Permit I•
C ITY OF TIGARD PLUMBING PERMIT
4A,0,�� DEVELOPMENT SERVICES DATE ISSUED: 02/24/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #: PLM2000 -00051
SITE ADDRESS: 07000 SW SANDBURG ST PARCEL: 2S101DD -00100
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM . WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B 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: 180 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace 180 feet of water service.
FEES
Owner:
Type By Date Amount Receipt
PAPE' PROPERTIES +
PAPE', TERRANCE/TOOKE, DIAN + PRMT DST 02/24/200C $70.00 00- 321817
PAPE', SHIRLEY N 5PCT DST 02/24/200C $5.60 00- 321817
EUGENE, OR 97440 Total $75.60
Phone 1:
Contractor:
DETEMPLE CO INC •
1951 NW OVERTON ST
PORTLAND, OR 97209 REQUIRED INSPECTIONS
Phone 1: 227 -2641 Water Service Insp
Reg #: LIC 00002510 Final Inspection
PLM 26 -25PB
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 these rules or direct questions to OUNC by calling (503) 246-1987.
t
Issued By: /(P-- Permittee Signature: A/ i
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed ` next business day
CI I�Y.CjNTIGARD Plumbing Permit Application
Rec'd By
13125 SW HALL BLVD. REC Ei mmercial and Residential
TIGARD, OR 97223 Date Rec'd o -3 -d
(503) 639 -4171 FEB 2 3 2000 Date to P.E.
FEB 17 200 Print or Type C M Date to q� T
€OM kjlja applications wil��nof �e SE � T Permit
I'�b - o��
I nc
Related SWR #
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job 1+l S' `ter Sales Sink 11.50
Address Street Address / , Suite Lavatory 11.50
-� DOD sW $WI4 bill Tub or Tub /Shower Comb. 11.50
Bldg # C /.State Zip Shower Only 11.50
Q7� -�-3 Water Closet 11.50
Name
5ern d Ca d Urinal 11.50
Owner Mailing Address Suite Dishwasher 11.50
Garbage Disposal 11.50
City /State Zip Phone Laundry Tray 11.50
Sqii L INO Name Washing Machine 11.50
Name 0) C a l v e - Floor Drain/Floor Sink 12" 11.50
Occupant Mailing Address Suite 3° 11.50
City/State Zip Phone • 4" 11.50
Water Heater 0 conversion 0 like kind 11.50
Name Gas piping requires a separate mechanical permit.
De Temple /t ,. MEG Home New Water Service 32.00 caivy
Contractor Mailing Address ( } ,� I wte MEG Home New San/Storm Sewer 32.00
I. o1 ,5) N W Q1/e("I) Hose Bibs 11.50
Prior to permit City /State Zip Phone Roof Drains 11.50
issuance, a copy Po r�4 -(pip, f 9 120°1 02,41 . 9 - 69 , -1 I
Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if A S 1 D Co /3 COO Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date
database c) L5 r (p / io /op
Name
Architect A Sewer - 1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
C ity /State • Zip Phone Water Service - 1st 100' SO 3800_ 331
Engineer Water rvice - each additional 200' ) 32..00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 40 Replace with like kind: Yes O No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial GD Commercial Back Flow Prevention Device 32.00
Additional description of work:
(e elate �a� Se�� �. Residential Backflow Prevention Device' 11.50
Catch Basin
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 m liance with Oregon State Laws. D
Si of Owner /A en Date
Sig 9 V/ 1440O 8% SURCHARGE UP
tact Person Name Phone
S;tat nev5"l . 2?- 7..P.6,t1 / "PLAN REVIEW 25% OF SUBTOTAL
1• BATH HOUSE $178.00 Required only if fixture qty. total is > 9
2 BATH HOUSE $250.00 TOTAL .15 41°
3 BAT}I 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 sower storm sewer and water service) . Device, whir is $25 + 8% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
I:tdsts'formstplumapp.doc 12/17/99
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
Urinal
Dishwasher
Garbage Disposal '
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
I:'dststfonnslplumapp.doc 12/17/99
3 /6 /00 Activities for Case #: PLM2000 -00051
11:41:17 AM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes •
PLMC003 Application received 2/23/00 DEB MAIL No Hold DEB 2/23/00
PLMC005 Permit Created 2/23/00 DEB DONE No Hold DEB 2/23100
PLMC711 Water Service Insp 2/23/00 2/23/00 3/2/00 TLP PASS No Hold AKJ 3/2/00
PLMC799 Final Inspection 2/23 /00 2/23/00 3/2/00 TLP PASS No Hold AKJ 3/2/00
PLMCO50 (F) Issue permit 2/24/00 DST DONE No Hold DST 2/24/00
PLMA800 Case Finaled 3/2/00 AKJ DONE No Hold AKJ 3/2/00
•
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested .37/ AM PM BLD
Location 70 O Sa ii ,c t. Suite MEC
Contact Person [ Ph �2 7 -2 , / PLM ZOOID - COOS I
Contractor Ph SWR
BUILDING Tenant/Owner Sof ELC
Retaining Wall j ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: me taJ
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
PASS R FAIL
l
Pos & Beam
Under Slab
Too Out
- a
Rai Drains
Na PART FAIL
ANICAL
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 fo reinspection RE: [ ] Unable to inspect - no access
ADA /1 /
Approach /Sidewalk Date Z 0 V Inspector 1 f o Ext
Other
Final /
PASS PART - FAIL DO NOT REMOVE this inspection record from the job site.