9200 SW VIEW COURT 9201) SW View Terrace
CITYOF TI GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00499
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/26/02
SITE ADDRESS: 09200 SW VIEW TERR PARCEL: 2S111AB-04400
SUBDIVISION: PENMAR TERRACE ZONING: R-4.5
BLOCK: LOT: 011 JURISDICTION, rIG
CLASS OF WORK: PLT GARBAGE DISPOSALS: MOBILE HOME SPACES:
IYPE OF USE: SF WASHING MACH: BACKFLOW PREVNI RS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHIER FIXTURES-
TUB/SHOWERS: SEWER LINE: 40 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Rriirarks: Replace 40'of sanitary sewer line.
Owner: FEES -
Descrip.'on Date Amount
RAMIREZ,JOSE AND --
DOLORES ANN IPLUMB] Pennit FCC 12/26/02 $72.50
92.00 SW VIEW TERRACE (TAX]8"/o State Tax 12/26/02 $5.80
TIGARD, OR 97223 Total $78.30
Phone :
Contractor:
FLYING H CONSTRUCTION CO
PO BOX 2533
WILSONVILLE, OR 97070
REQ0IRED INSPEc notiS
Phone : 503-678-4224 Sewer Inspection
Final Inspection
Reg #: I W 104699
I'LM 3-348PB
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 :pore than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Issued By: i_,.;. ,' .�� Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Fixtures
Plumbing Permit Application 4L '
Date received: /L Z, Permit no. �.
City of 'Tigard Sewe: permit no.: I Building permit no.:
Address: 13125 SW Ball Blvd,Tigard,OR 97223
City of Tigard Phone: (503) 6394171 Project/appl.no Expire date:
Fax: (503) 598-1960 I/J Date issued_ - ByLZ/- I Receipt no.:
Land use approval: l7 case file no.: _ Payment type:
-{&tee family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U N,;w constnirtdon U Addition/alteration/renlacement J Food service J Other:
JOB SFI F. 1 1ULE(ior spetial Information
Deticriptiout Qty. Fee(ea.) Total
_Bldg. no.: Suite no.: New 1-and 2-family dnellings only:
Tax map/tax lot/account no.: (includes 100 ft.foreach utility connection)
SFR(1)bath _
Lot: Block: Subdivision SFR(2)bath
Project name: SFR(3)bath
City/county: ,_/ ZIP: 7l/ - Each additional bath/kitchen -
Description and location of work n remises: —'— Site utilities:
a w Catch basin/area drain _
Fst.date of completion/inspection: Drywells/eac line/trench drain
CONTRACTORI PLUMBING Footing drain(no.lin.ft.)
Manufactured home utilities
Business name: F" ti s _ c,,, Manholes - --- —
.___. 14� __�___
Address: Rain drain connector
CittZ 'F—7L7�' Sanitary sewer(no. lin.fl.)
y' State:D ZIP: /
Phone: Fax: , G E-mail: Storm sewer(no. inn.—R.)
CCB no.: Plumb. bus.reg.no: Water service(no.tin.ft.
City/metro lic.no.: -,7/9/' 0 Fixture or it •nc
Contractor's representaiive si nature: Absorption va've
Back flow preventer
Print name: cc el Date: Zr Backwater valveWIN _
Basins/lavatory _
Name: i I' Clothes washer
Address: ! Dishwasher
er --
Drinking fountain(s) _
City: State: ZIP: Ejectors/sump
Phone: Z O I ax: E-mail: Ex ansion tank _
OWNER Fixture/sewer cap _—
Name(print). q 14111 r•ez_ Floor drains/floor sinks/hub
Mailing address: - Garbage disposal
Hose bibb
City: State:_ LII': Ice maker
Phone: Fax: E-mail: Interceptor/grease trap _ —
Owner installation/residential maintenance only: The actual installation Primer(s)
will he made by me or the nmaint-lance and repair made by my regular Roof drain(commercial)
employee on the property I twn as per ORS Chapter 447. Sink(s), p :a(s),lays(s)
Owner's si mature: Date: Suml — ---__
tubs/shower/shower pan
Name: Urina
- -- -- - Water closet
Address: _ - Water healer _
City: State: ZIP: _ --ole—r.
