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11300 SW FONNER STREET STE 100 r t 11300 SW Fonner Street #1100 i CITYOF TIGARD PLUMBING PERMIT -_ DEVELOPMENT SERVICE Q PERMIT#: PLM1999-00195 13125 SW Hall Blvd., Tigard, OR 97223 k Q )1;4- 1 N d r DATE ISSUED: 6/24/99 SITE ADDRESS: 11300 SW FONNER Sl-1W. ,96) �"ll L. PARCEL: 2S103AC-02000 SUBDIVISION: ZONING: P-4 5 BLOCI': LOT: — JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE C'ISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WACHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: VN.'ATER HEATERS: CATCH BASINS: _ FIXTURES �- LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: UP!NIALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: T1JR/cr4nWER5• SEWUR LINE: 100 ft WATER' CLOSETS: WATER LINE. ft DISHWASrii-RS: RAIN DRAIN: ft Remarks: Instal!ation of a sewer Gne. Owner: FEES CAROL "JILLIAMS Type By— Date Amount Receipt 9155 SW RAMBLER LN PRM-I DST 6/24/99 $50.00 99-316394 rORTLAND, OR 97223 MiSC !)ST 6/24/99 $2.50 99-316394 Total $52.50 Phone 1: Contractor: OWNER REQUIRED INSPECTIONS Phone 1: Sewer Inspection Reg#: Final Inspection This permit is issued subject to the regulations containF:i in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work v ill be done in accordance 'Kith approved plans. This permit w 11 expire if work is not started within 180 day„ of issuance, or if work is suspended for more than ig0 days ATTtNTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Iules 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) 246-1987. Issu By: t Pennidee Signature:_ ,>✓ Call (503) 639-4175 by 7:00 P.M for an inspection needed the n xt business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICESa ERMIT#: SWR1999-00139 �� 13125 SW Hall Blvd,,T,gard, OR 972.2.3 (503) 639 44 1N A ISSUED: 6/24/99 PARCEL: 2S103AC-02000 SITE: ADDRESS; 11300 SW FONNER ST 100 SUF3DIVIS!ON: ZONING: R 4.5 BLOCK: LOT: _ JURISGICIION: TIG TENANT NAME: WILLIAMS, CAROL USA NO: FIXTURE UNITS 1 CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remai ks: Sewer connection for an existing dwelling. Septic system must be drained, filled, capped ,)r removed. Owner: ___ — _ FEES CAROL WILLIAMS Typtl By Date Amount Receipt 3155 SW RAMBLER LN -- --- — --- PORTLAND, OR 97223 [IRM r DST 6/24/99 $2,300.00 99-316394 INSP DST 6/24/99 $35.00 99-316394 Phone: Total $2,335.00 Contractor: OWNER Phone: Req #: Required Inspections _ Sewer Inspection Septic Tank Filled This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer shall prospect 3 feet in all directions from the distance giver. If not so located, the installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted by the Offen-Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You ay obtain cdpies of these rules or direct questions to OUNC by calling (503) 246-1987 Issu d by: Permittee Signature: xt business day Call (503) 639-4115 by 7:00 P.M. for an inspection needed the ne CITY OF TIGARD Plumbing Permit Application Plan Check# 13125 SW HALL BLVD. Commercial and Residential Recd By TIGAKD, OR 97223 Date Recd (503) 639-4171 639-4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not b , accepted Permit#� /`�Q -O-SS Related SWR#/�44?' `6/3, Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job Sink 4 1 50 Address Street Address1 Suite Lavatory 11.50 _� : S 6 O YI � Tub or Tub/Shower Comb. 11.50 Bldg# Ity/Stale ZIP Shower Only - 11.50 _ NaMe Water Closet 11.50 nishwasher 11.50 Owner Mailing Address n r Suite Garbage Disposal 11.50 Washing Machine 11.50 City/State Zip Phone Floor Drain/Floor Sink 2" �^ —_ 11.50 Name 3" 11.50 4" 11.50 Occupant Mailing Address Suite Water Heater O conversion O like kind 11.50 Gas piping requires a separate mechanical permit. City/State Zip Phone Laundry Room Tray 11.i0 Urinal 11.50 Name Other Fixtures(Specify) 1500 Contractor Mailing Address Suite Prior to permit City/State Zip Phone Sewer-1 st 100' -,800 - Issuance,a copy Sewer-each additional 100' 3:.00 of all licenses are Oregon Const.Cont.Board Lic.