Permit CITY OF TIGARD
"A,wa.M ., , , � DEVELOPMENT SERVICES PLUMB NG RMIT
�iil LUMBI PERM
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PERMIT # • PLM99
DATE ISSUED: 01/25/99
PARCEL: 26111AD -11400
SITE ADDRESS...: 08840 SW REILING ST
SUBDIVISION • SCHECKLA PARK ESTATES ZONING: R -4.5
BLOCK • LOT :045 JURISDICTION: TIG
CLASS OF WORK..:OTR GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS......: 0 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...: 1 SEWER LINE (ft)...: 0
WATER CLOSETS.: 1 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Remove and relocation /replace existing plumbing fixtures.
Owner : - - - - -• - - - - -- FEES
JULIA ISLITZER type amount by date recpt
8840 SW REILING AVE PRMT $ 27.00 GEO 01/25/99 99- 312391
TIGARD OR 972240 SPCT $ 1.35 GEO 01/25/99 99-312391
Phone #: 620 -7647
Contract or-. - - - - -- •
JULIA ISLITZER
8840 SW REILING
TIGARD OR 97224
Phone #: $ 28.35 TOTAL
Reg #.. .
REQUIRED INSPECTIONS --
This per.it is issued subject to the regulations contained in the PLM /Underfloor
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top-out I n s p _
applicable laws. All work will be done in accordance with Final Inspect ion
approved plans. This per.it 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. i/i/i I Issued By: /
_ Permittee Signature: 1, ,.,:_,:e �4
+++++++++++++++++++++++++++++++++++++++++++++++ + +++ ++ + ++ + + + + + + ++ + + + +v ++ + ++ + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business 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
Permit * Incomplete or illegible applications will not be accepted Related s� # �� Oa 5
Called
Name of Development/Project FIXTURES (Individual) QTY PRICE AMT
Job nt
c (0 6() `/(' / -/ igra Sink / 9.00
Address Street Address Suite Lavatory 9.00
Tub or Tu Shower Com) / 9.00
Bldg # Ci State
?,3 Shower Only ` " 9.00
Nainc V // Water Closet / 9.00
J _IS VI - z er Dishwasher 9.00
Owner Mailing Address c� o Suite Garbage Disposal 9.00
(l� n JW t c' t I 1 r Washing Machine 9.00
City /State Zip 1 l
Phone Floor Drain/Floor Sink 2° 9.00
Nam ; 0,Q Q f 0 OR oil a 1 b-0 - -144. 3. 9.00
S).1 r i. J 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
Urinal 9.00
Name Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite 9.00
9.00
Prior to permit City /State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy
of all licenses are Oregon Const. Cont. Board Uc.# Exp. Date Sewer - each additional 100' 25.00
required if Water Service - 1st 100' 30.00
expired In COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00
database Storm & Rain Drain - 1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device' 15.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes X No O Any Trap or Waste Not Connected to a Fixture 9.00
Residential V Commercial 0 Catch Basin ' 9.00
Additional description of work: Insp. of Existing Plumbing 40.00
v�9 m O CL\ b,,--\, per/hr
Specially Requested Inspections 40.00
per/hr
Rain Drain, single family dwelling 30.00
Are you capping, mowing or replacing any fixtures? Grease Traps 9.00
Yes No 0
If yes, see back of rm to indicate work performed by
fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL
Isometric or riser diagram Is required K Quantity Total Is > 9
WORK COULD RESULT IN INCREASED SEWER. FEES. *SUBTOTAL
I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and 6% SURCHARGE
that plans submitted are In compliance with Oregon State Laws. I, 3S
``` Signne of Owner /Agent Date "PLAN REVIEW 26% OF SUBTOTAL
� / ` 14 � � Required only B fature qty. total Is > 8
Q TOTAL
d Contact arson Name Phone
-�/
�
�) � 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with Isometric or riser diagram
and plan review
I: ldstslplumapp.doc 7/2198
PLEASE COMPLETE:
e.... a :: > ;:::: < >�:: >< :: >::::: >; >: > >:.
...
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
1:1dsts plumepp.doe 7/7/98
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CROWN PLUMBING
23172 SW STAFFORD RD
TUALATIN OR 97062
Plumbing Signature Form
Permit # PLM99 -0015
Date Issued.: 02/08/99
Parcel • 2S111AD -11400
Site Address: 08840 SW REILING ST
Subdivision.: SCHECKLA PARK ESTATES
Block Lot: 045
Zoning • R -4.5
Remarks:
Remove and relocation /replace existing plumbing fixtures.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order
for the plumbing permit to be valid, please have the appropriate individual from your company sign
below and return this Plumbing Signature Form prior to the start of work.
No plumbing inspections will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
OWNER: PLUMBING CONTRACTOR:
JULIA ISLITZER CROWN PLUMBING
8840 SW REILING AVE 23172 SW STAFFORD RD
TIGARD OR 972240 TUALATIN OR 97062
Phone #: Phone #:
Reg #..: 000042
•
Signature of Authorized Plumber
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639 -4171, ext. #310
5/19/00 Activities for Case #: PLM99 -00015
2:46:45 PM • •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received 1/25/99 GEO RECD DST 1/25/99
PLMA005 Create Permit 1/25/99 GEO DONE DST 1/25/99
PLMA799 Final Inspection DST 1/25/99
PLMA720 PLM /Underfloor 1/25/99 2/12/99 MS PASS MRS 3/1/99
PLMA725 Top -out Insp 1/25/99 2/12/99 MS PASS MRS 3/1/99
PLMA050 (F) Issue permit 1/25/99 GEO PASS DST 1/25/99
PLMA057 Issue plumbing signature form 2/17/99 JMT RECD JT 2/16/99 per phone call from owner
PLMA845 Request inspection research • 5/19/00 ST DONE No Hold ST 5/19/00
Page 1 of 1
I
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested - / AM PM BLD
Location t 0� Suite MEC
Contact Person -- Ma /L/2 1 � Ph 3/ oZ .�7 / PLM q c/ 4 (;ejlS --
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation G7, q3 S Cr/l ' (� FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 1.6A . Ql -�i' SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
41:rei ab
.. •
'ater Service
Sanitary Sewer
Rain Drains
F'•
(( PART FAIL
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
Other Date /Z Inspector f fi ? t , Ext y
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.