Permit . :.;. ^: `
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PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2001 -00465
4 f I ' k 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/11/01
SITE ADDRESS: 11560 SW 67TH AVE PARCEL: 1S136DD-00200
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 2 TRAPS:
STORIES: 3 WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 0 URINALS: GREASE TRAPS:
LAVATORIES: 6 OTHER FIXTURES: 3
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 6 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing fixtures for new office building. "Other fixtures" include 2 hose bibs and 1 elevator sump pump.
FEES
Owner:
Type By Date Amount Receipt
GREEN, JOSEPH W PRMT CTR 10/11/01 $315.40 27200100000
PO BOX 759 5PCT CTR 10/11/01 $25.23 27200100000
PORTLAND, OR 97207 PLCK CTR 10/11/01 $78.85 27200100000
PRMT CTR 10/11/01 $315.40 27200100000
Phone 1: Total $734.88
Contractor:
TROUT PLUMBING
2095 NW 160TH
BEAVERTON, OR 97006 REQUIRED INSPECTIONS
Phone 1: 503 - 645 -4993 Rough -in Insp
Rough -in Insp
Reg #: LIC 101758
P Rough -in Insp
LM 34 -291 PB
Final Inspection
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
/
Issued By: / Permittee Signature: QA/ 6 1- 1 4 /°1-/ GO-77e A/
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
PO
Plumbing Permit Application
X Datereceive& / Permit no.•' / -- ,.I
v,.rd,., .. , City of Tigard c .1 44. I `J g Sewer permit no.: Building permit no.:
y - ` - ' ' Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 -4171 • Project/appl. no.: Expire date:
k Fax: (503) 598 -1960 Date issued: By: r e Receiptno.:
( Land use approval:
Case file no.: Payment type:
• .
TYPE Q1 PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other:
` .1011 SI'11. INMORMATION :;; FEE ;`.S( IIEDULE (for special information use checklist) l
Job address: l 5do S 6.'7 f Descri ition Qty. Fee(ea.) Total
Bldg. no.: Suite no.: New 1- and 2- family dwellings only:
Tax map /tax lot/account no.: (includes 100 ft. for each utility connection)
SFR (1) bath
- Lot: ' B • k: Subdi ision: SFR (2) bath =
Project name:. r - ,,/ 4100! SFR (3) bath = _ .
City /county: 2 BIM ZIP: Each additional bath/kitchen -�
Description and loca ion o' work on premises: Site utilities:
Catch basin/area drain II
Est. date of completion/inspection: Drywells/leach line /trench drain _ .
Footing drain (no. lin. ft.) -
• name: 1 LUMil11 . CO NT RA OR , -' Manufactured home utilities ME
Business i ., _ Gt 6 Ali''' •" Manholes S
.' ( Address: ._ Q - 5 A/ trel /64 a Rain drain connector 11.111
1 : \ State: Q rt ZIP: 7d 0 - Sanitary sewer (no. lin. ft.) 1111
Phone: 96q• : / f / Fax: E -mail: Storm sewer (no. lin. ft.) MI
/ CCB no.: / 0 / 7 re Plumb. bus. reg. no: 34/ -- q/ Water service (no. lin. ft.)
City/metro lic. no.: 0 0 O . q
Fixix tore or item: ill
Absorption valve
Contractor's representative signature: 4P11111 Back flow preventer ME
IMEEMIMEGIUM Date: - 02 8 Backwater valve I= -
? . _CONTACT PERSON -`' ` . •, . Basins/lavatory _
In __
") Name Gne Y ,w „`i S Clothes washer
\\ \ Address: _ p' S w 6 O Dishwasher
!' Drinking fountain(s) _
City: r ,g „`+ ' ZIP: e a '� Ejectors/sump IIIII
Phone: 6 9 `3/ 9'7 Fax: E -mail: Expansion tank -
(MINIM Fixture/sewer cap _
e N ame (print): Floor drains/floor sinks/hub MI
Mailing address: Garbage disposal 1 --
Hose bibb _
Z City: State: ZIP: _
Phone: Fax: -mat : Interceptor /grease trap =
Owner installation/residential maintenance only: The actual installation Primer(s) M -_
T will be made by me or the maintenance and repair made by my regular r Roof drain (commercial) _
A employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) _
- Owner's si :nature: Date: Sump- -
ENGINEER Tubs/shower /shower pan _
Urinal . MI
q Name: Water closet
O Address. Water heater NM
1 0 City: State: ZIP: Other: ME
-�
- Phone: Fax: E -mail: Total _
o%
C Q--..... Not all jurisdictions accept credit cards, please call jurisdiction for more information. f ee $
J c C3 Notice: This permit application \ Plan review (at %) $
Visa CI MasterCard expires if a permit is not obtained
Cre dit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires TOTAL $ ”
Name of cardholder as shown on credit card accepted as complete.
$
Cardholder signature Amount 440 -4616 (6/00/COM)
<A
�. ter• .
