Permit • CITY OF TIGARD
ko .. �, DEVELOPMENT SERVICES P PLUMBING PERMIT
'�.�, f'� ERM I T # PLM98-0358
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 10/06/98
PARCEL: 2510208 -01805
SITE ADDRESS...: 10400 SW PARK ST
SUBDIVISION ZONING: R -3.5
BLOCK LOT . JURISDICTION: TIG
CLASS OF WORK..: NEW GARBAGE DISPOSALS.: 1 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH 1 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:E3 FLOOR DRAINS 2 TRAPS • 1
STORIES . 0 WATER HEATERS 1 CATCH BASINS • 1
FIXTURES LAUNDRY TRAYS • 1 SF RAIN DRAINS 0
SINKS • 10 URINALS 0 GREASE TRAPS 0
LAVATORIES • 8 OTHER FIXTURES . 6
TUB /SHOWERS...: 1 SEWER LINE (ft)...: 100
WATER CLOSETS.: 8 WATER LINE (ft)...: 100
DISHWASHERS • 1 RAIN DRAIN (ft)...: 400
Remarks: Plumbing for construction of 6535 sq. ft. children's day school facilty
Owner: FEES
JUMBO FERNANDO type amount by date recpt
17549 OAK MEADOWS LN PRMT $ 568.00 DLH 10/06/98 98- 309739
LAKE OSWEGO OR 97034 PLCK $ 142.00 DLH 10/06/98 98- 309739
5PCT $ 28.40 DLH 10/06/98 98- 309739
Phone #:
Contractor
NORTHWEST CENTRAL PLUMBING
2870 SW 221ST
HILLSBORO OR 97123
Phone #: 642 -2067 $ 738.40 TOTAL
Reg #..: 000722
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 Rough—in Insp
applicable laws. All work will be done in accordance with Underfloor /Under
approved plans. This permit will expire if work is not started Top—out Insp
within 180 days of issuance, or if work is suspended for more Rain Drain Insp
than 180 days. ATTENTION: Oregon law requires you to follow rules Drinking F o u n t a i
adopted by the Oregon Utility Notification Center. Those rules are RP /Backf l ow Prey
set forth in OAR 952 -0001 -0010 through OAR 952-0001-0080. You may Final Inspection
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: 1 4 /A /Wir—rei _ Permittee Signature:
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + ++ + + + + + + + + + + + + + + + + + + + + ++ + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
A Tag 9 /} i
CITY OF TIGARD Plumbing Permit Applicatio Plan Ch (
13125 SW HALL BLVD. Commercial and Residential ,,► ,■(� Recd y i
TIGARD, OR 97223 e y as . vat ec'd '
f SI
(503) 639 -4171 ja t ,� D. a to P.E. :I'
2.94v Print or Type � � _ ►`ate to DST •
Incomplete or illegible applications will not be ac el21/ P ermit #f'Uy9� -o35?
1 7 1 6 , Related SWR #x/291 -0264,
FeA Called
Name of Development/Project FIXTURES (individual) . '7QTY4- - .PRICE AMT
Job / D Cf C7CD cur �ei'� Sink -' 10 9.00 goo&
Address Street Address Suite Lavatory ./ 8 9.00 -7
I 0 c l Q `• . A k L. _ Tub or Tub /Shower Comb. 9.00
Bldg # City /State Zip Shower Only ,, i 9.00
Name p Water Closet ,_ • 8 9.00 - 7 Z,_.
Li 1-.1,,‘\jp tAP1 ' Dishwasher L. I 9.00
Owner Mailing Address Suite A Garbage Disposal ,/ , 9.00 q
�
f� ' I SM Washing Machine ,/ i 9.00 I
City/Sta a Zip Phone
1 k�, �, :, �, � Floor Drain /Floor Sink 3" / f 9.00
Name 9
CL Itok -v-A . ela 1 r4 -?'e... 4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray / 9.00 4
Urinal 9.00
Name
i �� - Other Fixtures (Specify) 9.00
Po P.•: e„-� t v
Contractor Mailing Address „ Suite ')_:_ //L.' ' 1,-,,,---2, v' "Z 9.00 l%
2-1. O 2'2 1' ` Z C-, i 9 .00
3 z J.- . - - I r i k•,1 t -/ ik)
Prior to permit ' City /State . Zip Phone Sewer - 1st 100' I 30.00 ()-
issuance, a copy (4 i kI ,, - u `l7 ,a ., e{ /2 :� ' a Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if 7Z z a� S L! - � , , c, Water Service - 1st 100' ` 30.00 fir'
expired in COT Plumbing Lic. # a Exp. Date Water Service - each additional 200' 25.00 •
database 3 y - 1 1 7 - `� e? 6 J d -- G, '1 Storm & Rain Drain - 1st 100' ( 30.00 . e)
Name + Storm & Rain Drain - each additional 100' 25.00 7 ��
Architect W 64 t' 'P =1 Mobile Home Space 25.00
Or Mailing Address ,� Suite Commercial Back Flow Prevention Device or Anti- 25.00 S
CD \ 5 Li.) /1k_ .
