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Permit CITY TIGARD PLUMBING PERMIT 4'"1 ft DEVELOPMENT SERVICES PERMIT #: PLM2001 -00153 ' 131 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/13/01 PARCEL: 2S104DA -03100 SITE ADDRESS: 13350 SW 129TH AVE SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT: 017 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 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: Backflow preventor FEES Owner: Type By Date Amount Receipt KORNERSTONE CONSTRUCTION PRMT CTR 4/13/01 $36.25 27200100000 14247 NW SPRUCERIDGE LN 5PCT CTR 4/13/01 $2.90 27200100000 PORTLAND, OR 97229 Total $39.15 Phone 1: 260 -8918 Contractor: DMS PLUMBING INC 12602 NE 28TH STREET VANCOUVER, WA 98682 REQUIRED INSPECTIONS Phone 1: 360 - 254 -4539 RP /Backflow Preventer Reg #: LIC 80744 PLM 37 -271 PB 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: I Permittee Signature: �t161 Call (50 ) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application ` Date received: 1— — 13 —O ( Permit no.: PC./l1 a c49 -00 / 53 ""'4111';' - City o Tigard }, ( `J 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: , By: Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT ❑ — 1 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement l�d'New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: 1_ SC l" -Ct - t - Description Qty. Fee(ea.) Total Bldg. no.: I Suite no.: ' New I- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: (( (Block: I Subdivision:(p1 KA„" (41;FR (2) bath . Project name: SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premises: Site utilities: , Catch basin/area drain Est. date of completion/inspection: Drywells/leach line /trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: Nstl S p 0L , 1 , - 0.• Manholes Address: to 6,- RE_ �(3 _ k Rain drain connector City: Or).(‘-C, V-i.ir -. State:CJN ZIP: Qg4Q2_ Sanitary sewer (no. lin. ft.) Phone:? , _( I E -mail: Storm sewer (no. lin. ft.) CCB no.: g o / { I Plumb. bus. reg. no: '11—'X( pB Water service (no. lin. ft.) Z._ 5 Fixture or item: City /metro lic. no.: Absorption valve Contractor's representative signature: Back flow preventer ✓ '1 Print name: Date: Backwater valve CONTACT PERSON Basins/lavatory Name: Clothes washer Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: . Ejectors /sump Phone: Fax: E -mail: Expansion tank OWNER Fixture /sewer cap Name (print): �tkto�� � -p-tc> C S k-- Floor drains/floor sinks/hub Garbage disposal Mailing address: Kas. ( t, S }-t. r-2d Hose bibb City: by � -1 ar�,-K. I Stat . b tz, ZIP: 9 Ice maker Phone: 'Z 6.., _ 8 I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primers) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property n as per OR,S Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: IS ( � Date: c'() — . \ 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 Plan review (at _ %) $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Credit card number: / i 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 (6/00/COM) PLUMBING PERMIT FEES . • ..-:_ ," '.,..?„,:, :•. -,,...,,,,,, PRIC ,,TOTAL,- ','t•te1a,21.401::i!i(dTwepitig*Onik: ,..-, , - •• ' FIXTURES (individual) 'k - 1 ..4e-, ... QTY ., ':(6A) .`:., 'AMOUNT : !'(inpli.tdes14!1$4MbiOtifiiilurei.:.in . - .. PRICE ,,,g' - .j . 0 . * Sink 16.60 Alie!dWillirig iiidtke4TritlOCi ft. ' QTY :' (ea) * - i : iiii'eactvutiliticcoiiiiection) ` . Lavatory 16.60 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 16.60 Floor Drain/Floor Sink 2" 16.60 3" 16.60 PLEASE COMPLETE: 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 • v ...• • Quart* by,Wo'rk Performed . - Gas piping requires a separate mechanical Fixture Type; - ,.. . NeW' ,Moved.. . iReptaced„ Removed! .. , permit. . , ' '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 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 46.40 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 , • :i -::, , ' - • Isometric or riser diagram is required if Quantity Total is >9 *SUBTOTAL '" , ', , ,'s , ' - ''' :,,-, ---)r .."