Permit •
CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2000 -00322
*h., �; DEVELOPMENT SERVICES DATE ISSUED: 10/26/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -
SITE ADDRESS: 11510 SW TERRACE TRAILS DR PARCEL: 2S103CA -05100
SUBDIVISION: TERRACE TRAILS ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of two hose bibs and one residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
TAYLOR, CALVIN S JR/FRANCINE D PRMT CTR 8/29/00 $50.00 27200000000
11510 SW TERRACE TRAILS DR SPOT CTR 8/29/00 $4.00 27200000000
TIGARD, OR 97223
Total $54.00
Phone 1:
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone 1: Rough -in Insp
Reg #: RP /Backflow Preventer
Final Inspection
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:
e-
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 #
13125 S* HALL BLVD. Commercial and Residential Rec'd By 5
TIdARD, OR 97223 Date Rec'd
(503) 639 -4171 Date to P.E. °
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit # v2 - tXJ j 22
Related SWR #
Called /U - /3 - v (aj
',cow- Iv /Ca- 0414;
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
•
Job Sink 11.50
.- Address Street Address Suite Lavatory 11.50
�L---.. i 151 > S t+->T t te.c..Tx .; s .-. Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip
T,b oR 9 r7 -'2-3 Shower Only 11.50
Name Water Closet 11.50
Ce.kv:�. S• Tg1for Urinal .11.50
j Owner Mailing Address Suite Dishwasher
� 11.50
(I S 1 U SL, 1 .1 .ca \`:AS ) • Garbage Disposal 11.50
City /State Zip Phone
7";-c 0,-82 a
�. q^72:/:1 3'32 -1063 Laundry Tray 11.50
Name (sera i- ) Washing Machine /Laundry Tray 11.50
Floor Drain/Floor Sink 2" 11.50
Occupant Mailing Address Suite 3" 11.50
City /State Zip Phone
4" 11.50
Water Heater 0 conversion 0 like kind 11.50
Name Gas piping requires a separate mechanical permit.
O 1 n _ (1 --,r 311 O w J) E - MFG Home New Water Service 32.00
Contractor Mailing Address Suite MFG Home New San/Storm Sewer 32.00
.L Hose Bibs �,, ff. /� - 11.50 -2 vo
Prior to permit City/State Zip Phone I Roof Drains 11.50
issuance, a copy
Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp Date
required if Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date n-
database
Name -
Architect Sewer - 1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
Engineer City/State Zip Phone
Water Service - 1st 100' 38.00
Water Service - each additional 200' 32.00
Descnbe work to be done: Storm & Rain Drain - 1st 100' 38.00
New • Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 8 Commercial 0
Additional description'of work: Commercial Back Flow Prevention Device 32.00
T n { Residential Backflow Prevention Device*
/ 19.00 /9.0
I0.eS c,,,,,. (,,,i. o ye.c P c p '�lv -a eol� f Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes 0 No 0 Inspections per /hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 '
WORK COULD RESULT IN INCREASED SEWER FEES.
I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL
given is correct, that I am the owner or authorized agent of the owner, and Isometric or nser diagram is required if Quantity Total is > 9
that plans submitted are in compliance with Oregon State Laws. *SUBTOTAL 50
SI ature f Owner /Agent Date
n
IV 2.61 / Q 8% SURCHARGE 1 1
Contact Person Name Phone ']
C4A.,\,. S.Zylac 4- C• (S01)33Z "PLAN REVIEW 25% OF SUBTOTAL
I 1 BATH HOUSE $178.00 Required only if fixture qty total is > 9
2 BATH HOUSE $250.00 TOTAL 51/.06
' 3 BATH HOUSE $285.00 -
1 (This fee includes all plumbing fixtures in the dwelling and the find *minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
100 feet of sanitary sewer storm sewer and water service) _ Device, which is $25 + 8% surcharge
"All New Commercial Buildings require plans with isometric or nser diagram and
plan review.
