Permit CI TY OFTIGARD :.' ' , .' '. . •
, ...., ..
%, ryN ,.., i D EVELOPMENT SERVICES PLUMBING PERMI
- .. 13125SW Hall Blvd., Tigard, OR97223(503)639 -4171 ' PERMIT #' : 'PLM99 -12i018
' DATE ISSUED: 02/01/99 - •
• ' PARCEL: 2'S 1 X11 DD -•10I 1 00
SITE 'ADDRESS. ° ° i 07000 SW SANDBURG 'ST • • , - • , '
SUBDIVISION.... : .. ZONING: I -P .
BLOCK. ° ° ° °° ° °° • LOT °• ° ° ° ° ° °e ° ° ° ° °° JURISDICTION: TIE .
CLASS' OF- WORK. ° - : ALT - • GARBAGE DISPOSALS.: 0 . MOBILE HOME SPACES ° -: 0
TYPE OF USE. ° ° ° :COM WASHING, MACH ' 0 BfCKFLOW PREVNTRS. e : 0 ' • OCCUPANCY GRP :13 FL' OOR DRAINS„ ° °, . „ -: 0 . TRAPS . :' • 0 _
STORIES° ° ° : 0 'WATER HEATERS 0 ' CATCH BASINS. , .. : Qi
FIXTURE 5---- - - -- -- - - - -. -- LAUNDRY TRAYS— . °', : , 0 , SF, RAIN DRAINS 0
SINRS° ° °° ° ° °: •. • 1 URINALS— . ° ° ° °: 0 GREASE TRAPS ° 0 ,..'
• LAVATORIES., °,. ° : 0 OTHER FIXTURE, ° : 0 ,
TUB /SHOWERS. '° : ' 0 , - , SEWER: LINE ( f t ) . . . : 0 . " • '' , WATER , CLOSETS. : 0 WATER LINE (,ft ) -° ° ° :„ -100 • , ,.
'DISHWASHERS . ° 0 'RAIN • DRAIN. ( f t ) . . . : ' 0
Remarks: Emergenc:y water service - - '
:Owners,: ' -- -- . • FEES _ -' .
HYSTER COMPANY ' type 'amount by ' date recpt_ -
7000 SW SANDBURG STREET PRMT $ 30.° 00 B 02/01/99
TIGARD., OR 97224 . 5PCT $ •i° 50 B 02/01/99 99.- 31255.9
Phone #.: ,'
Contractor -- ____ -_ - - - - - -- - - --
DETEMPLE CO INC ,
1951' NW'QVERTON ST
PORTLAND OR 97209 -- - -- - - -_ . _-�- "-_
Phone #: 22.7' -2641 $ 31° 50 TOTAL ,. .
Reg #°'° : ,120002 , .
REQUIRED INSPECTIONS -
This per ®it is 'issued subject to the regulations contained- in the Wd`t er , Sery vice ce In n ___ _
' Tigard Municipal Code, State of Ore. Specialty Codes and all other' Final in ion � . '
' applicable - laws. All work will be done in accordance with _ • ___ _____�� „^ '
approved plans. This permit will expire if work is not started _ _ _ .. _ ' '
within °days of issuance, or if work is suspended for core ' _ .
than180,days. ATTENTION: Oregon law requires you to follow rules _ '
adopted by the Oregon 'Utility Notification Center. Those rules are ' . ' •
' set forth in OAR 95247M-8810 through.OAR 952-41:31-0880. You' may '- -_
- obtain copies of these rules or direct questions to OUNC by calling :__� __
(583)246 -1987. . - -- ' - -- . - -- - -
Is,s-1ed By: �`�,,,,�_ 'Per.mi.ttee Si gnature ,_ L
° + ++•4- + + + + + + + +-F + + + + + ++i + + + +.f +± + + + + +. + + +++ +-1 + + + + + + + + + + +' - + + + + + +1- , + + + +++ + + + + +• - + + + + +,-1-
Call 639-4175 by 7 :00 pa m° for an inspection needed .,the next. business day
- F+++++++++++++++++++ + + + +• +- + + + +• + + + + + + + + ++ +i= + + + + ++ 4. -+-F +++ ++ +; +•-F, + + + +-1- + ++t+ ++ + + ++ '
CITY OF TIGARD Plumbing Permit Application Plan Check
13125tW HALL BLVD. Commercial and Residential Redd By
TIGARD, OR 97223 Date Rec'd 7-1-17
(503) 639 -4171 Date to P.E.
