Permit C I TY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2001 -00056
,w �i DEVELOPMENT SERVICES DATE ISSUED: 2/27/01
74,14- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15825 SW STRATFORD LP PARCEL: 2S111 DD -04900
SUBDIVISION: STRATFORD ZONING: R -4.5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water heater
FEES
Owner:
Type By Date Amount Receipt
MEININGER, CARL R PRMT CTR 2/27/01 $72.50 27200100000
13755
13755 SW FAIRVIEW CT 5PCT . CTR 2/27/01 $5.80 27200100000
TIGARD, OR 97223
Total $78.30
Phone 1:
Contractor:
MICHAEL + CO PLUMBING
P 0 BOX 23008
TIGARD, OR 97281 REQUIRED INSPECTIONS
Phone 1: 639 -3189 Rough -in Insp
Reg #: LIC 67877 Final Inspection
PLM 26 -333PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: • c-- l ��
Call (503 639 -4175 by 7:00 P.M. for an inspection needed the next business day
y Plumbing Permit Application
Date received: o� ate / b Perri n 49 j , . - 5-(
d °jr : i 1 ;' City of Tigard
n'I ' City b Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
RI 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement •
0 New construction ® Addition/alteration/replacement 0 Food service 0 Other:
JOB SITE INFORMAATIION FEE SCIIEDULE (for special infori ation use checklist)
Job address: /S9 2$ & w J r r+rT-o d L.oelo Description Qty. Fee(ea.) Total
Bldg. no.: I Suite no.: New 1- and 2- family dwellings only:
Tax map /tax lot/account no.: (includes 100 ft. for each utility connection)
SFR (1) bath
Lot: IBlock: I Subdivision: SFR (2) bath
Project name: SFR (3) bath
City /county: 4.0 k I ZIP: Each additional bath/kitchen
Description and location of wor1� o n premises: Site utilities:
Q�Je a w all er Ted Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
Manufactured home utilities
Business name: TY%le ' aa.l J do P u rx 6 /NI Manholes
Address: Po (gy x aam:5P Rain drain connector
City: 7 d I State:o.( I ZIP: 97 ZZ 4 Sanitary sewer (no. lin. ft.)
Phone: (039 _ 31 , 99 I Fax: I E-mail: Storm sewer (no. lin. ft.)
CCB no.: (01 I Plumb. bus. reg. no: ,2 (, -333 0 3 Water service (no. lin. ft.)
City /metro lic. no.: 1 a-.S S Fixture or item:
Contractor's representative signature: r _ r i) G ,.., t ,f , „ Absorption valve
Back flow preventer
Print name: Q -4 0 tw Date: ../ 6 -o / Backwater valve
CONTACT PERSON Basins/lavatory
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s)
City: I State: I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer cap
Name (print): C, R / jr ei Al in/ e Q Floor drains/floor sinks/hub
Mailing address: /SSJ,.' 4-i..43 STra Ala i � Garbage disposal
Y 77 f'/6R.d I I 9 7 2 T I ce maker Hose bier
City: State r ZIP: I
Phone: L' 3q_ 84'/ / I Fax: I E -mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump
ENGINEER Tubs/shower /shower pan
Name: Urinal
ame:
Water closet
Address: Water heater /
City: I State: I ZIP: Other:
Phone: I Fax: I E -mail: Total .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ 7o? • s
Notice: This permit application
❑ Visa ❑ MasterCard if a permit is not obtained Plan review (at _ %) $ U
Credit card number: / / within 180 days after it has been State surcharge (8 %) $ S'
Expires TOTAL $ 7 S' • 3 0
Name of cardholder as shown on credit card accepted as complete.
$
Cardholder signature Amount 440 -4616. (6A0 /COM)
PLUMBING PERMIT FEES: i
•
PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavato 16.60 for each utility connection)
ry One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 - 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL ,
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain /Floor Sink 2" 16.60
3" 166.660 0 PLEASE COMPLETE:
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical / Fixture Type: New Moved Replaced Removed/
ii
permit. � �o • (a 0 Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
Tub or Tub /Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Fixtures (Specify) 16.60
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Sink: 2"
Sewer - 1st 100' 55.00 3"
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater /
Other Fixtures
Water Service - each additional 200' 46.40 (Specify)
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE: , -
Rain Drain, single family dwelling 65.25 ep o.c'Q J t�7dd" 1 4 f
Grease Traps 16.60
QUANTITY TOTAL V-' S-15
Isometric or riser diagram is required if / / �,
Quantity Total is > 9 l �� "
*SUBTOTAL
8% STATE SURCHARGE g 0
*'PLAN REVIEW 25% OF SUBTOTAL '
Required only if fixture qty. total is > 9
TOTAL $ 7g 3 c
* Minimum permit tee is $72.50 + 8% state surcharge, except Residential Backflow
Prevention Device, which is $36.25 + 8% state surcharge.
** AII New Commercial Buildings require plans with isometric or riser diagram and
plan review.
is \dsts \forms \plm- fees.doc 10/10/00
,7/ ;/'
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
2- Ho►A Inspection Line: 639 -4175 Business Line: 639 -4171
J BUP
Date Requested .3 - 2- AM PM BLD
Location / Z 41a 1- L7e , Suite MEC
Contact Person Ph G)9- b 5 / / PLM ploo / —vt v 5
Contractor f� Ph SWR
BUILDING Tenant/Owner 13 -9 1 1/ 44 . ELC
Retaining Wall ELR
Footing Access:
Foundation 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
Misc:
Final
PASS PART FAIL _ J
B
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
WV 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
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
Other Date 3/2 Inspector (V Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY QF TIGARD BUILDING INSPECTION DIVISION M
24 -H6w 4nspection Line: 639 -4175 Business Line: 639 -4171
• 13UP
Date Requested ., — zr AM PM L 3 BLD
Location / S$7 Z s S v4 L 1 e--, Suite MEC
Contact Person r'arl• P r ay, PLM 4// ovU S(,.
Contractor // 93 `S - 4' 6 SWR
BUILDING Tenant/Owner rZ' ), CGS( P- /1,7 ELC
Retaining Wall ELR
Footing
Foundation Access: ` A J l 0 ��
a . 3 vC � � ' sS Ci � FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath/Shear
Framing ming 6 � Q �^� / 4 •
O /�
v
Insulation / CC am -
Drywall Nailing / J ��
Firewall
Fire Sprinkler
Fire Alarm v) .
Susp'd Ceiling ) A �� 94
Roof
Misc:
Final
MS PART FAIL
L i/ S
Post & Bea
Under Slab te) 6,
Top Out
Water Servic= 104(4
Sanitary Sewer
Rai _rains
Air*
- ASS PART -¢
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
Approach /Sidewalk 77/103 \
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
(9.1( .
CITY OF TIGARD BUILDING INSPECTION DIVISION
X 24 - Fur Inspection Line: 639 -4175 Business Line: 639 1 MST
Date Requested 3 � E7 AM PM BLD 11111/—
Location 1) � Z� s w .5-A v4 / '' d Suite MEC \ �
Contact Person Ph 03 'J f f / f PLM )&G / Poo re
Contractor Ph SWR
BUILDING Tenant/Owner f,'e 5,! C ,4 (J /6 4 ' 4,4 ELC
Retaining Wall 7/'' yofr- �^'(1 / G-' 7'� 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 CLv r_
Fire Sprinkler / l
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
!Beam Beam
st
Under Slab t,.,;. 11
Top Out
Water Service
Sanitary Sewer
Rain P -i•
-
ally.# PART FAIL .:
M ' "NICAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk 3 / 77) ---1 - " ----1 Other Date " 7 ( / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1