Permit „ , CITY OFTIGARD
„ „u ,,, DEVELOPMENT SERVICES PLUMBING PERMIT
�"' 1UI i PERMIT # • PLM97 -0366
:......t, A 13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 DATE ISSUED: 09/ 08 / 97
PARCEL: 1S136CD -00100
SITE ADDRESS...: 11705 SW PACIFIC HWY
SUBDIVISION • ZONING: C —G
BLOCK LOT • 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 1 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: Installing a water heater
1 Owner: FEES
HAM RADIO OUTLET type amount by date recpt
11705 SW PACIFIC HWY PRMT 25.00 B 09/08/97 97 -29904E
TIGARD OR 97223 SPOT 1.25 B 09/08/97 97- 299042
Phone #:
Contract or
KENNEDY PLUMBING
13985 SW FARMINGTON RD
BEAVERTON OR 97005
Phone # : 643-5535 $ 26.25 TOTAL
Reg 11..: 001009
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
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 -0001 -0010 through OAR 952- 0001- C:s. You may
obtain copies of these rules or direct questions to OUNC calling
(503)246 -1987. •
'I Iilt► • •, , / ,
Issued B y: .P - 11i i L ,LL/ 1 .---- F e r m i t t e e Signature: / jl jf Q /4
0
+++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Or+++++++++++++++++++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++±+++++++++++++++++++++++++++++++ + + + + + + + + + + ± + + + + + + + + + + + + + + + + + + ++
L .
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125..SW Hall Blvd. Permit # 0L17 - 67,6(,
Tidard, OR 97223
(503) 639 -4171
n �! �� MINIMUM. $25.00 PERMIT FEE + ST. SURCHARGE
�(} Name of Development New Single Family Residences Only
Address f ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job 11105 50 PGct �t c 1`I ' w ❑ 3 BATH HOUSE $225.00
Address cit ap ✓ Fee includes all plumbing fixtures in the dwelling and the first 100 feet
--c-1-5,4 (' d Pr 912- 2 3 of water service sanitary sewer and storm sewer. See fees below.
Name (or e of Susmess) FIXTURES QTY PRICE AMT
LO 5 j,n�/,e 6-}-f�(1Pp- � Sink 9.00
Mating A C c7 Q Phone. Lavatory 9.00
'6
Owner go() 1 � 6iocicuA) 5 w Tub or Tub /Shower Comb. 9.00
cnysrate ZIP -U0 Shower Only 9.00
P 4-c j q 7 aO 5 Water Closet 9.00
Name (or name of business) Dishwasher 9.00
Occupant 4 a m l ac 0 598,0555 Garbage Disposal 9.00
p Mating aaeree. Phone Washing Machine 9.00
(1 105 5 ix, ear,. 01, X Floor Drain 9.00
City/State -. J Water Heater I. 9.00 q� O0
(I 5 a rd 0 7 c i 7 2- 23 Laundry Room Tray 9.00
Name 6115535 Urinal 9.00
1 t P (u m b i nc Other Fixtures (Specify) 9.00
Mating Address Phone 9
!7 s/y
Contractor 1 c1gC `0 .( n(mtn9+ v n 97oo7
l J cJ 9.00
City/State nP 9.00
V -h fa/'t f OA, 9 - 70°5 Sewer 1st 100' 30.00
State Registration No..// City Bus. Tax No. Sewer - ea. Addit. 100' 25.00
109 p1 3i i -9 2 e/3 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
give [ below.) Mobile Home Space 25.00
4 ti-c), ), Back Flow Prevention
Device or Anti - Pollution Device 9.00
Signature (owner or agent Date Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition Qf alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing 40.00 /hr
Specially Requested Inspections 40.00 /hr
Existing use of
building or property Rain Drain, single family dwelling 30.00 .
Residential backflow prevention
devices 15.00
Proposed use of
building or property
*(Except residential backflow
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL 5r01Oi
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE ( A5
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
■
TOTAL a6 )c?■ J
Special Conditions
Date issued 9 'q ' / ) by U
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location / 7 0 . Suite Z MEC
Contact Person V Ph PLM
Contractor Ph SWR
BUILDING' Tenant/Owner ELC
Retaining Wall - ELR
Footing
Foundation A I NOT REQU '` U- , X FPS
Ftg Drain SGN
Crawl Drain In FOUND DURING RESEARCH / /�✓Nf
Slab NO INSPECTION(s) IN FILE SIT
Post & Beam
Ext Sheath /Shear l -
Int Sheath /Shear U
Framing J
Insulation ` j. t
Drywall Nailing /
Firewall 77'
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
•
Post & Beam
Under Slab
Top Out ,-Ek
Water Service •
Sanitary Sewer •
Rain -a ains
!NM" PART FAIL
MECHANICAL:,µ` - _ ,
Post & Beam
Rough In °
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAf
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL •
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date l/ 9 ` 4 Inspector Ext
Final
PASS PART . FAIL • DO NOT REMOVE this inspection record from the job site.