Permit 4 , , CITY OF TIGARD PLUMBING PERMIT
Ik DEVELOPMENT SERVICES PERMIT #: PLM2000 -00193
, � I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/09/2000
SITE ADDRESS: 13665 SW STEVEN CT PARCEL: 2S102CC -04200
SUBDIVISION: BEREA ZONING: R -4.5
BLOCK: LOT: 003 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install a new gas water heater.
FEES
Owner:
Type By Date Amount Receipt
MCKERN, ELERY G AND PRMT KJP 06/09/2000 $50.00 0002844
J 5PCT KJP 06/09/200C $4.00 0002844
13665 S
13665 SW STEVEN COURT
TIGARD, OR 97223 Total $54.00
Phone 1:
Contractor:
SUN GLOW INC
2428 SE 105TH AVE
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Phone 1: 253 -7789 Top -out Insp
Reg #: LIC 000481 Final Inspection
PLM 26 -538PB
ORIGINA .
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 copie of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: P ermittee Signature: ` -ALL - 4 .rod
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF•TIGARD Plumbing Permit Application Plan Check#
1 13125tW HALL BLVD. RECEIVED Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(503) 639 -4171 JUN 0 8 zoos Date to P.E.
Print or Type Date to DST
cokmubmpteemcMEi legible applications will not be accepted Permit # vc PI 0m -60/ 1_3
Related SWR # •
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job ( / ' d L
l G-e6 Sink 11.50
Address Street Address Suite Lavatory 11.50
3 ‘65 W S +fee - , Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip Shower Only 11.50
A A 6 2 1.2x3 Water Closet 11.50
Name ((//
Dishwasher 11.50
Owner Mailing Address s / - e Suite Garbage Disposal 11.50
'�� Washing Machine 11.50
City /State Zip Phone Floor Drain/Floor Sink 2° 11.50
Name 3" 11.50
S 6 , --vrt -e-- 4° 11.50
Occupant Mailing Address Suite Water Heater conversion 0 like kind 11.50
Gas piping requires separate mechanical permit. I 1.5
City /State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
Nam,_
h---- /Sum Other Fixtures (Specify) 15.00
Contractor Mailing Address l � Suite
, V s� /0_.1
Prior to permit CI /State Zip Phone Sewer - 1st 100' 38.00
issuance, a copy Pte+ p f ,7 / L �5 -7 -1
Sewer - each additional 100' 32.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. ppte
required if .'J f 051 Ott 0 � Water Service - 1st 100' 38.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 32.00
database oC e- J L /1 -30-o O Storm & Rain Drain - 1st 100' 38.00
Name Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00
Pollution Device
Engineer City/State Zip Phone Residential Backflow Prevention Device' 19.00
(Irrigation timing devices require a separate
Des - work to be done: restricted energy permit.)
New Repair 0 Replace with like kind: Yes No 0 Any Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commercial 0 Catch Basin 11.50
Additi al description of work: �/ Insp. of Existing Plumbing 50.00
c e /j l d l'✓ (J', �/ T 12' r per/hr
50.00
Are you cappin oving or replacing any fixtures? Specially Requested Inspections per/hr
SO No 0
Rain Drain, single family dwelling 45.00
If yes, see back of form to indicate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL S
•
that plans submitted are in compliance with Oregon State Laws. TIggJ
Signature of Owner /Agent Date )& SURCHARGE V
Contact Person Name Phone "PLAN REVIEW 25% OF SUBTOTAL �
Required only if fixture qty. total is > 9
1 BATH HOUSE $178.00 TOTAL
2 BATH HOUSE $250.00 ,., '
3 BATH HOUSE $285.00 '' - - 'Minimum permit fee is $50 + • % surcharge, except Residential Backflow
° (This fee Includes all plumbing fixtures In the dwelling and the first Prevention Device, which is $25 + 5% surcharge S `t. ()()
100 feet of sanita sewer storm sewer and water service) . **AII New Commercial Buildings require plans with isometric or riser diagram
and plan review
t:tdstsVomistplumapp.doe 6/16/99
•
PLEASE COMPLETE:
Fixture Type V Quantity by Work Performed
New V Moved - Replaced Removed /Capped
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:
11dsts formsNplumapp.doc 6/16/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 4)/l 3 CO AM PM BLD
Location 3 ( O (O S ot• Suite MEC 7 3(
Contact Person VYLPA/ Ph ZS 3-7 W 7 8 / PLM 7 — OO I C i
Contractor ✓✓ Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation . �y� /� / FPS
Ftg Drain �/� / a SGN
Crawl Drain Inspection Notes:
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
MBIN el
Post & Beam
• Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
J - .: FAIL
CHA •
Post & Beam
Rough In
Gas Line
Smoke Dampers
• PART FAIL
ECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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 D I Other b(P Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1