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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.