Permit _A. CITY OF TIGARD
DEVELOPMENT SERVICES
PERMIT FILUMBING PERMIT
'°�' # PLM98 -0415
!+� �= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 1 1 / 09 / 98
PARCEL: 2S103CA -05100
SITE ADDRESS...: 11510 SW TERRACE TRAILS DR
SUBDIVISION ° TERRACE TRAILS ZONING: R -4.5
BLOCK LOT :001 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 • 1 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)...: 0
DISHWASHERS 0 RAIN DRAIN (ft)...: 0
Remarks: Replace existing water heater
Owner: FEES
CALVIN TAYLOR type amount by date recpt
11510 SW TERRACE TRAILS DR PRMT $ 25.00 JSD 11/09/98 98- 310674
TIGARD OR 97223 5PCT $ 1.25 JSD 11/09/98 98- 310674
Phone #: 639 -7215
Contractor
RESCUE ROOTER
PD BOX 1728
WILSONVILLE OR 97070
Phone #: 243 -1172 $ 26.25 TOTAL
Reg #..: 127325
REQUIRED INSPECTIONS
This peroit is issued subject to the regulations contained in the Misc. Inspection
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: 4 � Permittee Signature: 4 ,19M r d
++++++++++++++++ 4 + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF 'r "IGARD Plumbing Permit Application Plan Check • ■ 1
13125 SW HALL BLVD. Commercial and Residential , B y ` I
TIGARD, OR 97223 Date Rec'd O ` Y
(503) 639 -4171 Date to P.E.
Print or Type Date to DS
Incomplete or illegible applications will not be accepted Permit# 1-,4 S
Related SWR #
Called 0 / C
Name of Development/Project FIXTURES (individual) . QTY PRICE AMT
Job Sink 9.00
Address Street Address Suite Lavatory 9.00
l tA
► 0 J'& I rerr4 T/tas Tub or Tub /Shower Comb. 9.00
Bldg # City /State Zip Shower Only 9.00
r;:74---et 4e q 2-3
Name Water Closet 9.00
e � n-
d- / l/A7 T Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
cdon Washing Machine 9.00
City /State Zip Phone
5 ,0 , , 4.....e.-- 4 3,9-7a(.S Floor Drain/Floor Sink 2" 9.00
Name z..- 3" 9.00
) dri"-Q-- 4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion `(like kind 9.00
c !A Gas piping requires a separate mechanical permit. ZS
City /Stat Zip Phone Laundry Room Tray 9.00
C °y _ SGf.i 2 _ Urinal 9.00
Name
ke Sc t...-e_ � `LG Other Fixtures (Specify) 9.00
Contractor Mailing Address Suite _ 9.00
/ 2 flak /74-1 9.00
Prior to permit City/State . Phone Sewer - 1st 100' 30.00
t,'
issuance, a copy ij11 97 47o7b 2.y 3 /(7-2"' Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if 1 2 : 7 3 a - 3 , • f9 Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00
database 3 [j -/6g PF3 6 --'r y Storm & Rain Drain - 1st 100' 30.00
Name 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 Replace with like kind: Yes /r No O Any Trap or Waste Not Connected to a Fixture 9.00
Residential Commercial 0 Catch Basin 9.00
Additional description of work: /
�(, c e- ex/5 fi(/�J b, S Insp. of Existing Plumbing 40.00
per /hr
L1/ _ Jl„ / Specially Requested Inspections 40.00
!�f �' (/l per/hr
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes O 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 -,F
I hereby acknowledge that I have read this application, that the information o� �,
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE 1
that plans submitted are it complia ;- with Oregon State Laws. Ir
Signature o1 ner /Ag / 9/ Date "PLAN REVIEW 25% OF SUBTOTAL
/ 01/1.-- , ri ,r/ P �j Required only if fixture qty. total is > 9 • 66[ �"/ j TOTAL ���
Contact Pars Name Phone
/ /' / 9 �i G *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
( / Q Prevention Device, which is $15 + 5 %
**All New Commercial Buildings require plans with isometric or riser diagram
and plan review
1:\dststplumapp.doc 7/2/98
4
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New 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:
I:ldstslplumapp.doc 7/7/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
c 94/ / / L k/ Date Requested /1 PM BLD
Location 115/ 0 c W ..1-€A1) a 69 JAdtlid Suite MEC c� p /
Contact Person C - 2 g,(Tt /I'LL Ph 16).M [ O " C 4/5
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: — f , Q r ,� , t ei FPS
Foundation Z C
Ftg Drain J 5rruAtei, cuurf C l'L_ yI tJU� S
Crawl Drain Inspection Notes: // p
Slab I ' : I 10 eLiii (o3 q 7;.
Post h Beam G I _ ' _ �
Ext S / + F63,2_
Sheath/Shear (Ji9'(,/� - ` a-�-
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
0' PART FAIL
HANICAL
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 11 / �7 •
Othe�ach /Sidewalk Date [ � Inspector Ext ✓ )C
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.