Permit ORIGINAL
CITY OF TIGARD
PLUMBING PERMIT
1� DEVELOPMENT SERVICES PE
DEVELOPMENT PLM1999 -00137
�� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/3/99
SITE ADDRESS: 12215 SW SUMMER ST PARCEL: 1S134CB -00600
SUBDIVISION: SUMMER HILLS PARK ZONING: R -4.5
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 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: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Alteration; replace water heater and water lines.
FEES
Owner:
Type By Date Amount Receipt
CHRIS ANDERSEN PRMT DJL 5/3/99 $39.00 99- 315020
12215 SW SUMMER ST. MISC /x DJL 5/3/99 $1.95 99- 315020
TIGARD, OR 97223
. Total $40.95
Phone 1: 590 -4121
Contractor:
GEORGE MORLAN PLUMBING + APLIANCES
9806 SW TIGARD STREET
CCB (EXP 6/2002) REQUIRED INSPECTIONS
TIGARD, OR 97223
Phone 1: 624 -6895 Water Line Insp
Final Inspection
Reg #: LIC 000027
PLM 026 -60PB
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: ZJ mil_ Permittee Signature: / O `t���
y � g l/l v
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
RE C EI VED • Reca 9y DR .
ITY Gi�e&ARO Plumbing Application .. /m'IA �t Gate Rec a 5 -0,3 -q 9
3125 SW HALL BLVD. 3 1999 Commercial and Residential 0.110 to P E.
IGARD, OR 97223 1 Date l0 CST
:03) G39-1171 i�Ml949 7
COMMUNITY DEVELOPMENT Permit a
Print or Type aeuted SWR a •
Incomplete or illegible applications will not be accepted Gaited
1 . 3 /a° 10'- l(0 35(49 .
• FIXTURES Individual
, Name of CevetopmenuPro(ect 1 OTY PRICE AMT
Job !r 1.°1 �Yld�.l'-s4.Xl Sin* 9.00
S:reot adores Lavatory 9.00
Address . as l 5_ - 80 3wyt Tub or Tub/Shower Como. 9.00
aldg s .- C_i Stale Zip Shower Only 9.00
1 1 r X1 r. l9 1 3 Water Closet 9.00
N.sme
Dishwasher 9.00
Owner Mailing Address I Suite Garbage Oisposa) 9,00
Wasncng Macrene 9.00 i
wty.State Zip Ph Floor Drain 2' 9.00
�i c//.2/ i
Name
3' 9.00 I
• • 9.00 I
Occupant mailing Aadmu Suite
Water Heater I 9.00 9.00
Laundry Room Tray . 9.00
City/State Zro Phone • Urinal ' .9.00 .
N Otter Fixtures (SOeafy) .. .9.00.
. P - ,
40' 0 1.11 1 9. 9.00
Contractor ng Address_ Suite 9.00 -11 J 9.00
Pnor to issuance Ci rState zia Ppon
e 9.00
applicant must rc� (: cl7 (0A -t3C t_
provide ail Orego Cot. Cont. Board Lic.s _Exp. ate , 4' 9.00
n
contractors . ,__
., 7 � 0 •• ' ' 9.00
license Plumbing Li s Exp. ate ' J Sewer - 1st 100 30.00
information - � 0 / 9 4 Sewer - each atltlitfonal 100' 25.00
for COT COT Business or s Exp. daje Water Service - 1st 100' j I 30.00
database). / q //79 9
Mama !titer Service - says additional 200' 25.00
Architect Storm & Rain Drain - 1st 100' 30.00
Or Mailing Address Suite St & Rain Drain - each additional 100' 25.00
I Mobile Home Space 23.00
Engineer City /State .Zip Phone Cammeraal Baca Flow Prevention Device or And- I 25.00
Pollution Device
escr:be worx New O Ammon C .Jterauon O Repair O Residential 9ackeow 3 revention Device' L 15.00 I
_e sone; Residential 3)0" - on-residential 3 any Trap or Waste Nct Conneced to a Fixture I I 9.00
:art na f de ' s lo- c C. t wont �� ,w e Lx--) Calm Basin I I 9.00 I •
`�C' r 1 insp. of Existing :. umving '-\ 40.00
�
a-A \..tAk ,S 'O 1•Q * Qr . I penny
is:ing use 3(
I Specaily Requested Inspections 40.00 I
,tc:ng or property
oeuhr
Rain Drain, single family dwelling I I 30,00 1 •
:cosec use of Grease Traps I I 9.00 I
doing or progeny
QUANTITY TOTAL I I •
e : ou calming . moving or reptaang any fixtures? Yes Cr. No . isometric w ewer [imam ,s mewed ! O ny van Tout i s 2 9 ,
r 'es see back of form) 'SUBTOTAL I '
may acknowledge that I nave read this application, that the information 39. J
en is Correa. that I am me owner or author=ed agent of me owner. and 5 /a SURCHARGE I I ,9 si
It scans submitted are r.:omoliance with Oregon State Laws.
Mature or net /Agent � r Date PLAN REVIEW 25% OF SUBTOTAL
I
141‘1•10 fl A an rea my +Swum cry ► :ow �s 9 I
TOTAL I L ,b
/moot arson Name Phew. �1
/ - / I �J / - 'Minimum permit fee is 525 • 5% surciarge. except Resiaenoal Bacxnow
..../ �. . ' I/ i t! - to056 Prevention Device. w-ict is 515 - 5% surcharge
i:`dsts:plmapp.doc 3/96
6/30/99 Activities for Case #: PLM1999- 00137
1:40:58 PM
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA003 Application received - 5/3/99 DJL DONE No Hold • DJL 5/3/99
PLMA005 Create Permit 5/3/99 DJL DONE No Hold DJL 5/3/99
PLMA71 Water Line Insp 5/3/99 5/3/99 No Hold DJL 5/3/99
PLMA799 Final Inspection 5/3/99 5/3/99 6/10/99 MS PASS No Hold AKJ 6/10/99
PLMA050 (F) Issue permit 5/3/99 DJL - DONE No Hold DJL 5/3/99
PLMA800 Case Finaled 6/10/99 AKJ DONE. No Hold AKJ 6/10/99
•
•
Page 1 of 1 •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
q Gt O ? 1 BLD
Date Re u ested AM X PM
Location 1221 S Sl,&fh rYlei Suite MEC p
Contact Person Ph C / PLM I 9R ? - X 137
Contractor 7etr Ph , 7 1f ' L- 0.2 ( SWR
BUILDING Tenant/Owr4r ELC
Retaining Wall ELR
Footing Access:
Foundation f / / s FPS
Ftg Drain SGN
Crawl Drain Inspection "otes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler t /AP
Fire Alarm //
Susp'd Ceiling ,;` -1
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out 1 if
Water Service
Sanitary Sewer
Rain Drains
Fin- P yr
PART FAIL
CHANICAL
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
Otheoach /Sidewalk Date qiealg‘f Inspector 1 / � Ext 9I2
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the. job site.