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Permit (91) CITY OF TIGARD PLUMBING PERMIT y,1 DEVELOPMENT SERVICES PERMIT #: PLM1999 -00372 ! 13125 SW Hall Blvd., Tigard, OR 97223 (5 Q3) 9-4171 DATE ISSUED: 11/10/99 SITE ADDRESS: 16200 SW PACIFIC HY S ( l G / PARCEL: 2S115BA -00101 SUBDIVISION: PP1994 -028 ZONING: C -G BLOCK: LOT: 001 • i, JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS; 1 TRAPS: STORIES: 0 WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: 0 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Commercial TI - Relocate 1 water closet, 1 lavatory and 1 water heater. Install new fixtures, 1 water closet, 1 lavatory and 1 mop sink with 2" drain. FEES Owner: Type By Date Amount Receipt IBJ SCHODER BANK & TRUST PRMT DEB 11/10/99 $69.00 99- 319712 BY ALBERTSONS INC #565 SPOT DEB 11/10/99 $5.52 99- 319712 ATTN: CORP ACCT DEPT BOISE, ID 83726 Total $74.52 Phone 1: Contractor: DEAN WARREN PLUMBING 3111 SE 13TH PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone 1: 236 -4152 Top -out lnsp Reg #: LIC 172 Final Inspection PLM 26 -83PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notific ioxi_ -nter. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. Y may obtain c• +ies of these rules or direct questions to OUNC by calling (5 3) 246 -1987. I sued By: 1 44,E � i t / l Permittee Signature: Call (503) • 9-4175 by 7:00 P.M. for an inspection needed he next business day CITY OF TIGARD Plumbing Permit Application Plan Che • 13125 SW HALL BLVD. Commercial and Residential Rec'd By i . I,1Al /, :_,! TIGARD, OR 97223 Date Rec'd (( - ' '->i (503) 639 -4171 • Date to P.E. Print or Type Date to DST . 9 . Incomplete or illegible applications will not be accepted Permit# Pr ►,1494 - 0037 Related SWR # < we `►g ago • Called //177 B/4 ae. 8a' /F-7(7.-a,--).,;:`.).7 alPiet a,M 0 g 57) Name of Development/Project . (individual) QTY • PRICES AMT Job e�K L3u-S1 E ie id eo Sink go Address Street Address Sui te Lavato Z 9. r : n rY it s J . /62mo SA f' hE S Tub or Tub /Shower Comb. • 00... Bldg # City /State YYV Zip Shower Only 9.00 l 04kt ©* X 1 72 7 -� an Na J Water Closet Z 9.0 - l+f+ A j • t BMA- A/44 T/2u Sr Dishwasher • 10 Owner Wailiv Address - 1/ Suite Garbage Disposal 9 r.70/V /NG.S6S Washing Machine ' 10 . C YO �'tv /St ate Zip Phone (S i6 Floor Drain/Floor Sink 2 "• 9 ' . Nam _ __ 3" .00 x014 10(h$ TEA_ ( V / ae-O 4" 9 :0 - Occupant Mailing Address Suite Water Heater 0 conversion CT. like kind r /'4' r j / -rte as 2. 871 @� Gas piping requires a separate mechanical permit. !•SD City/State Zip Phone Laundry Room Tray 00 Urinal 9 :0 Nam�e L(/Q/1^fl -2111 Other Fixtures (Specify) • 10 Contractor Mailing Address Suite ?'t -eia S /N! , 1/ / • �� // c/// SE /3 9.r Prior to permit Ity/State Zip Phone Sewer - 1st 100' • .0 issuance, a copy 'o JI fk L q v Z 236- _5-c Sewer - each additional 100' 25.00 licenses are Oregon Const. Cont. Board Lic.# Exp. Date . equired if de2/7 1Z -2—"5— if Water Service- 1st 100' 30.00 expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00 (v w f database 25 Pb PB -3 4.0 Storm & Rain Drain - 1st 100' 30.00 Name Storm & Rain Drain - each additional 100' 25.00 Architect Mobile Home Space 25.00 Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 Pollution Device Engineer City/State Zip Phone Residential Backflow Prevention Device' 15.00 (Irrigation timing devices require a separate Describe work.to -be done: restricted energy permit.) New X Repair 0 Replace with like kind: Yes A No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial 14 Catch Basin 9.00 Additional description of work: 1RE-LC +6 (_ we ' V _ ( Le A"g 46 -ie� Insp. of Existing Plumbing 40.00 _ per/hr 14E. fLJ- ( - Lt1C (.