Permit •
CITY OF TIGARD
PLUMBING PERMIT
Alf DEVELOPMENT SERVICES PERMIT #: PLM2000 -00183
Alt 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED:
rs
SITE ADDRESS: 08770 SW PINEBROOK ST PARCEL: 2S111AD -05400
SUBDIVISION: PINEBROOK TERRACE ZONING: R -4.5
BLOCK: LOT: 077 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: 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: Install new water heater.
FEES
Owner: -
Type By Date Amount Receipt
BRIAN STRAHAN PRMT GEO 06/06/200C $50.00 0002711
8770 SW PINEBROOK ST 5PCT GEO 06/06/2000 $4.00 0002711
TIGARD, OR 97224
Total $54.00
Phone 1:
Contractor:
D + F PLUMBING
4636 N ALBINA
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone 1: Final Inspection
Reg #: LIC 000004
PLM 26 -23pb
ORIGINAL
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 thes- rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: f �� /�� Permittee Signature:
Call (503) 63' 17 by 7:00 P.M. for an inspection needed business da
( ) 5 Y p day
CITY OF TIGARD Plumbing Permit Application Plan Check*
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
•
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit#
Re ted SWR it
Called
/
Name of Devel ! FIXTURES (individual) QTY PRICE AMT
Job 6 R /JYjQ/9 /T/9/V Sink 11.50
Address Street Address / Suite Lavatory 11.50
8'77 0 5 ngz',B,Q(br` Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip Shower Only 11.50
'T /64RZ 97,22V Water Closet/Urinal (Specify) 11.50
Name
4'LL � 1-7 Dishwasher 11.50
Owner Mailing Address ,,. Suite Urinal 11.50
p
p.sc,-3 SL . , 72. Garbage Disposal 11.50
Qily/State Zip Phone Laundry Tray 11.50
CO/iVU OR � / /// Washing Machine /Laundry Tray (Specify) 11.50
Name
Floor Drain/Floor Sink 2" . 11.50
Occupant Mailing Address Suite - 3" 11.50
4" 11.50
City/State Zip Phone
Water Heater 0 conversion lilike kind / 11.50
Name Gas piping requires a separate mechanical permit. /
Dir Ha/NB/A/6 MFG Home New Water Service 32.00
•
Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00
11636 /l/_ , %8/ Hose Bibs 11.50
Prior to permit ity/State �° Zip_ Phone Roof Drains 11.50
•
issuance, a copy ORTM ft 0 yZ L242 0 993 Drinking Fountain 11.50
of all licenses are Oregon Cond. Cont. Board Licit Exp. Date
t
required if T / / r! Other Fixtures (Specify) 15.00
(D
expired in COT Plumbing Lic. # Exp. Date
database , 2 , 6. - 023 / 'B ,
Name
Architect Sewer - 1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
Water Service - 1st 100' 38.00
Engineer City/State Zip Phone
Water Service - each additional 200' 32.00
Describe work to be ne: Storm & Rain Drain - 1st 100' 38.00
New 0 Rep ' O Replace with like kind: Ye No O Storm & Rain Drain - each additional 100' 32.00
Residential Commercial 0
Commercial Back Flow Prevention Device 32.00
Additional description of work:
1 . /fir O? I/ Residential Backflow Prevention Device' 19.00
A/ } �� A WiT/ Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 Inspections per/hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL that plans submitted are in compliance with Oregon State Laws.
Sign -t of V nerl • ! ent • ^ Da ' 0 8% SURCHARGE
Contact Perso • Name Phone
i 7.1 A/ /?7/A /Ole oZ -O??3 **PLAN REVIEW 25% OF SUBTOTAL
1 BATH HOUSE $178.00 Y R •aired on it fixture • . total is > 9
2 BATH HOUSE $250.00 TOTAL 3
3 BATH HOUSE $285.00
(This fee Includes all plumbing fixtures In the dwelling and the first 'Minimum permit fee Is $50 + 8% surcharge, except Residential Backflow Prevention
100 feet of sanitary sewer storm sewer and water service) Device, which is $25 + 8% surcharge
• "All New Commercial Buildings require plans with Isometric or riser diagram and
plan review.
I:tdstsVorrns\plumapp.doc 10/8/99 _ - _
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved I Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Urinal
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
I:ldsts forms \plumapp.doc 10/8/99 — -
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested te/VOo AM PM BLD
Location �s 7 QLVOO d Suite (E2000 — OOL&
Contact Person Ph 42),.2-07741 -- a'C 1 83
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Framing th /Shea � r ^ I ■ 7.21 44- + I
Y /' � -3•
Insulation wa O 2 S ' 9 4-c n
Drywall Nailing V
Firewall
Fire Sprinkler Z S C� �.�
Fire Alarm .�
Susp'd Ceiling 4 (--o•---SL c e ` `M
Roof
Misc: 60 e , _ (1 _ , (1 3-
���C ��v �/�-� -mac
Final ] / �� _ D Q 4- ji
PASS T FAIL o
UMBIN � , —. c,-6\ ,2k
U Beam A Undnd Under Slab
Top Out , , _ �l
Water Service • 1 V � `' _)c ,
Sanitary Sewer
Drains 1/L.(_ ( kt
air 1 _
_'� FAIL ei2-1/\ S v. -A-6
.I'I I �J'T ' L l L — � Q Post & Beam IN / Ro In / � G � 5 fee c l as Li I Crt-S
1 '
Smoke Da • -r. ses ATh
n J • FAIL 4_ i s �+ ., n - � TRI � ��/ " Service ` � � 5 y� �✓\c
Rough In •
l
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
A \� , �►
Approach/Sidewalk
Date �/ 66 Inspector " �" Ext 3 l
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.