Permit CITY TIGARD PLUMBING PERMIT
401 DEVELOPMENT SERVICES PERMIT #: PLM2000 - 00001
4. DATE ISSUED: 01/18/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09575 SW LOCUST ST PARCEL: 1S126DC-04500
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3
OCCUPANCY GRP: R1 FLOOR DRAINS; 7 TRAPS:
STORIES: 2 WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 12 URINALS: 2 GREASE TRAPS:
LAVATORIES: 49 OTHER FIXTURES: 3
TUB /SHOWERS: 48 SEWER LINE: ft
WATER CLOSETS: 50 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing work associated with 45 unit addition to existing motel. Sewer permit (SWR2000- 00007) to be paid
prior to issuance.
FEES' •
Owner:
Type By Date Amount Receipt
VIP MOTOR INNS INC PRMT GEO 01/18/200C $2,089.00 00- 321204
29757 SW BOONES FERRY RD PLCK GEO 01/18/200C $522.25 00- 321204
WILSONVILLE, OR 97070 5PCT GEO 01/18/200C $167.12 00- 321204
Phone 1: 503682 - 9284 Total $2,778.37
Contractor:
TAPANI PLUMBING
21707 NE 206TH AVE
PO BOX 1458' REQUIRED INSPECTIONS
BATTLE GROUND, WA 98604
Phone 1: 206 - 687 -3983 Top -out Insp
Rain Drain Insp
• Reg #: LIC 00060958
PLM 37 -269P6 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: ��� Permittee Signature: _d_
Call (503) 639 - by 7 :00 P.M. for an inspection needed the next business day
I CITY OF T, ARD Plumbing Permit Application Plan Check# L. C
13125 SW HALL BLVD. Commercial and Residential Rec'd By K�
TIGARD, OR 97223 Date Rec'd !a(a.gi 199
(503) 639 -4171 Date to P.E. - '99
Print or Type Date to , - l / (7 1 e0
Incomplete or illegible applications will not be accepted Permit# G41006/ n Related SW #duo - 6
6u p 099-00g/7 Called
me of Developmerit/Project 'FIXT URES r( intlividual);, ;,,' a';F ,, ;:QTY.7 '.:P AMT .h
Job / �6e- Kt yA n • Sink t 7 11.50 13z)
Address SStre Adore �s Suite Lavatory 'J c, 11.50 c 4
`7 7 C-(7C Lt ' Tub or Tub /Shower Comb. 4' 11.50 SS
Bldg # City /State Zip Shower Only 11.50
(ofiere 012. 9 7 2-2-5 /
Water Closet /Fawn 11.50 � ''. �
Name _ ���
V 11 n LA T 1 S Urinal 11.50 r „ ,,,,
Owner Mailing Address Suite Dishwasher 11.50
aV9 75% SO gooL)C.5 a.Y RA,. Garbage Disposal 11.50
rr City/State Zip Phone &03 Laundry Tray 11.50
( LSaoo LLIE ' 7a7O h%7-925-7 Washing Machine 11.50
Nam P O e Y\ I ! 1 � Floor Drain /Floor Sink 2" 11.50
Occupant Mailing Address Suite L1 p . ; 1 - - 11.50 ii
f ik-4- ..i 4" 11.50
City/State Zip Phone
Water Heater 0 conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit. 2 2,
Name
TA V A y-i % T LLA HIS l'OC , MFG Home New Water Service 32.00
Contractor Mailing Address Suite 34. O MFG Home New San /Storm Sewer 32.00
7 6 ,liry. n� -7 3 s C c - 7 _ 3 y r� Z Hose Bibs 11.50 Z -
Prior topermit City /State Zipa (1 � Phone Roof Drains 11.50
issuance, a copy R,47.7.t_ r i�u ,Un Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if Gn 1 f- 7- 2_3 _0 Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date Ems_ t I 4 T , , d0 / .
database 7 7 - 17;3 a' ''`e _ lS
Name
Architect Sewer - 1st 100' 38.00
•
or Mailing Address Suite Sewer - each additional 100' 32.00
Water Service - 1st 100' 38.00_
Engineer City /State Zip Phone
g Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial 0
Additional description of work: Commercial Back Flow Prevention Device -3 32.00 //
Residential Backflow Prevention Device* 19.00
/ - 5 --- v Li 1 r .c 1 4 ViJ I Tl b ti Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 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 �' Pia
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 7 =
`SUBTOTAL = ,` :' ,
that plans submitted are in compliance ith Oregon State Laws. V, ` r Off/
Si natur Owner Date
/! j ' F '" „:' ";' ""
g 2 -? 4'- `� 8% SURCHARGE r .,. !off
Ill . ,:,...
Con t e on ave. 'I Pho �-, • ` '' t "` " "z / if ,
Yom'` c- H Cy y � _ * *PLAN REVIEW 25% OF SUBTOTAL °°a .,
0 1 y ! = ^, Required only if fixture qty. total is > 9 :4- . "' S�
'�- :a•'; 1�, .� q.:_. , , t om.
'1�8 H.,. ` ' ' ` _ �.z ; ,:., P
, , ,.. TOTAL ' ;> •: ,,.. _a
3 i4 er :. = y .. x . ti, ,....- .>.;ay;��;,;•',;�;« ... r:�« n }.f, ',.;x- � "•�', Y � ,y.� '� °;��',' -� feexinclud Iumbin fi in 4#1, nd >fitst; 7. „ i ue , :a ; 1�.•„ g` �` g �. ,'- � *Mlnlmum penult fee is $50 + 8 %surcharge, except Residential BackTlow Prevention
, It ' feet of 8 itary s ewer storm sewe antf ter service),��"% , ;t „,= Device, which is $25 + 8% surcharge
**All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
I: \dsts \forms\plumapp.doc 12/17/99
dm%
PLEASE COMPLETE:
.._„
- rat
wx 7 .wrt-7 - iy ,k1F e
Sink
Lavatory v ifq
Tub or Tub/Shower Combination
Shower Only
Water Closet
Urinal V t
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain/Floor Sink 2" q
3 "
4"
Water Heater v
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE: -
•
I: \dsts \forms \plumapp.doc 12/17/99
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MsT
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested �— ` AM PM BLD
Location 9:5 5 S w &4i G k 54 / Suite MEC
Contact Person rY Ph 9/ u f /9 Y 7 PLM ..fib`O o ' '
Contractor Ph SWR
BUILDING 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 J y %��
Roof 1 '
Misc:
Final
PASS PART FAIL i A // . "4" . /L I —
—1 LUMBIN0-'' �
• os eam
Under Slab
Top Out
Water Service
Sanitary Sewe
Rain Drain
Altrik
dii4P: PART FAIL
ECHANICAL
.6/1/7(-/"..5
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
Approach /Sidewalk
Other Date 1 0 Inspector Ext CJ V
Final VVV
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.