Permit CITY OFTIGARD
Avg/0.4A D EV EL O PMENT SERVICES PLUMBING PERMIT
��I
°= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # ° PLM98 -0425
DATE ISSUED: 11/17/98
PARCEL: 28101DD -00600
SITE ADDRESS...: 06700 SW SANDBURG ST
SUBDIVISION • SALEM FREEWAY SUBDIVISION ZONING: C —P
BLOCK • LOT •003 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP..:B FLOOR DRAINS • 0 TRAPS ° 0
STORIES • 0 WATER HEATERS • 0 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: Western Family Foods irrigation backflow device
Owner: FEES
WESTERN FAMILY FOODS, INC type amount by date recpt
6700 SW SANDBURG PRMT $ 25.00 JSD 11/17/98 98- 310853
TIGARD OR 97223 SPCT $ 1.25 JSD 11/17/98 98- 310853
Phone #:
Contractor
CATANDELLA IRRIGATION &
BACKFLOW
5334 SE DEL RIO CT
HILLSBORO OR 97123
Phone #: 356 -8022 $ 26.25 TOTAL
Reg #..: 11498
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Rack f low Prey
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- 0001-0010 through OAR 952-0001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
•
4111011111601' _ III
Issued • '� Permittee Signature: _�i
++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed , e next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application Plan Che
33125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd l/ / .7
(503) 639 -4171 Date to P.E.
Print or Type Date to DST _� Z S
Incomplete or illegible applications will not be accepted Permit #1
Related WR #
Called (J
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job L�S.�n qt.,. (k/ ED 0 1 S Sink 9.00
Address Street Address ( Suite Lavatory 9.00
Co 00 SL So.t..,ckvr Dr" Tub or Tub /Shower Comb. 9.00
Bldg # City/State Zip Shower Only 9.00
Name Water Closet 9.00
<A ,c t� l CDO, S Dishwasher 9.00
Owner Mailing Addre Suite Garbage Disposal 9.00
Washing Machine 9.00
City/Stat . i� Ip Phone
AP' Floor Drain/Floor Sink 2" 9.00
, a , e - 3" 9.00
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
N me, I
(.0. .Ae e..., -1t-rr �I a- r.k.4}o.J Other Fixtures (Specify) 9.00
Contractor Mailing Address ' Su 9.00
. 533 SE DU R•. C4 9.00
Prior to permit City/State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy u ,\ ks\x t -p 91 17..3 , R02,7_,
Sewer -each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if �O Z..Z o2 /ZS AN Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # Ex p. Date' Water Service - each additional 200' 25.00
(� t
database 04-49 1/3( 1 ! 1 q Storm & Rain Drain -1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect NA Mobile Home Space 25.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 uo
Pollution Device I Z.5 -
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 7C Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential O Commercial Catch Basin 9.00
Additional description of work:
re- , a 1 "R I ` C 1 � 1e...0 t _� Insp. of Existing Plumbing 4e�m�
Jc.X per/hr
Requested Inspections 40.00
per/hr
Rain Drain, single family dwelling 30.00
Are you capping, moving or replacing any fixtures?
Yes O No O 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
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL
. X
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 5% SURCHARGE
that plans submitted are in compliance with Oregon State Laws. f ,
Signat5 re of Owner /Ag Date "PLAN REVIEW 25% OF SUBTOTAL
44A 1. �` 1 r / i / 9 Q C' Required only if fixture qty. total is > 9 TOTAL - J
C,t6nta�t Personn NNameee Phone �,(p•C/�
((-� b
*Minimum permit tee is $25 + 5% surcharge, except Residential Backflow
J t C � rs � ` �1 ^ eb e A ( � S6 807.:"L Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram
al O? (--(7 and plan review
I:tdststplumapp.doc 72/98
PLEASE COMPLETE:
Fixture: >T : e. Q uanti :.; <:b. Work: :;:
Yp: Y...Y
:: ..a: `d /C e„
: ; > :. . :.: . ; .:.::.. .New Moved Replaced.R m ve pp
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:
lAdsts\plumapp.doc 7/7/98
4/24/00 Activities for Case #: PLM98 -00425
2:46:01 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 11/17/98 JSD PASS JSD 11/17/98
PLMC005 Permit Created 11/17/98 JSD PASS JSD 11/17/98
PLMC799 Final Inspection 1/22/99 TLP PASS TLP 1/22/99
PLMC750 RP /Backflow Preventer 11/17/98 1/22/99 TLP PASS TLP 1/22/99
PLMCO50 (F) Issue permit 11/17/98 JSD PASS JSD 11/17/98
PLMC800 Case Finaled 1/22/99 TLP PASS VLN 1/22/99
Page 1 of ,1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
i Z/ Requested //0. AM PM BLD
.
Location (' Zed ,/ � /�t ' J 1r u. . Suite MEC
Contact Person Ph -3SZ - PLM - QV..).5"
Contractor , / _ _ ! . ge.4.0 • Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: Slab 123/t SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 0 Susp'd Ceiling : �' C
Roof
Misc:
Final
PASS PART FAIL
Under lab Under ab ^�. �� s n
der l �i' , 'T 7
Top Out
Water Service
Sanitary Sewer _
Rain Drains
Frei
,PASS ART FAIL
MECHANICAL
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 [ I 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 /. Z Z
Other Date r Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.