8962 SW COMMERCIAL STREET CO
ca
as
N
Cn
n
O
3
3
c�
n
Cn
cv
8962 SW Commercial Street
CITE" OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00458
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/25/02
SITE ADDRESS: 08962 SW COMMERCIAL ST PARCEL: 2 S102AA-04800
SUBDIVISION: ZONING:
BLOCK.: LOT: JIIRISDICTION:
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 5 ft
Remarks: Repair 5' storm drain under sidewalk. _
Y
Owner: -- — —FEES
Description
--
Description Date Amount
1R1-COUNTY METROPOL11-AN i —
TRANSPORTATION DISTRICT OF ORE II'I.1 if�t{31 I'rrmit Fix 11/25/U2 $72.50
4012 SE 17TH AVE I I'I.l (•1131 I'rrmit FCC 11/25/02 $0.00
PORTLAND, OR 97202 I I;�\I `{ state'i'm 11/25/02 $5.80
I f 1\IS",,~tate Tat 11/25/01 $0.00
Phone 1: Total $78.30
Contractor: —'—
APOLLO DRAIN + ROOTER SERVICE
2208 NW 131RDSDALE #8
GRESI-IAM, OR 97030 REQUIRED INSPECTIONS
Phone 1: '39-MKOI Storm Drain Insp
Final Inspection
Reg#: MET 10un03082
LIC 0004941 x
I'LM 26-531143
This permit is issueu subject to the regulations contained in the Tigard Municipal Code, State oi OR.
Specialty Codes an(] all other applicable laws. All work wi:l be done in accordance with approved
plans. This permit will expire if work is riot 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
Issued By: Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
Building Fixtures
Plumbing Permit Application
Date received: Permit nony}�-�)
Uri
Cit of Tigard
YSewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard Phone: (503) 639-4171 Prnject/appl.no,: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval: Casc file no.: Payment type:
TVIPE 01, PeRM111
U I &2 family dwelling or accessory Commercial/industrial U Multi-family U Tenant imrroven)cni
U New construction U Addition/alteration/replacement U Food service U Other:
.10B SITE INFORMATfON
Jib address: c<-A 6 :5,-,-, CC"^,rV Description Qt . Fee(ea.) Total
Bldg. no.: Suite no.:
New -an -ram ly dwellings only:
Tax map/tax lot/account no.: (includes 100 B.for each utility connection)
SFR(1)bath _
Lot: Block: I Subdivision: SFR(2)bath _
Project name: j r; E SFR(3)bath
City/county: ,,,-J• I ZIP: Ci 7-L-L Each additional bath/kitchen
Description and loco Ion of work on premises: :51-v- -fSlte utilities:
Catch basin/area drain _
Est.date of completion/inspection: Drywells/leach line/trench drain]PLUMBING CONT111ACtOR _ -
Footing drain(no lin. fl.) _
Manufactured home utilities
Business name: \ U Manholes
Address: -2 e 1� i,-A rtes Jt,. le Rain drain connector
City: C V ' ._ . - State:( ZIP: 7U Sanitary sewer(no.lin. ft.) _ —-
Phone: 1 �$ Fax: q kSb E-mail: Storm sewer(no.lin. fl.)
Water service(no.lin. it.)
CCB no.: Ll 5 I 1 " Plumb.bus.reg.no:
�
City/metro lie.no.: AbsoFixture or item:
Contractor's representative signature: Back tion valve
Print name: Back flow preventer _—
F le e r g W, Date: J I tS-o Z Backwater valve
ir Basins/lavatory
Name: Clothes washer
- -- ---
Addt ass: Dishwasher
_ -
Drinking fountain(s)
City. State: IIP: Ejectors/sump _
Ph me: Fax: E-mai;. Expansion tank
Fixture/sewer cap
Name(print): Floor drains/floor sinks/hub
Mailing address: — ------_Garbage disposal -
- Ilose bibb
City: State: ZIP: Ice maker
Phone: Fax: I E-mail: Intercerlor/grease trap
Owner installation/msidential maintenance only: The actual installation Primer(s)
will be trade by me or the maintenance and repair made by my regular Roof drain commercial)
employee on the property I own as per ORS%hapter 447. Sink(s),basin(s),lays(s)
Owner's si nature:_ Date: Sump
Tubs/shower/shower pan
Name: Urinal _
Address: - — Water closet
Water heater
City: State: ZIP: Other:
Phone: I Total
Not all mrisdictions accept credit cards,please cell jurisdiction for more information. Minimum fee................$
Notice: This permit application Plan review at
❑Via U MasterCard ( — %) $
expires If a permit is not obtained ° �-
Credit card number / / State surcharge(8%)....
