Permit i
.- CITY OF TIGARD PLUMBING PERMIT
Vii DEVELOPMENT SERVICES PERMIT #: PLM2001 -00645
!I � 13125 SW Hall Blvd., T OR 97223 (503) 639 -4171 DATE ISSUED: 2/13/02
SITE ADDRESS: 08770 SW SCOFFINS ST PARCEL: 2S102AA -02800
SUBDIVISION: TIGARD HIGHWAY TRACTS ZONING: CBD
BLOCK: LOT: 026 JURISDICTION: TIG
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 4 URINALS: GREASE TRAPS:
LAVATORIES: 6 OTHER FIXTURES: 6
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 6 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Building plumbing. Other fixtures to include 3 ea hose bibbs lea elevator. sump 2ea drinking fountians.
FEES
Owner:
Type By Date Amount Receipt
TUALATIN VALLEY MENTAL HEALTH PRMT CTR 2/12/02 $381.80 27200200000
8770 SW SCOFFINS RD PLCK CTR 2/12/02 $95.45 27200200000
TIGARD, OR 97223 5PCT CTR 2/12/02 $30.54 27200200000
Phone 1: 503 - 617 -3827 Total $507.79
Contractor:
EAGLE PLUMBING
13801 S FORSYTHE RD
OREGON CITY, OR 97008 REQUIRED INSPECTIONS
Phone 1: 503 - 650 -8703 Rough -in Insp
Reg #: LIC 47914 Rough -in Insp
PLM 3 -154P6 Rough -in Insp
Final Inspection
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:
aevt■et.c__. Permittee Signature: bdt.,13 G �--------
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed (he next business day
12/05/2001 15:17 FAX 5035981960 CITY OF TIGARD �l 002/003
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Plumbing PermitApp •�,
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City of Tigard $ev petrni no.: Bsdld lx�+ t no.:
, s j 1 I! Address: 13125 SW Hall Blvd. Tigard, OR 97223
CIO of Expire date: _ •
Tl'gard p'pl.no.: S _ .
Phone ( 503) 639 - 4171 Project/a 1 N
Date issued: 13y: Rteeiptno.: \
Fmt: (503) 5984960 S.i;
Land use approval: Casa 61c no.: payment type:
0
'I'1•PE OF PERMIT
Cl Multi- family ❑ Tenant improvement
O 1 & 2 family dwelling or awry 13 �" O Other. ,
*New construction 0 Addition/alteration/replacement 0 Food service •
JOB Si T'E lNI OR\1:LT1O\' FEE SCIIEUIJI..L• :for special information use checklist)
Description +[, Total
Job address:
5 Co S New 1- and 2 , , wellings onlyt
Bldg. no.: Suite no ' (inclndes10011.foreacb y n)
Tax m: .. •: lot/account no.. SFR (1) bath
Lot Block: Subdivision:
Project name: • t► , ,r eNI ■ ►.. • (3) bath
.. lion •. � s cripti tl'' MI
De
Sites
Description and location of work on premises: Catch basin/area drain
III
Drywellsll h . , .. -, drain
Esc date of calm • etiodi lion: Footing din no. ft- r
PLUMBING CONfRA('iOR ufactur dhomeutiities MI
Business name: (QCa t-.ri?' f l ► tvc Manholes r
Address: • • L rtte i -D Rain drain connector r
a : f • i =Ea ZIP: 17j 5 Sanitary sewer fur. lin. R.) ME
Storm sewer (no. lin. ft.) IIMI
mom: . 'U O fit" • t - a• E-mail: Storm
sere cc . o. . 1. ilii
OCB no.: At 79 I 4./ Plumb. bits. in . no: 3-/X1 P$ • Fixture or Items ■
City/metrti lie no.: ! 31 Ab sorption valve
Contractot'e representative sl ._ , , , , • . :., kilo Absorption
ter
Print name: U41 - ) Dace: L 4) Backwater valve
• CONTA(Ti PERSON L '• valory FM
eT►Tf, M •
Name: Di • washer •
Address: i T5. • : fountains
City: State: ZIP: _ ectors/su • i • M
E
Phone: Fax cud: : ,•: . . „ tank
OWNER - Fixture/sewer : , NM •
r•
.. :. o ar sin ub IIM
Name (print): --QAuArrI . - Tot— :e ch- ..o : NMI .
Mailin address: 00 ,j.. Hose blbb Ell
City: `a Stott: :. — ZIP: —7 - - ce m r _
MI Fax: E-mail :....� . are .
