Permit 40 k CITY OFTIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
LM
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT #
DATE ISSUED: 06/16/97 97 -0230
PARCEL: 2S102BD -01001
SITE ADDRESS...: 09975 SW WALNUT ST #1
SUBDIVISION • NO.TIGARDVILLE ADDITION AMEND. ZONING: R -12
BLOCK • LOT •7 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •MF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R1 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: Install water heater
Owner: FEES
RON BLINE type amount by date recpt
8170 SW MAPLE DR PRMT $ 25.00 JSD 06/16/97 97- 296036
TIGARD OR 97223 5PCT $ 1.25 JSD 06/16/97 97- 296036
Phone #:
Contractor
KENNEDY PLUMBING
13985 SW FARMINGTON RD
BEAVERTON OR 97005
Phone #: 643 -5535 $ 26.25 TOTAL
Reg #..: 001009
REQUIRED INSPECTIONS
This permit 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.
, `� .. till, is 1. I. PP
Issued By. �, Permittee Signature: /. l /k...�it�
+ + + + + + + + + + + + + ++ ++++++++++++++++++++++++++++ + + + + + + + + + +! + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD Plumbing Application Recd By
13125 SW FALL BLVD. Commercial and Residential Data Recd loi S
TIGARD, OR 97223 OjIe to P E
( 503) 639 -4171 Cate to DST
Permits �f.-#1"1- 9 ?-a
Print or Type Related SWR s
Incomplete or illegible applications will not be accepted cooed o r rG
Name of CevetopmenuPrplect FIXTURES (Individual) 1 QTY PRICE AMT
Job LOGIhu,t- Coui'f ,4,4 - .5 , sink 9.00
Lavatory
Address S;reet Address Suite 9.00
9 c 15 S t,0 Loa I n‘,0* ruo or ruo/Shower Como 9.00
I dla k,..t _State Zito Shower Only
9.00
db I I I5 (1. (d O ✓ C I, 1 22'3 Water Closet 9.00
vamen
Dishwasner
K on 81(n e• 9.00
Owner I Mailing Address Suite Garoage Disposal 9 00 I
l S110 Sw ►'Y1aF le o✓ . Washin Macnine 9.00
• C i Phone Floor Drain ; -
I t tc p✓ � "I 3 ).97 - 4' 0 Z 3 i 2 I Sao
Name
I 3- 9.00
4- 9 00
Occupant Mailing Address Suite Water Heater 1 9.00 9 , II op
Laundry Room Tray 9.00
City/State Zip Phone Unnal
9.00
Name Other Fixtures (Speufy) 9.00
Ke r\f\ed-L Pl.umbir
. Contractor Mailing Addrees ✓ 5 9.00
Suite
3\55 9.00
1
5 w (mi i -on 9.00
(Prior to issuance ity_State Zip Phone
applicant must � 1 /4- n o ( 11 OO5 643. 553 5 9.00
provide ad Oregon Const. Cont. Board Lic.s Exp. Date Q I 9.00
contractors 1 0 9 6 7 0 .1 0 Zt; I 9.00
license Plumbing Lic. ic z Pa p. Date 4� Sewer 1st t00'
information ' 30.00
ess Tax or Metro s c � Sewer -each additional 100' 25.00
for COT COT Burgess Exp. Date
database). le , O ( 9 -4- Water Service - 1st 100' 30.00
Name :'rater Service - caul additional 200' 25.70
Architect Storm & Rain Drain - 1st 100' 30.00
Or Mailing Address I Suite Storm & Rain Drain - each additional 100' 25.00
Mobile Home Space 25.00
I
Engineer City /State Zip Phone I 25.00
9 Commercial Baut Flow Prevention Device or Anti-
Pollution Device i
Describe •.vork New C' Addition 0 Alteration Recair 0 1 Residential 9ack°.cw Prevention =evice• I "5 00
:o ce bone. Residential 0 Non- residential 0
Any Trap or Waste Nct Connerad to a Fixture ( I 9.00
Additional descnonon or wcnc
Catch Basin I 9 00 •
insp. of Existing i- umoing 40.00 '
per/fir I i
- Existing use of Soeaaity Requested Inspections i 40.00
= ulcing or property i oerrhr
Rain Crain. single family dwelling I I 30.70 I •
'rocosed use of I Grease Traps - 9.00
•
:uiiaing or property .
QUANTITY TOTAL I I
a re •.du caooing moving or reolaung any fixtures? YeS ✓ \ No isoTC� N iser C'agrarn •s reCured f Chaney 7ctat •s > ? I
{tf yes see back of form! 'SUBTOTAL
`ereoy acknowledge that 1 have read this application, that the information 2 5
;wen is correct. that I am *he owner or authonzed agent of :ne owner and 5% SURCHARGE a 5 '
:hat plans sucmitted are •- mchance with Oregon State Laws.
3ignat f Owner/Agent I( Date C� PLAN REVIEW 25% OF SUBTOTAL
� n ` I ' I I 1 ? eC�tC.7 DnfV ! ;[7Cl.te C`r 'o al :s > 3
VV� I� -/,/W\ TOTAL
Contact P on Name I Phone
j, I I G
'Minimum permit fee is 325 - 5 surcharge. except Residential Beddow Prevention D
1 C f-e, SS I �j� Sv 3 ✓ evice. which is $15 - 5'.'° surcharge �
i.`.osts'.olmapp.doc 87g6 l S�
i
'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
j Fixtures to be capped, moved or replaced Qty
Sink
j Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
�OMMENTS REGARDING ABOVE:
14 CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested •• AM PM BLD
/
Location ?7� W ,, Suite MEC
Contact Person Ph PLM 77-0 30
Contractor Ph W
SR
BUILDING Tenant/Owner 1.1)1..(0424-1—e71", ELC
Retaining Wall ELR
Footing Acces Not Request Foundation FPS
Ftg Drain 1 -- Found - Durm'g Res arch —� SGN
Crawl Drain Inspei '' Tnsnection(sl In File ; "
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
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
PART FAIL
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
Other oach /Sidewalk Date 17 / C Inspector /2 22
/ �i EXt✓'
Final !!!
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.