i \dsts \forms\plumapp doc 11/18/99
i
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved I Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I \dsts \forms\plumapp.doc 11/18/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / C AM PM BLD
Location J 5 /o��§uite MEC_
Contact Person Ph %
PLM ?O —06
Contractor Ph SWR
BUILDING Tenant/Owner ,.� / /// 09V& ELC
Retaining Wall _ ELR
Footing rr-.t r ,,rY r ; f «,��. ;;;fw !'':r ,Y,:.y�... �,�; or- t
t .���C' � lh +�` --ti .. 'Iri: � ., \ ; 1 -1.�•
Foundation � t+�;,i rt" -� i . ,Ya� r. L l. �'� ,,: -: r t FPS
Ftg Drain ��a�Nj� "�� G '�! ^'p .:yow y' � , �. •� •w 4 ,
Crawl Drain Ins p ecti i n Note _ SGN
Slab c` s ' 0�1 - ' , 0)413c / /./9 / ✓ SIT
Post & Beam (///e Ext Sheath /Shear O�/a/c/e` . /�G'G i
Int Sheath /Shear k�? 1 Mi -i? o {J 7; //e-' /// %,, ( 2 /,7 / 0 ��
Framing � ��Gr /� J
Insulation
Drywall Nailing
Firewall
Fire SprinklerT 1 � C - /? o
,//
Fire Alarm 1 e / / . _ ` Z*t/ /'
Susp'd Ceiling � � � e r � j I °� -
Roof C /l' r f-� S KoC � O / 77
Misc:
Final
PASS FAIL � %f t '� l er '
< PLUMBING i' ,e / e e v
Post & Beam
Under Slab (7 ; V (7 •
Top Out /
Water Service
Sanitary Sewer
Rain Drains
PASS PART (PAIL)
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
A roach /Sidewalk Date t 5
Other �/� � In spector / � � �� �rJ - � - Ext S d
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location / " / 5 T�� Suite MEC
Contact Person Ph ( ) PLM H2O 003 2- 2--
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _ _ ELC
Footing S - D /S C -fie
Foundation ELC
Access:
Ftg Drain /A-1 ELR
Crawl Drain _ —� �� Q7f I'7 er
Slab ; " A'ectlon Notes: J SIT
Post & Beam
Shear Anchors —
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ;
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
SS PART FAIL
. NICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk D at e s ^ Inspector ' f / / 40- /&(/ — e - Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY.QFTIGARD • • 24 -Hour • - r
Ittl atiiNG Inspection Line: (503) 639 -4175 I g� •
INSPECTION DIVISION Busine .Line: (503) 639-A1,71----.------., MST �.
� " 3 td * A a o BUP
Received Date Requested 4._.-
- _ ' = – -' BUPv'�P – dQ�% .
Location / l / v — Aei / /e/N ' uites-- MEC
Contact Person - C awC F Ph ( ) !a 1 ,../.4/ /''9 .� PLM ®Q� 0032- Z
Contr Ph ( 64 - 3 - '? e SWR
B ILDING Tenant/Owner £ di/V YW 2 - /v'_ ELC
Footing-°- e-, ELC
Foundation :,.►,•s-- �,: ,, -Y .:..),�. Jti: yr-,� «.-�s
�' ", ' "L : { -k'e: ; :i:?'.� -��. . ''?f . �'; , � *- �r•t -4 ;.:: - 1 "� /� � EL
Ftg Drain '
Crawl Drain `� - r� �i:it :,L... . s h. ; 1.; _?�1..�: :, .
Slab �. Inspection - .
SIT
`Post & Beam _ _
' Shear Anchors
_ Ext' Sheath/Shear ti .
Int Sheath/Shear ` . / 6-c— , -C',..) . , ' �
Framing I \ -e—,...k � v 1
Insulation ' j-- "`'"' �,��� _e s -_ j
• Drywall Nailing !
Firewall • .�� 3 4 ' .E j'-<„ ,
Fire Sprinkler - ' j ' • ; - /
Fire Alarrn . ,
Susp'd Ceiling V }� •
Roof _ i/ p = ��
r h V ��- 3--.b dJ c x - t--, l �_ .1.
•
�A V FAIL `
• (PLUMBING V • 'u a / = - -- sc.. -f ail,.
1:'ost8"Beam V )
Under Slab . _ - .
Rough -In K1 0 1 Q ; ) - iAA Q - -k S '`- -‘--,^.- C
Water Service v _{�
- Sanitary Sewer • • lam _ - t - C-- (� ■ ■.�vN, , A4
._ Rain Drains
Catch Basin / Manhole V • Lt) f- '- 6r,-_ \ • AJ ,._6) s
"Storm Drain '• ( 1
. "Shower Pan ' . `gyp Al n - K-1, \ o ��( L) Ora C
Other:
Final - ice. d.� -e—e__ '1 A— A -iv- -E. S Gjj.J.....A
PASS . PART ;FAIL ) • -
MECHANICAL '? ` / 2-Q C � \D � .. - 1- -e_-- a.
_Post h Beam ail,. 0, \ , U.,..2 LA) ‘. 4--........ '- LI C (...4 L.-., .,.tea
Rough
Gas Line �.,%_!
Smoke Dampers S - i
Final
PASS PART FAIL_
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage _
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART -FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line '
ADPA oach/Sidewalk Date 4 1 / nspector Ext
P _
Other: -
Final DO NOT REMOVE this inspection record from the Job-site. _ .
' PASS PART FAIL ,__