Permit CITY OF T PLUMBING PERMIT
^ %�,,,�,� DEVELOPMENT SERVICES DATE ISSUED: 08/05/98 -067
PARCEL: 1S135DD -03301
SITE ADDRESS...: 11945 SW PACIFIC HWY #109
SUBDIVISION • HOFFARBER TRACTS NO.1 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 • 0 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 • 0 RAIN DRAIN (ft)...: 0
Remarks: Alteration to plumbing for commercial tenant.
Owner: FEES
EAGLE PLUMBING ENTERPRISES INC type amount by date recpt
13801 S FORSYTHE RD PRMT $ 25.00 B 08/05/98 98- 308003
OREGON CITY OR 97045 -1219 5PCT $ 1.25 B 08/05/98 98- 308003
Phone #:
Contractor
EAGLE PLUMBING ENTERPRISES INC �a\
13801 S FORSYTHE RD EXP® g, &i
lea
CITY OR 97045 -1219
1 Phone #: 760 -5565 $ 26.25 TOTAL
Reg #..: 47914
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 4001-0010 through OAR 952- 0001 -0080. You say
obtain copies of these rules or direct questions to 011NC by calling
(503)246-1987.
6 Issued By: / Permittee Signature:, ��C---,_
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
GITY OF TIGARD Plumbing Permit Application -
Plan Che• '
c.1''3125 SW HALL BLVD. Commercial and Residential Rec'd By ,
IGARD,'OR 97223 Date Rec'd ME
(503) 639 -4171 Date to P.E.
Print or Type Date to DST -
Incomplete or illegible applications will not be accepted Permit # Pin 9 9, - ,6 1 .2 6�
Related SWR # .P- O /99
/ ^ a2.6 /°/_,49 2,9 'r1e Called CARL U-m? *7o
Name of Development/Project FIXTURES (individual) QTY PRICE 'AMT
Job Der. 5 Itei..../ Sink 2 9.00 lc Address Street Address Suite Lavatory 9.00
( Q �S 5 �,) ?PL KLA Tub or Tub /Shower Comb. 9.00
Bldg # City/State Zip Shower Only 9.00
��e/ U c7h�>7 Water Closet 9.00
Name
?ttZt BuevcE" Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
1) Washing Machine 9.00
City /State Zip Phone
Floor Drain/Floor Sink 2" 9.00
Name 3 " 9.00
#lA G 4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit.
City/State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Name Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 9.00
1.35Nc k S Rd-c5.1 igib 9.00
Prior to permit City/State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy c a t s < 9704s- 'a 5 703
Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if
1 79 p4 a1 . 97 Water Service - 1st 100' 30.00
expired in COT Plumping Lic Exp. Date Water Service - each additional 200' 25.00
database 3 -- /.S* Q Q _ S-59 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 EXPIRED Commercial Back Flow Prevention Device or Anti- 25.00
�lJ� 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 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Reside 0 Commercial 4 Catch Basin 9.00
Additional description of work:
Insp. of Existing Plumbing 40.00
IA,D.D - 2 S 10IL.3 M CN1,S1iNcj per/hr
S e C / ` 3 ep Specially Requested Inspections 40.00
<_A e f�l J l 1 / 1 r �, v „� per/hr
•
Are you capping, moving.or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes No O Grease Traps 9.00
If yes, see back of form to indicate work performed by
fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL
Isometric or riser d iagram is required N Quantity Total is > 9
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL A5
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
that plans submitted are in compliance with Oregon State Laws. 7, 2
Signature of Owner /Agent Date "PLAN REVIEW 25% OF SUBTOTAL
^ Q C . - 8 -3,4 Required only if fixture qty. total is > 9 TOTAL �1
Contact Pers Name Phone A, •D
0,{JL4 C+-ire--0 (Q'ct) -2 A v + '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
/S"/ 3 5 ^ 3_5o/ and plan review
I:tdststplumapp.doc 7/2/98
PLEASE COMPLETE:
fixture T.: e
Y .. Quanfi.. b:.:: Work. Performed.:::;:
w
Ne. >`> :IVloved' : :::::R la c e d: : ::
p . R em oved /Cappe'd> •
Sink _2-
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3" 1
4 "
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:\dsls\plumapp.doc 7/7/98
p e_e_cle c-7r e S ti P
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 11 �
O A. . P.M. MST:
� 1 l -
Location: S / BUP:
Tenant: ui ldg: MEC: o /
Contractor: r. Phone: �, — E7 d 3 PLM: %�5 0®� 6 7
Owner: Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof Un. Slab Rough -In Ceiling Water Line
Slab Framing . • 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 6i Approved Dr Heat Pump Low Volt
Approved (�` Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
O Call for re' do inspection 0 Reinspection fee of $ required fore ne i 0 Unable to inspect
Inspector: � Date: Page of
7V? � Pa g