--- 8% STATE SURCHARGE : 'PLAN REVIEW 25% OF SUBTOTAL . • Required only if fixture qty. total is >9 , TOTAL ' :-,!.,' ; ,- - • $ i c * 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 plans with isometric or riser diagram and plan review. i:\dsts\forms\plm-fees.doc 10/10/00 _ J cITY'OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP Date Requested 4-- 27 - d / AM PM BLD Location / 3 3. 1 ?-5 '' Suite MEC Contact Person Ph c2.w- — gq/k 40 ,0 — 00 ig Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection 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 PART FAIL 0 4 ; - Post & Beam a y / Under Slab n Top Out `� Water Service (%V Sanitary Sewer Rain Drain § , 1 . C. PART FAIL . ANICAL Post & Beam • • Rough In Gas Line Smoke Dampers Final PASS PART FAIL • EL ECTRICAL ,- ',. , 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 4( 1 2)')/6 Inspector Ex Other Final Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF.TIGARD BUILDING INSPECTION•DIVISION :-: = - 2,; _Ii) :J'�3„' 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 - // / BUP y` Date Requested '114 - AM', PM BLD Location / 3 3 5 '5(...) / 2 f / 4 Suite MEC. . ...,,,,// _ Contact Person • • • . . , 14a 8. /' • PL Y' OO !S 3 Contractor. • . ph SWR 4 Tenant/Owner ELC Retaining Wall ELR Foot g Access: C�c /C 6 Foun• :tion _ FPS tg.Dr- •n .1 • 4' �) yawl D -in - Inspection Notes: Slab . _ _ . .. . SIT - - Post 8. Ext_ Sheat_ ar Y --z,...,0 _661 S� l Irit Sheath/S ar & - / _ � 1 1 -�- ' d, Framing C�''L�- ( ,� J =iling � ` � J . .. eS�`- D Firewall �}�, ,� Fire. Sp nkler "`--� ' S. `'O S Fire • - Ceiling r / _ Sus• d Ce . . -- _ �- cf Ro• S L_ LS - 2, 1 / l Mi•.c: PASS PART FAIL S ��' 1 . PLUMB' tit: 1,1 6' v z`� 2lf 1f k " - Post & Beam `=\� d Under-Sleb 1t/Top Out - ,(://, - }- Water Service ,�3 Sanitary Sewer ' `� . ` Q �" Rain Drains �cl es.... �,.c�t/l�. �j -- � � •,r FI A PART ... U I� �� --,---,/ L s .u' - Gas Line Smoke D • • pers (Tm '''''PAS: PART • FAIL E . C,TTRICAL t • - 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 Z11. (p ( \ `. Inspector �� Ext Final ! PASS - PART FAIL - DO NOT REMOVE this inspection record from the job site. Z. z y y CITY OrfIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ST 2.e6 BUP Date Requested `t -' z 7 AM PM BLD Location / 3 7 }Z S C- /2 f' �i Altdi Suite MEC Pi"; (-Ai" Contact Person Ph Z e- ,n ?-6 06 l Si Contractor Ph �� I 00 d-e BUILDING" Tenant/Owner ELC Retaining Wall -- ELR /047o6 (ma) Footing Acces • Foundation r co /e FPS Ftg Drain O4-Crawl Drain Inspection • = _ • SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing eLH2,,c, / v 1 l 5 Insulation Drywall Nailing etc —rx Fire wall k ( -1-r) / d Fire Sprinkler Fire Alarm . Susp'd Ceiling Roof Misc: Final PASS PART FAIL FV Post & Beam �der�ab - 0 Out Water Service it/Sanitary Sewer �ain Drain PART FAIL ANICAL 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 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 �i / 2� Approach /Sidewalk Date (C) -- E.; LC) other Inspector Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site • • CITY OF BUILDING INSPECTION DIVISION a yP .. : - • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171' ST ct! C fr . 3 6 Date Requested q--2-40 AM / - AM BLD Location / 7 3 5 se.) /21 �A1ue Suite MEC Contact Person Ph o26 -Try J8• ► 6 ,Q0D (" 0C1 s 3 Contractor Ph 427, — 0 0 - 1e7 BUILDING ' . : Tenant/Owner ELC - ktS Retaining Wall ELR tO e 60 ✓Y1 es Footing Access: Foundation (-NA / , ) FPS Ftg Drain 8u SGN /Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear kit Sheath/Shear J . , e _ s z � ^ �, ; ` ; `� Framing `� Insulation Drywall Nailing Firewall (A-41,e_ Fire Sprinkler 6 "P U 9 � �. Fire Alarm -11-2.) v "'�--& \� . S p Susp'd Ceiling Roof Misc: Final ; � 4'\i/LW t---\ PASS PART FAIL X81 /.- O Le." ` r- -0--( S --,,, Post & Bea , tea , 0: — w. R-I c - . 