Permit CITY OF TIGARD
�Aa;d DEVELOPMENT SERVICES PLUMPING PERMIT
illil PERMIT # • PLM97 -0519 l,L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 12/05/97
PARCEL: 2S102CB -00303
SITE ADDRESS...: 13165 SW PACIFIC HWY
SUBDIVISION • NORTH TIGARDVILLE ADDITION ZONING: C —G
BLOCK • LOT •033 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..:P3 FLOOR DRAINS • 1 TRAPS • 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 1 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: Plumbing TI. Sewer tally will be assessed by Mike S. at a later date.
Owner: FEES
POORMAN, JOHN & MARTHA type amount by date recpt
13165 SW PACIFIC HWY PRMT $ 25.00 B 12/04/97 97- 301443
TIGARD OR 97223 5PCT $ 1.25 B 12/04/97 97- 301443
Phone #:
Contract or
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN OR 97062
Phone #: 691 -6166 $ 26.25 TOTAL
Reg #..: 000879
REQUIRED INSPECTIONS
This pereit is issued subject to the regulations contained in the Top —out Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This pervit 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 - 0801-0010 through OAR 952 -0001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-1987.
Issued By: eXtlikegk' Permittee Signature: em (LC 01 1. -044411 1,
++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
:ITY OF TIGARD Plumbing Application Reed
3125 SW HALL BLVD. Commercial and Residential Date Recd I
`1GA1 D, OR 97223 Date to P.E.
503) 639 -4171 Date to DST
Permit Si Cl-4491 -QS(9
Print or Type Related SWR s
Incomplete or illegible applications will not be accepted Called
Name of Development/Project .Fl7CTURE4;11ndlvld_ ual) 4400Ma p C,E4 WADI
Job b U v2-6 L.1 1‹.-.% A, b 5l / 9.00 rt.'
Address Street Address - Suite Lavator 9.00
3 1 (a s ,$O PA'L. Tub or Tub/Shower Comb. 9
Bldg $ - City /State 1 Zip Shower Only 9.00
T\ \ 4rl fin- water Closet 9.00 Dishwasher
'S 1 .i '(i - K C0ns1 • 9.00
Owner Mailing Address Suite a 9.00
Washing Machhe 9.00
City/State Zip Phone - -- Floor Drain r 9.00
Name r 9.00
4 ' 9.00
Occupant Marling Address Suite Water Heater 9
Laundry Room Tray 9.00
City/State Zip Phone Urinal 9.00
Name Other Fixtures (Specify) 9.00 .
fl rLl11)1AL,wt. ,,1i 3L4L 4 9.00 qQa-
Contractor mailing Address Suite I ,. • 9,00 .
1 1120 $ has T14u.5.(1 Q (A)a.44 9.00
(Prior to issuance
City/State Zip Phone
applicant must , j u r,.1 a{� h ,4 p12 et -10(.1 & q 1- Is,l 6 k 9.00
provide all Oregon Const. Cont. Board Lie.* Exp. Date - 9.00
license ors 00 0 to / > /lq /9R 9.00
cons Exp. Date Sewer - 1st 100' $0
>
Information ). v n s /?6//9g Sewer - each additional 100' 25.00
database). oCOTCOT Business Tax or Metro S Exp. Da CQ Water Service - 1st 100' 30.00
8 //!
(o Water Service - each additional 200' 25.00
Name
Architect storm & Rain Drain - 1st 100' • 30.00
Or Mailing Address ' Storm & Rain Drain - each additional 100' 25.00
Mobile Home Space 25.00
Engineer City /State Zip Phone Commercial Back Flow Prevention Device or And- 25.00
• Pollution Device
Describe work New 0 Addition 0 Alteration At Repair 0 Residential Badtlow Prevention Device' 15.00
'.o be done: Residential 0 Non - residential 0 My Trap or Waste Not Connected to a Fixture 9.00
Additional descripdon of wort 1 Catch Basin 9.00
1 t. �Yl� � Insp. of Existing Plumbing 40.00
per/ hr
'Lusting use of Specially Requested Inspections 40.00
- .Lidding or property 12 7 (U' Yi p 11>t j(„t �
Rain Drain, single family dwelling 30.00
R Tiding or pro o perty Bon )(► • 1 - Grease Traps 9.00
QUANTITY TOTAL �.p 1
Are you Ca -;;.."--$ ...
