Permit CITY OF TIGARD PLUMPING PERMIT
DEVELOPMENT OP s DATE I ISSUED: 02/18/99
SERVICES 5 -0049
PARCEL: 25110CB -01700
SITE ADDRESS...: 11902 SW IMPERIAL AVE #002
SUBDIVISION • KING CITY APARTMENTS ZONING: ?
BLOCK LOT - JURISDICTION: KIN
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -MF WASHING MACH - 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R1 FLOOR DRAINS • 0 TRAPS : 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS - 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS - 0 URINALS • 0 GREASE TRAPS - 0
LAVATORIES • 0 OTHER FIXTURES • 1
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS - 0 RAIN DRAIN (ft)...: 0
Remarks: Replace underslab cold water piping. Installing new pipe above slab.
Owner: FEES
AMERICAN PROPERTY MANAGEMENT type amount by date recpt
1126 NE 28TH PRMT $ 25.00 B 02/18/99 KING CITY
PORTLAND OR 97232 5PCT $ 1.25 B 02/18/99 KING CITY
Phone #:
Contractor
HYDRO TEMP MECHANICAL INC
28465 SW BOBERG RD
WILSONVILLE OR 97070
Phone #: 582 -8525 $ 26.25 TOTAL
Reg #..: 000639
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Service In
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Final Inspection
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 - You may
obtain copies of these rules or direct questions to WIC by calling
(503)246 -1987.
: 'v ' f `/ v
Issued By I _ Permittee Signature: � f/ici 'IMAM
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639-4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
--""' " JAN- 07 -'00 SAT 01:03 ID: FAX NO: 4012 P01
I
CITY OF TIGARD Plumbing Permit Application
Plan C InI
13125 SW HALL BLVD.
Commercial and Residential Recd By ICU
TIGARD, OR 97223 Date Rec'd2. - F/4k
(503) 639 -4171 oats to P.E.
- Print or Type Date to OW
Incomplete or illegible applications will not be accepted Perrr'it* l - Ama m
Related SWR *
Called
Name of DevelopmentlProJect ;l571 1 1 (I,r�! i( it I : 1 517)'i "; 1iTi t
Job Sink _... • .. .., . ___.. _ .• __..,. F._ K,._ , .1_ _ ..,...__.. s
Street 9.00 nu
Address / /9n Address_ Suite Lavatory - 9.00
',Rt (1.1
c2- Tub or Tub/Shower Comb. 9.00
Bldg S C /State
ma y ,. i p
Shower Only 9.00
" - Water Closet 9.00
Ali ree Fry? Dishwasher 9.00
Owner Mallino Address c•.av oareayo Daapuaal ' 9.00
/12( /! /e Washing. Machine g o0
C , /State Zip Phone
AV/ ■ 6f.. Floor Draln&FloorSink 2' 9.00
' i
N -me 3' 9.00
4 9.00
Occupant Mailing Andress Suite Water Heater 0 conversion 0 like kind
9.00
Gas piping requires a separate mechanical penult.
f City /State Zip Phone laundry Room Tray 9.00
Urinal
N me / � //-- � � 9.00
G� /b / Yr Mf-G!/l ,-/t c Other Fixtures (SPeGf 9.00
Contractor a tin Address ,Suite Alf P! �Vl/ T fl _ C
? 9KSSw ,b� Rol. 9.00
_
Prior to permit /,(41 x/e�els ///' Phone _ � Sewer- 1st 100'
issuance. a coin aa/1,,,,-ar<° q , 7CJ � / ? ,2- t7, _-� C 30.00
of all licenses are Ore on Coat Cord. c Uc_t . Date
Sewer - each additional 100' 1 25.00
required if ,7
7 /-,2, 5 - Water Semite - 1st 100' 30,00
expired In COT Plumbing Uc. S Exp. Date Water Service - each additional 200' 25.0o
database ,6 3 5 7 PL /" ' .7 �?`- Storm g Rain brain let 100'
Name 30.00
Storm & Raln Drain - each additional 100' 4 25.00
Architect Mobile Home Space 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or And-
25.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device -
15.00
(irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair a Replace with like kind: Yea 0 No 0 _ . Any Trap orWaste Not Connected to a Fixture 9.00
Residential A Commercial 0
Catch Basin
Ad Monet description of work: / 9.00
//ptL(Q� _Sic e c L5e C Id Le/te- e " Insp. of Existing Plumbing 40.00
c ' ��S/ 1 _ (f fu w 2 la0 vC'� Specially Requested Inspections per/hr
0
- S-•67- - //IV f i )t4?) r'''. 30.00
Are you capping, moving or replacing any fixtures? Rain Oraln, single family dw�ling 30.00
Yes 0 No ' Grease Traps 9,00
If yes, see back of form to indicate work performed by
fixture. FAILURE TO ACCURATELY REPORT FIXTURE .QUANTITY TOTAL ,,"' f. t
WORK COULD RESULT IN INCREASED SEWER. FEES. I' O'" errtca riser diagram rarequlrcyAQuardhy Total is .9 IF ;.. '.' - ✓,;;:.,,,
I hereby acknowledge that I have read this application, that the Information 'SUBTOTAL G c s .
given Ig totted that I am the owner or authorized agent of the owner, and r _ 1 ;.0
that •lens submitted are compliance with Oregon State Laws,' •
6% SURCHARGE
St• a re of Owne • g: Date ! "PLAN REVIEW 26% OF SUBTOTAL r - T a
!`is "A / / / 5 j ' R . wi on y f futur qty. total is > 9 t f { ,_
•n Nato Phone _ TOTAL ' ' r r 1.= .,-,,' .,;s
a -Sit /.. 57 - 41 0 `•SS , "Minimum permit fee is 925 + 5% surcharge, except Residential Backfow
Prevention Device, which is S15 + 6% surcharge v, ' --
••Ail New Commercial Buildings require plans with Isometric of tiger diagram
and plan review �
I ∎ci. ,....pp.aoc 7 72,90 ,_.. � _ k� '.
r i ll.c. W14 z
CITY OF TIGARD BUILDING INSPECTION DIVISION MST g;t:_
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
(Date Requested � /`� AM PM BLD
Location / /(_ Suite MEC
Contact Person Ph 5 7 ) PLM 95 0o y�
Contractor _y _,", `_ Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ✓? 2
Slab f -- SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final K /0.--5" �� Z
RT FAIL
�
Post am
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
r PART FAIL
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
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 11°51
Other Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.