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Permit CITY TI GAR PLUMBING PERMIT t A' A PERMIT #: PLM1999 -00238 DEVELOPMENT SERVICE R I G 1 N ± 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/2/99 SITE ADDRESS: 13185 SW PACIFIC HWY B-4 PARCEL: 2S102C6 -00302 W SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G BLOCK: LOT: 033 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2 OCCUPANCY GRP: FLOOR DRAINS; 1 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: Installation of a water heater and two (2) back flow prevention devices, and an indirect floor drain. Floor drain replaces an existing drain. Dummy sewer permit (SWR1999- 00161). FEES Owner: Type By Date Amount Receipt ALADDIN MOTOR INNS PRMT GEO 8/2/99 $87.00 99- 317332 10155 SW CAPITOL HWY 5PCT GEO 8/2/99 $6.09 99- 317332 PORTLAND, OR 97219 Total $93.09 Phone 1: Contractor: SUNSET PLUMBING CO G LONG ENTERPRISES INC PO BOX 23263AU REQUIRED INSPECTIONS TIGARD, OR 97281 -3263 Phone 1: 245 -4926 Rough -in Insp Reg #: L IC 0120893 Underfloor /Underslab e g RP /Backflow Preventer PLM 34 -246PB Insp existing /capped fixtures Final Inspection 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 copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued B • /- i / L Permittee Signature A �� / _ L � Call (503 .3' -4175 by 7:00 P.M. for an inspection needed the net business day CITY OF TIGARD Plumbing Permit Application Plan C c 13'25 SW HALL BLVD. Co I II - •..l and Residential Rec'd y TIGARD, OR 97223 O " Date Rec'd (503) 639 -4171 - Date to P.E. • -"n0 c Wi ' Date to DST �. Q A 4 _ - I . • _ Permit # kin / / 35 l Inc • Print or pe - • plications will not be accepted -� m , � „ o 0...6)./A.- 0...6)./A.- 10. 1, /� Related SWR # iff9- -6 l/W LZ 1 ` J / r� l - 0 7r 0�-4/�9.7�� Called • � L(Q � J/ w Na /n C m e e of Dev J C, ( FIXTURES (individual) QTY PRICE AMT Job Er,Qg (7.: ka -"l,eN 0 Sink 11.50 Address Stree ddress / � Suite Lavatory 11.50 j3 o',5" SO P�r1C1L_ $ ""I 13 "1 Tub or Tub /Shower Comb. 11.50 Bldg # City/State Zip Shower Only 11.50 _Trpgr d j oft Water Closet/Urinal (Specify) 11.50 Name // )/,v/g/v(r [doff/ _ /t am q Dishwasher 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 i3 2 R'5 .S 1[) a 41, Ay, Z. ' • Washing Machine /Laundry Tray (Specify) 11.50 City/State Zip / Phone Floor Drain/Floor Sink 2" 11.50 Mar d e 3" .( 11.50 /bin!) Na / / / &$ G l..& r 5 4" .11.50 Occupant Mailing Address Suite Water Heater *onversion Jike kind 11.50 ll sit / 3 2 irS Sw A i i c ,Q V Gas piping requires a separate me anical permit. I City /State Zip Phone MFG Home New Water Service 28.00 9a/'d/ R` ' MFG Home New San/Storm Sewer 28.00 Nme t� 1 -__. ; n7£7 Hose Bibs 11.50 Contractor M ilin A ress Suite Rain Drains 11.50 0 _dress Z3 20 Drinking Fountain - 11.50 Prior to permit , CiV /State ZiE_ Phone Other Fixtures (Specify) 15.00 issuance, a copy 1 r�tt r � y 7G0/3ZC 7I 5 - c/`l C of all licenses are Ore on Const. Cont. Board Lic.# Ex ate required if r Z og q) � lb expired in COT Plum Lic. C( J1 E xp 0 0 database c f 2 I' database � 7 Name Sewer - 1st 100' 38.00 Architect Sewer - each additional 100' 32.00 Or Mailing Address Suite Water Service - 1st 100' 38.00 En ineer City /State Zip Phone Water Service - each additional 200' 32.00 g Storm & Rain Drain - 1st 100' 38.00 Describe work to be done: Storm & Rain Drain - each additional 100' 32.00 e New 0 Repair 0 Replace with like kind: Yes, No 0 Commercial Back Flow Prevention Device 32.00 'b Residential 0 Commercial i Residential Backflow Prevention Device` 19.00 d oonal.descxiptio gf ir /� ` a•rL,t� at, d1 � 4.A..... t.tidLt.