Phone: Fax: _ E-mail: Total
Not all Jurisdictions accept rredil cards,please cell Jurisdiction for more Information. Minimum fee................ 7a
Notice: This permit application at�._ %) S
U Via. U MasterCard expires if a permit is not obtained plan review( °
Credit card number _ / within 180 days atler it has been State surcharge(8%).... S
Name of card older u sown on credit ca –„Z. �T
xpuce �7 b
--- accepted ea complete. TOTAL.......................• S
S _
—� Car ider signature ^' Amount 440-4616(6MCOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES individual QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwe,anp?rd the flinii ft. QTY (ea) AMOUNT
16.60 for each ,tlllt connection
Lavatory _ One 1 bath _ $249.20
Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00
Shower Only 16.60 Three 3 bath $399.00
Water Closet 1 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" 16.60
- - PLEASE COMPLETE:
3„ 1660
4" 16.60
Water Healer O conversion O like kind 16.60 Quantit b Work Performed
Gas piping requires a separate mechanical Fixture Typo: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
Tub or Tub/Shower
Hose Bibs 16,60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Other Flxturo,3(Specify) 16,60 Urinal
Dishwasher
Garbage Disposal
'-�
Laundry Room Tray
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 st 100' 55.00 3"
Sewer-each additional 100' 46.40 4"
Water Snrvice-1st 100' 55.00 Water Heater _
Water Service-each additional 200' 46.40 Other Fixtures
S eGf
Storm B Rain Drain-1st 100' 55.00
Storm 6 Rain Drain-each additional 100' 46.40
commercial Back Flow Prevention Device 46.40
Residential Jackflow Prevention Device' 27.55 --
Catch Basin 16.60 _
Inspection of Existing Plumbing or Specially 62.50
Requested Ins ectioas perrhr COMMENTS REGARDING ABOVE:
Rein Drain,single family dwelling 6525
Grease Traps 16.60 - - -
QUANTITY TOTAL - - -
Isometric or ilser diagram Is required It _
Quantity Total is �-9 ---- -
'SUBTOTAL - - -
8%STATE SURCHARGE -
"PLAN REVIEW 25%OF SUBTOTAL
Required only If fixture qty total Is>9 1
TOTAL I F $
"Minimum permit fee Is$72 50 4 6%state sui^.harge,except Residential eackllow
Prevention Device,which is$36 25•6"/stele surcharge
"All New Commercial Buildings require 2 sets of plans with Isometri,or riser
diagram for plan review.
0,1sts\forms\plm-fees.doc 12/26/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 NIST --- -
INSPECTION DIVISION Business Line: (503) 639-4171 BLIP
Date Requested�o` =- ---AM PM BUP
Received __ . q
— —�_._— _._� L�-- ---Suite--.----
fv1 E G
Location __ _ Q _
Contact Person - —_-- Ph(-- ) l- PLM
ContractorPh SWR
- -. - -
81 u1.JING
-- —� TenanJOwmr ELC
Fooxing ! ELG - -
Fouriation I Access: ELR
Ftg Drain
Crawl Drain ---- -- SIT
Slab Inspection Notes:
Post&Beam -
Shear Anchors -
Ext Sheath/Shear --
Int Sheath/Shear
Framing r
Insulation -
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof -
Other:_-�-_-- --
Fine
PASS PART FAIL
PLUMBING -
Post&Beam
Under Slab -
Rough-In -
Water Service -- ------ - -- --
a ----
Rain Drains ------ _------------------- - --
Catch Basin/Manhole
Storm "rain
Shower Pan - - _ ----------- --
Other:
Fi -
ASS PART FAIL -
NICAL -
Post& Beam ----�- ----_ -. _-- -
Rough-In ---- ------ -Gas Line
Line - --- ----- - -----
Smoke Dampers -- ----- — ------T
Final ---------- --- -_
PASS PART FAIL
_ -- -
LECTRICAL - ---_ - — --------- ----- —
Service
Rough-In ---
UG/Slab
Low Voltage --- - -----
Fire Alarm
Final E] Reinspection fee of$ required before next Inspection. Pay at Ci
ry Hell, 13125 SW Hell Blvd.
PASS PART FALL_
SITE [� Please call for reinspection RE: --- --- - ❑ Unabl inspect-no access
Fire Supply Line 1
----
ADA Gatit1 Inspector AA_L� Ixt
IApproach/Sidewalk
Other:_
Final ITO NOT REMOVE this Inspection record from the job 9te.
PASS PAR f FAIL