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Permit CITY TIGARD i� PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2000-00220 6 " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: SITE ADDRESS: 12162 SW 131ST AVE PARCEL: 2S104AB 06300 SUBDIVISION: MORNING HILL NO. 4 ZONING: BLOCK: LOT: 092 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 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: Install a residential backflow prevention device. FEES Owner: Type By Date Amount Receipt ROAST, BRAD + LAURA PRMT DEB 6/19/00 $25.00 0003083 12162 SW 131ST 5PCT DEB 6/19/00 $2.00 0003083 TIGARD, OR 97223 Total $27.00 Phone 1: Contractor: OWNER REQUIRED INSPECTIONS 1: RP /Backflow Preventer Phone Reg 1 . Final Inspection \C 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. � ! Pe rmittee Signature: Issued B 1 �� .► .� _ g ,� ... r _ Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day CITY OF Plumbing Permit Application Plan Check 13125 SW HALL BLVD. Commercial and Residential Rec'd By TIGARD, OR 97223 Date Rec'd (503) 6394171 Date to P.E. ,. ,j Print or Type Date to D T zpo-ocizzO Income t or illegible applications will not be accepted Permit #nlyl S 16 2000 Related SWR # Called IOMan11s.1nY nFitri npurtp Name of Development/Project f; FIXTURESxi :'(ndivtdual) ; °' x.. '`QTYa PR .� - - - -- . te r, >.,.�.�. �_ _� E��s� � , �� a -_ ,`° �.. fCE i A1NT Job Sink 11.50 Address Street Address Suite Lavatory 11.50 12- 162 54. /3/ L',,, Tub or Tub /Shower Comb. 11.50 Bldg # City /State Zip Shower Only 11.50 • 7C,f!A' g 9 722.3 Water Closet 11.50 Name tt RA *D I aPy 7- Urinal , 11.50 Owner Mailing Address Suite Dishwasher 11.50 1 2,1 62 64.>/ 3 / ..6 Garbage Disposal 11.50 City /State Zip Phone .5'c7. -. ��aA.4 ®Iz 972Z3 J 3 / _ Laundry Tray 11.50 Name Washing Machine /Laundry Tray 11.50 Floor Drain /Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11.50 4" 11.50 City /State Zip Phone Water Heater 0 conversion 0 like kind 11.50 Name ' Gas piping requires a separate mechanical permit. MFG Home New Water Service 32.00 Contractor _ Mailing Address Suite MFG Home New San /Storm Sewer 32.00 • Hose Bibs 11.50 Prior to permit City /State Zip Phone Roof Drains 11.50 issuance, a copy . Drinking Fountain 11.50 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date required if Other Fixtures (Specify) 15.00 expired in COT Plumbing Lic. # Exp. Date . database Name • Architect Sewer - 1st 100' 38.00 or Mailing Address Suite Sewer - each additional 100' 32.00 Water Service - 1st 100' • 38.00 Engineer City /State Zip Phone • Water Service - each additional 200' 32.00 Describe work to be done: Storm & Rain Drain - 1st 100' 38.00 New 0 Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Residential Commercial 0 E�c,.A cE. ATMC 5 1 p 1'i E/2, ' Commercial Back Flow Prevention Device 32.00 Additional description of work: R t�A G U U M 31? i A &,,Z tom/ T'ri/ Residential Backflow Prevention Device* / 19.00 ip c' <-..t 04. E /" G' fir V / vE 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 Rain Drain, single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 O _ QUANTITY TOTAL � l WORK COULD RESULT IN INCREASED SEWER FEES. a:, e� I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9 �� given is correct, that I am the owner or authori ed agent of the owner, and *SUBTOTAL 7-f":11 that plans subm� �Cn ted are in rnpllance with Oygon State Laws. SUBTOTAL == -f;:,. =; - S" ure wner /Agent Date . . p 8% SURCHARGE `f,1: "� Contact Person Nape-, Phone ` Phone Ni ' `' ,'�, ?p,C? .5. 7 5 rgn _ 33.i sr * *PLAN REVIEW 25% OF SUBTOTAL ; "" �"" 1 BATH= HOUSE OQM- E Required only if fixture qty. total is > 9 'T �t ;. PTA W r TOTAL 2-13A HOUSE $250 00 V BATHHOUSE #Z$Sr:00 x i (Thies fes lncludei IIPlum�b in a dwel ling andxthe;i�irst, *Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention 10- feet_of$anita geiltrer StQRn' BWei�t seIYIC@ Device, which is $25 + 8% surchar e �._, - . *a , tea.. 9 **All New Commercial Buildings require plans with isometric or riser diagram and plan review. l:\dsts\forms\plumapp.doc 11/18/99 PLEASE COMPLETE: _ _ 0 pijj4 , a* " ! :1" ' 4e* MO " Ved'r IRefilated k r T9"Y.9. AWW4'' evrte■Isev: , „ Sink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain/Floor Sink 2" 3 " 4 " Water Heater • Other Fixtures (Specify) LJ 117, • COMMENTS REGARDING ABOVE: 1:1dsts \formskplumapp doc 11/18/99 'CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested I/ AM PM BLD Location / 3 / 3 f Suite MEC Contact Person fl4 e c Ph Sze 33/V PLM vv - 2 zU 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 ' � -/ 1`. �'� - --� Fire Alarm Susp'd Ceiling Roof Misc: Final / PASS PART FAIL j � UMBI �� fr_4 7� Post & Beam Under Slab Top Out - Water Service Sanitary Sewer ains �i cft w 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 (2- rr ! 6 Inspector y� ') Ext Final PASS PART FAIL D NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit -4 Inspection Description Date Passed By Inspection Description Date Passed 4By 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 - ‘I 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 � 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 Fireproofing Lab Final Mechanical final Structural observation Final inspection PLM - Plumbing Permit Inspection Description Date Passed 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 " Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plum bin: final // 24' CO Sprinkler supply lines / Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils I Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP PLM, SWR ELC, ELR, MEC SIT PERMITS CI TY OF TIGARD PLUMBING PERMIT ,A, PERMIT #: PLM2000 -00220 — 13125 ,' ®EV W Hal BIv SERVICES s ) 639 -4171 DATE ISSUED: SITE ADDRESS: 12162 SW 131ST AVE PARCEL: 2S104A6 -06300 SUBDIVISION: MORNING HILL NO. 4 ZONING: BLOCK: LOT: 092 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 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: Install a residential backflow prevention device. FEES Owner: Type By Date Amount Receipt OAST, B +LAURA 131 2162 SW 131ST PRMT DEB 6/19/00 $25.00 0003083 IGARD, OR 97223 5PCT DEB 6/19/00 $2.00 0003083 Total $27.00 Phone 1: Contractor: WN ER REQUIRED INSPECTIONS Phone 1: RP /Backflow Preventer Reg #: Final Inspection 0 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 f� 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. u ssued By: Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day 8/21/00 Activities for Case #: PLM2000 -00220 3:45:06 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMA003 Application received 6/16/00 GEO MAIL No Hold GEO 6/18/00 PLMA005 Create Permit 6/18/00 GEO DONE No Hold GEO 6/18/00 PLMA750 RP /Backflow Preventer No Hold GEO 6/18/00 PLMA799 Final Inspection No Hold GEO 6/18/00 PLMA060 (F) Issue permit 6/19/00 DEB DONE No Hold DEB 6/19/00 PLMA055 (F) Reprint Permit 8/15/00 ZZZ DONE No Hold ZZZ 8/15/00 , • • Page 1 of1