Permit CITY OF TIGARD
r DEVELOPMENT SERVICES PLUMPING PERMIT
FERMI T # F'L M98 —
80
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 10 / 1 5 98
PARCEL: 2S1O2CC -01000
SITE ADDRESS...: 13660 SW PACIFIC HWY
SUBDIVISION • ZONING: C —G
BLOCK • LOT • JURISDICTION: TIG
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °MF WASHING MACH 0 BACKFLOW PREVNTRS..: 2
OCCUPANCY GRF'..:R1 FLOOR DRAINS ° 0 TRAPS ° 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS 0
FIXTURES LAUNDRY TRAYS 0 SF RAIN DRAINS • 0
SINKS 0 URINALS • 0 GREASE TRAPS • 0
LAVATORIES 0 OTHER FIXTURES ° 2
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 3
DISHWASHERS . 0 RAIN DRAIN (ft)...: 0
Remarks: replace existing water system
Owner: FEES
FIR GROVE VILLAGE type amount by date recpt
13660 SW PACIFIC HWY PRMT $ 128.00 GEO 10/15/98 98- 310020
TIGARD OR 97223 -0000 SPCT $ 6.40 GEO 10/15/98 98- 310020
Phone #:
Contract or
R D PLUMBING INC
13900 NW SPRINGVILLE RD
PORTLAND OR 97229
Phone #: FAX 297 -7344 $ 134.40 TOTAL
Reg #..: 000739
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Service In
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started RP /Backf low Prey
within 188 days of issuance, or if work is suspended for more Final Inspection
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 952-8881-8880. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By it( . Permittee Signature :,(411.... � I
+ ++ + + + + + + + + + + + + + + + + + ++ ++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Application Rec'd By
13125 HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 6394171
Date to DST d
Permit # m � / r'4
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project On back indicate Work Performed by fixture.
Job Fir Grove Village FIXTURES (Individual) • • QTY PRICE AMT-
Address S treet Address Suite Sink 9.00
13660 SW Pacific WY Lavatory 9.00
Bldg # City /State Zip Tub or Tub /Shower Comb. 9.00
Tigard, OR 97223
Name Shower Only 9.00
Water Closet 9.00
Owner Mailing Address Suite Dishwasher 9.00
Garbage Disposal 9.00
City /State Zip Phone Washing Machine 9.00
Name Floor Drain 2' 9.00
3' 9.00
Occupant Mailing Address Suite 4' 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
R. D. Plumbing, Inc. Other Fixtures (Specify) . 9.00
Contractor Mailing Address Suite
13900 NW Springville Rd Yard hydrant 2 9 18.0)
Prior to permit City/State Zip Phone 9.00
issuance, a copy Tigard, OR 97229 297 -7422 9.00
of all licenses are Oregon Const. Copt. Board Lic.# Exp. Date - 9.00
required if 73913'-' 06/31 /00 Sewer - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date . Sewer - each additional 100' 25.00
database 26 -313PB 06/30/99
Name Water Service - 1st 100' 1 30.00 30.00
Architect Water Service - each additional 200' 2 25.00 50.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City /State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 Pollution Device
to be done: Residential 2 Non - residential 0 Residential Backflow Prevention Device* 2 15.00 30.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
replacement of water main Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property multi - family residential _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property same
QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Ouanity Total is > 9 .7
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that pia • submitted are in com • ce with Oregon State Laws. -128.00
Sig of c. . r /Agent Date °
■
/ 5 /° SURCHARGE 6. '40
Contact Person Name Pho a PLAN REVIEW s> OF SUBTOTAL
Required only if fixture qty. total Is > 9
297 -7422 TOTAL
134.40
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
I:tdststpImapp.doc 5/97
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
Capped / Removed Moved Replaced
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
•
I:tdstslplmapp.doc 5/97
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 4,
24- our Inspection Line: 639 -4175 Business Line: 639 -4171 BUP _
91 I3 Date Requested I '30 - IS' AM PM BLD r�
V
Locatio 3. .1 ' - � Sui MEC
r
Contact Person i ` L J/ a . -or — : _' 'h , 3 9 -77 79 76P PLM /
Contractor /f /Qii/j71 � Ph ?-/7 - 7 q�d — SWR
BUILDING Tenant/Owner i� F/Z i6i A-PX5 ELC
Retaining Wall ELR
Footing Access: � �
Foundation g !' (. �7 (U 7b FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing /f
Drywall v ��� / /A &a/
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PA S PART FAIL
PLUMBING
Poi & tSearri
Under Slab
ut
cyVater ServiciTh
Sanitary fewer
r. ; :.! rains
i- ,4'• . ) - ART FAIL
NICAL
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 v/ � /�
Otheoach /Sidewalk Dat / f (/ / (� Insp 7(//3O 9 a Ext
l
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.