Loading...
Permit CITY OF PLUMBING PERMIT ' l, DEVELOPMENT SERVI DATE Q�7/O7/97 -0260 PARCEL: 26114BB -01200 SITE ADDRESS...: 10225 SW SERENA WAY SUBDIVISION ° PICKS LANDING NO.1 ZONING: R -4.5 PD BLOCK LOT °26 JURISDICTION: TIG CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE °SF WASHING MACH • 0 BACKFLOW PREVNTRS••: 1 OCCUPANCY GRP..:R3 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 ( f t ) . . . : 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS ° 0 RAIN DRAIN (ft) °• °: 0 Remarks: Installing residential backflow prevention device Owner: FEES KEVIN NOLAN type amount by date recpt 10225 SW SERENA WAY PRMT $ 15.00 B 07/07/97 97- 296839 TIGARD OR 97224 SPCT $ 0.75 B 07/07/97 97- 296839 Phone #: • Contract or MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN OR 97062 Phone #: 691 -6166 $ 15.75 TOTAL Reg #° .: 000879 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the RP /Backf low Prey Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I n s p e c t i o n 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- ' -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issued By: l i t&A J4L U i/L4 __Permittee Signature: Atli/ _ ape + +++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + ++ + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day + ++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Application Recd By YON 9 p P n Date Recd * -7-7-q7 13125 5W HALL BLVD: • Commercial and Residential Date to P.E. TIGARD, OR 97223 Date to DST (503) 639 -4171 Permit* P1- 7' n D Print or Type Related SWR # . Incomplete or illegible applications will not be accepted Called Name of Devlopment/project 4 p � JJev Slflgle:Famih► Resfdent�s Onli Job a `t �. s 7 / � � . l G / Watt c� ' '`� ?>f S � • . Z "r � =�Y+ � Rr �R£� 1. ` ,�.7"_n 2 �e'�.� �.sF s J Gt .),... e✓'L' Yea_ wa-y g r . T- ` HoiSEt) r c2;BATo •500 C Street Address Suite ' " ,r T ,�, USE319 � Address s�,..�„�� E14 osiaATH oo :` � e - , .� � r Bld P -Fee lncludes all.p, umtii ig,flznire dweliriw - 00 fet of7� +x� # City/State .water 89rv 8anita se * � ' o k>'s4;t �' 4 � , Ti Bldg State Y /� /� � �./ Zip `� � � ry, wel storm .sewer�See'.fees:below:u��.� :r�k.�a . »x 'a'n �,wr:.u; m �4ia t' u^ e' �r,.` ;e�- h xu-:.:: r+ e�' o" 1 :: r. �1,° �,`.? �4sk :W}�x. eik�'a�y ame FIXTURES (individual) QTY PRICE AMT I<_& i r1 no I c vl Sink 9.00 Owner Mailing Address the Lavatory 9.00 0)-35 S cJ ,5e ie e /A---15%- h' Tub or Tub /Shower Comb. 9.00 City/State Zip Phone 7c 9 0)2 1 ) a (/' & -r,-- ysy7 . Shower Only 9.00 Name Water Closet 9.00 C -P Dishwater 9.00 Occupant Mailing Address Suite Garbage Disposal 9.00 Washing Machine 9.00 City/State Zip Phone Floor Drain 2" 9.00 Name 3" 9.00 Yh Od 4 " 9.00 Contractor Mailing Address Sense. Water Heater 9.00 / //b © _5/-z- r t Laundry Room Tray 9.00 City/State Zip Phone Urinal 9.00 %vi.Q oyL 976ba 0 I -6 lb Other Fixtures (Specify) 9.00 Oregon Const. dont. Board Lic.# Exp. Date X) -� Attach Copy of , 90 g /,- fig -7 9.00 Current Plumbing Lic. # /� Exp. Da 9.00 License `j�( o� S"0 6 /) 7 Sewer - 1st 100" 9.00 COT Busin Y d o Exp. 7 / /r Sewer -each additional 100' 30.00 Name Water Service - 1st 100' 25.00 Water Service - each additional 200' 30.00 Architect Mailing Address Suite Storm & Rain Drain - 1st 100' 25.00 or Storm & Rain Drain - each additional 100' 30.00 Engineer City/State Zip Phone Mobile Home Space 25.00 9 Commercial Back Flow Prevention Device or Anti- 25.00 Describe work New 0 Addition 0 Alteration la'(' Repair O Pollution Device to be done: Residential Non - residential 0 Residential Backflow Prevention Device' 15.00 /5, Additional description of work ' Any Trap or Waste Not Connected to a Fixture 9.00 /1 s,tei Jt 'ZJ th4) - ( 4 Catch Basin 9.00 Insp. of Existing Plumbing 40.00 use of per hr Existing Specially Requested inspections 40.00 building or property per hr Rain Drain, single family dwelling 30.00 Proposed use of Grease Traps 9.00 building or property QUANTITY TOTAL ' Ar+? "agna Are you capping any fixtures? Yes 0 No p Isometric or riser diagram is required if Quanity Total is > 9 '. I hereby acknowledge that I have read this application, that the information _ 'SUBTOTAL : , 1' 15 !?L) given is correct. that I am the owner or authorized agent of the owner, and _ _ , vii 'w.9Wb. . 'h a4,7.7. 4, that plans submitted are in compliance with Oregon State Laws. 5% SURCHARGE i"' 1- , , 47 X1``,'7° Signature of Owner/Agent Date 0- F / / kn.( P ,o-4-1 - 71 a 11 `� ;4. ;; , _� , � PLAN REVIEW 25% OF SUBTOTAL •� ; :,;.' , r�� �;yy�.. y'�" fixture only if ure qty. total is > 9 w? 4 1 'x';�s.°" ,° Contact Person M me Phone /r TOTAL :I "rr'� , 1 5 1 / 1 y l'�'e �n �` xr "�I ' Minimum permit fee is $25 + 5% surcharge, except Residential Backflow i:\dsts\plmapp.do Prevention Device, which is $15 + 5% surcharge 5/18/99 Activities for Case #: PLM97 -00260 • 4:56:53 PM _ Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMA003 Application received 7/7/97 B RECD BON 7/7/97 PLMA005 Create Permit 7/7/97 B PASS BON 7/7/97 PLMA799 Final Inspection 7/9/97 RAB FAIL VLN 9/17/98 1. Need 6" clearance under valve. 2. Need gravel under - valve. 3. Need test report. 4. Need valve to be completely installed, not connected to anything now. INSPECTION REQUEST FOR RESEARCH TO HAP W. 9/18/98. PLMA750 RP /Backflow Preventer 7/7/97 7/9/97 RAB FAIL J *H 8/12/97 PLMA050 (F) Issue permit 7/7/97 B PASS BON 7/7/97 PLMA799 Final Inspection 9/22/98 GS PASS J *H 11/3/98 PLMA800 Case Finaled 11/3/98 GS PASS J *H 11/3/98 • • • • Page 1 of 1 • • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location /6,2c.,_5 5,(// Se/ 7 aktei Suite MEC Contact Person Ph PLM 9 7-.. • Contractor Aux.,6/ Ph &7/ SWR BUILDING Tenant/Owner J eV //1I /6/e, 6_,-) (7�� 7 ELC Retaining Wall ELR Footing Foundation A� NOT REQUESTED FPS Cr Ftg ain Inc FOUND DURING RESEARCH Gt ' SGN Slab NO INSPECTION(S) IN FILE 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 PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer RainJDrains Fin SS PART 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 [ ] 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 c Approach /Sidewalk D 5° Z Z�/ I ,�/ Other Ext Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.