Permit CITY O
eAm DEVELOPMENT SERVICES PLUMBING PERMIT
A I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # ° PLM99 --0 @70
DATE ISSUED: 03/12/99
' PARCEL: 2S111CA -04400
SITE ADDRESS...: 09700 SW LAKE SIDE DR
SUBDIVISION : SUMMERFIELD NO.12 ZONING: R -7
BLOCK ' • LOT °664 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH . 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS • 0 TRAPS ° 0
STORIES ° 0 WATER HEATERS - 1 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS.....: 0 SF RAIN DRAINS ° 0
SINKS : 0 URINALS - 0 GREASE TRAPS....... 0
LAVATORIES ° 0 OTHER FIXTURES 0
TUB /SHOWERS...: 0. SEWER LINE (ft) ...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS.....: 0 RAIN DRAIN (ft) ...: 0
Remarks: Installation of a new water heater.
Owner: -- -- FEES
WILLIAM SPEAR type amount by date recpt
9700 SW LAKESIDE DR PRMT $ 25.00 GEO 03/12/99 99- 313641
TIGARD OR 97224 SPCT $ 1.25 GEO 03/12/99 99- 313641
Phone #: 624 -2122
Contractor
AAA HEATING & COOLING
2915 EN MARTIN LUTHER KING BLVD
•
PORTLAND OR 97212
Phone #: 284 -2173 $ 26.25 TOTAL
Reg #..: 222
REQUIRED INSPECTIONS --- -- - ---
This permit is issued subject to the regulations contained in the . Final Inspect ion
Tigard Municipal Code, State of Ore. 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 k
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 - q0 through OAR 952-0001-0. You may •
obtain copies of these rules or direct questions to OUNC by calling
(503)246-1987.
Issued By° ,/� `/�. Permittee Signature: •
+ + + + +-F +-h +++++ ++ =F + +-F ++++++++++++++++++++++++++++++++++++++++++++++++-+++++++++-±
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++- 1-+++++++++++++++++++++++++++++++++++++++++ + + + + + + ++ + + + + + + + + + + + + + + + ++ + + + + ++
r
RECEIVED •
:lTY O'TIGARD MAR 12 1999 Plumbing Permit Application Plan Check •
3125 SW HALL BLVD. Commercial and Residential Recd By
'IGARD, OR 97223 COMMUNITY DEVELOPMENT Date Recd
503) 639 -4171 Date to P.E.
Print or Type Date to DST
al
Incomplete or illegible applications will not be accepted Pe"r"t'rN 79--7/0
Related SWR S
Called
Name of Development/Project .RE&,_ ntflvidt a ' - = = _ - _ QTY-i it li
lg -i :i
^Vcr:E:.::::;::,:::;:- �:::-,° --::- r :. �`= is ' ri° fi:- :;:f .._:...- ::_:::: :: - ..... ..... .. -
Job • Sink 9.00 •
Address Street Address I Suite Lavatory 9.00
Tub or Tub/Shower Comb. 9.00
Bldg It I City /State Zip Shower Only 9.00
Water Closet 9.00
1 . _ _ ��! A.-. fl
Dishwasher 9.00
Owner r M - ailiing • ddress � S Ic(R� Suite Garbage Disposal 9.00
19 00 . L� Washing Machine 9.00
City /State Zipp c� Phone ^�
f,.As- l'A I -a 1 , �oZ Li "D�o Floor DrairUFloor Sink 2' 9.00
t° 9.00
C 1 4' k , 9.00
Occupant Mailing Suite Water Heater conversion 0 like kind 9.00 0-0,
Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 9.00
Name
Urinal 9.00
f - W \ -\ A ` M% Other Fixtures (Specify) 9.00
Contractor Mailing Address ` S e 8
q 9 1 5 I r ll r I . 1 5 9.00
• Prior to permit City /State Zip Pho Sewer -1st 100' 30.00
issuance, a copy W�r� l�02 02 O y J 7�
Sewer - each additional 100' 25.00
of all licenses are X Oregon Const. Cd'it. Board tic.* . Date ���///��/
required if /) -a- ,. 7-076$-. Water Service - 1st 100' 30.00 ,
expired In COT Pluming tic.? . Date Water Service - each additional 200' 25.00
database ,26-, -.319-99 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 City /State Zip Phone Residential Badxflow Prevention Device* 15.00
(Irrigation timing devices require a separate .
Describe work to be done: restricted energy permit.)
New R it 0 Replace with Ete kind: Yes No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential Commercial 0 Catch Basin 9.00
Additional description of work:
Insp. of Existing Plumbing 40.00
per/hr Specially Requested Inspections
�_ �s �r� L �� � - Q �'- t) ^
Rain Drain, single family dwelling 0r 0
Are you capping, moving or replacing any fixtures?
Yes O No7:& Grease Traps 9.00
If yes, see back of form to indicate work performed by QUANTITY TOTAL ;';;_ =_`` r
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isornemric or rme( diagram is required it Quantity Total is > 9 _ _::::,-.•.1 WORK COULD RESULT IN INCREASED SEWER FEES. 'SUBTOTAL rs'.c=3:= e "?' ;=' 0
I hereby acknowledge that I have read this application, that the Information ? ; ' :: j € . 9 : T - .s. ^. / � .
given is correct. that I am the owner or authorized agent of the owner, and 6% SURCHARGE Er::::.!: = i *; i �
that pia , sub '�. ed are in compliance with Oregon State Laws. _ = ' . - -
r: of .. Agent Date "'PLAN REVIEW 25% OF SUBTOTAL a `` - `; :_: - 7- , Required only Il lithium qty. total is > 8 - - ' /
i rd , t TOTAL 'w it= - -- r- _ =� a
Phone ' 'T:'= : _- .._..: 7CIy
'Minimum permit fee is $25 + 5% surcharge, except Residential Baddlow
Prevention Device, which is $15 + 5% surcharge
"AII New Commercial Buildings require plans with isometric or riser diagram
and plan review
AdstsVarn mrapp.doe2/5/99 - - - - -- - -- -- - - - - - - - - - - - - - -- - - -
. - 1 or A
zoo UHVJLL JO aLLID 096T 96S COS xvd gt 60 am 66
•
PLEASE COMPLETE:
:...:..:... ::.:
..::.:.:::::...
...:,.... :... � itt ����
a{Ih' < . `�R�p[aG�d l"tetriov�ct�+Cap
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
rum nionmsal
Washing Machine
Floor Drain /Floor Sink 2"
3" •
4"
I Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
-,avam,.neen.disca/s/es — —
a of a
coo !.'nLfl
so
airs dO pro 096T sss COS xv� rv:so sn ss isoi�o
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q BUP
Date Requested 3- - I ' I AM x PM BLD
Location c ? L ( toy: Suite MEC
Contact Person C r1 Ph '"g PLM 91- 00
Contractor 1i Pto A i Ph SWR
t/ %
BUILDING: ` w aW` ,w "M TenanA (,IBC i4C ) e .peat-r ELC 99'0 , 2.
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
Fire wall �\
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final t /
PASS PART FAIL �( ✓
il_• LUMBI ` ��J�
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
`GS4: PART FAIL
Post Beam
Rough In
Gas Line
Smoke Dampers
Final
P PART FAIL
LECTRIC
Service
Rough In
UG /Slab
Low Voltage
Fi - • larm
S PART FAIL
SITE ',, "b" a w y
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 / �� Inspector �
Other / / 9 p � Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.