Print or Type Date to D�
Incomplete or illegible applications will not be accepted Pem, ��
Related SWR #
Called
Name of Development/Project P 1 ct ;fIXTURES: indtt;•id4a /64i QT:Y PRIDE A
Job I-1 y S•4-er- J M P. s Sink 9.00
Address Street ddress Suite Lavatory 9.00
115 $L) S'a'LA ✓t..- Tub or Tub /Shower Comb. 9.00
Bldg # City/State Zip
ri: / / i rig_ q 77E9-"? Shower Only 9.00
Name • e , / Water Closet 9.00
f S ScLi* S Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
1NYD 1) S 0. Vid L - Washing Machine 9.00
City/State Zip Phone
Tv 1 - ,,' X (7,) 3 Floor Drain/Floor Sink 2° 9.00
/ Name 3" 9.00
1 ,,fjf'Ci y�Je 4" 9.00
Occupant Mail g Address �� �// // Suite Water Heater 0 conversion 0 like kind 9.00
- 7 (1 ii SGu't(/( //VI Gas piping requires a separate mechanical permit.
City /State ,t1� Zip Phone Laundry Room Tray 9.00
�f C .Q � -Z-V Urinal 9.00
Narn�SS�d
b e- fijt p 1e /( Other Fixtures (Specify) 9.00
rYyyJ�(�f,
Contractor Mailing Address Suite q 9.00
1 95/ Ant, 0 veriem. 9.00
Prior to permit CM/State Zip Phone Sewer - 1st 100' 30.00
issuance, a copy rQ r}-1 a, L 97 09 i -6- (- 1
Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required If 5t 0 (a -qq Water Service -1st 100' ✓ 30.00 36
expired in COT Plumbing Llc. # Exp. Date Water Service - each additional 200' 25.00
database -.1-& - ;-CPR (e - 11 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 SA Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial 0 Catch Basin 9.00
Additional description of work: Insp. of Existing Plumbing 40.00
&i /e lrie � , ( /a- L C f " ! r S pecially Requested Inspections // ions 40.00
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
fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL . , : ' : ,- -
Isometric or riser diagram is required if Quantity Total Is > 9
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL , Yn ` "' "
I hereby acknowledge that I have read this application, that the information :; -k. _ i°
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE .. "`° ",' °&
that plans submitted are in compliance with Oregon State Laws. ..:...�,,, _, x, s ; .,.. I.
Sign ure of Owner /Agent - Date "PLAN REVIEW 25% OF SUBTOTAL g w.
�} R e q uired only R facture qty. total is > 9 a" ; > .. t =.=�,
Tim/ .��1 ,9, -7---q so
TO TAL .
Cont#ct Person Name Phone z ' 3 I
S an 1/1,41/V jJ a Ym n_7 I1 f L// *Minimum permit fee is $25 + 5°k surcharge, except Residential Backflow
l d c110 Prevention Device, which Is $15 + 5% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram
and plan review
1.ldststpiumapp.doc 7/2/98
PLEASE COMPLETE:
Fixture. Type Quantity by Work Performed
. =.
New
Moved J 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
Date Requested �I \ AM PM BLD
Location O) i/ f Suite MEC
Contact Person J�.(is Ph RIC PLM Oo 1 er
Contractor " S7. k Ph SWR
BUILDING Tenant/Ow er X3.;33 ELC
Retaining Wall ELR
Footing Access: ()�, FPS
Foundation _
Ftg Drain SGN
Crawl Drain Inspection Notes: o
Slab V J.i1 a.- SIT
Post & Beam
Ext Sheath /Shear f'k. ,'.s " i.� - cQ� .
Int Sheath /Shear /
Framing / / , i
Insulation
Drywall Nailing
Fire wall `0 ` 0 /' v )
Fire Sprinkler /
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING (ti
Allk Post
e r S laam
U ab 1 � WS F / 9 ndr l
Top Out -_ f
ater Serve e
Sanitary Sewer
Rain Drains o /
ma
, PART FAIL
CHANICAL
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
Approach /Sidewalk
Other Date ; Inspector Ext?'
Final
. PASS PART FAIL ' 0 OT REMOVE this inspection record from the job site.
03/03/2000 Activities for Case #: PLM99 -00018
•
11:29:14 AM
•
Assigned Hold Updated •
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 02/01/1999 B RECD DST 02/01/1999
PLMC005 Permit Created 02/01/1999 B DONE DST 02/01/1999
PLMC799 Final Inspection 02/02/1999 MS PASS MRS 02/02/1999
PLMC711 Water Service Insp 02/01/1999 DST 02/01/1999
PLMCO50 (F) Issue permit 02/01/1999 B PASS DST 02/01/1999
PLMC800 Case Finaled 02/02/1999 MS PASS _ MRS 02/02/1999 •
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