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15350 SW OAKTREE LANE a w cr. 0 tI) _ Q D m m r A z m 15350 SW OAKTREE LANE. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) G39-4171 BUP Received _ ,Date RequestedAM _-__ PM _- BUP Location 3�� L,4e -: 4-Aau 7 -Suite EIEC Contact Person Ph( ) PLM _'71 Contra,-tor p Ph(—) SWR -_- BUILDING Tenanti'Gwner _ _t-_ _ ELC - Footing ELC Foundation Access: Fig Drain ELR Crawl Drain - Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing - Insulation Drywall Nailing _ - - -- - --- - Firewall Fire Sprinkler ---- ----- Fire Alarm Susp'd Ceiling - - Root Other:---- Final _ PASS PART FAIL - -- -_--�- - -_ ---- -- -- - - PLUMBING Post&Beam Under Slab ;i�p Roi7dh-(n Water Service - -- Sanitary Sewer Rain Drains -__----------_- --___-- _ _ Catch Basin/Manhole Storm Drain - Shower Pan Otthhw, AAA 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 F'j Reinspection fee of$_ -_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ^- �� Plea30 call for reinspection RE. [] Unable to Inst ect-no access Fire Supply Line ADA Approach/Sidewalk DaAte Intrpsraor Other:-- -___-- l Pinai DO NOT REMOVE this Inspection record from the Job site. -PASS PART FAIL CITYO C T I GAR D PLUMBING PERMIT DEVELOPMENT SERVICES PEEcMI,'#: P21/03 00445 DATE ISSUED: 8!21/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 633-4171 PARCEL: 25111 DQ-08300 SITE ADDRESS: '15350 SVV OAKI-REE LN SUBDIVISION: SUMMERFIELD NO.10 ZONING: R-7 BLOCK: LOT: 544 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILF HOME SPACES: TYPE OF USE: SF WASHING MACH: BACK11:L0W PRE VN RS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS-. SF RAIN DRAINS: SINKS: _ URINALS: GREASE TRAPS. LAVATORIES: OTHER FIXTURES: 1 TUB/SHOWERS: SEWER LINE: WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Valve for tub/shower enclosure FEES _ Owner: Description Date e— Amount SIMS, CECIL C +BILLIE J [I'LUMti] Permit Fcc � 8121/03 $72.50 15350 OAKTREE LN [TAX] K",4.Statc Tax 8/21/03 $5.80 TIGARD, OR 97224 ---_— Total $78.30 Phone Contractor: ACTION PLUMBING& HEATING 19587 SW RED OAK LN ALOHA,OR 97007 REQUIRED INSPECTIONS Final Inspection Phone : 503-356.9630 Reg #: I W 138159 III \1 34-3691113 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 --� Permittee Signature: t i Issued By. --- Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day Building Fixtures Plumbing ermit Application Received Plumbing Date/e \a Permit No. Lm aoo .o D I f Planning Approval Sewer ("lty Ol rrlgal-d Date/By: _ Permit No.: 13125 SW I lall Blvd. Plan Review Other Tigard,Oregon 97223 DateB : Permit No.: —� Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/By- Case No.: Internet: www.ci.tigard.or.us Contact Juris.: See Page 2 for 24-hour Inspection Request 503-639-4175 Name/Method: — Supplemental Information. _ TYPE OF WORK FEE*SCHEDULE(for special Inf.,.. ition use checklist) New constructionDemolition __ Description rtiL on L" Fectca.) Deal [] Addition/alteration/replacement Other: New 1-&2-family dwellings _ (Includes 100 ft.for each u Ility co ni on CATEGORY OF CONSTRUCTION S-FR�(1 bath _ 7.20 r 1 & 2-Fainily dwellin� WCommercial/Industri_al Z bath 350.00 Acres-so Buildin Mi J-Faml� sFR 3 bath 3`7`7(10 Master Builder Other: Such additional bath kitchen 45e 2 _ JOB SITE INFORMATION and LOCATION Fire sprinkler-sq. fl.: Pa e 2 Job site address:L . !z �c} 1 -t' Site Utilities Bld ./A t.#: Catch basin/area drain 16.60 Y Suite#: g— --- Dr ell/leach lint/trench drain 16.60 e Pro et Name: __ _ S�w.,�_ -- Footing drain nu.linear ft. Page 2 Cross streeL/Directions to job site: Manufactured home utilities 110.00 _ Manholes 16.60 Rain drain connector 1660 Sanitary sewer(no.linear ll ) Page 2 S Lot#: Sturm sewer(no.linear fl. Pae 2 ubdivision: _Z _— -- ------ Water service no. linear Tax ma / arcel #:Y FlitAre or[tem DESCRIPTION OF WORK Absorption valve i 6.60 _ V—L %A�1 '� Backflow prcventer Pae 2 _ A-Y •`J Backwater valve 16.60 _f -- Clothes washer 16.60 ------.