Permit 4 -..
C ITY OF TIGARD PLUMBING PERMIT
° • COMMUNITY DEVELOPMENT PERMIT #: PLM2009 -00030
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/18/2009
PARCEL: 2 S 104 BA - 00100
SITE ADDRESS: ‘4208 S1/VT3'5TH_AVE POOL ZONING: R -25
SUBDIVISION: GREENFIELD VILLAGE APARTMENTS LOT: JURISDICTION: TIG
PROJECT: GREENFIELD VILLAGE
Project Description: Replace RP device in pool room.
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
CAMBRIDGE REAL ESTATE MGMT
PO BOX 2968 Description Date Amount
PORTLAND, OR 97208 [PLUMB] Permit Fee 2/18/2009 $72.50
[TAX] 12% State Surcha 2/18/2009 $8.70
Phone : Total $81.20
Contractor:
MRP SERVICES
PO BOX 33585
PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 253 -1393
FAX 503- 241 -6565
Reg #: LIC 106824
PLM 3 -265PB
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 OU NC by c ing 503.246.6699 or 1.800.332.2344.
Issu d By: , /
` ► r Permittee Signatu • : � , ;1 ! "
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.
M 12/15/2015 05:20 FAX 5032413638 HRPSERVICES 0001 /003
RECEIVED
Plumbing Permit Application , 01 t SE ONl. l .
III City of Tigard FEB 18 2009 Received 4
OF TIGARD Datetby, i t o ► L� OJT
n 1 3125 $W Hall Rlvd., Tigard, OR 97223 hate /Fiy; _ _ Permit No : /1 /yt Q�
plan Idevtew
' Other Ponnit No.. OiCs
■ , Phone: 503.639.4171 Fax: 503.598,
inspection Line: 503.639.4175 Drle' ltaad /B M to 0 Sec Page 2 for
TT Internet: www.tigard or,gov BUILDING DIVISION Nolifled /Method: „ad Snr lcmcntal Information
1kt ( i
( �i t 4 r.. M . 4 ,t " 'a 1 415"r'' . `( �� I it ,1 „ + ^, '. y r l ) ? �rt 'r•, r r i r r. 1
i 1 f e t �, � yr p s n� .r ^•(1, I,,
t,,t n 4 y, �j
. ,,,, i : SI i'PYJ∎ I ' +ii" , r. r . (l 1 I xt,K Lt.y . i . , t 9 0 , q o ry Cn71 �' r�l�,r4 • ,,. Zl ..., 4 , . � ... . .
❑ Ncw construction ❑ Demolition For specla! tlj[ormatton use checklist-
..- ,�_.. .,„_.. - - -- Desert non _.__....._ --.._ L Qt I Ea. I Total
II , Addition/alter ationlreplaccmcnt ❑ Other: New 1- 2- faintly dwellings (includes 100 ft. for each utility connection)
�,>r:li'
1 SFR (1) bath T 249.20
`,� J1 , T'i. +gyp v . -t. 8,n i , d t d V ; � r id C t ti , t . ' _ -
,4 it B^ • iu 1 � I . ' �'fi .. , ' Jd . S'ssavn . Y�LS —... , , . ..._ _. -_ ..
