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Permit CITY TIGARD PLUMBING PERMIT r� DEVELOPMENT SERVICES PERMIT #: PLM2000 -00008 All '�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/10/00 SITE ADDRESS: 12519 SW QUAIL CREEK LN Q ► `, 1\‘'.. PARCEL: 2S104DA -00100 SUBDIVISION: QUAIL HOLLOW - EAST Q 0 ZONING: R -4.5 BLOCK: LOT: 038 JURISDICTION: URB CLASS OF WORK: OTR GARBAGE DISPOSALS: - MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 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: Installation of residential backflow prevention device. FEES Owner: Type By Date Amount Receipt DON MORISSETTE HOMES PRM4 DEB 1/10/00 $25.00 00- 321029 5000 SW MEADOWS RD 5PC2 DEB 1/10/00 $2.00 00- 321029 STE 151 LAKE OSWEGO, OR 97035 Total $27.00 Phone 1: Contractor: PROGRASS LANDSCAPE SERVICES , 29895 SW KINSMAN RD WILSONVILLE, OR 97070 REQUIRED INSPECTIONS Phone 1: 682 -6076 RP /Backflow Preventer Reg #: LIC 00006136 Final Inspection PLM 11558 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 these rules or direct questions to OUNC by calling (503) 246 -1987. Issued B • , I/ A �� � Permitte Signature: ,.V� 1;€ Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next usiness day 06/06/99 TtE 10:57 FAX 503 598 1960 CITY OF TIGARD Ch 002 CITY OF TIGARD Plumbing Permit Application Plan Cr 13125 SW HALL BLVD. Commercial and Residential Redd B TIGARD, OR 97223 Date Re:d / -/0-00 (503) 639 -4171 Date to P. . -- Print or Type Date tc DsT In or illegible applications will not be accepted Permit :I g Related S/dR # Caked Name of Development/Project L 3 Ce 1 FD('FURES;,(polvlduell ,• ; -_ :_ _r; -= _- _ , 'QV - ?PRIC:,: SAT;:; L Job ©-a.•- 4"0llmk3 - SInk 11.50 Address St reet Address S'su Q.t,t(Z•a{, I . Suite Lavatory 11.50 19 c_r e 4 Levu, I Tub or Tub/Shower Comb. 1 11.50 Bldg rY City /State Zip I I - 1Q GA& 0 Q. 9 -'3-3 ShaNer Only 11.50 Name J Water Closet I 11.50 Dort /11M Sce - I1<. 1fame.S Cishwasher I 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 WQ30 Sw G abe r x cL Washing Machine 11.50 City/State Zip Phone Floor Crain/Floor Sink 2° 11.50 C a•KG L tuego o R., 790 - Le c! SO ' i Name 3° 11.50 • 4° 1 50 Occupant Mailing Ad , ss Suite Water Heater 0 conversion 0 Ike kind 11.53 • Ces piping requires a separate mechanical permit. City /State Zip Phone Laundry Room Tray 11.50 I Urinal 11.50 •( CISC&PC- P ro &raSS Ls SG Other Fbdures (Specify) 15.00 I Contractor Mailing Address Suiie I a 'iS r/ty IGnsmal. Pricr to permit City/State Zip Phone Lea - Sewer -1st 100' 38.00 Issuance. a copy Wi f Sin Vrlk, 010707o fr0740 atr1 sower- each additional 100' 32.00 of all licenses are 'Oregon onat. Cont. Board Lk.