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Permit . CITY � »• PLUMBING PERMIT 40001 & DEVELOPMENT ������Ud����� --~--------- —'--'—' ----'--'-~--~~ PERMIT #..~....: PLM97-0430 a��- �J� t3� 5 SN/�NBA�, Tigard, 013.97223 ��)��4/7l DATE ISSUED: 10/28/97 PARCEL: 15126DC-04800 SITE ADDRESS...: 09495 SW LOCUST ST #E SUBDIVISION....: LEHMANN ACRE TRACT ZONING: C-P BLOCK..........: LOT........~....:004 JURISDICTION: TIG CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE....:COM WASHING MACH......: 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:B FLOOR DRAINS......: 0 TRAPS..............: 0 STORIES. . . . . ... : 0 WATER HEATERS.... . : 0 CATCH BASINS.. . ... . : 0 FIXTURES-------- LAUNDRY TRAYS.....: 0 SF RAIN DRAINS.....: 0 SINKS. . .. . . . . . : 1 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . : 0 LAVATORIES....: 1 OTHER FIXTURES....: 0 TUB/SHOWERS...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 1 WATER LINE (ft ) . . . : 0 DISHWASHERS....: 0 RAIN DRAIN (ft)...: 0 Remarks: Capping 2 sinks, moving 1 sink, 1 lay & 1 water closet. Owner: ----- ------ ---- FEES -------------- MBM BUILDING type amount by date recpt 9495 SW LOCUST PRMT $ 27.00 B 10/28/97 97-300472 TIGARD OR 97223 5PCT $ 1.35 B 10/28/97 97-300472 Phone #: Contractor---- --- - BCS PLUMBING ' 6165 SW 190TH AVE • ALOHA OR 97007 - ------ Phone #: $ 28.35 TOTAL Reg #..: 000940 ------- REQUIRED INSPECTIONS ------- This peroit is issued subject to the regulations contained in the Top-out Insp • Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection applicable laws. All work will be done in accordance with Insp existing/ea approved plans. This permit will expire if work is not started Final Inspection 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 952-001-0080. You may obtain copies of these rules or direct questions . to 8UNC hy calling ' <503>246-1987. ■ . ---- - ' -- -- ___ ' '', �-_- Issued By: _ • __'. ' Permittee Signature:- ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Call 639-4175 by 7:00 p.m. for an inspection needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ '' CITY OF TIGARD Plumbing Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd / ' 1 TIGARD, OR 97223 Date to P.E. Wi Date to DST """ (503) 639 -4171 Permit* LH - Print or Type Related SWR # 14 7 Incomplete or illegible applications will not be accepted Called f-;7-q u itu ' Name of Development/Project + On back indicate Work Performed by fixture. Job r 8 r" nil i c f -.'t go s 1. c Yt i -- FUCTURES.' ` c` . r l o ;QTY, =' PRICE• 4 , Address re� Address � � ��� } Suit Sink � � I _ A MT, ; 9.00 9,6i d `GI Lavatory I 9.00 Bldg # City/State Zip 9. ©U Name / l q «1 u I o q 7 t 73 Shower Onlyhower Comb. 9.00 n1 W [ rr ry o-FO /q Li 4sDCiLLks Water Closet 9.00 06 Owner Mailing Address Suite Dishwasher Li gS S ti) 6. 616-5 - 9.00 Garbage Disposal 9.00 1 City/State Zip Phone -TTC a4 d P Ii G z z 3 itir ? Washing Machine 9.00 ! O h , Floor Drain 2" 9.00 bV . e irn I Ca- iteSe 1-/LL9 3" 9.00 Occupant M i ng Addrev_ v 1 G.d r4sSuite 4" 9.00 `~t Water Heater 0 conversion 0 like kind 9.00 City/State Zip Phone - a.y, _ 2 Laundry Room Tray 9.00 Namea Urinal 9.00 tc�C /� b� H Other Fixtures (Specify) 9.00 Contractor Mailing Address /1"),t A,, Suite - �5- S 9.00 !!/ Prior to permit City / /$ tate Zip /� � Phone 9.00 issuance, a copy ✓ /f� D ) GC 0(C "i 7 &I/7 ;2122_ 9.00 of all licenses are Orego , C onet. Cont. Board Lic.