Permit C ITY OF TIGARD PLUMBING PERMIT
A, . DEVELOPMENT SERVICES PERMIT #: PLM2000 -00019
,11.14- A DATE ISSUED: 01/27/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11945 SW PACIFIC HY 210 PARCEL: 1S135DD -03301
W
SUBDIVISION: HOFFARBER TRACTS NO.1 ZONING: C -G
BLOCK: LOT: 002 • 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
TIGARD PROPERTIES INC PRMT KJP 01/27/200C $50.00 00- 321452
2106 SE OCHOCO ST 5PCT KJP 01/27/200C $4.00 00- 321452
MILWAUKIE, OR 97222
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
Reg #: LIC 000027 Final Inspection
PLM 26 -60BP
ORtG
INAL
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 copi: if these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: X Permittee Signature: t,
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
JAN -20 -2000 15 31 P.01
:1I Y U1 • 1 I19AKU riumntng rermlt Application
3125 SW ;TALL BLVD. Commercial and ResidentinkEIVED
•IGAAtD, OR 97223 PLM
503) 639-4171 JAN 2 7 2000
Print or Type
Incomplete or illegible applications hgl
0 el;i 105 9938
Name of Development/Project x ; ;.: .:
' f; RF c�aiiiaivr0.tr�il�:; ��k ���x:x � �� >� Y m,�: ��T�1 ..; �A�er
1..� c/e -'^ ..< A./;. »xw' HM.. .:�rF..r:.A:.r . r . . .. fi. ` . .e. .r .
:
/�t� I 11.50 f
Job e tar • e ° CaC e. Lavatory 11.50
Address �� _ Tub or Tub/Shower Comb. 11.50
p� 11.50
Pi Bklp � � J'� Zip ; Shower Only
Wuac ' # 9 • v� • c -j1 . Water Closet 11.50
it
h' 4 p e L °/a C e) DiethWaeher 11.50
Owner � / /� �� � e Suite e Garbage Disposal 11.50
Washing Machine
•- • /Sta : Zip Phone
oCr • I a • dote, Floor DrelrilFtoor Sink 2' 11.50
3• 11.50
Name r
4• 11.50
Occupant Ong Addreee Suite ' Water Heater 0 conversion isr like kind / 11.50
Gas piping requires a separate mechanical permit.
City/State ZIP Phone Laundry Room Tray 11.60
• Urinal 11.50
'
i ii • Other Fixtures (Specify) 15.00
'O. Le• i•
Contractor
Prior 6o permit I >, �� Sewer -1st 100' lumin, a spy � • Sewer - each additional 100' 32.00
of all If are •~^ Con � ' BoardUcd 0 , D7 O � WaterService - let 100' 38.00
expired In COT Plum • . Lie. • tp,' nn Water Service - each additional 200' 32.00
database _ , - • • P.8 U w Storm & Rain Drain -1st 100' 38.00
Name Storm & Rain Drain - each additional 100' • 32.00
Architect Mobile Home Space 32.00
or Mailing Address Suite Commercial Back Flow Prevention Device or MU- 32.00
' Pollution Device
Engineer °Wfe Zip Phone Residential Baddtow Prevention Device' 19.00
(IMgatton timing devices require a separate
D escribe wont to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes i No 0 Any Trap or Waste Not Connected to a Fixture 11.60
Residential 0 Commerd Catch Basin 11.50
Additional description of work. • Insp. of Existing Plumbing 60.00
re 'Lace. eI ee4-r lc, -er hee,.4- Q, - per/hr
50.00
Are ou capping, moving or replacing any fixtures? Specially Requested Inspections perlhr
Yes 0 No 0 Rain Drain, single family dwelling . 45.00
If yes, see back of form to Indicate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL " = ` >
I hereby edcnowledge that I nave read this application, that the Information Isometric or nser diagram Is required If Quedky Total Is > e <- . - « " :.s.r
given b cored. That I am tiro owner or authorized agent o /the owner, and 'SUBTOTAL - °'' "" " - OC
that 'lens submitted are In cc •lance with Ore, on State Laws. "' . .. .., y. r
Sig . S �yyrr gi A MIAMIll Data SURCHARGE x ` =" -`; ` GO
Nurrts - Phone ••PLAN REVIEW 26% OF SUBTOTAL =. ` � ; "v
, V /.5 ... • - D36 Required only endure qty torsi la 9 ∎ `` r Z . < , w
re s ; FR ..�.
Y : J r _ TOTAL
'0:5. k i
, ; !, .---;,,,..L;.. { , ' { ` p erm it fee Is $50 + 5% surcharge, except Residential Back low
,: Minimum rp
v � L. r , ` . r� ' `� • , Prevention Device, which is $26 + 6% surcnarge
r.. ..... _. .• ,,. ..., .. • • •,,.,,,r E ,. ... .. 4 :1 "All New Commercial Buildings require plans with Isometric or riser diagram
and plan review
aDlereWOranapo.dot saeraa
TOTAL P.01
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
- BUP
/
Date Requested f I ' /03 AM PM BLD
Location i � 945 P4!. l/ L Suite e MEC
Contact Person Ph V2 Y 3O PLM 29 O G I Q
Contractor �.r1 a Ph SWR
BUILDING Tenant/Owner 1 v , C 2L — Nee ELC
Retaining Wall U 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
Po�s'
Under Slab
Top Out
Water Service
Sanitary Sewer
Rai Drains 100 44—
die 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 r/
Approach /Sidewalk D ► Inspector Ext
Other
,
Final
PASS PART FAIL ' 0 N ' T REMOVE this inspection record from the job site.