# Exp.Date required if Water Service-1st 100' 38.00 expired In COT Plumbing Llc.# Exp.Date Water Service-each additional 200' 32.00 database Storm&Rain Drain-1st 100' 38.00 Name Storm&Rain Drain-each additional 100' 32.00 Architect Mobile Home Space 32.00 Or Mailing Addl-ess Suite Commercial Back Flow Prevention Device or Anti- 32.00 _ Pollution Device Engineer City/Stale Zip Phone Residential Backflow Prevention Device' 19.00 _ (Inigation timing devices require a separate Describe work to be done: restricted energy perndt.) New O Repair O Replace with like kind: Yes O No O Any Trap m Waste Not Connected to a Fixture 11.50 Residential O Commercial O �— Catch Basin 11.50 Additional description of work: Insp.of Existing Plumbing 50.00 erlhr Are you capping,moving or replacing any fixtures? specially Requested Inspections 5000 _ per/hr _ Yes O No O Rain Drain,single family dwelling 4500 If yes, see back of form to indicate work performed by Grease Traps 11 50 fixture. FAILURE TO /ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWEF FEES, QUANTITY TOTAL I hereby ackn,;wle.dge that I have read this application,that t,le information isometric or rleei dla nm ler ulred N ouenllly tots is >s given Is correct,the'.I am the owner or authorized agent of the owner,and *SUBTOTAL �- that plans submitted are In compliance with Oregon State Laws. 'rJ Signature of wrier/Agent pate 6%SURCHARGE c9ntact Person Name Phone "PLAN REVIEW 25%OF SUBTOTAL C /9/7_1 w 1 L L. / A z�f t�.,1'—�1'/ Required onlyIf fixture qty total is>9 11 BATH HOUSE$178.00 TOTp.L � n'1� i.BATH HOUSE$250.00 ',3.BATH HOUSE$285.00 y 'Minimum permit fee IS'50+ 5%Surcharge,except Residential backflow._ (This too Includes all plumbing fixtures Ire the dwotll Prevenlinn[device,which is$25+ 5%surchalye 100 foot of sanitary newer storm sewer and water service) "Ali New commercial Buildings regwie plan,:with Isometric or riser diagram and plan review I ldeleVorme'plumepp doe 6!11.9 PLEASE COMPLETE: Fixture Type - Quantity by Work Performed _ New Moved TReplaced Removed/Capped Sink - ---- Lavatory Tub or Tub/Shower Combination ^— - --- -- Shower Only Water Closet _—�------_— - --- -- -------- --- ..—____..__ Dishwasher _---_-- - - - — — - Garbage Disposal Washing Machine -- Floor Drain/Floor Sink 2" — - _ - --- --- Water HeaterLaundry Room Tray -----_--- -- -- -T—_ "- Urinal -- Other Fixtures (Specify) ---- -- COMMENTS REGARDING ABOVE: I kd%tgkf,—gkplumapp Anc G!: CITY OF TIGARD BUILDING INSPECTION DIVISION MST _ 24-Hour Inspection Line: 639-4175 Business Line- 639-4171 E3UP _ Date Requested �� C7 AM __—--PM BLD ------ ( ��1�� Suite MEC — -- Location— c� Ph __ PLM Contact Person -"-- Ph - - ---"--- SWR —_ Contractor _ — ELC BUILDING Tenant/Owner --- ---- ELR Retaining Wall Footing Access. FPS FoundationSGN Ftg Drain _-- "---- Crawl Drain Inspection Notes SIT -- Slab - --- - -— - Post&Beam -- --_--..---__-- Ext Sheath/Shear Int Sheath/Shear -- Framing Insulation - - - - Drywall Nailing Firewall — Fire Sprinkler "-" - Fire Alarm 1-7 - -- Susp'd Ceiling - - -'�-----i Roof - ----- ---.—. Misc: Final r - PAST FAIL UUBB II Post&Beam — Under Slab ---- Top Out _-1. - ----- Water S�1yic.�__ t Sew i -- - ---•-• Rain Drains Final PASS PART FAIT_ ---- --- MECHANICAL - Post& Beam - - -- Rough In Gas Line Smoke Dampers -- Final PASS PART FAIL - ELECTRICAL Service Rough In UG/Slab ---"--� Low Voltage Fire Alarm Final PASS PART FAIL ------- SITE --- - - Backfill/Grading Sanitary Sewer [ Reinspection fee of$— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Storm Drain [ ]Unable to inspect-no access Catch Basin [ ]Please call for reinspection RE: -- -- Fire Supply Line ADA Ext L Approach/Sidewalk Date *2-57/— Inspector__ �� —._---— Other Final r DO NOT REMOVE this irnspetction record from the job site. PASS PART FAIL