Permit CITY OF TIGARD
4" 1, DEVELOPMENT SERVICES PLUMBING PERMIT
V 'I �� 13125 SW Hall Blvd., Tigard, 503)639-4171 PERMIT # PLM99 0072
T
DATE ISSUED: 03 /15/99
PARCEL: 28115BA -90216
SITE ADDRESS...: 11992 SW ROYALTY CT #16
SUBDIVISION • ZONING:
BLOCK • LOT JURISDICTION: KIN
CLASS OF WORK..:REP 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 • 1 CATCH BASINS 0
FIXTURES LAUNDRY TRAYS 0 SF RAIN DRAINS • 0
SINKS • 0 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: Replacement of water heater with like kind.
Owner: FEES
NORMA PLATT type amount by date recpt
11992 SW ROYALTY CT PRMT $ 25.00 DEB 03/15/99 KING CITY
KING CITY OR 97224 5PCT $ 1.25 DEB 03/15/99 KING CITY
Phone #:
Contract or
ACTION WATER HEATERS ONLY INC
8948 SW BARBUR BLVD #418
PORTLAND OR 97219
Phone #: 503- 643 -2737 $ 26.25 TOTAL
Reg #..: 108953
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Misc. Inspection
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 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 952-1 -0010 through OAR 9521 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
i
Issued : Permittee Signature: 1 , �D
+++++++++++++++++++++++++++++++++++++++++++++++ ++ + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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MAR- 15 -'99 MON 10:53 ID: FAX NO: #067 P02 • Plumbing Permit A : RYp :
CITY OF TIGARD
9 PPlication Plan Check* '.: • • ra:` ` `
w - :
13125 SW BLVD. Commercial and Residential Redd By • '•'.,° f .
TIGARD, OR 97223 Date Redd .?-/ 1 11 %- 1 1 .6.
(503) 639 -4171 Date to P.E. ---- -' !
Print or Type .. Date to DSz 3 - 1• -91
Incomplete or illegible applications will not be accepted Perrrdt PL/419 ')-
Related SWR ft
Called .( , ; :
•
Nerve Of tpYV BlO7) 7 . b 1' 0� � v , _I I P r ( " l l , n s , P 4 F1 i' 900
A/ J ��f7 � ► JobAddress s ` R1J r �uita �� - Lavatory, .9.00 . •
/ f � t5t n � te 40. / V Tub or Tub/Shower Comb. _ 9.00 ,
B I ri nr/1 c l Z g ZU Li Shower Only .. 9.00
Name Water Closet 9.00
• N t Dishwasher 9.00
Owner Mailing Address 1 Suite Garbage Disposal _ 9.00 _
. Washing Ma- e 9.00
City/State Er, Phone Floor Drain/Floor Sink 2 _ 9.00 •
Marne 3' 9.00
S/I /'�*' 9.00 •
Occupant Mailing Address 1 Suite Water Heater 0 conversion ' Ake kind - 9.00
Gas • • • re • aims a ae • rate mechanical • • milt,
City /State Zip , Phone Laundry Room Tray _ 9.00 _
Nn� - �) �, / p ' y] `�,�p 9.00
17c l j �Oai" 'Witt- 1� 1 i egS 0 -�I iki Other FWaures (Specify) 9.00
Contractor Suhe- 9.00 ,
��� it 9.00 �
Prior
u erto permit copy CI10 dii �A / Sewer- t 100' 20.
77y 3rro each _ 00
issuance. a m � �" ZI
(� Sewer - each aOdltlona1100' 21:.00
of arequi R are • Oregon Coml. ri n Exp. Date Water Santee - 1st 100' _ 30.00 iiff q
expired in COT Plumbing Lie. a Exp. Date Water Bendel) - 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 Anil- - 25.00
PoHution Device
Engineer City /state ZIP Phone Residential Badtflow Prevention Device' . 15.00
(Irrigation timing devices require a separate
Describe werk to be done: realricted • • -rmii.
• New 0 Repplr 0 Replace with like kind: Yes No O • . Any Trap or Waste Not Connected to a Fbture 9.00 _
Residential 10 - CommerClat O - - Catch Basin 9.00
Additional description of wont: insp. of Existing Plumbing 40
Specially Requested Inspections 1111111 40.00
,:Mir
Rain Drain, single family dwelling 30 mil
Are you capping, moving or replacing any fixtures?
• Yes O No 0 _ Grease Traps 9.00 ;:
If yes. see back of form to Indicate work performed by • QUANTITY TOTAL ••C ` , ' ;!
fixture. FAILURE TO ACCURATELY REPORT FIXTURE • c ^'a , i"
Isometric or 'bet diaoram is required NCI , , Total Is > 9 a U • WORK COULD RESULT IN INCREASED SEWER.FEES. ' ,.SUBTOTAL 7F
ro
t hereby acknowledge that 1 have read this application, that the information
given Is correct. that I am•the owner r authorized agent of the owner, and 5% SURCHARGE ` r s -
that plans submitted are � . rnpl : ce with Oregon State Laws. „ , • a 9 ;,' '
Sig re o e � ,, Data ` R •' .•..:. .: t , i at :.:
'/fir PLAN REVIEW 25% OF SUBTOTAL , ; s- --
L�V'�1/ "� •�-p�
Ft arrows u. totaliso9 � �.
Detect Poreo TOTAL <;, , '
n Nams PROM ,/ +� . .. ; :, .:; • > • . ;•';,- 4 ..,, , , . "%l, � ( c , :; 4. ;
,:e ,,,
/�� //
/ + -i /l 1
'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow,,;
f/ U / t/ ✓ Prevention Device, which is $15 • 5% surcharge • • "'` ' -r"
• "All New Commercial Buildings require piens with Isometric or riser dfa'ram .
• ' and plan review'
•
n.app.doc 7/2/S5 4 . :
F*. :
•
7/25/99 Activities for Case #: PLM99 -00072
6:35:33 PM
•
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done. By Disp. Level By Updated Notes •
• PLMA003 Application received 3/15/99 DEB FAX DRA 3/15/99
PLMA005 Create Permit 3/15/99 DEB DONE DRA 3/15/99
PLMA799 Final Inspection 3/18/99 RB FAIL RB 3/22/99 40 Gal. Rheem (RUUD)- 6-yr
Warranty- Action Water Heaters
• 643 -2737. Water Heater
installed 3 -2 -99 Ticket #3868
• Serial # RHNG- 1098155679
Model # 21V40 -7 1. Sediment
• trap on wrong side. NOTE: At
time of inspection- gas odor
• . present.
PLMA740 Misc. Inspection 3/15/99 - • DRA 3/15/99
PLMA050 (F) Issue permit 3/15/99 DEB DONE DRA 3/15/99
PLMA799 Final Inspection 3/22/99 3/22/99 RB PASS AKJ 3/22/99
PLMA800 Case Finaled 3/22/99 AKJ PASS AKJ 3/22/99
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Page 1 of 1 •
CITY OF TIGARD BUILDING INSPECTION DIVISION pfd MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
1 BUP
Date Requested 'j - -q 9 AM PM BLD
Location I I qC o- tZ o 1 j O:19 R • /( Suite MEC
Contact Person n h(YY')A a ; Ph (.p�l "q059 PLM q9 007a
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: 5 a9 I'�
Post & Beam �� SIT
Ext Sheath /Shear r7°.i f7 Sp.
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS P*RT FAIL
ECHANIC
Post & : eam it
Rough In A
Gas Line
Smoke D, ap'ipers
ASS 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 Date '' - 5/7 2 — / 6 19 Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.