*.r; w . T a ctual ' on '1 s) MI
Owner � •� taatt►t only: , : Tati
will be made by me or the msinienaace and repair made by my regular Roof drain_' ,. ial M
e m p l o y e e on t h e p r o p e r t y I own as per ORS Chapter 447. IVrzl!;13 . L —
Owner's si _ • Dam Tubas . . Wei . an NE _
ENG f Mtn _
Nance: . s _. - Ot..TI Water closet us •
c • • • . u . " aterheater - OM
City: ,�,� r ZIP: 1.$1 aim; m; NM
• .ne: Fax: E -mail: Total
iscr�a is execs Minimum fee ..... $ 8/• SO
Nat Toni execs credit s. t r t cord la for mac il;fcm ti' Notice: 'Ibis permit application
Minimum
iew tev iew (at . ° 6) $ • s
O Vlsa O MasterCard expires if a permit is not obtained State ev surcharge at (8%) - $
creole crud eamb� within, 180 days after ill been State $ 7,35....y...1._
ms 7' 7_2_ m emdis Goa accepte es complete.
arc $ .
caertholder ague= Amount 440.1616(6/00/CO
•
12/05/2001 15:18 FAg 5 035981860 CITY OF TIGARD !3003 /003
• i
PLUMBING PERMIT FEES: . ;
i •
:RICE'r: hTQT lh'. P it IC TQ
;EtX[ iitE 't 'divi�iis0';. Q.'. ? ea • . • ':', = '4 l . . 1 �:.. . (ea)
nk 16.60 . rtetai•Utr , `co - ne9tLtn _
tr' •. , 0 4
60 Ali $29. '•
$
�i Two 2 •ath $399.00
76.60 Three (3) bath
Shower • ne
Water Closet _ (p 16.60 BUBTOT • L Illt
• urinal 16.60 :% 8TA SU - CHARGE
Olatsvvasher 16.60 • - LAN - W 25% OF SUB '• TAL
TOT 1 MS .. •
c = ...:..= Disposal
16.60
..... Tray MO 16.60
e 1 .
r Sink 2" 16.60 PLEASE COMPLETE: 1 6.60
16.60
- •,T -:.� j . . �.. �;b :•yyaii'P..eifofift�::;::+
Gas p Heater 0 conversion e pra O like kind 1e.60 ' F"13 thl �'1Y11{18 , i : F.0 "?• i f 'WY Y .,�� . •, • d,. : Repia .d' ='i ` eat
Oas p�+n9 requires a e mechanical /Q M •� �fi��y �:y � *,yr'��.�,-.' `.�'I�i °•Y;:`.#i- �r,f..:I ti:7:. , . iz,
,: -. 46.40 ' Sink .
MFG Home New Water Service _ Lava ,
MFO Moms W - - =wen 46.40 Tub ' Tubl r Ell
Hose Bibs - Comet
Roof Drains 16.86 She = r Ord
DM , • euntab+ 16.60 110M771111111111111171111
Other F'Ixarres (Specify) rimi-jun �
Dishwasher 0 Di Mill - arbO rbe•eDls•• ,t
T. �,� Laun(�y - oom Tray 11111 .
r , i - MI Wash' , Maurine
ewer -131,100' - 55.00 W iM 3 a _________
46.40 4"
Se � -•-- - � eter Hee l er ....-• ,
8� ---- service - 1st 100' `� ii< :
Other F6dures
Water Service - each additi • - 200' r 46.40 `MI (Specify) i
Storm 8 Rain Drain - 1st 100' 55.00 10J! : -
Storm & Rain Drain • each addilOnal 100' • 46A0 J OS.'' eta
Colrtm erlGial Bear tow Preventbn Device 46.40 .
Residential 8= • • Prevention • , 27.55
Catch Basin
ill 16.E
inspection of Existing Plumbing or Specially 72 COMMENTS REGARDING ABOVE:
Rain ReQS � d Drdtn, single family dwelling 6625 T
Grease Traps 16.60 - _ _
• QUANTmr TOTAL . G:;, ; ' ,1`..:•/.`",;: : , 4 r'`
'commie or deer diagram is rapYfred �, y i : ':; k ••
"SUBTOTAL ;1.,-,,;_:,-,:•. , ; ` �3 ;T :r ?.,
• 8g4, STATE SURCHARGE "' ; `:; ':
-
"PLAN REVIEW 26% OF SUBTOTAL �' :`Y
- lie fixture u
d • • ir rre , . total is >9 z .: ' °N '
TOTAL "' *'iite.:. ` $
%Minuet permit tee IS $2.60 + 6% slam sruenwge. extent Residentiad saskle.
Prevention Gavle% widen Is $30.213+ $% state sumharge.
and
'"All New Com+nerdal Building) require P with iao>r+elda or deer dti set
plan wvka. .
•
•
l %dstsitem+alpt .- fees.doC 10/10100 '
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISI N� / Business Line: (503) 639 -4171 MST
g h BUP
Received Date Requesed AM PM BUP
Location 1 0 A
I I/ Suite MEC
Contact Person Ph ( ) 19 --(31( „70 d l — Od (D 5
Contractor ( Ph ( ) SWR
�
BUILDING Tenant/Owner V \ V U� ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Note ---d- , 1�-�- SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing / ►
Insulation �/
Drywall Nailing t n 4
Firewall
Fire Sprinkler /
Fire Alarm l
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
CRCURB
Post & Beam /
Under Slab
(-/
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
(4 11° 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA I
Approach/Sidewalk Date V Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL