Permit CITY OF TIGARD
A
DEVELOPMENT SERVICES PLUMBING PERMIT
- - n W 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # ° PLM99 -0037
DATE ISSUED_: 02/18/99
PARCEL: 2S11OCA -00200
SITE ADDRESS...: 11985 SW KING GEORGE DR #012
SUBDIVISION 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 L I NE ( 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 I n
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 OUNC.by calling
(503)246 -1987.
Issued By:8 YitANAezzit I Permittee Signature: _eVl (l('Ld-0 mtiu
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + +1L + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
"" - JAN-07- ' 00 SAT 00:41 ID: FAX NO: 14009 PO2
•
CITY OF TIGARD Plumbing Permit Application .;=, ; . , ..
131; SW HALL BLVD. Plan Cite
Commercial an Residential Recd B •
TIGARD, OR 97223
Date Recd Z`
(503) 639.4171 Date to P.E. C
- Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit! 0� d 7
Related SWR a
Called .. .
Nil of�O�evet ni/Pro cX i c, _
Job .4 Pie Sink
9.00 Inn
Address d I 1 Lavatory 9.00
i e • I 1 !'4, r Tub or Tub/Shower Comb.
9.00
Bldg * 4 ''' r /
!Stele O ' 7J
7'? 7 i/ Shower Only 9.00 Mai
EINI
N n '/ � c / C. y C / i7 ureter Closet 9.00
j�'' / I-� � t '1�G � � � � //L Dishwasher 1.11 9,00
Owner Meal Address ' Disposal b `t" I ,(�, 1 Ite Garbage Disosal 9,00
1
OW/State f ' ` t } Washing Machine 9,00
t ` (.rte L p( Jr-� Floor Draln/Floor Sink . 2" . 9.00 MIMI
Name �� ? 3" 9.00 ,
4 " 9.00 ® .
Occupant - Mailing Address Suite Water Heater 0 conversion O Ilse kind - 9.00
Gas •'. n • : , rail a .. - • arate Mechanitel • rmit.
CIty/State Zip Phone Laundry Room Tray 9.00
Na�n,/e ryI iM Urinal GAO r 1 i O b ' l 'Y ! ! ip / 1 if /�O Other Fixtures (Specify) 9,00
Contractor , - i Ad •
Cam/ i Ito �! // I ` � �� II""' p 4Aee •
Prior to permit C tale Zip Ph • ne 9.00
A
issuance, a copy - 1 1 1 1, • • _4, , Sewer - 1st 100' 30 00 111111
of all licenses are Oregon C o 2 n t Q . C• t, Board Lie.* Exp. 1 ale Sewer - each additional 100' 2S_00
required if (/ n . "/ r)� 5 - Water Service -1st too' 30.00
expired In COT Plumbing Ue ( e w Water Service - each additional 200' 25 .00
database — 3 7 v / -9 � Storm & Rain Drain - 1st 100' 30.00 Ems
Nemo Storm & Rain Drain - each additional 100' 25,00 .
Architect Mobile Horne Space 25.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- Y5.g0 IIII
Pollution Device
Engineer City /State Zip Phone Residential 'Mallow Prevention Device' 15.00
- (Irrigation timing devices require a separate ■
Describe work to be done: • restricted ene • • rmit
i New 0 Re),Ir Replace with like kind: Yes 0 No O Any Trap or Waste Not Connected to a Fixture 9.00 •
Residential Gommerdal 0 Catch Basin 9,00
A ditional ,
deeeiption of work: ,, `
A Q.. �J�}( � a,b tt1d -tx- Insp. of Existing Plumbing 40.00
,� Specially Requested Inspections 40.00
o
o 5'\OJD lv0 �= i X dhr
Are you capping, moving or replacing any fixtures? Gr ^ D ^• single family dweNing 30.00 ME
Yes 0 No _ Grease Traps 9.00
If yea, tree back of form to indicate work performed by QUANTITY TOTAL • 7.
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isomeric or riser diagram Is required If Quant Total le .9 k- i `
WORK COULD RESULT IN INCREASED SEWER FEES_ '�
' SUBTOTAL ; ' ""'r
I hereby acknowledge that I have read this application, that the information . I ,
given Is correct. that I am the owner or authorized agent of the owner, and 6% SURCHARGE
that pier submitted are In corn. iance with Oregon State Laws, - ' MP
Sig : of Owner /A, ..
� , I� % Dare "PLAN REVIEW 25% OF SUBTOTAL �" W I ,
sJ e/ . // i C7� g9 R •wired an If fixture • . total is> 9 , , - t. -- ', ''
TOTAL f -
C• n .ctP: : me Phone F• •
11 = .... r / 552-85-2 � •Minimum permit fee 525 % urcharge, except Residential Baddlow •.
O •,✓ Prevention12 ,w 5% surcharge' ?a.<,.,a;7 r. ;v,. . : •r.
itai " t i "
y s r vy ui.e Fi A_ i , w':+iili kswnoul� Of it iss al'ttirl rani •
--"e pc...- oomm or:IaI o.
and plan review '''.+:,.'• 7
owaiumapO.Ccc 74rsa -,C : i x.R,F o
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Date Requested 31/ 7 AM PM BLD
Location / / 9� Suite MEC
n ✓L/ Ph 2-- PLM
Contact. Person ,�� .��( ��� h J�� x � � 96.037
Contractor Ph SWR
BUILDING ' m - *m 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 1 \
Insulation
Drywall Nailing
Firewall
Fire Sprinkler '/ ✓�,¢
Fire Alarm /�'/ S e did/ e
Susp'd Ceiling
Roof
Misc:
Final
P NT FAIL
LUMBItst ;
Post & Beam
Under Slab
To • 0 --
San
Rain Drains
tzgDp PART FAIL
NICAL';,
Post & Beam
Rough In •
Gas Line
Smoke Dampers
Final
PASS PART FAIL
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 ✓ /"?(
Otheoach /Sidewalk Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.