Y capping . moving or replacing any fixtures? Yes p No p I ^ diagram is required d 0uanay Tots a 9 ;:%% ,. -
pf yes see back of form) SUBTOTAL ,;
I hereby acknowledge that I have read this application, that the information •` [%
;even is correct. that I am the owner or authorized agent of the owner, and 5% SURCHARGE ..: _r: 3,'
:hat plans submitted are in compliance with Oregon State Laws. / --'77-
.S ignature of Owmer/Agent Date PLAN REVIEW 25% OF SUBTOTAL :'
Recuireo only (future ply. total is t 9
/LlL �� = TOTAL . / l�
ron - - Ninon 1.1 .. Pho e - ' G
(Yp.r/ r V( �.Sk t 13 I -q-) • Prevention Device. which is $15 + 5% surcharge. except surcharge Residential ow
1:\plmapp.doc 12/96 (dst)
Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0519
MODERN PLUMBING
13165 SW PACIFIC HWY
04/09/98
Action Description Req/ Schd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
PLMC003 Application received / / / / 12/04/97 RECD B 12/04/97 BON
PLMC005 Permit Created / / / / 12/04/97 DONE B 12/04/97 BON
PLMCO50 (F) Issue permit / / / / 12/05/97 PASS B 12/05/97 BON
PLMC725 Top -out Insp 12/04/97 / / 12/05/97 Inspected 2 wc; 2 lave; 2 handsinks (1 PASS MS 12/08/97 J•H
existing, 1 new); 1 floor sink (2- inch);
7 2 -inch floor drains; 3 compartmental
sinks (commercial).
Grease traps need to be larger.
PLMC799 Final Inspection / / / / 01/06/98 require flow restrictors for grease trap FAIL MS 01/06/98 MRS
PLMC799 Final Inspection / / / / 01/08/98 req,proper flow restrictor for grease FAIL MS 01/08/98 MRS
trap
PLMC799 Final Inspection / / / / 01/09/98 RESTRICTOR INSTALLED PASS MS 01/09/98 MRS
PLMC800 Case Finaled / / / / 04/07/98 04/07/98 JT
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / _ A.M. '.M. MST:
Location: Amihr BUP:
{� I i j
Tenant: Q u J1/._-- Suite: Bldg: / MEC:
Contractor: `1 Phone: 6) / - 6/ (P PLM: T7 D S(
Owner: Phone: :
ELC•
ELR:
SIT:
BUILDING BLDG (con't) . I 1: IN . MECHANICAL ELECTRICAL SITE
Site Post/Beam 4 r : -: Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFI/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC. 1
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL RINXI> FINAL FINAL FINAL
kr-w,-0; /
-- --- ...„„„,6,_......,. ...._
,.. ,.....
�' 7
for reinspection CI Reinspection fee of $ required before next inspection CI Unable to inspect
V✓ Inspector: Date: / ( 4\ Page / of _i_
12 11 15
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: /.-Z -05- q 7 A.M. P.M. MST:
Location: /3/ W 5 S6U Airt BUP:
Tenant: „ (. Suite:
Al Bldg: MEC:
Contractor. _ _ ii Phone: ,6 9 / ( — 4 [ 6 (r; PLM: ? 7 -( ln
5/ 9
Owner: Pho e: ELC:
AA d. /_.L.�. /i_/L.J / /.' /17 ELR:
SIT:
BUILDING BLDG (con PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Po Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab' Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinlder
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Ap roved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
.s9 g . W CJ
j.q c/s
. a it /7 ftj
2_.D° 5 i'7 / 5
2.._o 0(f47/s -- Th/../1 2._ j ,
y _ ldA./,i /1�...rAp S vi i
1 A
..AW d -
7
O Call for reinspection O Reinspection fee of $ required before next • tion O Unable to inspect
Inspector: 07) Date: / 2 0 3 (� Page_ of / /
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 9— i / _ A.M. X P.M. MST:
Location: S. j , t - S . BUP:
Tenant: I,(/� J) f .Z'1 ■ / Suite: Bldg: MEC: c77-02.50
Contractor: Bl
Phone: p 3 3 ° C7 % / PLM: 7 (Yf q
Owner: Phone: ELC:
O i a. (A D 0( ELR:
SIT:
BUILDING BLDG (con't) �UMBING MECHANICAL . ELECTRICAL SITE
Site Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved i i n Not Approved Not Approved Not Approved
FINAL ( PINZ/l FINAL FINAL FINAL
5_ 4,......
/
r /l 1°1 7'
....10
i i
, / II-
O Call for r7/71 ' pection El Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: �� Date: 1/ e, Page / of /