Permit CITY OF TIGARD
f � i �; DEVELOPMENT SERV6CES F'ERMI # RING PERM F'LM98 -0450
DATE ISSUED: 12/07/98
PARCEL: 2S102CB -02500
SITE ADDRESS...: 13090 SW PACIFIC HWY
SUBDIVISION • FREWINGS ORCHARD TRACTS ZONING: C —G
BLOCK ° LOT °007 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..:A3 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: Replace and existing water heater.
Owner: FEES
FOODMAKER, INC. type amount by date recpt
9330 BALBOA AVE PRMT $ 25 °00 GEO 12/07/98 98-311225
SAN DIEGO CA 92123 SPCT $ 1.25 GEO 12/07/98 98- 311225
Phone #:
Contract or
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY
BEAVERTON OR 97005
Phone #: 643 -7619 $ 26.25 TOTAL
Reg #..: 000128
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. 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 CUE by calling
(503)246 -1987.
■
Issued By ' i/ Permittee Signature :_.,r
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + +++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Recd 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 RelattedswR # �_ 645--d
Called
Name of Development/Project FIXTURES (individual) QTY. ; PRICE -' AMT
Job ,I fV2, . ' Ni - T' -. - F-'c :%(,- Sink 9.00
Address Street Address Suite Lavatory 9.00
t 3o 1 C (:)\14 P( FIL HA : ( Tub or Tub /Shower Comb. 9.00
Bldg # City /State Zip Only 9.00
-Tico z.o ; L ? t i•1-' -a
Name P� Water Closet 9.00
ri., L ; \ KAY--ea l X - Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
4.5oc. 5 , 'V VA:';G 4,,/ . � Washing Machine 9.00
City /State t'? Zip _ Phone
V L, ✓!�W J J " (5D 6,, I 4-61"-t- Floor Drain/Floor Sink 2° 9.00
Name 3' 9.00
RICAL,. ' 18N1 ' 1 7: 4 t - a- Y 4° 9.00
Occupant Mailing Address Suite Water Heater 0 conversion )like kind 9.00
0 - - .5 IA- , °°?� lt : ' 14.,, Gas piping requires a separate mechanical permit.
CitX /State Zip Phone Laundry Room Tray 9.00
-II : " - 4 , : . ' - ' e - 917-, ) 9 - - 4t, lA' Urinal 9.00
Name -- % O ther Fbctures S
������ f=� _ t �- d_- f �f � 1t�_� (Peary) 9.00
Contractor Mailing Address _ Suite 9.00
h `r w _
'": .5 . Li: . 1.: J . !1. ; 9.00
Prior to permit City /State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy `8'; I)t G C ` t d ? , -16 11
all licenses are Oregon Sewer - each additional 100' 25.00
of
regon Const. Cont. Board Lic.# Exp. Date
required if Water Service -1st 100' 30.00
expired In COT Plumbing Uc. # Exp. Date Water Service - each additional 200' 25.00
database Storm & Rain Drain - 1st 100' 30.00
Name r_ Storm & Rain Drain - each additional 100' 25.00
Architect '2i M i 41 ` ' Lk.; ") L -e' 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 O Repair 0 Replace with like kind: Yes O No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial 0 Catch Basin 9.00
Additional description of work:
)- M;. Sri Y �k- -- r
if TM .ti Insp. of Existing Plumbing per/hr
F 01
- y N.1!"-1A...' Specially Requested Inspections 40.00
per/hr
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes ® No 0 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 diagram is required if Quantity *SUBTOTAL Total is > 9
WORK COULD RESULT IN INCREASED SEWER FEES. _
"SUB �-
I hereby acknowledge that I have read this application, that the information , s - ?. /,,R5
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE 4' '_'. '`°:
that plans submitted are in compliance with Oregon State Laws.
Slgna re oSOwner/Ag t ' I Date **PLAN REVIEW 25% OF SUBTOTAL
�l F,
C 4' r 2. G 7, ,;,- Required only it fixture qty. total is > 9
�� �,. ! ' TOTAL g5
Contact Person Name Phone
rr�� rr�� I ; = 1r *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
� � I t-4 t-4 i' 1 t; L j '.. - - -' 1 .� i % c) L ' ' 4,' - � - Prevention Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or rise( diagram
and plan review
tldstslplumapp.doc 7/2/98
PLEASE COMPLETE:
IaGed........Removed /Ga
Sink
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:tdststplumapp.doc 7/7/98
Page No. 1 CASE HISTORY FOR CASE NO.: PLM98 -0450
•
FOODMAKER, INC.
13090 SW PACIFIC HWY
12/28/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
PLMC003 Application received / / / / 12/07/98 RECD GEO 12/07/98 DST
PLMC005 Permit Created / / / / 12/07/98 DONE GEO 12/07/98 DST
PLMCO50 (F) Issue permit / / / / 12/07/98 PASS GEO 12/07/98 DST
PLMC799 Final Inspection / / / / 12/09/98 PASS MS 12/09/98 MRS
PLMC800 Case Finaled / / / / 12/09/98 PASS MS 12/09/98 MRS
N
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
8 Date Requeste /.Z - - qiff AM PM BUD
Location
/3O90 `
��C�i Suite MEC
Contact Person Th11 C 4 ttJi ej Ph 0 7 ?J Q6 W-05
Contractor 411 . : 41C," 1 e/ ! d 1 l ug Ph 9- 0 SWR
/
BUILDING Tenant/Owner v/l kL //J 7f ,so)c 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 i v,
Firewall
Fire Sprinkler L ,0 .
Fire Alarm
Susp'd Ceiling
Roof
Mi
sc:
Final
P T FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer , ,
Rain Drains /
Fin P T 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 Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidew Date / l
2/4' Inspector � h — Ext `
Other
Final
PASS ` R FAIL DO NOT REMOVE this inspection record from the job site.
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