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building ►1 Multi- family _ SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other
Fire sprinkler ( sy. fl,) Page 2
,?e , ` •e rr i a • d o a Site utilities
; rr nt c u lariat �tti� t d , r i 1 1 t
Job site address ..1 6 ,v1■ IV -
L%YI Catch basin or area drain _ 16.60 —
City /State/ZIP: frifiirmint /!I /J /� Drywell, leach line, ur trench drain 16.60
5uite/bldg• /apt. no.: P roject name: j�1 r Footing drain (no. linear ft.: _) Page 2
- + ��� " " -' "� , �� Manufactured home utilities 110.00
Cross streeUdirections to job site: -
_ Manholes 16.60
_ Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _,_) Page 2
w_ Storm sewer (no. linear ft.: ) - Page 2
Subdivision: Lot no.: Water service (no, linear ft: ) Page 2
Fixture or item
Tax map /parcel no
• n ]r? : r ? i I M y rw ' 1,',, Np,(widtd 1+' �ptg S R ,,.� Absorption valve - 16,60
:'. 4 , rv + . � � W • r d . ti • � V ! '. a t o B acsuow preventer / Pagc z
� Y r (, swW;
. d) 111 riz mmit 1 I II1 /I1 riprilmi Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
�t , R K r r r mr r rya y 9� t t Drinking fountain 16.60
X11 /� r Ej cetors l sump 1 6.60
Ir.11 i'4l ;,r1F Rif IIIMEI NIl f i Expansion tank 16.6(1
Address: iii iztrig1g j Fixture /sewer cup 16.60
City/State/ZIP: ` •�
/StatelZIP: y , - riT /l r Floor drain /floor sink/hub 16.60 -
Phone: ( ) Garbage disposal - 16.60
„ n v ast Hose bib 16.60
r . • * r r psoaP) ` t+ t'&�/
' " i Ili 4 I � ..
� 0 sr,,'� � n ia It )A;�, our .^�s rfs 16,
3 Iccmt 1,0
I dt nr tiFr� ats� it; r
Business name: r r Interceptor /grease trap 16.60 ....
Contact name: ' Medical gas (value: $ _
i 1 JF l � ) Page 2
Address: I P24 , Primer 16.60
City/State/ZIP: r FT �� ,i` ./ / „IF Roof drain (commercial) - I C.(rO
Sink/basin/lavatory 16.60
Phone: ( Fax:: ( j ) I
Tub /shower /shower pan 1 6.6
E-mail: I N a, , r e 1 r ii Urinal 16.6(1
( �.I i ,, � iiA W closet 16.60
ra f'7��4a�ti • '�`t x r �'' n�� arMi ..a. ' 1 ►1► � � � wt r 1.'.. tr i � ft er -• —
name: /� � . water heater ., 16.6o
Business
Address: O' / 1 �� a / Other: 41 Subtotal 41 4-0
City /State /ZI r ' L ' 110 ' / Minimum Pcrmit fee: $72.50
Phone: ( r i, r /Bp Fax: ( 0 � ' LP ., Residential backflow minimum permit fee: 536.2.5 72 ,
• g �/� Plan review (25% of permit fee)
• Plumbin Lic. no.: . LAS % - *� /
CCR LiC.: I i State surcharge (12% of permit fee)
Authorized signature: TOTAL PERMIT FEE r
I L
Print name: s 1 - Date: 1 •i'his perntit application expires if a permit is not obtained within
�. 180 days after it has been accepted ns complete.
*Fee methodology set by Tri- County Building Industry Service Board.
INiuildittg \Permits\PLM•Penni,App.doc 06126106 440-4616T00r02/COtrowta)
�1 „2/15/2015 05:21 FAX 5032413836 MRPSERVICES 0002 /003
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su+ ' ression S stems:
`A °^4' > V�VP; ^':,�b,� j:�r,(:1S.� .` „(� ('�yr�.:�� 1t •, r. �,��.},�y��,ry�:,• y � ,l ..,,� 1 f,,., .,�j}. .} :. —
1 ! 5 • ? �Ak11,�li iW,l �r�lf„riP, ,r �w�"7 61.M "', ?r. +p'41ini , d n " " ;� 'tl �a` y `�'•�( 1',}!�'1(4f �t a '...
