Permit ", .
,„
CITY OF TIGARD
PLUMBING PERMIT
�. DEVEH OPMENO SERVICES �ARE O2/18i��
PARCEL: 2S11OCA -00200
SITE ADDRESS...: 11935 SW KING GEORGE DR #003
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 GFcEASE 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 /Underf 1 oor
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 - 'x through OAR 952- 0001 -w4:. You may _ .
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: et A Permitt Si gnat ure :(,�V1 k.U4(4�- -(W
+++++++++++++±+++±±++++++++++±++++++++++++++±++ + + + + + + + + + + + + + + + + + + + + + + + + + + ± + + ++ _
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + ++
. - . JAN- 07 -'00 SAT 00:54 ID: FAX NO: #011 P01
CITY - OF TIGARD Plumbing Permit Application Plan Che tt I
1 X125 ' HALL BLVD. Commercial and Residential Reed By 130k)
TIGARD, OR 97223 Date Rac'd 7-'2-9' FAX - :ICL
(503) 639 -4171 Date to P.Q.
•
Print or Type Date to D
Permit 0
Incomplete or illegible applications will not be accepted
Related SWR e
Called
., ...._ . . -- : :._. } , .; ∎ ,: ", ,
Name of Developmem/Proect ' - -
4 . ! �� �li � I��' , I t ; "�; k �t ,�,;' „ .S�r= - �w .i;
...,. �;';,; rsr t.
_,...:.::::.;%:,
Job
Sink 9.00
Address S d. 6 1 Sw Lavatory . 9,00 T `
Tub or Tub /Shower Comb, 9.00 -
IVig ii 1 Ca Z - � Shower Only 9,00
N o Water CJoset 9.00
o1 �C I 1 Dishwasher 9.00
Owner Nln Addre % � Garbage Disposal 9 . 0
J"/ ,t_ .: / _ Washing Machine 9 p0
�� 1 ,e ??1,Z —UJkij Floor Drainfl9oor Sink 2' 9.00
Name 3' 9.00
4' 9.00
• Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind • 9.00
• Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 9,00
N Urinal 9.00
/
r 1m 7 / ) ! Other Fixtures (Specify) 8.00
Contractor M =iii _ / dd . , .s , e AI 1 rW�i'+.I//1K��g, 1 ��
i . T/ 0 h. '1LJ
Prior to permit C' ' �} P one 1�7� 30.00 copy Sewer - 1st 100' 4
issuance, a py u
UL►) ek fr� Sewer each additional 100' • 26.00
Board .
of all licenses are Oregof cot, Cont. Bd Lic.0 Ex Date •
required If l 40, n -7 � Water Service - 1st 100' 30.00
expired in COT Plumbin Uc. Date Water Service - oath additional 200' 25 -00
database -,D '3 P I - 1 - c19 Storm & Rain Drain -1st 100' 30.00 '
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00 .
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 ' ,
Pollution Device
Engineer Clty/5tate Zip Phone Residential Backflow Prevention Device 15.00
(Irrigation liming devices require a separate .
Describe work to be lone; restricted energy permit.) • • • •
New 0 Repair Replace with like kind; Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 • .
Residential , Commercial 0 Cair.h Basin 9.00
A dition I description of work: .
VC_ VO/ OD1• C-ten
.> � �•' tr Insp. of Existing Plumbing 40.00
• per/hr
-\7 l \ ^ r� 1. -�1 Vim? •� Specialty Requested Inspections 40,00 - •
U_,y' ' c \O } Ci' IV [ per0rr
Rain Drain, single family dwelling • 30.00 '
Are you capping, moving or replacing any fixtures?
Yes O Nt; - Grease Traps - 9,00. ,
If yes, sea back of form io Indicate Work performed by
QUANTITY TOTAL ?yi ;. .u.-;; t
fixture. FAILURE TO ACCURATELY REPORT FIXTURE i "; ', ( ;,.� ,
WORK COULD RESULT IN INCREASED SEW IsomeulcadserQiartramiarequhedllQueml� +Tutells >9
�R.FEE$- .SUBTOTAL .. ... : :.
'" . , .
I hereby acknowledge that I have F Fs? 'G` . `
Y 9 � re ad this application, that the Information � ; : ��� •
given Is correct, that I am•the owner'or author- ed agent of the owner, and 6% SURCHARGE VA4
that plans submitted are In compliance wit ` , on State Laws. '
rat O e g J "'PLAN REVIEW 25% OF SUBTOTAL YC�'*4-10. -�
B n rlA ant Date P "A ;t . ••� r
SI ,
/ . - 1 / , Re on ly If ruture qiy total is' 9 .. T AL ; ; ^ � ,, F ;� SURCHARGE .
e ' e TOT w aA . ?b : :,= . .; •
Person Na r ,
Contact Pets Ph ez :Y , ..xa , " _,;; < ,;r,; ; 7 :; s
f • t % - Z *Minimum permit fee Is $25 + 696 - surcharge, except Residential Backflow,
al
Prevention Device, which is $13 +5 %surcharge . % <f' :' xF ^? ° ' " •
_ _ "All New Commercial BuIldinge require plans with Isometric_or , *6 111191'4
a review
;.i . .
L' �:
�pkimgPP.doc 72/98 ::1 i .. _ � . tt ' '< .. •
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3h AM PM BLD
Location / K- ,ems Suite MEC
Contact Person Ph PLM G
Contr.• ctor Ph SWR
Tenant/Owner ELC
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
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof 4-5
Misc:
Final
RT FAIL
LUMBING
Po abm
Under Slab
TopOut
ater Service
San er
Rain Drains
i na
SASS PART FAIL
MECHANICAL
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 ! 9/ ns p Approach /Sidewalk Oth D Inspector Ext
Final
PASS PART FAIL DO NOT REMO E this inspection record from the job site.