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Permit ' r . CITY OF TIGARD � � DEVELOPMENT SERVICES PLUMBING PERMIT ' .. '� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE 03/04/99 - 00, 9 PARCEL: 15136AD -04301 SITE ADDRESS...: 11475 SW PACIFIC HWY SUBDIVISION • VILLA RIDGE ZONING: C —G BLOCK • LOT -002 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 1 TRAPS : 0 STORIES • 0 WATER HEATERS 0 CATCH BASINS • 0 FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0 SINKS 2 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 • 1 RAIN DRAIN (ft)...: 0 Remarks: Install new plumbing. Owner: FEES VERN LOEHNER type amount by date recpt 15890 SW 146TH AVE PRMT $ 36.00 DEB 03/04/99 99- 313438 TIGARD OR 97224 PLCK $ 9.00 DEB 03/04/99 99- 313438 5PCT $ 1.80 DEB 03/04/99 99- 313438 Phone #: Contractor POWER PLUMBING CO P 0 BOX 23144 TIGARD OR 97281 Phone #: 244 -1900 $ 46.80 TOTAL Reg #..: 000523 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Rough —in Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Underfloor /Under applicable laws. All work will be done in accordance with Top —out Insp 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 952-00011010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to DUNG by calling (503)246-1*,: Iss► d By: / fe./4%—e.... Signature: �;� .., �f. a '\ V +++++++++++++++++++++++++++++++++++++++++++++ + + + + + ++ + + + ++ + + + + +�., + + + + + + + + + ++ t Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Permit Application Plan Che• # 63^0 ,3d 13125 SW HALL BLVD. Commercial and Residential Rec'd By *- TIGARD OR 97223 Date Rec'd - (503) 639 -4171 Date to P.E. - Print or Type Date to DST . Incomplete or illegible applications will not be accepted Relat swR #9q -c s � V cane& O ail 3, cii Name of Develop ent/l ct FIXTURES (individual) QTY I PRICE :AMT Job I 1Yllt_ LJ.S. Sink 2 9.00 18os. Address Street Address 1 • Suite Lavatory 9.00 1 14 is sw r ke \ I' �. A Tub or Tub /Shower Comb. 9.00 Bldg # City /State Zip Shower Only 9.00 1 tez. OP`' 5-1 223 Water Closet 9.00 Name \f.o t, P , - 1 y Dishwasher 9.00 9, 00 Owner Mailing Address Suite Garbage Disposal 9.00 5 &`tO SW 1�(°t►. �� Washing Machine 9.00 City /State Zip Phone Floor Drain/Floor Sink 2" 1 9.00 0 T Na 3" 9.00 I e� ,Ors 9x224 _ G-9 -1c5n �' � rule, ©lt r-- 1J,, 4" 9.00 Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00 (� 7� _ ) R4,11411.-.4 Gas piping requires a separate mechanical permit. City /State Zip 1 Phone Laundry Room Tray 9.00 T1 e 91223 _ Urinal 9.00 Na , e GW�� C , Other Fixtures (Specify) 9.00 e u O 11v � 9.00 Contractor ailing Address Suite C) Q13\Vc 9.00 Prior to permit it tat Zip Phone Sewer - 1st 100' 30.00 issuance, a copy � do U 912.s\ a')4 - lf:‘ O O Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date required if 5a3-1 a, / _ i 2 _ o ) Water Service - 1st 100' 30.00 expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00 database 34 -ts0 3 6-3o-79 Storm & Rain Drain - 1st 100' 30.00 . Name Storm & Rain Drain - each additional 100' 25.00 Architect Mobile Home Space 25.00 Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 Pollution Device Engineer City /State Zip Phone Residential Backflow Prevention Device' 15.00 (Irrigation timing devices require a separate Describe work to be done: restricted energy permit.) New>t Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial' " Catch -Basin 9.00 Additional description of work: - ( A�t�, 2 HAe4% S ∎,sK'S per/hr Insp. of Existing Plumbing c � per/h ta&& t ,,..wAb Specially Requested Inspections 40.00 per/hr Rain Drain, single family dwelling 30.00 Are you capping moving or replacing any fixtures? Grease Traps 9.00 Yes 0 No`-� If yes, see back of form to indicate work performed by • fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL Isometric or riser di agram is required if Quantity Total is > 9 WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL .5‘ 00 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 2 2 that plans submitted are in compliance with Oregon State Laws. ' - nature f Owner /Ag Date '^'PLAN REVIEW 25% OF SUBTOTAL /I 4D 3 -1-411 Required only it fixture qty. total is > 9 `'� t i‘ Contact Pe Na?uukr Phone TOTAL "/TQ c.v.- \ �eS C 2 I4I4- 1C ‘ OD *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow �� �JJJ t l Prevention Device, which is $15 + 5% surcharge \ **All New Commercial Buildings require plans with isometric or riser diagram and plan review I:tdstslplumapp.doc 72/98 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New _ Moved Replaced Removed/Capped Sink 2 Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I: tdstskplumapp.doc 7!7198 • 6 /30 /99 Activities for Case #: PLM99 -00059 2:35:44 PM Assigned Hold Updated Activity . Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMC003 Application received 3/1/99 GEO RECD GEO 3/1/99 PLMC005 Permit Created 3/1/99 GEO DONE GEO 3/1/99 Received Washington County Heath Depart. letter at time of submittal. PLMC799 Final Inspection 4/1/99 TLP PASS AKJ 4/1/99 PLMC007 Plans routed to Plans Examiner 3/1/99 GEO SENT GEO 3/1/99 • PLMC008 Plans Approved /Routed to DST 3/1/99 3/2/99 MS PASS MRS 3/2/99 PLMC015 DST Post Review Complete 3/3/99 BON DONE BON 3/3/99 Received Wash Co Health Depart letter at time of submittal. It is an attachment with the plumbing application. Must pay for SWR99 -0045 • before issuing this permit. PLMC715 Rough -in lnsp 3/1/99 GEO 3/1/99 PLMC720 Underfloor /Underslab 3/1/99 3/8/99 TLP PASS TLP 3/9/99 PLMC725 Top -out Insp 3/1/99 3/8/99 TLP PASS TLP 3/9/99 PLMC008 Plans Approved /Routed to DST 3/2/99 MS PASS MRS 3/2/99 PLMC040 (F) Ready to issue 3/3/99 B PASS BON 3/3/99 PLMCO50 (F) Issue permit 3/4/99 DEB DONE DST 3/4/99 PLMC800 Case Finaled 4/1/99 AKJ PASS AKJ 4/1/99 • • Page 1 of 1 • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location I U - 75 194 e. nw Suite MEC Contact Person Ph OL/ )q07) PLM qq Contractor Ph SWR BUILDING en Owner ` Pi,th 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 RT FAIL U Post & m Under Slab Top Out Water Service Sanitary Sewer Rai Drains a Orjn 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 • Approach /Sidewalk Other Date , /�� Inspector ■ie Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.