00/top Out 6am Water Service 4 1)il1/Sanitary Sewer Q �- e ,✓Rain D_ r„ai_ns - WI $ A.a.41./ (....4.. kAi ' 0/ i A C.- SS PART rn-'D 1 5 o kA.d k S MECHANICAL 4� \' ...1 1 �--Q Post & Beam - Rough In b O y .,,r1 Gas Line Smoke Dampers Final PASS PART FAIL l f • l _s L. X. q ELECTRICAL , •_ (/. - . - v ,, '\ Service • S . ° • Rough In UG /Slab Low Voltage °� 1F - ! Fire Alarm �� -. - "__ • S Final L -�S r 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 c Approach /Sidewalk Date ® \ [ Othe Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 3z /, CITY OF rIGARD '3U'ILDING INSPECTION DIVISION. ` . boa -acv �/3� 24 - Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 4 --/ 7 AM PM BLD Location /33) .51.-.1 /&9 r' ,&' Suite MEC Contact Person Ph 266 VV / g LM 0 2/MU— 0a I.-3 Contractor Ph R 600 -6d;--/ 2 BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation 1 „I " 4e1-f' ' " FPS Ftg Drain / SGN OZ(,-Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Sheath /Shear yo -� j 0 -k — 00 a s �, _ , r . L Framing (i® dam/ `� Insulation _ Drywall Nailing -e , Firewall Fire Sprinkler _ Fire Alarm /� _ . Susp'd Ceiling AS � � - Z • (� Roof C -P/ -% /D A110” g C.‘_ . C.. — Final \ _ �` c �Z q �ASC -ART FAIL ° p ,F Pte , . Post & Beam .:e1,___30...,22_,.... ttli, Top Out IN Water Service ex,-..-4--4R•D, / .UJ Sanitary Sewer 0,2.(Aain Dr jgs," anal 111• ASS PART (f; MECHANICAL y : j N , c — -- f t - d �C�� �ce Post &Beam Rough In C - - Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL` ; y: Service Rough In UG /Slab Low Voltage Fire Alarm � 1 _ Final PART FAIL ��- � • SITE'S.... ' ' lir I - Backfill/Grading Sanitary Sewer - _ 6:P'-' Storm Drain Reinspection fee •' $ 'P required next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call ft rei -- - ° . [ ] Unable to inspect - no access ADA Approach/Sidewalk /i A Other Date [ / Inspector Ext t9 Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By I Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall 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 4 Inspection Description Date Passed By Drywall nailing 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 Fireproofing Lab Final Mechanical final Structural observation Final inspection Wove- - Plumbing Permit 4 Inspection Description Date Passed I By BUP — Fire Protection System Permit ' Plumbing underslab Inspection Description _ Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out ,r Sprinkler fmal RP /backflow preventer 4/ L o I Fire alarm fmal Rain drain _ Storm drain Water service SIT - Site Permit ` Sanitary sewer J Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final 4 (2 7/U , Sprinkler supply lines • Sprinkler underfloor /slab Catch basin/Manhole SWR - Sewer Permit Engineered soils Inspection Description Date Passed By Engineering acceptance Sanitary sewer _ Final inspection Final inspection INSPECTION RECORD - BUP, PLM SWR, ELC ELR MEC SIT PERMITS CIT OF TIGARD PLUMBING PERMIT � DEVELOPMENT SERVICES PERMIT #: PLM2001 00153 41I DATE ISSUED: 4/13/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 104DA -03100 SITE ADDRESS: 13350 SW 129TH AVE SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT: 017 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 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: Backflow preventor FEES Owner: Type By Date Amount Receipt KORNERSTONE CONSTRUCTION PRMT CTR 4/13/01 $36.25 27200100000 14247 NW SPRUCERIDGE LN 5PCT CTR 4/13/01 $2.90 27200100000 PORTLAND, OR 97229 Total $39.15 Phone 1: 260 -8918 Contractor: DMS PLUMBING INC 12602 NE 28TH STREET VANCOUVER, WA 98682 REQUIRED INSPECTIONS Phone 1: 360 - 254 -4539 RP /Backflow Preventer Reg #: LIC . 80744 PLM 37 -271 PB th This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Q 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 O Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. O You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: / Permittee Signature: , y' Call (50 ) 639 -4175 by 7:00 P.M. for an inspection needed the next business day