Permit CITY TIGARD PLUMBING PERMIT
A DEVELOPMENT SERVICES PERMIT #: PLM1999 - 00358
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/29/2000
SITE ADDRESS: 07400 SW LANDMARK LN PARCEL: 2S112AB 00400
SUBDIVISION: ZONING: I -
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing for commerical building. SWR1999 -00232 EDU fees to be paid prior to issuance of this permit.
FEES
Owner:
Type By Date Amount Receipt
GLEN HAYTER PRMT GEO 11/02/199 $92.00 99- 319234
5455 SE ALEXANDER 5PCT GEO 11/02/1995 $7.36 99- 319234
HILLSBORO, OR 97123
Total $99.36
Phone 1: 503 - 542 - 5611
Contractor:
OREGON CASCADE PLUMBING
PO BOX 12127
SALEM, OR 97309 • REQUIRED INSPECTIONS
Phone 1: Rough -in Insp
Reg #: LIC 127 Underfloor /Underslab
PLM 24 -33P6 Misc. Inspection
Final Inspection
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
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
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: � �j� /�i�_doe " Permittee Signature:, i
Call (503) 639 -41 i y 7:00 P.M. for an inspection needed the next business day
10/18/99 MON 14:56 FAX 503 598 1960 CITY OF TIGARD 0 002
CITY OF TIGARD Plumbing Permit Application Pla Check# ,
13125 SW HALL BLVD. Commercial and Residential Revd By . .r -
TIGARD, OR 97223 Date Re . /0- ?/-579
(503) 639 -4171 • Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit *pc h'!/949- a3f8'
Related SWR _t /44 - 06 F5R.
Called / Z
Name of Development/Project : _tui ualr ..._. ........._..,.. . .... .. ......
= �FIXXURIrSi.:lnd
:w' :
.IG ialVETii•
Job .6
6 V,-'7' Sink 11.50
Address Streee Address Suite Lavatory 11.50 ) F _
7 00 fa. ed9N0/� Tub or Tub /Shower Comb. 11.50
Bldg it • Cit /State Zip Shower Only
•
?l a"
Name te Closet/Urinal (Specify) , Q 11.50 1/4
c z."it/ A f /�- / Dishwasher 11.50
Owner Mailing Address _ Suite Urinal 11.50
✓' f -s'C • Aa}R'N ^2 Garbage Disposal 11.50
City /State Zip Phone
hftZL51ot f oe 97/1 2 .%// Laundry Tray 11.50
Name Washing Machine /Laundry Tray (Specify) 11.50
e//7/,C' Floor Drain /Floor Sink 2" 11.50
Occupant Mailing Address - 1 Suite
3" 11.50
4" 11.50
City /State Zio ; Phone
Water Heater 0 conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit.
Name MFG Home New Water Service 28.00
Contractor Mailing Address ' 'Suite MFG Home New San /Storm Sewer 28.00
PO 0v>( /0, 7 I Hose Bibs • 11.50
Prior to permit "City/State Zip a Roof Drains 11.50
issuance, a copy 5.4 '.l 0 if 973O'/ - ?'3 "
Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if ) ! 7 1 „9 , 5 --,_ 6 0 Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date •
database g I/ - 3-3 I/ /� (- 30 -- 0 .
Name -
. Architect EPAYy67DE/%F�y/3 /*/4/1 Sewer - 1st 100' " 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
201 #, fto.2.41 fI - /o Z
Engineer Cit /State Zip ,P hone Water Service - 1st 100' . 38.00 �
. i 04 9730 le /seO Water Service - each additional 200' 32:00
Describe work to be done: (` Storm & Rain Drain - 1st 100' 38.00 I
New ;l r Repair 0 Replace with like kind: Yes 0 No 0 ��`• Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial /
Additional description of work: Commercial Back Flow Prevention Device 32.00
Residential Backflow Prevention Device* 19.00 •
Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 4 Inspections per /hr
If 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
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
�
I hereby acknowledge that I have read this application, that the information Cr i p i 's . ::
- ;;;;;.
given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required if Quantity Total Is > 9 ' 4.7 i ; ;;,i`; }P: :;;. :;;!iii,;
that plans submitted are in compliance with Oregon State Laws. ° 4'::_"" - 'ta:' i .. :;t =:i
SUBTOTAL I` €- si`�::st ca
S p,atytre_ Owner ent Date
�,(( 8 %, SURCHARGE 73 �
Contact e N e Phone
f /tie_ , 6 , ,� �j Dd- 0 3 7 '� ** PLAN REVIEW 25% OF SUBTOTAL _ is
�_ _ v H h,,�:. -rte � h„ • b ,�._. ���� _ -: Required only if fixture qty. total is > 9 ;;F:1:;:;::::::::: _,_......, ...:.
y .tit "!. ; -'t a J ii ' .� ,_._ S ._.....��.•`_ =i_l- licit? iu ._ .. - m:...-.._;.� : ; . y r d
i!(jt.� 4 0 • :4-0-. • Jfi I _ _ ^^��.���/ C.T- ..:5.. .t• ,;� t'�.�,�[ -_.:� � _ -
_ �: v` _._ TO TAL
�.a.���t t• _ "- 1. -= - t r r, .!f = ��R+
'yt Ati l''k , u.'T:���s• A' � r- ^ . ,- r- ...� i 3. ._ , �4.'1N!t ; fi�•�. - ..� R .... ._ ....•.i
13 „� AIONi "p b7ag , ,.: -' It W ar...
,,,, �.-�- f� x;,�;�- ,:._...� -.._T � .- ,g� � eN; {�,w ' � *Minimum permlt fee I;_$50 + 8�� surcharge, except Residential BackFlow.Prevention
. ' . 4 ,,." f. : `lgfi:E*n` iF gatt- ' Device, which is $25 +8% surcharge
""All New Commercial Buildings require plans with isometric or riser diagram and
. plan review.
I: \dsts \iorms\plumapp.doc 10/1 /99 . p 1:..)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
c� l�r� BUP
Date Requested s b/ w AM PM
/ BLD
Location T _I O(/ 4 "■ Suite MEC
Contact Person -U) n Ph 9 3 2' 4-IS UQ ? PLM 1 f qq - OO S g
Contractor Ph SWR
BUILDING' . ° °.. ` °m z 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
• Roof
Misc:
Final
PASS PART ICLUMIPka)
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
a" 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 ///rii- 7
Approach /Sidewalk
Other Date-5 i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.