Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00040
T IGARD DATE ISSUED: 2/1/2008
1 . 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102C6 - 00100
SITE ADDRESS: 12850 SW GRANT AVE ZONING: R -
SUBDIVISION: CF TIGARD ELEMENTARY LOT: 041 JURISDICTION: TIG
PROJECT: CHARLES F TIGARD RUNNING TRACK
Project Description: Installation of trench drain for new running track.
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:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
WACO SCHOOL DISTRICT NO. 23
6960 SW SANDBURG ST Description Date Amount
TIGARD, OR 97223
[PLUMB] Permit Fee 2/1/2008 $72.50
[TAX] 12% State Surcha 2/1/2008 $8.70
Phone : 503 -431 -4017 Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # : PRI
Reg #:
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 Notification Center.
Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC
by calling 503.246.6699 or 1.800.332.2344.
Issued gay \ ( LGr'_ex, i Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1 4 .
Plumbing Permit Application FOR OFFICE USE ONLY
City of Tigard Dare /B c nn 1 d • Permit No.: W
e' r.iaI
IlIl
V 13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review
C . • Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit No.:
Inspection Line: 503.639.4175 Date Read /B Se Pa e 2 for
TIGARD and -or. ov y Notified/Method: www.ti g
www.tigard Notified/Method: f �.- Supplemenlallnformation
TYPE OF WORK FEE* SCHEDULE
-® New construction ❑ Demolition For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ l- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder ® Other: Site
Fire sprinkler ( sq. ft.) Page 2
JOB SI'Z'E INFORMATION AND LOCATION Site utilities
Job site address: 12855 SW Grant St Catch basin or area drain 16.60
City /State/ZIP: Tigard Or, 97224 Drywell, leach line. or trench drain
( 16.60
r- Footing drain (no. linear ft : _ ) Page 2
Suite /bldg. /apt. no.: I Project name: CF Tigard Track
Manufactured home utilities 1 10.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _ ) Page 2
y Storm sewer (no. linear ft.: _ ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: _ ) Page 2
Fixture or item
J Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Build all weather track Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
4. ® PROPERTY OWNER Drinking fountain 16.60
❑ 'TENANT
Ejectors /sump 16.60
Name: Tigard School District Expansion tank 16.60
Address: 6960 Sandburg St Fixture/sewer cap 16.60
City /State/ZIP: Tigard Or, 97223 Floor drain /floor sink/hub 16.60
Phone: (503)431 - 4017 Fax: (503)431 - 4020 Garbage disposal 16.60
❑ APPLICANT ® CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: HBH Engineering 1
.- __ __- -- - _ - Interceptorigrease trap 16.60
Contact name: Dave Boatman Medical gas (value: $ 1 Page 2
Address: 20015 SW Pacific Hwy Suite 101 Primer 16.60
City /State /ZIP: Sherwood Or, 97140 Roof drain (commercial) 16.60
Phone: (503) 625 - 8065 Fax: : (503) 625 - 1531 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E - mail: DBoatman @hbh consulting.com
Urinal 16.60
CONTRACTOR Water closet 16.60
Pusiness name: Owner Water heater 16.60
Address: Other:
Subtotal
City /State /ZIP:
,Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential hacktlnw minimum permit fee: $36.25 7? 50
CCB Lic.: Plumbing Lic. no.: Plan review (ZS to of permit fee) 0,-
State'.urcharge (8% of permit fee) t (0
Authorized signature: �:� /< fOTr \L PERMIT FEE � (�
This permit application expires if a permit is not obtaine within
Print name: E- L - 13u,," Date: -31 -O£' 180 days after it has been accepted as complete.
*Fee methodolow set by 'Fri- ('aunty Building Industry Service Board.
I: \Bmldine \Permits \PLM- PermitApp.Jnc 0626/0 440-46Itir(10102/1.1 "1 /WLB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Pl..M 200& -00(MO
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 211/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 P_
INSPECTION WORKSHEET FOR DATE: 5/13/2008 TIME: 7:02AM PAGE: 17
SITE ADDRESS: 12850 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: CF TIGARD ELEMENTARY LOT #: 041 TYPE OF USE:
PROJECT NAME: CHARLES F TIGARD RUNNING TRACK
DESCRIPTION: Installation of trench drain for new running track.
OWNER: WACO SCHOOL DISTRICT NO. 23, PHONE #: 503 - 431 -4017
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Pl um ping rough - in 069802 -01 503 -793 -6644 N
� - I 1
Corrections /Comments/ Instructions:
r;,..,„LetpL)
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Ch Lvr�.j1 Date: S1I3 ] a Phone #: (503) 718-