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Permit CITY OF TIGARD ,,___,,, 1, DEVELOPMENT SERVICES PLUMBING PERMIT +L 13125 SW Hall Blvd., and Ti 503 - FERMI T # • PLM98 -0379 Tigard OR 97223 ( )639417 1 DATE ISSUED: 10/15/98 PARCEL: 1S125DB -07000 SITE ADDRESS...: 07 125 SW SHADY CT SUBDIVISION • SHADY DELL NO.2 ZONING: R -4.5 BLOCK • LOT °043 JURISDICTION: TIG CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE-HOME SPACES.: 0 TYPE OF USE -SF WASHING MACH - 0 BACKFLOW PREVNTRS..: 0 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 (ft)...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 57 DISHWASHERS - .0 RAIN DRAIN (ft)...: 0 Remarks: Alteration of water service for residence. Owner: -• - FEES TIM STINE type amount by date recpt 7125 SW SHADY CT PRMT $ 30.00 DLH 10/15/98 98- 310017 TIGARD OR 97223 • SPCT $ 1.50 DLH 10/15/98 98- 310017 Phone #: 246 -9418 Contractor • BURFITT PLUMBING ' 6223 NE HASSALO ST PORTLAND OR 97213 -- Phone #: 287 -1267 $ 31.50 TOTAL Reg #..: 000010 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Water Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. 1111 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- A10 through OAR 952 1.''1 -0080. You may obtain copies of these rules or direct questions to OIJNC by calling (503)246 -1987. • Issued By: ('` / "ii, - ' . . _ Permittee Signature? ,,, 1 a. �,;;�i ' + ++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day + ++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Plumbing Permit Application Plan Check # 13126 SW HALL BLVD. Commercial and Residential Rec'd By tzl>l�ff ilGARD, OR 97223 Date Rec'd /o //s79, (503) 639 -4171 /' Date to P.E. - Print or Type f Date to DST - Incomplete or illegible applications will not be accepted Permit# PL/ig,P -4379 Related SWR # Called Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job Sink 9.00 Address Street Address " Suite Lavatory 9.00 -1 5 51/U ' !4' ( C.-4' Tub or Tub /Shower Comb. 9.00 Bldg # City /State Zip Shower Only 9.00 Name Water Closet 9.00 - II yY) r■ Dishwasher 9.00 Owner Mailing Address l Suite Garbage Disposal 9.00 1 i7... S�V ` i q C +, Washing Machine 9.00 City /State Zi Ph (.'A 2 r� � 7 a�� j -f .qt g Floor Drain/Floor Sink 2" 9.00 Name 1 3" 9.00 IU Inn-e 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 Name Urinal 9.00 Sli d 1 Y n ilibri bl 1A.5 Other Fixtures (Specify) 9.00 Contractor Mailing Address Suite 9.00 la 2A Ni) lica tto 9.00 Prior to permit Zip Phone Sewer - 1st 100' 30.00 issuance, a copy Q 1- �I61VL( 0 r. 91213 is 7-12_1- 7 Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# C ate / required if • I, 0 3 / E /j. 4 om. V Water Service - 1st 100' 5�r / 30.00 30.00 expired in COT Plumbing Lic. # Date Water Service - each additional 200' 25.00 database Zp- I i'g 1 41 v Storm & Rain Drain -1st 100' 30.00 Name a 0 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 0 Catch Basin 9.00 Additional description of work: Insp. of Existing Plumbing 40.00 1 �n per/hr WIT` c� �) �� Speci ally Requested Inspections 40.00 per/hr Are you capping, moving or re • I- ing any fixtures? Rain Drain, single family dwelling 30.00 Yes O No Grease Traps 9.00 If yes, see back of form to in. ' a - work performed by fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL WORK COULD RESULT IN INCREASED SEWER FEES. Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL ,0 I hereby acknowledge that I have read this application, that the information . trO given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE that plans submitted are in corn 'Hance with Oregon State Laws. s� Si. afore •f Own . � 41___- Date **PLAN REVIEW 25% OF SUBTOTAL i o /9 t j/ Required only if fixture qty. total is > 9 TOTAL 3/. / . 56 'ntact Perso Name � Ph. • e Ed 11-1/1 H ,- layi -ek.l ;formai _ *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow t Prevention Device, which is $15 + 5% surcharge 2 v I � **All New Commercial Buildings require plans with isometric or riser diagram and plan review I:'dststplumapp.doc 7/2/98 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replace Sink Lavatory Tub or Tub/Shower Combination Shower Only Water Closet - Dishwasher Garbage Disposal Washing Machine Floor Drain/Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I:\dsts\plumappdoc 7/7/98 • 03/24/2000 Activities for Case #: PLM98 -00379 • 10:13:31 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp.. Level By Updated Notes PLMA003 Application received 10/15/1998 DLH RECD DLH 10/15/1998 • PLMA005 Create Permit 10/15/1998 DLH DONE DLH 10/15/1998 PLMA799 Final Inspection 03/13/2000 RB PASS AKJ 03/13/2000 by review PLMA710 Water Line lnsp 10/15/1998 DLH 10/15/1998 PLMA050 (F) Issue permit 10/15/1998 DLH DONE , DLH 10/15/1998 PLMA800 Case Finaled . 03/13/2000 AKJ DONE No Hold AKJ 03/13/2000 • • • • • • Page 1 of 1 03/21/2000 Activities for Case #: PLM98 -00379 12:02:55 PM • Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. - Level By Updated Notes PLMA003 Application received 10/15/1998 DLH RECD - DLH 10/15/1998 PLMA005 Create Permit 10/15/1998 DLH DONE DLH 10/15/1998 PLMA799 Final Inspection 03/13/2000 RB PASS AKJ 03/13/2000. by review , PLMA710 Water Line Insp 10/15/1998 _ DLH 10/15/1998 • PLMA050 (F) Issue permit 10/15/1998 DLH DONE • DLH 10/15/1998 • PLMA800 Case Finaled 03/13/2000 AKJ DONE No Hold AKJ 03/13/2000 • • T. • • • Page 1 of 1 - • /- CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 5 3A3 6 AM PM BLD Location — 7 1 a S 5)/1 cc6U1 (4- Suite MEC aG C � Contact Person Ph 6 /b 003° 1 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing - — A C Foundation FPS Ftg Drain NOT REQUESTED Crawl Drain In FOUND DURING RESEARCH - r. SGN Slab I N�SPEECT�I ON _ (S) LE Dxszkr _ SIT Post & Beam Ext Sheath /Shear lJ�' — '� ` wc'„' 92:_r_. —� 4113 q Ina Sheath /Shear „ j - C ( � ^ \� /\ rc 8 Framing f/ f v v 1 Insulation Drywall Nailing Nal__ Firewall Fire Sprinkler Fire Alarm • �1 n ,o 1 " ( _ i '7�� 1 / ^ S c �� Susp'd Ceiling 1✓ �� /l `r� Roof ( __A–k _ Q Misc: Final ( x J PASS PART FAIL Prcr Ida ) _ I ' — Pod & : -am e � 1 Under Slab � (---- Top Out Water Service Sanitary Sewer r ili !"Ra in� Drains 1 Q PART FAIL c ' ANICAL Post & Beam t Rough In r. 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 Approach /Sidewalk e 1� ° EXt 1 (j Other Date Inspector �/" ` Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.