Permit CITY OF TIGARD
1 ' ^^ ! AlA4,5A, I A DEVELOPMENT SERVICES PLUMBING CES F'ERMIT# F'ERM �LM98 —Q�293
Tigard, (503)639-4171 DATE ISSUED: 08/25/98
/ «0 PARCEL: 2S112DD -01600
SITE ADDRESS...: 15575 SW SEQUOIA PKWY'
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..:B FLOOR DRAINS • 0 TRAPS ° 0
STORIES - 0 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 1 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: Demo and cap existing sink.
Owner: FEES
PACTRUST type amount by date recpt
15350 SW SEQUOIA PKWY STE 300 PRMT $ 25.00 BON 08/24/98 98- 308544
TIGARD OR 97224 SPCT $ 1.25 BON 08/24/98 98- 308544
Phone #:
Contract or
RAYBORN'S PLUMBING INC
PO BOX 69
TUALATIN OR 97062
Phone #: 503 -692 -4139 $ 26.25 TOTAL
Reg #..: 000878
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 -0001 -0010 through OAR 952- 0001 -0080. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By° ;- „ Permittee Signature: + + + + + ++ ++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + ...---71e---",e-alfe-j)
+ + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
s a a - _ a Y i _ - _ _ _ __ _ - _ _ _ _ - • _ _.
City o Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # P P- 90
Tigard, OR 97223 , e9 -Q of `
(503) 639 -4171 ,
MINIMUM $25.00 PERMIT FEE + ST. SURCHARG
bur loo
Mama al Droaioorned / - New Single Family Residences Only
Job _*:ti D 1 BATH HOUSE $140.00 D 2 BATH HOUSE $195.0Q
15,575 S l� sE ouizi? O rriti
i vy D 3 BATH HOUSE $225.00 ,
Address Comee ao Fee Includes all plumbing fbctures in the dwelling and the first 100 feet
Ir Q _ net . q' of water service, sanitary sewer and storm sewer. See fees below.
Nam Or name FIXTURES QTY PRICE AMT
PAC -fi 4 vt s Sink OEm0 ONLY j 9.00 1.0
Lavatory 9.00
Owner l S 3 5(A/ --( b f'vi P y Tub or Tub/Shower Comb. 9.00 ,
p1y" \ C wt 3 O 0
Shower Only 9.00
l a EC) 4 `Y , 4� - r Water Closet 9.00
"°"' nano a1 h° [ ) � D ishwasher 9.00
Occupant COPI in t �Q ` `--
P A T/ .. / Garbage Disposal 9.00
'"° A d''° p Washing Machine 9.00
Floor Drain 9.00
0°"'B'"' ZIP Water Heater 9.00 •
r79 : &ft ` , 5A-S- Laundry Room Tray 9.00 . .
Urinal 9.00 i
•
S pain/ Ej lAf� Other F ctures (Specify) 9.00 .
Contractor
l i Boo .. pain/ 9.00
0, gOx 67 . 672 - 4//39 9.00 I
� 9.00
. � u
4 "r ) ne , 978(2 Sewer 1st 100' 30.00. •
State R°°ra.°°" N°. My Bus. Tax No. Sewer - ea. Addit. 100' 25.00
371552 /066 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. AddiL 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are In compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) Mobile Home Space 25.00
Back Flow Prevention
idiL--- g/21� Device or Anti - Pollution Device 9.00
° c°""°` ° , Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration.• repair 0 Catch Basin 9.00
•
to be done residential 0 non - residential,, Insp. of Exist Plumbing 40.00/hr
Existing use of Specially Requested Inspections 40.00/hr
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
•
Proposed use of
building or property
'(Except residential backflow
prevention devices)
NOTICE *Minimum Fee $28.00 SUBTOTAL c CO
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 't • 9
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF :i 5% SURCHARGE I. Z
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED 1
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL l �/ . • 2i)
Special Conditions
•
Date Issued by
1
2/22/00 Activities for Case #: PLM98 -00293
4:50:35 PM
Assigned Hold Updated .
Activity Description Date 1 Date 2 Date 3 To Done By Disp. • Level By Updated Notes
PLMC003 Application received 8/24/98 GEO RECD GEO 8/24/98
PLMC005 Permit Created 8/24/98 GEO DONE GEO 8/24/98
PLMC799 Final Inspection • 8/27/98 TLP PASS TLP 8/27/98 .
PLMCO50 (F) Issue permit 8/25/98 GEO PASS GEO 8/25/98 .
PLMC760 lnsp existing /capped fixtures 8/27/98 TLP PASS J'H 8/28/98
PLMC800 Case Finaled 8/28/98 TLP _ J'H 8/28/98
Page 1 of 1 .
7/27/99 Activities for Case #: PLM98 -00293
5:18:00 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 8/24/98 GEO RECD GEO 8/24/98
PLMC005 Permit Created 8/24/98 GEO DONE GEO 8/24/98 •
PLMC799 Final Inspection 8/27/98 TLP PASS TLP 8/27/98
PLMCO50 (F) Issue permit 8/25/98 GEO PASS GEO 8/25/98
PLMC760 Insp existing /capped fixtures 8/27/98 TLP PASS J'H 8/28/98
PLMC800 Case Finaled 8/28/98 TLP J'H 8/28/98
•
•
Page 1 of 1
Page No. 1 CASE HISTORY FOR CASE NO.: PLM98 -0293
PACTRUST
15575 SW SEQUOIA PKWY Unit: 180
01/20/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
PLMC003 Application received / / / / 08/24/98 RECD GEO 08/24/98 GEO
PLMC005 Permit Created / / / / 08/24/98 DONE GEO 08/24/98 GEO
PLMCO50 (F) Issue permit / / / / 08/25/98 PASS GEO 08/25/98 GEO
PLMC760 Insp existing /capped fixtures / / / / 08/27/98 PASS TLP 08/28/98 J *H
• PLMC799 Final Inspection / / / / 08/27/98 PASS TLP 08/27/98 TLP
PLMC800 Case Finaled / / / / 08/28/98 TLP 08/28/98 J *H
•
•
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�} (� BUP
/1 Requested � �7 — 7 0 AM PM BLD
Location /55 75 (5'60 MlJ' ' suite l a 6 MEC
Contact Person /LS / Ph l0 7 .2- 4/95y 98-6.293
Contractor Ph SWR
BUILDING Owner / c4M1_l/G ELC
Retaining Wall ELR
Footing Access:
Foundation / C � FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof e19 , � i ��/ Misc: C�
Final
PAS FAIL
LUMBIN
_
Post & Beam / _-
Under Slab 4
Top Out
Water Service
Sanitary Sewer
ains
'f J 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: [ ] Unable to inspect - no access
ADA
7(2
Approach /Sidewalk
Other Date i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.