/- .. C „\ Pollution Device r L
Engineer I t /St tp Phone Residential Backflow Prevention Device' 15.00
9 �`';- _ �/"I� �. ;''-' i (Irrigation timing devices require a separate
•
Describe work to be one: J� I ! restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture ( 9.00 9
Residential 0 Commercial 0' Catch Basin ( 9.00
Additional description of work:
Insp. of Existing Plumbing 40.00
per/hr
Specially Requested Inspections 40.00
per/hr
Are you capping moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes 0 No 43 -----
0 Grease Traps • 9.00 _
If yes, see back of form to indicate work performed by
QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is > 9 `> , 4 ' "' 4: ".s-
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL "::"t:
I hereby acknowledge that I have read this application, that the information ,....i;•,:;,,, _ z - -, : �Lv
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE , '' '"'� {
�.,;�" Lip plans submi ed are in compliance with Oregon State Laws. 7 � ;'<;,', j ,: , '
Signature of 0 . erlAgent , Date ""'PLAN REVIEW 25% OF SUBTOTAL �4 \NZ
Required only if fixture qty. total is > 9 44. � -°
� ► 9 -Zi, : - i..'3,' TOTAL . . .
C : ct Person Name
Phone
- -T / L /� *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
`J (J A C/ �- - Prevention Device, which is $15 + 5% surcharge
�� ; ,h, • **All New Commercial Buildings require plans with isometric or riser diagram
- and plan review
I:tdstslplumap•.: • 7/2/98 57 S S- cV
,-)
•
PLEASE COMPLETE:
• Fixture Type Quantity by Work Performed::':
New;:'::;::::. Moved Replaced:: :.Removed /Cap;ped_:
Sink I
Lavatory . U
_ Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine I
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
_ Laundry Room Tray
Urinal
Other Fixtures (Specify)
x ;
:) �� 3 f 1
COMMENTS REGARDING ABOVE:
•
I:ldstskplumapp.doc 7/7/98
8 /8 /99 Activities for Case #: PLM98 -00358
3:19:34 PM
Assigned . Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received - 9/28/98 BON RECD DLH 9/28/98 '
PLMC005 Permit Created 9/28/98 DLH DONE DLH 9/28/98 .
PLMC799 Final Inspection 5/6/99 TLP FAIL AKJ 5/6/99 Turn on water heater, recall
insp
PLMC007 Plans routed to Plans Examiner 9/28/98 DLH SENT DLH 9/28/98
PLMC008 Plans Approved /Routed to DST 9/30/98 - TLP PASS TLP 9/30/98
PLMC710 Water Line Insp 10/1/98 10/8/98 TLP PASS TLP 10/8/98
PLMC715 Rough -in Insp 10/1/98 TLP 10/1198
PLMC720 Underfloor /Underslab 10/1/98 10/8/98 TLP PASS TLP 10/8/98
PLMC725 Top -out Insp 10/1/98 12/29/98 MS PART MRS 12/30/98 water tested ok need to test •
waste
PLMC735 Rain Drain Insp 10/1/98 - TLP 10/1/98
• PLMC745 Drinking Fountain 10/1/98 TLP 10/1/98
•
PLMC750 RP /Backflow Preventer 10/1/98 TLP 10/1/98
PLMC015 DST Post Review Complete 10/2/98 • B DONE BON 10/2/98 •
PLMC040 (F) Ready to issue 10/2/98 B MEMO BON 10/2/98 SWR98 -0266 must be paid
before issuing this permit.
PLMCO50 (F) Issue permit 10/6/98 - DLH DONE DLH 10/6/98
PLMC725 Top -out Insp 12/30/98 MS PASS MRS 12/30/98 waste tested ok
PLMC711 Water Service Insp 4/6/99 4/6/99 4/6/99 AKJ DONE No Hold AKJ 4/6/99 Pass TLP
PLMC799 Final Inspection 5/9/99 5/9/99 5/7/99 TLP PASS No Hold AKJ 5/9/99
PLMC800 Case Finaled 5/9/99 AKJ DONE No Hold AKJ 5/9/99 •
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date 1 Requested 5 .- — ! I AM PM BLD
Location ( (/L OD 7 e _ S+'' Suite MEC
Contact Person ' 011/ / 1. W Q, Ph t", q"z ! r PLM TE
Contractor Ph ,39 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation 3'- Q _ FPS
Ftg Drain J 1 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
_-ART FAIL
Post ' ;earn
Under Slab
Top Out
Water Service
Sanitary Sewer CAQs�
Rai D rains
a .r17 PART FAIL
M' CHANICAL
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 D 5 / l
Inspector Itor
Other Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.