Permit - A% CITY OF TIGARD PLUMPING PERMIT
. 1 � DEVELOPMENT SERVICES PERMIT # • PLM913 -0397
„..- ° .. � -. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10 / `7 / 98
PARCEL: 2S101DC -04000
SITE ADDRESS...: 07500 SW TECH CENTER DR #A
SUBDIVISION • ZONING: I -L
BLOCK • LOT • JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:B 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)...: 100
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replace water services.
Owner: FEES
SPEIKER PROPERTIES type amount by date recpt
4380 SW MACADAM PRMT $ 30.00 DLH 10/27/98 98- 310322
SUITE 100 5PCT $ 1.50 DLH 10/27/98 98- 310322
PORTLAND OR 97201
Phone #:
Contractor
ROWLAND PLUMBING
4524 N LOMBARD
PORTLAND OR 97203 -4799
Phone #: 285 -2586 $ 31.50 TOTAL
Reg #..: 5628
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Service In
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 :/0/G
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
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CITY OF TIGARD Plumbing Permit Application Plan Check# -
13125 SW HALL BLVD. Commercial and Residential • Rec'd By . L.H
TIGARD, OR 97223 Date Rec'd /iv aa /5.4p-
(503) 639 -4171 Date to P.E.
Print or Type -11. Date to DST -
Incomplete or illegible applications will not be accepted Permit* P411 ®97
Related SWR #
Called
Name of Development/Project ' FIXTURES (individual) QTY PRICE -AMT
Job _ to mai C cEz le Sink 9.00
Addr
'fe 'd. ress, Sui Lavatory 9.00
', ^ � ♦ ' �] au i jFJP 4"°5e Tub or Tub /Shower Comb. 9.00
�, _ , City /S to Zip Shower Only 9.00
Water Closet 9.00
-s
i lea- -Pcbio Dishwasher 9.00
Owner mailina AAddress �l, Suite Garbage Disposal 9.00
a( it / ° �� �n /DQ Washing Machine 5.00
State Zip Phone •
�J � 97ZOjt Floor Drain/Floor Sink 2" 9.00
Name 3" 9.00
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
Urinal 9.00
�
64/J 4�� , � Other Fixtures (Specify) 9.00
N
Contractor allin�d J ss, n , f ,� _ y� Suite 9.00
^t t L ntti3 Ki 9.00
Prior to permit City /State Zi Phone �� Sewer - 1st 100' 30.00
. issuance, a copy PbQe'�e p n 17 3 ' �Ii ' ��
Sewer - each additional 100' 25.00 -- 0
of all licenses are Oregon Co t. oard Licit Exp. ,
• Dat q ✓ Water Service 1st 100' / 30.00 ` !'i
required if Cont. � , // 9 /
expired in COT Plumbm Ic. # �p . [date g ,/ Water Service - each additional 200' 25.00
database '- P k1 ge / / Storm & Rain Drain - 1st 100' 30.00
Name 1 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/ No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial Catch Basin 9.00
Additional description , of wo + q , ecs Insp. of Existing Plumbing 40.00
• ^
E J 4C �r�r
-R per/hr
L ()Dar �EleV Specially Requested Inspections 40.00
4 2S %/ per/hr ,
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes 0 No Grease Traps 9.00
If yes, see back of form to indicate work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is > 9
WORK COULD RESULT IN INCREASED SEWER. FEES. `SUBTOTAL 0 0
I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE 0 '
that plans submitted are in compliance with Oregon State Laws.
Si net a of Ow er/ - Date "PLAN REVIEW 25% OF SUBTOTAL
: V - I 0 `� n f e Required only if fixture qty. total is > 9
L TOTAL 0
Conte t Person ame Ph ne '
- 1 T 1.4 r 10e � �� j-Z `Minimum permit fee is $25 + 5% surcharge,. except Residential Back' ow
1 Prevention Device, which is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I:tdstslplumapp.doc 7/2/9
/2/98 /
��
.Sio
PLEASE COMPLETE:
.Fixture Type : :Quantity:: Work. Perf ormed
New:::::: Moved:::::::Re laced:> < <Removedl.Ca ed
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:'dststplumapp.doc 7!7198
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ! oi AM PM BLD
Location ?SO() T PP4' Q. K Yl Suit; ME
Contact Person Ph P "CO g9
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH - SGN
Crawl Drain
Slab NO INSPECTION(S) FOUND IN FILE X I �( SIT
Post & Beam Ll '
Ext Sheath /Shear i `[
Int Sheath /Shear
Framing
Insulation
Drywall Nailing / , /
Firewall . ,'F7'.
Fire Sprinkler IF � il
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final i
F2ASS PART FAIL
Post & Beam
Under Slab
Top Out ` t/'
Water Service
Sanitary Sewe
Rain Drains _
40r PART FAIL �� ✓ A L / / / .:%i. / i . i�
� . .� - ANICAL / / � /
Post & Beam ��� -imt - � . ! /L� . _ L_ ✓� ��.
Rough In /
Gas Line
Smoke Dampers
Final �c -p
PASS PART FAIL !
/ / / f
ELECTRICAL ' / ' � �
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm ( /
Final cy
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 �6
Approach /Sidewalk
G
Other Date I nspector �j/�� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.