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InitiallyGood � i Pik a � CD N Ln Ul r E CD C v � W Lo ct I LQ25 SW BURNHAM STREET i CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: 13LM2.000-00419 13i25 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/15/00 SITE ADDRESS: 09025 SW BURNHAM ST PARCEL: 2S102AD-01700 SUBDIVISION: ZONING: CBD BLOCK- LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ Fl;,TURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Repair sanitary sewer line. FEES Owner: —'—^ ----- — Type By Date Arnount Receipt ZUBER, JOHN H — — -- 9025 SW BURNHAM PRMT CTR 11115100 $72.50 27200000000 TIGARD, OR 97223 5PCT CTR 11/15/u� $5.80 27200000000 Total $78.30 Phone 1: Contractor: OWNER REQUIRED INSPECTIONS Phone 1: Sewer Ir;pection Reg #: Final Inspection This permit is issued subject to the regG'ations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issttarice, or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-198' Issued B e_ Permitter; Signature- Call i nature-Call (503) 639-417s by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application City of Tigard Date received: // /s Permitno.:,/�2 y/ 9 ` Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard.OR 97223 Ciryr�fTigard Phone: (503) 639-4171 Project/appl.no.: Expin,date: Fax: (503)59$-1960 Date issued: By: Receipt no.: Land use apprc.val: Case file no.: Payment type: 1 U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant impn,v cmrnt U New construction U Add ition/al teration/replace n)c lit U Food sen ice U Other: 1I SITE INFOIIMATIO* 00R= .lob address: ?p� `` / Description Qfy. Pec ca. 7 ofal �f _ ( ) Bldg.no.: Suite no.: - New I-and 2-family dwellings only: / Tax map/tax IoUacCOulnt� no.: (includes 100 ft.for each utilifvconnect io.l) -- ( SFR(1)bath Lot: Block: it Subdivision: SFR(2)bath Project name: SFR(3)bath City/county: ZIP: Each additional bath/kitchep. - -"-- Description and location of work on premises: _ Siteutililies: Catch basin/area drain Est.date of completion/inspection: Dryw-Hs/leach line/trcnch drain - F(w)ting, drain(no.lin.ftPit ) Manufactured home utilities Business name: `j Manholes Address: e, - Rain drain connector _^ City: State• ZIP:± 7 2 a 3 Sanitary sewer(no.lin.ft.) Phone: �01,5 Fax: 5-VE-V74 J E-mail: Storm sewer(no.lin.ft.) CCB no.: p Plumb.bus.reg.no: Water service(no.lin. ft.) City/metro lic.no.: Fixture or Item: Contractor's representative signature: Absorption valve Back floe; rev Print name: _ ,4 Date: /i--/� enter_ a Backwater valvealligNMINEld -- Basins/lavatory Name: h //�' �7 Clothes washer __- Address: Dishwasher - —- Drinkingfountain(s) City: State: zip: Ejectors/sump - Phone: - y1 Fax: E-mail: Expansion tank Fixture/.ewer cap Name(print): �� r' Floor drains/floor sinks/hub Mailing address: — Garbage disposal City: State: ZIP: Hose bibbIce maker Phone: Fax: E-mail: Interceptor/grease trap Owner instal Iation/resident ial maintenance only: The actual installation Primer(s) _ will he made by me or then 'ntenance and repair made by my regular Roof drain(commercial) employee on the pro p�rfn,a� r O S Chapter 447. Sink(s),basin(s),lays(s) Owner's signature: Date; / - =-oo Sum Tubs/shower/shower pan Name: Urinal - Water closet Address: Water heater _City: State:- State: ZIP: Other: - - I::�nc: Fax: E-mail: 11'01311 Not all Jurisdlctlam accept coedit cards,pleae call Jurisdiction for more information. Minimum fee................$ �� C Notice:This permit application O Visa ❑MasterCard Plan review(at _ 96) $ Credit card numb": / expires if a permit is not obtained -- __L_ -- within 180 days atter it has be^n State surcharge(896) ....$ p . n Nene d cardholder v shown on credit card accepted as complete. TOTAL. .......................$ 7? _ S Cardholder Aimamre Amount 440-4616(tr0011COM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2-family dwellings only: FIXTURES individual) � _QTY eat AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16 60 the dwelling and the first100 h. QTY (ea) AMOUNT Lavatory 16.60 for each utiles connection) One 1)bath _ $2_49.20 Tub or Tub/Shower Comb 16.60 Two 2)bath _ $350.00 _ Shov,or Only 16.60 Threes bath _ $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 _ ____ TOTAL ------- Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" T16.603'• PLEASE COMPLETE: 4~ 0 Watei F;eatorOconversion O like kind —— _ Quantnn b Work Performed Gas pipi.ig requires a separate mechani(al Fixture Type: New Moved Replaced Removed/ permit. _ _. -Capped_._ MFG Hime New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46,40 