* E g . Date • required if ( • $ /311 c Water Service -1st 100' 38.00 expired In COT Plumbing Lie. L Exp. Date' Water Service - each additional 200' L 32.00 , . database I Storm & Rain Drain - let 100' 38.00 Name Storm & Rain Drain - each additional 100' 32.00 r Architect Mobile Home Space 32.00 or - Mailing Address Suite Ccmrnercial Back Flow Prevention Device or Anti- 32.00 • Pollution Device Engineer I City/Slate Zip Phone Residential Beddow Prevention Device' c IS 19.00 , (Irrigatier. timing devices require a separate 1 Describe work to be done: restricted energy permit.) New 0 Repair 0 Replace with like kind: Yes 0 No O Any Trap or Waste Not Connected to a Fbdure 11.50 Residential 0 Commerdal 0 Catch Basin 11.50 Additional description of work: . Insp. of Existing Plumbing 50.00 - per/! r 50.00 I Are you capping, movin or replacing an fixtures? Specially Requested inspections • per /i Y moving Y ■ perl�r Yes 0 No 0 Rain Drain, single family dwelling 4 If yes, see back of form to indicate work performed by Grease Traps I 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. - QUANTITY TOTAL 6. : :: r` ° - �' I hereby acknowledge that i have read this application, that the information l Quart* Tie cr riser diagram is required If Qua Trial is > 9 . ! ! ? = :." _ _ given Is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL ;:.r...:':.: _ - ' . ' - obi that plans submitted are In compliance with Cregon Stale Laws. _ -- -_ eg :"' Slyra*ero gent Date V9, 15.% SURCHARGE _ • Contact Person a Phone "PLAN REVIEW 25% OF SUBTOTAL =' '•` =`' • Requieec xiy rf future qty. total is >. 9 .. •^'•' surcharge, except Resider »= _ - =1_ .r -= _-.. __ �:r._r�_° =�- -- TOTAL _ _ . f ;TS mss?. I.tib_.- _ : : :___ -� _ - = !.. - USIA i� . _ 'v = r s k.. ;yr - i .` 4- 02 ti. 4Ai - :=F ;. �ai�stildr. _cs :sue.. t 'r.._ -- ...-. -r".". -- - �� =��� �•� �� '�� � ��r � �'" =s minimum permit fee $50 + 5 ? Mii 5% ri ial 8ackilow ° ��=''- '' ' - ° " - �' ' Prevention Device, whLh is $25 + 5% surcharge k:'? lilsTej*`; l�r?EA !"r4J__?du+et'3e�nsJs? :w� ;Waeiiit1 sev<e>•gn_sevriezatt , r - ' _=a "All New Commercial Buildings require plans with isometric or riser diagram , ,.: � - .,.. :_to1r •- = = •-= :�.n and plan review : dsts%formstplumapp.dc :912/S9 02 /09 /2000 Activities for Case #: PLM2000 -00008 8:13:13 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMA003 Application received 01/10/2000 DEB DONE No Hold DEB 01/10/2000 PLMA005 Create Permit 01/10/2000 DEB DONE No Hold DEB 01/10/2000 PLMA750 RP /Backflow Preventer 01/10/2000 01/10/2000 No Hold DEB 01/10/2000 PLMA799 Final Inspection 01/10/2000 01/10/2000 01/25/2000 TLP PASS No Hold AKJ 01/25/2000 PLMA050 (F) Issue permit 01/10/2000 DEB DONE No Hold DEB 01/10/2000 PLMA800 Case Finaled 01/25/2000 AKJ DONE No Hold AKJ 01/25/2000 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested I /2S 00 AM PM BLD Location (25 ( � IA G; 4 1 & p )4 Suite MEC Contact Person Ph (,42-4067(:, !ca (y(p n Contractor Ph X Z (? SWR BUILDING Tenant/Owner ELC Retaining Wall ELR 2..c ,,��yy�� X ! t II Footing Access: Foundation FPS Ftg Drain 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 RT FAIL PLU Pos earn Under Slab Top Out Water Service Sanitary Sewer Rai 1 IP rains PART FAIL HANICAL Post & Beam Rough In Gas Line I Smoke Dampers / Final — PASS PART FAIL OcTRICAt Service Rough In UG /Slab Lorrofo taio F' - larm PART FAIL �`�; 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 Other Date / ?. Inspector 7/ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.