Permit A CITY OF TIGARD
. DEVELOPMENT SERVICES PLUING PERMIT
PERMIT # MP PLM99 -0068
• 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03 / i 0 / 99
• PARCEL: 25118DA -00300
SITE ADDRESS...: 15830 SW SEQUOIA PKWY #100
SUBDIVISION • ZONING: I —P
BLOCK ° LOT . JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: .0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:A3 FLOOR DRAINS • 9 TRAPS ° 0
STORIES ° 0 WATER HEATERS ° 0 CATCH BASINS ° 0
FIXTURES LAUNDRY TRAYS 0 SF RAIN DRAINS • 0
SINKS • 2 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: Interior remodel of plumbing fixtures.
Owner: FEES
PACTRUST type amount by date recpt
15350 SW SEQUOIA PKWY PRMT $ 99.00 B 03/10/99 99- 313597
SUITE 300 PLCK $ 24.75 B 03/10/99 99- 313597
TIGARD OR 97224 SPCT $ 4.95 B 03/10/99 99- 313597
Phone #:
Contractor
SUNSET PLUMBING CO
G LONG ENTERPRISES INC
PO BOX 23263AU
TIGARD OR 97281-3263
Phone #: 245-4926 $ 128.70 TOTAL
Reg #..: 018089
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rough —in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top —out Insp
applicable laws. All work will be done in accordance with Final Inspection
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 952-0801-0010 through OAR 952 -0001 -0080. You may
obtain copies of these rules or direct questions to OM by calling
(503)246 -1987.
Issued By: tW Permittee Signature: OA �L� „Air, f
+++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + ++ + + + + + + + + + + +++ + + + + + ++ + + ++ ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business da
+++++±+++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Permit Application Plan Chuck# 45' ,
13125 SW HALL BLVD. Z S ' '� , Commercial and Residential Rec'd
TIGARD, OR 97223 1.7 5 Date Rec'd ' - i2 ,-
(503) 639 -4171 Date to P.E. - _ -11". n
Date to DST IL�
Print or Type ,
Incomplete or ill gi applications w' no acc ed Per '° ,
Related SWR #
/ i 1 iq / C J Called r)Vg
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job DA Yr)OA! S Sink at 9.00
Address Street Address 1 ud h Lavatory 9.00
`
1 523 0 Ste SEetW u VO Tub or Tub /Shower Comb. 9.00
Bldg # State Zip Shower Only 9.00
Name
/ 1 [� Water Closet 9.00
,' t? ) . , ./ i , Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
Washing Machine 9.00
City /State Zip Phone Floor Drain /Floor Sink 2" a 9.00 36 of,
Name 3 " / 9.00
---- F - --AA - M r KJ ` 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
Navas to N Sej I I U )- i )Y6 Other Fixtures (Specify) 9.00
Contractor { iling,Address Suite 9.00
r l `,B6X. c.?. 3 9.00
Prior to permit Ci�t i/State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy ) / 6 o I ' 7 5 ,.;?,>/s--,74.) (c Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if 0,) 68q...3 2 coo Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. * Exp. Date Water Service - each additional 200' 25.00
database 3-i/ 9(-/ 6 P 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 0 No 0 . Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial Catch Basin 9.00
Additional description of work: ( ' 1 Ins of Existing Plumbing per /h
\D6 per /hr
n � Specially Requested Inspections 40.00
' per /hr
Are you capping, moving or replacing ny fixtures? Rain Drain, single family dwelling 30.00
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
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 Oregon State Laws.
ign ure o caner /Agent D !�� * *PLAN REVIEW 25% OF SUBTOTAL
,ten 1 Required only 'rffixture qty. total is > 9 TOTAL
--Gorr arson Name Phone
ell-H / `( i ko ' lT . *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
I * *All New Commercial Buildings require plans with isometric or riser diagram
LiS - ' 61 and plan review
I1dststplumapp.doc 7/2/98
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory Z 3
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2" /8
3 "
5
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
' °Q t
r
t - 3 ' - Lfts. t ✓awe- rV I &.■ �1E. \ 1
I:ldsts\plumapp.doc 7/7/98
6/6/99 Activities for Case #: PLM99 -00062
9:27:19 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 2/26/99 DEB RECD DRA 3/3/99
PLMC005 Permit Created 3/3/99 DEB DONE DRA 3/3/99 Delay in creating due to waiting
for plans and Wash Co letter of
approval. Plans and letter
received on 3 -2 -99.
PLMC799 Final Inspection 4/29/99 TLP PASS AKJ 4/29/99
PLMC007 Plans routed to Plans Examiner 3/3/99 DEB DONE DRA 3/3/99
PLMC008 Plans Approved /Routed to DST 3/9/99 TLP DONE TLP 3/9/99
PLMC725 Top -out Insp 3/10/99 3/11/99 TLP PART TLP 3/11/99 floor sinks /trap primers /water
line
PLMC715 Rough -in Insp • 3/10/99 DST 3/10/99
PLMCO50 (F) Issue permit 3/10/99 B PASS DST 3/10/99
PLMC725 Top -out Insp 3/17/99 RB PASS RB 3/17/99 Above floor level- Rough -in.
PLMC800 Case Finaled 4/29/99 AKJ DONE No Hold AKJ 4/29/99
Page 1 .of 1-
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested - -79 AM PM I • � `T` - ' . BLD
•
Location I cZW SQq M ,( ) / G. Suite/ 00 MEC
Contact Person Ph ZLiS'LJ?Z PLM 91 -- a: 0 2
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
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
PAS RT FAIL
Post Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
PART FAIL
HANICAL
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: 4. [ ] Unable to inspect - no access
ADA _ T�
Approach /Sidewalk D r Inspector of iO Other Ext p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.