-- Expires within 180 days after it has been �
TOTAL. ......................
Name of cardholder a+shown on credit card accepted as complete. $
S
--Cardholder signature Amount 404616(MICOM)
PLUMBING PERMIT FEES:
PRICE 1 iTAL New 1 and 2-famlly dwellings only:
FIXTURES (individuaij_ QTY as AMOUNT- (Includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling anc:the firsl100 ft. QTY (ea) I AMOUNT
Lavatory 16.60 for each utility connection)_
One(1)bath _ $249.20
Tub or Tub/Shower Comb. 16.60 Two 2 bath __� _ _ _$350.00
Shower Only 16.60 i �hreebath_____ _ $399.00
Water Closet 16.60 -- ----- -�
___ SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE _
Dishwasher 16.60 _PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 -- PLEASE COMPLETE:
4" - 16.60
Water Healer O conversion O like kind 16.60 4uantit b I Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced TRemove dI
permit Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory__ _
Hose Bibs 16.60 -- Tub or Tub/Shower
Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Other Fixtures(Specify) 16.60 f Urinal _ -
_� Dishwasher
Garbs e�Disposal
Laundry Room Tray _
--
Washing Machine _-
Sewer-1 at 100' 55.00 Floor Drain/Sink:
3" -
Sewer•each nddil!onal 100' 46.40 4" _
Water Service-1 st 100' 55.00 Water Heater -
Water Service-each additional 200' 46.40 Other Fixtures
_
Storm&Rain Drain-1st 100' 55.00 (Specify)
Storm&Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 41,40 - -- ------
Residential Backflow Prevention Device* 27.55 ------ --
Catch Basin 16.60 --- - -- --
Inspaclicn of Existing Plumbing or Specially 6250
Requested Inspections perthr COMMENTS REGARDING ABOVE:
3:!n Drain,sinc;l4 family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL -`
Isometric or riser diagram Is requited If
Quantity Total Is >9
'SUBTOTAL _ - --
8%STATE SURCHARGE
"PLAN REVIEW 25%OF SUBTOTAL
Required only it fixture9ty total is>9
TOTAL. $
Minimum permit fee Is 1572 50+8%slate surcharge,except Residential Backflow
f revenbon Device,which Is$36 25 4 8%state surcharge
"All New Commercial Buildings require 2 vets of plans with Isometric or riser
diagram for plan review.
!:\dsts\forms\plm-fees.dnc 12/26/01
t
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP -_—
Received ___ _-_ ��.� Date Requested- __ AM___..— PM- - BUP
Location __-___- _ Suite.___._._.__ ___ MEC
Contact Person Ph (--_) __ - Oo1 PLM
Contractor - _
_-- SWR
BUILDING Tenant/Owner -__ - _-- _.__� __.- ELC
Footing ------- '_=1_C
Foundation Access:
Ftg Drain _ ELR ---
Crawl Dain
Slab Inspection Notes: SIT ---_----.- ------- _ _-
Post&Beam --- --- - -----
------------
Shear Anchors ---" - ------ —-
Ext Sheath/Shear
Irit Sheath/Shear
Framing --- - -- - - --- --
Insulation
Drywall Nailing -- - -Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceding __ - _ ------ -- - - ---- __.
Roof
Other - -
Final
PASS PART FAIL - - - - -- - - --
PLUMBING /
Host& Beam - - -- j -- — - — -
Under Slab ---- (�
Rough-In
Water Service ---
i ar-yevygt�
ain rains ---- -
Satch Basin/Manhole
Storm Drain -- -- ---- ---`-- — -
Shovmr Pan
Other - -- - - - -- -
Final
_PASS PART FAIL - _-
MECHANICAL
Post& Beam
Rough-In -------- -- -- - - --------
Gas Line
smoke dampers
�.
Final
PASS PART FAIL - ------ ---
ELECTRICAL
Service -- ---- - - -----_-_--�---
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13'26 SW Hall Blvd.
PASS PART FAIL
------------
SITE _ Please call for reinspection RE: Unable to inspect-no access
Fire Suprly Line
ADA
Approach/Sidewalk Dater! Inspo--tor Ext
Other
incl DO NOT REMOVE this Inspection record from We Job site.
PASS PART FAIL