Lavator, — __ _--_ Tub or Tub/Shower Hose Bibi 1660 Combination Roof Drains 1660 Shower Onlyv _ Dr;nkiny Fountain T 16.60 Water Closet _ Other Fixtures(Specify) 16.60 Urinal Dishwasher__ Garbage Disposal Laundry Room Tray _ —--— Washin Machine _ _— Floor Drain/Sink: 2" — ��' Sewrlr• 1si 100--- 55.00 — 3" -- - — Sewer•each additional 100' 46.0 4" Water Service-1st 100' 55.00 Water Heater Water Service-each additional 200' 46.40 Other Fixtures _—_ (Specify) _—_... Storm d Rain Drain-1st 100' 5500 Storm&Rain Drain-each additional 100' 46.40 — Commercial Back Flow Prevention Device 46.40 ----- Residen ial Backflow Prevention Device' 27.55 — — Catch Basin 16.60 Inspection of E.Osting Plumbing or Specially 7250 Requested Inspections _— er/hr _ COMMENTS REGARDING ABOVE: Rain Drain,sligle family dwelling 6525 _— Grease 1 raps 1660 QUANTITY TOTAL —" Isometric or riser diagram is required it --"— --`-- ---------- - Quantity Total is9 -----.----___.__�--- —^ 'SUBTOTAL - -- — 8%STATE SURCHARGE ---- ---- "PLAN REVIEW 25%OF SUBTOTAL i Required only if fixture qty total Is>9 _ TOTAL 5 Minimum permit fee is$72 50-e%state surcharge,except R•_vidential Backflow Prevention Device,which is$36 25+B%stain-_•-harge "All New Commercial Bulldings require plans with Isometric or riser diagram and plan review i:\dsts\forms\plm-foes.doc 10;10/00 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspectic,i Line: 639-4175 Business Line: 639-4171 MST — BUP _-- -- -_-)ate Requested,_f r/- I AM _PM BLU -- I_oc:ation��� sw � t,k, 16r>✓L S� � Suite _ _-- MEC Contact Person _ Ph VZ _— PLM 2-evV -&0 Contractor Ph SWR BUILDING Tenant/OwnerELC _ Retaining Wall — — ELR - - Footing -------. Foundation Access: FPS Ftg Drain ------------ Crawl Drain Inspection Notes: SGN Slab Post& - SlabBeam -- -- --------- ---- SIT Ext Sheath/Shear Int Sheath/Shear —------- ----- Framing Insulation ---- —--..__ --�- - --_— -..------- -- —_----- Drywall Nailing - - Firewall -------- --- - ---- ----- ---- Fire Sprinkler Fire Alarm Susp'd Ceiling -. - -------------Roof _ ----- ---- --- - Mis:.: - - - --- ------- - --- ----- -- Final PASS PART FAIL ----------- - -- --.._.�__ � PLUMBI -----_--- Post& Beam Under Slab — Top Out ---- - - --- Water Service - lain main. !7pa�'AR I FAILVMH ------ ---- - ANICAL ------ -- --- .__— — - --- Post& Beam --- - - -- - ---------- ---- - Rough In --------------- - Gas Line -- --- -- Smoke Dampers _-------- - - ------ - -------- -- Final --- -. PASS PART FAIL --_----- -�--- --- ---- -_ ELECTRICAL --- - - - — Service Rough In - - -- _---- UG/Slab ----------- ----- Low Voltage -------- -- ---- Fire Alarm Final - - -- ------- ------ -- PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain ( ] Reinspection fee of$ required before nex;inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line I ]Please call for reinspection RE _ - _-_- [ )Unable to inspect- no access ADA Approach/Sidewalk. / IG ' Other Date -IL_ Inspector____—/ �-----Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the j a site. CITY Ca TIGARD MECHANICAL. E*RM I T -" DEVELOPMENT SERVICES '�f � F . 13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 PERMIT #. . . . . . . : MEC96-0360 (/\ ��Iq v DATE ISSUED: 10/E'l/9F, SITE ADDRE59. . . : 09025 SW BURNHAM STli PARCEL-: ES102AD-01700 9UBD I V 13 T ON. . . . : ZONING: CBD BI-OCK. . . . .. . .. . . . : I-OT. . . . . . . . . . . . . .. CLASS OF WORK. REP FLOOR F1JR1\1. . . . 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. - :A1 VENTS W/O APP1-: 0 VENT SYSTEMS: 0 STORTES. . . . . . . . 0 BOIl.-ERS/C0MPRE5SORS HOODS. . . . . . . : 0 FUEL- 0-3 Hr-*,. 0 D&MES. IIVC IN: 0 3-15 HP. 0 COMML. INCIN: 0 MAX TNPUT: 0 BTU 15-30 HP. . . . : I REPnJ.R UNITS- 0 F'I RE DP(IPERS?. . 30--50 HP. . . . : 0 WOODSTOVES. . : QA GAS P''<EFSURE. . . 1504 HP. . . . : '0 Cl-.O DRYERS. . : 1A 1\10. OF UNITS------------ AIR HANDL.ING UN I TS OTHER UNITS. : o FURN ( 100K BTIJ.' 1 10000 cfm : 0 GAS OUTL.ETS. : 0 FURN ) =100K BTU: 0 > 10000 c'fm : 0 Remarks : FURNACE REPAIR Owner: FEES JOHN ZUBER type �Jmol.lnt by date r-e C--p t 9025 SW BURNHAM PRMT $ 33. 00 TAT 10/21 /96 96-285444 SPOT 1. 65 TAT 1.0/21/96 96-285444 TIGARD OR 97223 Phnnp #: 639 0395 COLUMBIA HEATING PO BOX 230397 TIGARD OR 97281 Phone #: 624--2704 $ —4. 65 TOTAL Peu ##» « 76359 REDUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Gas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Mise. InSPE-r-tiOn applicable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for sore than 188 days, Permittee SigTiz i.t ,e : s 1.t e d BY : Call for inspection 639-4175