Footing drain - 1' 100' 55.00 0 to 2,000 $1 15,00
Footing drain - each additional 100' 46.40 2 001 to 3,600 $160.00
Sewer - 1st 100' 55 DO 3,601 to 7,200 $220.00
7,201 and greater 5309.00
Sewer - each additional 100' 40.40 Water Servtcc - 1st lOD' 55.00
Medical Gas Systems:
Water Service - each additional 100' 46.40 r dti'5+. ttrrh ,� ,
Storm & Rain Drain - 1st 100' 55.00
$1,00 to $5,000.00 Minimum fee $72.50 _
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the fast $5,000.00 and $1,52 for each
` d ,l(^ • . Lln 1 6 i t
' LlJo� 11s' 1 L' r, 771 n' g, ?� �� ",�j "S" r q � �'""^"
(' $ ;tx " rc,�;`ar� »� a a additional $100.00 or.fraction thereof to and is rt��, including $10 _
Commercial Back Flow Prevention Device I 46.40 , $10,001 -00 to $25,000.00 $145.50 for the first $10,000,00 and $1.54 for
Residential l3ackflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36,25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65,25 525,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1,45 for
each additional 5100.00 or fraction thereof, to
inspection of existing plumhing or and including $50
specially requested inspections -per hour 72,5(1 $50,001.00 and up $742.0(1 for the first $50,000,00 and 51.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture work: o �� itF",'Jdv �� ti � ' 'j "` ll w er �� b r. ' F.711 ., 1 ' " " ,,
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. 0 Any new commercial building with water service 2" and
w +a greater, except systems designed and stamped by licensed
•
ry},gr ¢ur ^ ^tt u of-!in-Fri en -
� y'z 1F 1 1, ❑ Any new exterior plumbing site utilities.
Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities,
Bath - Tub/Shower ❑ Any multipurpose fire sprinkler system.
- Jacumi /Whirlpool ❑ Any complex structure as defined in 0Al2.918 -780 -0040.
Car Wash - Each Stall _
- Drive Thru Submit 2 sets of plans with any of the above.
Cuspidor /Water Aspirator
Dishwasher — Commercial *;" d, ° J ° 1 a ,. , .;, „`• ` •.gy �•.�,�;.,.;,
- Domestic
Drinking Fountain • Isometric or riser diagram is required for new buildings
Eye Wash that meet the qualifications above.
Roar Drain/sink - 2"
-3" Comments regarding fixture work:
g g
Car Wash Drain -
Garbage - Domestic
Disposal - Commercial
- Industrial — -
Ice Mach- /Refrig. Drains
Oil Separator,Gas Station)
kec. Vehicle Dump Station
Shower - Gang *Note: If the fixture work under this permit results in an
- Stall increase of sewer EDUs, a sewer permit will be issued and
Sink - Bar /Lavatory - fees assessed for the sewer increase must he paid before the
- Bradley
Commercial plumbing permit can be issued.
- Service
Swimming Pool Filter _ T
Washer- Clothes
Water Extractor
Water Closet - Toilet
Urinal _ _
Other Fixtures:
\ Bultding \rormllA\PLM- Pcrnd,App,doc OW22!06
CITY OF TIGARD
BUILDING DIVISION A 1 PERMIT #: puvi2t109- oi703f)
13125 SW Hall Blvd., Tigard, OR 97223 DAT ISSUED: 2/ . t..,a
Phone: (503) 639 -4171 771, � r. Inspection Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 7 J 19/2009 TIME: 7:01AM PAGE: 28
SITE ADDRESS: 1 2085 SW 135TH AVE POOL CLASS OF WORK:
SUBDIVISION: GREENFIELD VILLAGE APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENFIELD VILLAGE
DESCRIPTION: Replace RP device in pool room.
OWNER: CAMI:3RIDGE REAL ESTATE MOMT, PHONE #:
CONTRACTOR: MRP SERVICES PHONE #: 503-253-1393
Inspection Request Scheduled For: Date: 2/19/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 080624.01 603-652-2626 N
Corrections /Comments /Instructions:
4 1P
_
v
n PASS ❑ PARTIAL APPROVAL [)t. CANCEL f l NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \� D ate: c \ A /e Phone #: (503) 718- 2Y2
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: ft Aot r x 5n REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description • PASS Date $y
: -Code .� �Inspection Description , -' PASS;Date " gy: :
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing • 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls _ 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
.235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing •
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 _ Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 pr nailing 610 Gas line •
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping .
899 MFG- Structure final 625 Duct work
498 Gradin: Final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 • Water service •
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing y 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
1. \ Building \ Forms \InspCard- AOP- Blank.doc 02/02/07