# Exp. Date 9.00 required if 9'4'0-7 ,y 7 7 "L 1 Sewer - 1st 100" 30.00 expired in COT Plumbin Lic. # p. Date database 3 / - 2 -i r o 6 `3 0 - '7C- Sewer - each additional 100' 25.00 Name Water Service - 1st 100' 30.00 Architect Water Service - each additional 200' 25.00 Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00 Storm & Rain Drain - each additional 100' 25.00 Engineer City/State Zip Phone Mobile Home Space 25.00 Commercial Back Flow Prevention Device or Anti- 25.00 Describe work New 0 Addition 0 Alteration, ' Repair 0 Pollution Device to be done: Residential 0 Non - residential Ak Residential Backflow Prevention Device' 15.00 Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00 Catch Basin 9.00 Insp. of Existing Plumbing 40.00 - per/hr Existing use of - Specially Requested Inspections 40.00 building or property - per /hr Rain Drain, single family dwelling 30.00 Proposed use of building or property Grease Traps 9.00 QUANTITY TOTAL I hereby acknowledge that.l have r- ad this application, that the information Isometric or riser diagram is required if Quanity Total is > 9 given is correct, that I ain.the own: or authorized agent of the owner, and that .tans submitted are in, ,•mp .rice wit Oregon State Laws. *SUBTOTAL ,.a . gyp. : Sig ature o Owne /Age ' Date 5% SURCHARGE 4 e = ,� 'i ll / 1 104, A /L// a-6 /0 -23 " /�7 / PLAN REVIEW 25% OF SUBTOTAL ;OntaCt Person Neva- Phone Required only if fixture qty. total is > 9 S G t� /G�l2 � °J�`/Z2 TOTAL j 3 5---- 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge I:dststplmapp:doc 5/97 PLEASE COMPLETE: Fixture Capped I Removed Moved Replaced Sink ir A Lavatory. Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3 " 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: 1:Idsts1p1mapp.doc 5/97 Tenant Name:/\)10 'sir;. ' ' '' Sewer Tally This SWR #: � Address: qLf' -1 l^ ����` L'GL ` .- 1 7 -- °' This PLM #: • Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New Value Capped off value added # added total #s total Count off #s count value values Baptistry /Font 4 Bath - Tub /Shower 4 - Jacuz/Whpl 4 Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 • Dishwasher - Commer 4 - Domest 2 Drinking Fountain 1 • Eve Wash 1 Floor Drain /sink - 2 inch 2 • - 3 inch 5 • - 4 inch 6 - Car Wash Drain 6 Garbage Disposal 16 - Dom (to 3/4 HP) - Comm (to 5 HP) 32 - Ind (over 5 HP) 48 Ice Machine /Refrigerator Drains 1 Oil Sep (Gas Station) 6 Recreational Vehicle Dump Station 16 Shower - Gang (Per Head) 1 - Stall 2 Sink - Bar /Lavatory 2 0 - Bradley 5 - Commercial 3 ! / 1 - Service 3 Swimming Pool Filter 1 Washer, Clothes 6 Water Extractor 6 Water Closet, Toilet 6 Urinal 6 TOTALS Total fixture values: divided by 16 = l, X57 EDU ;�c its : e ZA. HISTORY PLM#% EDU# 1S SWR# -0461, -) PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# • 2/10/00 Activities for Case #: PLM97 -00430 • 4:23:08 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMC003 Application received . 10/23/97 BON RECD DRA 10/27/97 PLMC005 Permit Created 10/27/97 DRA PASS DRA 10/27/97 PLMC799 Final Inspection 1/26/00 MRS PASS AKJ 1/26/00 PLMC760 Insp existing /capped fixtures 10/27/97 DRA 10/27/97 PLMC740 Misc. Inspection 10/27/97 DRA 10/27/97 PLMC725 Top -out lnsp • 10/27/97 10/29/97 MS PASS MRS 10/30/97 PLMC040 (F) Ready to issue • 10/27/97 DRA PASS DRA 10/27/97 Issue and final SWR97 -0391 when this permit is issued. PLMCO50 (F) Issue permit 10/28/97 B PASS BON 10/28/97 PLMC800 Case Finaled 1/26/00 AKJ . DONE No Hold AKJ 1/26/00 • • • • • • Page of • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 /' BUP Date Requested / 2 &/ O AM X PM BLD Location 9 ! Z I SuiteCa°7 � MEC Contact Person Ph PLM 17 ,3O Contractor Ph SWR -BUILDING° :; , Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain —'----- SGN Crawl Drain Inspection Notes:CM ,, Slab SIT Post &Beam �^Y n�� Ext Sheath /Shear l d' Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling • Roof Misc: Final PASS PART FAIL Ullni Post & Beam Under Slab Top Out Water Service Sanitary Sewer R • rains ' AS 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 Date / /l Approach /Sidewalk D a e IL � Other i A Inspector V,- Ext Final PASS PART FAIL i' • NOT REMOVE this inspection record from the job site.