Permit CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
A PERMIT # • PLM98 -0125
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 05/08/98
PARCEL: 2S111DA -01800
SITE ADDRESS...: 08602 SW LODI LN
SUBDIVISION • APPLEWOOD PARK NO. 1 ZONING: R -7 PD
BLOCK • LOT •014 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE .SF WASHING MACH 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:R3 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 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: Install backflow prevention device
Owner: FEES
LEGEND HOMES type amount by date recpt
6900 SW HAINES ST PRMT $ 15.00 JSD 05/08/98 98- 305607
TIGARD OR 97223 5PCT $ 0.75 JSD 05/08/98 98- 305607
Phone #:
Contractor -- —
MARTIN SANDERS
PO BOX 307
NORTH PLAINS OR 97133
Phone #: 647 -5567 $ 15.75 TOTAL
Reg #..: 11068
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Back flow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 952-0801-0010 through OAR 952-0001-0080. You may
obtain copies of these rules or direct ques ons to OUNC by 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 Permit Application Plan Check #D
13125 SW HALL BLVD. Commercial and Residential Rec'd By �,,p
TIGARD, O 97223 Date Recd OK ��
(503) 639 -4171 7 7 -6 3 Date to P.E.
Print or Type Pew %s ✓ --Ore
Incomplete or illegible applications will not be accepted Related SWR*
Called el , (-
Nam of Development/Project On back Indicate Work Performed by fixture.
/ .-
Job /74( (,J U Q d FIXTURES (Individual) - , . , QTY PRICE AMT
Address street Suite Sink 9.00
8 6 0 2_ U L 1 Lavatory 9.00
Bld # Ci ty /State n Zip s Tub or Tub /Shower Comb. 9.00
T G,.( O / 7Zz1 Shower Only ly 9.00
Le. e ti go es Water Closet 9.00
Owner Mailing Address n n Suite Dishwasher
"- ■ \,^ S Garbage Disposal 9.00
City/State Zip Phone
6Z0 83 o& 0 Washing Machine 9.00
Name Floor Drain 2• 9.00
,A / •Q- 3' 9.00
Occupant Mailing Address Suite
or 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Name
,, / Urinal 9.00
/t 1�v i h J S C p IV 9 Other Fixtures (Specify) 9.00
Contractor Wiling Address Suite
0d 7 - 9.00
Prior to permit City/State Zip f7� 33 Pone _ 9.00
issuance, a copy Al 7:-/-4 /4;4.5 (J1-e b �7 5,5 67 Sewer- 1st 100' 30.00
of all licenses are Oregon . Date Cont. Board Lic.# Ex ate Sewer - each additional 100' 25.00
required if S Z _ y p 30 7' Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date
database • i (p `I , o 75 Water Service - each additional 200' 25.00
Name Storm & Rain Drain - 1st 100' 30.00
Architect Storm & Rain Drain - each additional 100' 25.00
or Mailing Address Suite Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Engineer City/State Zip Phone Pollution Device
Residential Backflow Prevention Device* 4 15.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 Any Trap or Waste Not Connected to a Focture 9.00
to be done: Residential 0 Non - residential 0 Catch Basin 9.00
Additional description of work: Insp. of Existing Plumbing 40.00
per /hr
Specially Requested Inspections 40.00
• per/hr
Rain Drain, single family dwelling 30.00
Existing use of
building or property Grease Traps 9.00
Proposed use of QUANTITY TOTAL
building or property Isometric or riser diagram is required if Quanity Total is > 9 -
*SUBTOTAL "
I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE .: fix%.- ; .4 -
that plans submitted are in compliance with Oregon State Laws.
Slgnatu f er/ nt Date "PLAN REVIEW 25% OF SUBTOTAL - ?- '..r. -
Required Doty tf fixture qty. total is > 9 a =
TOTAL •''
Contact Person Name Phone
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
**All New Commercial Buildings require plans with isometric or riser diagram
/ 6 ✓ plan review / 0
I:tdstslplumbapp.doe 5J5/99 0(
PLEASE COMPLETE:
Fixture T Quantity b :Work Performed
YP....... tY. Y
New Moved: la Rem
w. Mo '.:Rep 'Replaced .: Removed/Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4 "
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
i:ldststpiumbapp.doc 5/5/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / GJ AM PM BLD
Location q 6 �' � Suite MEC CC
Contact Person Ph PLM 6 6601 0( 2$
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
Roof
Misc:
Final
PASS PART FAIL
Post & Beam (JQ
Under Slab
- Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
4j = PART FAIL
`ECHANICAL
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 D - Inspector �� V Ext
�`
Final
PASS PART FAIL D NOT REMOVE this inspection record from the job site.
l -
ISt ,` AS,AB 1 -0
I I CITY OF TIGARD BUILDING INSPECTION DIVISION
rkr 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: l — l /( P.M. MST: q7-05,3S1
Location: 8 60, AL4) c 11( BUP:
Tenant: Suite: Bldg: MEC:
Contractor. Phone: 5180 -070_z PLM: 78 -- 0Q, \
Owner: Phone: ELC: (tSa e L 5— L M - r 015 (..D i e 1f ' i1 dtu/7CL-' ELR:
0 .L L A,/ % ! 6 I Z' SIT:
BUII DIN e' llriir F • n't) e'� • I ; ra e4P I CHANICAL) ' CTRICAL SITE
Site Post/Beam . ' , ::: Post/Beam oTer - v- Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain . A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
• pproved • pproved Approv:. Approved ' Approved
Appr /Sdwlk — 6i — E ; .roved !' . • y .. • -. _ ornw . 'roved Not Approved
A cu`lbio INAL f A isa I FINAL
•
O Call for 'on O Reinspection fee of $ req fired before next inspection O Unable to inspect
Inspector: Date: S/ // (9 Page of