Permit - AL CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2000 -00018
, �y DEVELOPMENT SERVICES DATE ISSUED: 01/27/2000
13125 SW Hall B lvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11420 SW PACIFIC HY PARCEL: 1S136AD -06200
W
SUBDIVISION: ZONING: C -G
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace electric water heater.
FEES
Owner:
Type By Date Amount Receipt
BLANCHARD, MALCOLM A PRMT KJP 01/27/200C $50.00 00- 321445
c/o ADAMS, MICHAEL J 5PCT KJP 01/27/200C $4.00 00- 321445
11420 SW PACIFIC HWY
TIGARD, OR 97223 Total $54.00
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING
9806 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 624 -6895 Top -out Insp
Final Inspection
Reg #: LIC 000027
PLM 26 -60BP
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: `ma::
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JAN -14 -2000 16:26 P.01
UI I T Ur I I1.3AKU r1u1iIL7iity rtsiluni Mppltt+dltuts
13125 SW 1, ILL BLVD. Commercial and Residen p L M a nco - 0001%
TIGAR , OR 97223
(503) 6394171 JAN 2.7 2000
Print or Type
Incomplete or illegible applications v61191 etibeEteleisplod
9LED*t10517 .
. W.
. x.1:4 - :. :..t K
. g, ;FR 0 > A
Name of Development/Pro)eet =; UC E0 d ill.1 ...,...v,.....,,-. x� ;,:'r;n; , v`;,rr ` :.. . ' ; -.
Job ad • a.. - 11 _ _ . sink ` 1 11.50
Address b Lavatory y
a 'F Is li „ Tub or Tub/Shower Comb. 11.60
Bldg s 4 /State Zip , Shower Only 11.50
NI !,I • Or. - -:!i W a t er Cl ose t 11.50
e 11.50
Cl I nt.b e•Y- Oishwaeher
Own @r Garbage Disposal 11.60
11166Faileg a a. Washing Machine 11.60
L4 i
Floor Drain/Floor Sink 2' 11.50
411E1Iiiiiiii 3• 11.60
Name 5
4- 11.50
Occupant Melling Address Suite Water Heater 0 conversion , like kind / ` 11.50 n
Gas piping requires a separate mechanical permit.
City/State Zip Phone Laundry Room Trey 11.50
• Urinal 11.50
1 ,, h ,� _ • Other Fbdures(Specify) 16.00
u. U 1/ /
Contractor
LViipliffirINIVIN
•
Prior to permit City • to Zl+ I Sewer -let 100' , 38.00
Issuance, a copy / 4 - IMMO Sewer - each additional 100' 32.00
of all licenses are -Oregon i.. net Cont. Board tic* Ex .. D to Water Service - let 100' 38.00
required If ■
I__
expired In COT Exp. Do Water Service - each additional 200' 32.00
database . P 1 8 60 00 Al Storm & Rain Drain - let 100' 38.00
Name Storm & Rain Drain - each additional 100' • 32.00
Architect Mob11e Home Space 32.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Mti- 32.00
' Pollution Device
Engineer CApr/State Zip Phone Residential Baddiow Prevention Device* 19.00
(irrigation timing devices require a separate
Oesatbe worts to be done: restricted energyjernfl.)
New 0 Repels' 0 Replace with Idle kind: Yes No 0 . My Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commerda Catch Basin 11.60
Addhmnal description of work' Insp. of Existing Plumbing 60.00
re. 0 IC1G€ e C i 1.0oi -4 er hearer-' per/hr
50.00
Ara yo capping, moving or replacing any fixtures? Specially Requested Inspections per/hr
Yes 0 No 0 Rain Drain. single family dwelling 45.00
If yes, see back of form to Indicate work performed by Grease Traps 11.60
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL '° R ^e': " '" ''
I hereby acknowledge that I have read this application, that the Information isometric or riser Megrim Is required il Quantity Total Is • 9
Men Is coded, that I am the owner or authorized agent of the owner. and.;: "'.. - -
given 9 'SUBTOTAL w * '� fxr _:;:;t -,^ . ►
that • lane submitted am In mm • lance with 0 : on State Laws. tie = xs° ... 1
• Date S .r SURCHARGE •, S;M , ; :.> :.: w :: ' co
ate /: � / � _ �� a � Y�}. •: ... �..,'
• N xx
- P LAN REVIEW OF SUBTOTAL L
• Phone Required ony If notes qt louat I. -.4.- y. a O . - < .
o� B T
r lOQ30 i TOTAL ' ° : '' '' ' • 00
�r . .
',f':',..:-'-''..1,' : < • Minimum permit fee is $50 + 5% surcharge, except Residential Baddlow
1.; k h: >, r . Prevention Device, which Is $25.5% surcharge
. I ,
' r L } + - -
••All New Commercial Buildings require plans with isometric or riser diagram
and plan review
detsVomislelumapp.dat wares
TOTAL P.01
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3P0/00 AM PM BLD
Location It 0 Pa ¢-.kJJ Suite MEC
Contact Person 00910/e, Ph 02,Lt - (D a PLM 2.000 Cnb/
Contractor Ph y S- 17 9(o SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation ijQ j/f /f FPS
Ftg Drain ( l z�"�
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 -& tueam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains 1.0
PART FAIL
CHANICAL
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 - 6 � Inspector /2 yy� 2 ( - � Ext c
Final
PASS PART FAIL DO NOT ' EMOVE this inspection record from the job site.