-----_...___ _ - Dishwasher 16.60 _ _ Drinking fountain 16.60 _TFRO"ERTY OWNERTTENAN'� B'cctors/sum 16.60 Name: t.� '��__ Expansion tank 16.60 Address: �,"j S` S W `� \ i t `< �Y Floor drain/floor c. _ 16.60 Floor drain/floor s:�k/hub � I6.60 City/State/Zip: G1121_-y.- _------ Garbe cdis oral 1660 Phone: Fax: Dose bib 16.60 PLICANT ONTACT I'GRSON Ice maker 16.60 Name: �►� 1M S va v� Interco tor/ rcase trap 16.60 - r - Medical gas-value. $ Pae 2 Address: k.S` '� Primer 16.60 _ CitXstate/Zi : , d b 1 __— Roof drain commercial 16.60 Phone: 'C( �Q rax: 3,k-kV 212_ Sink/bcsin/levator 16.00 E-mail: Tub/shower/shower pan 16.60 CUNTRA_CTO Urinal 16.60 1 Water closet 16.60 Business Name �e U.._ �� 0 16.60 -- Water heatrr Address: % "1 (:K.k_L \-v\ Other: Ctt /State/t't K\-.v., _� Other _ .! Plumbing Permit Fees* Phone:'��,�o-q� a Pax: �+ _ Subtotal $ _ CCB L1c. #: 5 Plumb. Lic.#. - Minimum Permit Fee$72.50 5 Authorized �� - Residential Backflow Minimum Fee$36.25 7a Signature: /� �- '�" Date: 2�� plan Review(25%of Permit I-ce 5 5-. O --— State Surcharge 8%of Permit Fee $ —-- - _- ---Ihlease print name) -- - TOTAL PERMIT FEE 5 Notice: This permit application expires if a permit Is not obtained within All new commercial buildings require 2 seta of plans with Iwmetric or 180 days after It has been accepted as complete. riser diagram ror plan review. *Fee methndology set by Tri-County Building Industry Service hoard. ODsts\Permit Porrns\PltnPcnnitApp doe 01/0; Plumbinf? Permit Application - City of Tiflard Page 2 - Supplemental Information Fee Schedule: — Residential FiMSore Systems: pStoni & ite Utilities ~— Qty. Fee tea) Total Square Foots e: Fee: — U to 2,000 rain- I" iOo, --- 5 (X1 2 t of t0 3,600 rain•each additional 100' 4v.40 3601 to 7 2I st 100' 55.00 7,201 end greater ach additional 100' 46.40 rvice- Ist 100' -75—00 Medical Gas Systems: 16.40 f io Permit Fee: ervice-each additional 10(1' Valuation: Rain[pain ist 100' 55.00 $1.00 to$5,000.00 Minimum lee$72.50 _ Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each _ additional$100.00 or fraction thereof,to and Fixture or Item Qty- Fee(ea) Total includin $10000.00. commercial Back Flow Prevention Device 110,001.00 to$25,000.00 $148 50 for the first$10,000,00 and$1 54 for each additional$100.00 or fraction thereof,to Residential Backflow Prevention Device 55 and including$25,0K00- 27 minimum omit fee$36.25 $25,001,00 to$50,000.00 $379.50 for the first$25,000.00 and 51 45 for Rain Drain,single fomily dwelling ('5.25 arch additional$100.00 or fraction thereof,to Inspection of existing plumbing or and including$50,0(10.00. l7250 rciall rc nested ins actions- er hour . $50,001.00 and up $'4200 for the first$•50,000.X0 and$1.20 for Subtotal: each additional$100.00 or fraction thereof. Fixture Work: Are you capping,nun'ing or replacing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accuratel re)ort fixtures could result in increased sewer fees*. Cowinents regarding fixture work: uantll•b Fixture Work Performed Fixture Type: Replace New Moved Existin Ce) d Iia itislr /Font - Bath -Tub/shower - -Jacuxzi/Whirl xil C'ar Wash Each Stall -Drive'I htv — Cum idor/Water Aspirator — Dishwasher -Commercial — --- -Domestic - --- — --.. ----- -- — Drinkin --- E c Wash - Floor Drain/sink 2" — --— 4" _ Car Wash Drain --- *Note: if the fixture work under tills permit results in an Garbage -Domestic increase of sewer FDUs,a sewer permit will be Issued and Disposal -Commercial fees assessed for the sewer increase must be paid before the -Industrial plumbing permit can be Issued. Ice Mach./Refrig.Drains Oil Se arator Gas Station Rec.Vehicle Dum Station Shower -Gang - -Stall _ Sink -13ar/1_avatory - -Bradley --- •Commercial —- -Service Swin:min Pool Filter Washer-Clothes —— Water Extractor -- Water Closet-Toilet _ --- Urinal -- _ Other Fixtures: - ODstOermit Fomrs\PltnPermitAppPg2.doc 01/03 l