ug a er Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain ®, l Shower Pan ,f( Other: Pan/ Fee / PART M ANICAL 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: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector 917 Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 - c;2_. / 2 INSPECTION DIVISION Business Line: (503 63* _, ,, �_ �• Received Date Re uested PM BUP j5 Location 6 / ! T" �- Suite MEC Contact Person Ph ( ) Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation g Access: Ft 3 (� ELR Drain Crawl Drain Slab Inspection Not s: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post am r Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final �A9S ART FAIL MECHANICAL Post & Beam �1 Rough -In q°(1' - 11_0, l i /'l4 / 7 !' P 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 5 Approach /Sidewalk Date ,7 - z ' o Inspector 1C Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL .CIT,Y OFTIGARD 24 -Hour _ BUILDING Inspection Line: (503) 639 -4175 . INSPECTION DIVISION Business Line: 5 MST BUP Received Date R quested i 7 AM PM BUP Location /50O /// ulte MEC Contact Person At/0 5 77 — « O D PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: � Ftg Drain J ELR Crawl Drain fl Slab Inspection Notes: A SIT Post Beam Shear Anchors hl Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _ / / • ,.Li� 4 : ' Firewall 4.0 ,44.4 7 �X�.,�'�i� 5 VP r/5 k7 ` �/ S Fire Sprinkler Fire Alarm ( paw Leo / 2,S e AIV/ S - Susp'd Ceiling Roof Other: Final PASS PART FAIL V NIBItia N N B� nder ab Roug - n Water Service 131;17-e_ lro"o"' yr j r er.-t •c 749 r.,. ". •c1, Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pa Other: Final PASS : FAIL MECHA L 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: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date S ^ � 7- 6 Inspector Zi // G V e Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL BUP - Building Permit ELC - Electrical Permit -4 Inspection Description Date Passed By 4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wali cover Footing drain _ Ceiling cover Waterproof bsmt walls _ Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation _ Post /beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall _ Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils _ Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final — Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab z t -v �- Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab i Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final 7 77 Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01 s .. •I CITY TIGARD PLUMBING PERMIT` *il DEVELOPMENT SERVICES PERMIT #: PLM2002 - 00143 ; 4,,,1 '6 � � DATE ISSUED: 5/15/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15900 SW 116TH AVE PARCEL: 2S110CD 00105 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: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: A3 FLOOR DRAINS; 8 TRAPS: STORIES: 1 WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS: SINKS: 4 URINALS: GREASE TRAPS: 1 LAVATORIES: 1 OTHER FIXTURES: 3 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing tenant improvement for new restaurant. FEES Owner: Type By Date Amount Receipt UNITED STATES NATIONAL BANK PRMT CTR 5/15/02 $378.40 27200200000 REAL ESTATE MGMT DIV -T3 PO BOX 8837 PLCK CTR 5/15/02 $94.60 27200200000 PORTLAND, OR 97208 5PCT CTR 5/15/02 $30.27 27200200000 Phone 1: Total $503.27 Contractor: flailli BUD'S PLUMBING 605 NW 22ND STREET BATTLE GROUND, WA 98604 REQUIRED INSPECTIONS Phone 1: 360- 687 -9226 Rough -in Insp Reg #: LIC 147300 Top -out Insp PLM 37 -507P6 RP /Backflow Preventer Final Inspection Ni % a 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. 14 You may obtain copies of these rules or direct questions to OUNC by calling (50a,1246-1987. Issued By: �( ' � L/ { �e(t Permittee Signature: /) Cam- �� Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day