&L , Catch Basin 11.50 w • J • Insp. of Existing Plumbing 50.00 Are you capping, moving or replacing any fixtures? per/hr Yes 0 No Specially Requested Inspections 50.00 If yes, see back of form to indi ate work performed by per /hr fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain, single family dwelling 45.00 WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50 I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL . given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required if Quantity Total is > 9 that plan . itted are in compli ce with Oregon State Laws. *SUBTOTAL 'eel ignat • Owner/ ent Date 87 OW c & -2 - Q q 7% SURCHARGE • el j Con . t Person e Phone �p //Y-,/ / iglu R629 - 32 70 * *PLAN REVIEW 25% OF SUBTOTAL 1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9 2 BATH HOUSE $250.00 ' TOTAL ! 5•� ✓ C1 7� 3 BATH HOUSE $285.00 ; (This fee Includes all plumbing fixtures In the dwelling and the first 'Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention 100'Yeet of sanitary sewer storm sewer and water service) Device, which is $25 + 7% surcharge ' // ; *`A11 New Commercial Buildings require plans with isometric or riser diagram and plan review. 1:1dstsforrnstpIumapp.doc 7 /19/99 - 0 • • PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed /Capped 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:ldsts\formslplumapp.doc 7119199 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ' - BUP Date Requested .� ��7 AM PM BLD Location ---<- J Suite A --/-1 MEC Contact Person / 3 es pa.C4,a� 9 ' Ph PLM / 9-to Z ? Contractor Ph SWR BUILDING Tenant/Owne `� (-% I ! /! - ELC Ay 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 Q Drywall Nailing I _.i��I - o /Iii _ _. Firewall .� � � Fire Sprinkler -• / /Id__: - i / Fire Alarm 4 : Susp'd Ceiling / - /�� . � A - Misc: i_� ` _/• �� i ' i Final % PA�_, FAIL cialTi 1 V) , ,r • % /' - Post & Beam / ` r Under Slab , / / � � Top Out / Water Service 1 Sanitary Sewer Rain Drains --if —I_11 �� �/ / %! Final f �( PASS PART k- MECHANICAL / Post & Beam ` �..,. narrifir i Rough In - - i /� /: ��/ Gas Line 4 Smoke Dampers , �✓. r � / i . a ' Final 'e PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage % /l..f Fire Alarm ,. b.� � A � I L (�7� ��I Final /I /�'a�I 511 PASS PART FAI A ��� SITE . /, i�/ f Ii r Backfill /Grading ? W �// 1 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 1 Approach /Sidewalk n )/� Z Other Date 2 Inspector 1 2 2' 2 Ext Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested --2 ) - 1/ -/ AM PM / BLD Location I r I S S (�ZC / Suite g -`7 MEC Contact Person OCtira Ph Z?9'j2,7o PLM 'l q - apa3B Contractor Ph SWR BUILDING c' Owner al c , 4 -CSSC6 S 4 dIANASELc 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 PASS PART FAIL <PLIMAIMFM Post & Beam Water Service Sanitary Sewer Rain Drains PART FAIL MEC ICAL 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 3 ,/ ' Inspector Ext Final PASS • PART FAIL DO NOT REMOVE this inspection record from the job site.