• t i/ /- � Imo, .5c. Spedally Requested Inspections 40.00 per/hr Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00 Yes No Grease Traps 9.00 If yes, see back of orm to indicate work performed by QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is > 9 6 WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL #.DV I hereby acknowledge that I have read this application, that the information ,,�� given is correct, that I am the owner or authorized agent of the owner, and 8 /o SURCHAR -0., that plans sub itted are in compliance with Oregon State Laws. u �r `"' Signature of ner /A ent /J Date "PLAN REVIEW 25% OF SUBTOTAL %AS / a-e..a , -- i /! 5 '-- COr / Required only if facture qty. total is > 9 TOTAL c� ,, ntact Person Name Phone • `r G _ 'i /S� ' *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow I t� Prevention Device, which is $15 + 5% surcharge **All New Commercial Buildings require plans with isometric or riser diagram and plan review I:tdststplumapp.doc 7/2/98 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New.:::.::;::: <:::Moved. Replaced : > ::::Removed /.Ca e.d : . Sink Lavatory I • 1 Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: 1:ldsts1plumapp.doc 7!7/98 Tenant Name L ST k. fhJ ED Accumulative Sewer Tally This swR #:o _ /799 -0 `/o Address: 1V0&00 6,...0 H,(- Hwy , 7 - 1.- S This PLM #: L799 - DO 7a Fixture Value • Previous # Previous Credits Capped Fixtures Fixtures New New Value Capped off value added I added total #s total Count off Is count value values Baptistry/Font 4 Bath - Tub /Shower 4 , - Jacuz/Whpl 4 • Car Wash - Each Stall 6 , - Drive Through 16 , - Cuspidor/Water Aspirator 1 . Dishwasher - Commer 4 , - Domest 2 - Drinking Fountain 1 , Eye Wash 1 - Floor Drain /sink - 2 inch 2 / • - 3 inch 5 - 4 inch 6 • - Car Wash Drain 6 . • Garbage Disposal 16 - Dom (to 3/4 HP) - Comm (to 5 HP) 32 . - Ind (over 5 HP)- 48 . Ice Machine /Refrigerator Drains 1 - Oil Sep (Gas Station) 6 Recreational Vehicle Dump Station 16 • I Shower - Gang (Per Head) 1 . . -. ' - Stall 2 Sink - Bar /Lavatory 2 / A - Bradley 5 - Commercial 3 - - Service 3 • Swimming Pool Filter 1 i Washer, Clothes 6 Water Extractor 6 /- Water Closet, Toilet 6 - / 69 Urinal 6 . . TOTALS 1 /59 _ /d Z9 Total fixture values: e/69 9 divided by 16 = A9.51 EDU . -0u 'S /00 mod} Na, E_ • HISTORY / • PLM #1 -o037EDU# AF SWR # /999— oa (lv� PLM #97 `/ EDU# a.2. SWR# %7 — 00090 PLM# Yg-D043 EDU# • SWR# 98-460 PLM# EDU# SWR# PLM# 9 8 Vic/ EDU# 9 ' / SWR# Y'-- PLM# EDU# SWR# • PLM #97 - L 37 ?EDU# cae) SWR# 77- 0'358 PLM# EDU# SWR# 12/17/1999 Activities for Case #: PLM1999-00372 3:05:33 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes PLMC003 Application received 11/08/1999 DEB DONE No Hold DEB 11/08/1999 PLMC005 Permit Created 11/08/1999 DEB DONE No Hold DEB 11/08/1999 • PLMC725 Top -out Imp 11/08/1999 11/08/1999 11/12/1999 MRS PASS No Hold VT 11/15/1999 top out and ground pass. need nail plates for metal studs water & ABS PLMC799 Final Inspection 11/08/1999 11/08/1999 12/03/1999 TLP PASS No Hold TLP 12/06/1999 PLMC040 (F) Ready to issue 11/08/1999 DEB DONE No Hold DEB 11/08/1999 Sewer permit already finaled. PLMCO50 (F) Issue permit 11/10/1999 DEB DONE No Hold DEB 11/10/1999 PLMA800 Case Finaled 12/09/1999 JMT DONE No Hold JMT 12/09/1999 • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST i111 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested /?/ 31 c 15 AM / P grow �� pp ��� BLD Location /400 -0 U P ac e e� 4W L1 Suite S MEC Contact Person Lea./3^— U)G(Ye Pt v Ph ? 3 (P /Sa■ PLM / Q - Ua 3 7 � Contractor Ph SWR ??//II BUILDING Tenant/Owner ►L tC ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS T FAIL Ctire _ mBuig2 earn Under Slab Top Out Water Service Sanitary Sewer Rain Drains 4 01 • 1p, 1. i■ 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 PASS . PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date Inspector E Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site. — �