Permit CITY TIGARD PLUMBING PERMIT
Vii, DEVELOPMENT SERVICES PERMIT #: PLM2000 - 00069
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/07/2000
SITE ADDRESS: 09685 SW JOHNSON ST 017 PARCEL: 2S102BA 01400
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R -12
BLOCK: LOT: 054 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 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: Replace an existing electric water heater.
FEES
Owner:
Type By Date Amount Receipt
WOODARD PARK APARTMENTS, LLC PRMT GEO 03/07/200C $50.00 0000474
2083 NW JOHNSON ST #1
ATTN: ROBERT D BALL Total $50.00
PORTLAND, OR 97209
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING
9806 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 624 -6895 Final Inspection
Reg #: LIC 000027
PLM 26 -60BP
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable Taws. 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: r_ L „„ - / Permittee Signature:
Call (503) 63• -4175 by 7:00 P.M. for an inspection needed the next business day
\FEB -25 -2000 10 35 P 01
' t 1 r • ..I ': \V I Tull w itltl� 1' CI 1111L MtJ f/IUt.CILIVIl Plan Check#
3125 SW HALL BLVD. Commercial and Residential RECPIvi ' Re-v:0 By
IGARD, OR 97223 Date Rec'd
;03) 639 -4171 MAR 3 2000 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will nc4'V 1Wt eiPte
P ermit 4 01 0 " q
Related SWR 4
1-) /0 /055 79g (- Called
Name of Development/Pro' ecl �� '' - '' :- i P�JC P �, ES` .' IndtvJdual � ,�. � . ,, � : �Q '-!‘MT
Job Sink 11.50
Sot Address 3(,o L�,,v �-1/' #/� Tbor Tub/Shower Comb. 11,50
Bldg # City/ to Zip ' Shower Only
.1 11.50
' � � ��� - Water Closet 11.50
L me jam - l i r� u lt Urinal , 11.50
Owner tiling Akiddre r e Dishwasher 11.50
[J
f 0 .407 c>2' Garbage Disposal 11.50
City Late Z Phone
J�arnl `T 7 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
City /State Zip ' Phone 4" 11.50
Water Heater 0 conversion Af like kind . / 11.50
Gas piping requires a separate mechanical penult. 5O
Na,)Tte ,�/� _r Can P / ( � L M FG Home New Water Service 32.00
Contractor flaflinQ Address / � / � 1 C ` ^ L Hose Bibs 11.50
SSuite U MFG Home New SaNSlortn Sewer 32.00
` '/F060 Si Y`75
Prior to permit - City /State Phone Roof Drains 11.50
Issuance, a copy l , ?Q yet,/ 197 6, `6
Drinking Fountain 11.50
of all licenses are O re9oA Const. Cont. Board Lic.# Exp. Dal q,
required if - O2 70 erz G (pa Z. Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date
database c:(19 - 6 pb o /bo
Name
Architect Sewer 1st 100' 38.00
Or Mailing Address Suite Sewer - each additional 100' 32.00
A Engineer City /Slate Zip Phone Water Service 1st 100' 38.00,
a 1g Water Service - each additional 200' 32.00
)escribe work to bo done: Storm & Rain Drain - 1st 100' 38.00
Jew 0 Repair 0 Replace with like kind: 'Yet No 0 Storm & Rain Drain - each additional 100' 32.00
2esidentlal 0 Commercial 0
>dditti
Residential Bac
o onal description of work: Commercial Back Flow Prevention Device 32.00
r aC� t A )a- er h ea 4 e Bach - now Prevention Device' 19.00
e Lee Catch Basin 11.50
Ire you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 Inspections per/hr
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
'IORK COULD RESULT IN INCREASED SEWER FEES.
QUANTITY TOTAL ',,.. tc. ;::'4 .ni ',',-
hereby acknowledge that I have read this application, that the information ; x, ,
ven is correct. that I am the owner or authorized agent of the owner, and Isometric or riser dlaomm Is required A Quantity To®I Is 9 ; :w,,.
tat plans submitted are in compliance with Oregon State Laws. 'SUBTOTAL ;,•;y.f 4 ^c:. • :i,:, r , �; p,p
ignatu ail • er /Agent - Date f `r , �t1`; �- •
i 8% SURCHARGE ;;;;;;;*!.?4` �, s
.. - - /�. fir pp
Phone , .,'
-. Ai ,430 "PLAN REVIEW 26% OF SUBTOTAL 1 t. t t + 1
p 17ti Cl IY ; ,^ w Required only if fvdure qty. total Is > 9
r _� V r11 t YJ Ilk! 1 9 0- i , ' y , 4, . b M t S1 k1 TOTAL .'.....' W
�l +a v 1 IT �£ i a y r " ,'4,.
7 rya' a � T e; q� , :.
..,
I �1,i141:4' r r l' i� 1 ,11 ) t f'!,:`; 1 i ` ! ': , :'..r '..i'.:.'1! ri, I i e 17i. 'Minimum permit fee Is $50 + 8% surcharge, except Residential Bocidlow Prevention
!.: e4 ; . I.1i '?,I'.., . i r 1 ,. ' + . ,r ".Ii1 r ` :,i' ,(I,,,)i ° av, : < );?, Devito. which is $25 + 8% surcharge
"All New Commercial Buildings require plans with Isometric or riser diagram and
plan review.
ran Aplumepp. doe 11/18/99
-.
TOTAL P.01
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
p� y� BUP
Date Requested s / 7/ 0 0 AM BLD
Location 0 1 ((A S In 1 S 6)1 .c fi Sae K2 ME t�,t
Contact Person f 10ll/} Ph W6 1 1SO PL _.✓ 4 .0 — CD /Oq
Contractor f a • M 0 4ar) Ph to ZL Ro SWR
BUILDING Rh. w Tenant/Owner woo d c 1, ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear ,� �� Q Q ,rye
Int Framing th /Shear 74/ B, (AMA(' /
1 ° v ► - p l�,i /i l�' C - c t � : (6( i
=lail n .0 I/) �� (O" 3� ) 1
� 1� � [ 9 - CE�'1 � J j6
Firewall •
Fire Sprinkler l al i /_� °_. °"" A 1 9 � 9-02 l. f VO
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
4i.tn -B-IND )_ .
Post rjeam
Under Slab
Top Out
Water Service
Sanitary Sewer w
Ra ' •rains
/ 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA ( /�
Approach /Sidewalk Date / ?/ /j \ D Inspector / J Ext
Other 1
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.