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 dwelling and the first100 ft. QTY (ea) AMOUNT
d,O for each utility connection)
Lavato ry 16.60 �� 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 & 16.60 9y' O
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 3
3" 16.60 Z _ ° PLEASE COMPLETE:
4.0 4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical -L 1° Fixture Type: New Moved Replaced Removed/
permit. 3 3 Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
16.60 Tub or Tub /Shower
Hose Bibs
3) Lv Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
16.60 / Urinal
Other Fixtures (Specify) / 6 Dishwasher
eief/ rt tC4- 4
.4 „4 R .. Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Sink: 2"
Sewer- 1st 100' 55.00 3 ..
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater
Water Service - each additional 200' 46.40 Other Fixtures
(Specify)
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device* 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
Isometric or riser diagram is required if l 7
�±
Quantity Total is > 9
*SUBTOTAL VC i
8% STATE SURCHARGE �3 .
Z
s." -
**PLAN REVIEW 25% OF SUBTOTAL 7
Required only if fixture qty. total is > 9 / � ° � /6-"(-°1
TOTAL $ y /9 ()ott St 4v / 1
Pci W tr11" N °
* Minimum p permit fee is $72.50 + 8% surcharge, except Residential Backflow p 0.. 1l a`
Prevention Device, which is $36.25 + 8% state surcharge.
7- IA r r ✓ � / N
** All New Commercial Buildings require 2 sets of plans with isometric or r' : a - w
diagram for plan review. f " q _ -2 7 - u
is \dsts \forms\pim- fees.doc 08/29/0 � _... �-
\ t' 7-1., er
f „
CITY OF TIGARD
v
BUILDING DIVISION PERMIT #: PLM2001- 00465
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2001
Phone: (503) 639 -4171 / pa ve
Inspection Requests (24 Hrs.): (503) 639 -4175 i
INSPECTION WORKSHEET FOR DATE: 7/312006 TIME: 7:03AM PAGE:
SITE ADDRESS: 11660 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: ZEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: GREEN OFFICE COMPLEX
DESCRIPTION: Plumbing fixtures for new office building. "Other fixtures” include 2 hose bibs and 1 elevator sump
pump.
OWNER: PHONE #:
CONTRACTOR: TROUT PLUMBING PHONE #: 503- E��i5r4993
Inspection Request Scheduled For: Date: 7/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 032625 -02 503 - 806 -3004 Y
Corrections /Comments /Instructions:
R A-k -- e.... - ok V- iA.fr.. (Ci- el" Pz i--A a-v-A- 4-o. ee b _ :I._ 10
R t../ Co vvY--z...4e o /1.Ja +(c c. 0 a 4-C41 C / 2.-7 / O G :Su o ,, V --- 0 1 r-,
∎2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS .
_ FAIL 1 1 CALL FOR INSPECTION . 111 ADDITIONAL FEES ASSESSED
Inspector: 1 -41. -At ti i%,w.1 --- Date: `7,3/0G Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ex , � _ �q,�
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED:
Phone: (503) 639 -4171 lomni i i i k
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: f TIME: PAGE:
SITE ADDRESS: ( SC 67 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: ' 9'_
�. ] 1 --
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # ' Message
M f Cj F C— i VX (VlY -
•
Corrections /Comments / Instructions:
l '
. / L/ Al � A1 A /i / _' _ ' _ ./. 7� /_ /
// /LL /Ar - - /O / " � ._/ i • �/ 4/s -��
- -, ` - - �
j ,/ ✓ ...0 Vii
❑ PASS )4EARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector. 1 1 Date. Phone #: (503) 718 /
•
CITY OF TIGARD 24 -Hour
BUILDING InspectiorfLine: (503).639 -4175
INSPECTION DIVISION Business Link:. ''(563) 639 -4171 MST
BUP
Received Date Requested " L i'.2% s AM PM BUP
Location l 152 7 $ • Suite MEC
Contact Person 9/ - Ph ( ) 4 b 3 0 ¥ PLM ,�0 O[ --4000 ��$
Contractor
v SWR
Ph ( )
BUILDING Tenant/Owner - ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling I —
Roof
Other: -
Final '° /
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole /F�«
Storm Drain ,
Shower • - n i
Other: ' u•i s
Final \
PASS PART. / FAIL
MECHANICAL
Post & Beam -
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service 0
Rough -In -
UG /Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Q Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA •
Ext
Date ! Inspector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BLULDING Inspection Lirle: (503) 639 -4175
INSPECTIONDIVISION Business Line: 4503) 639 -4171 MST
BUP
Received Date Requested ` ( AM PM BUP
Location [ I S 6 A-0—e-- Suite MEC
Contact Person Ph ( ) 9 7 0 PLM a d °/ —46
Contractor Ph ( ) SWR d WS
BUILDING Tenant/Owner ELC
Footing
o Access: D ELR
` "PP'
Slab - Inspection Notes:. SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final -
PASS PART FAIL
PLUMBING
Post & Beam
Unde b
ug -1
ater Service
Sanitary Sewer
Rain Drains --
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fina
S PART FAIL
ECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
. Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: El Unable to inspect —.no access
Fire Supply Line
ADA 6.10
Approach/Sidewalk Date i/0 Inspector Ezt
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION'DIVISION MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /6 /� -- AM PM BLD
,-�
Location / / d 4: 7 94- Suite MEC
Contact Person 9 ,, Ph 57 PLM
Contractor Ph SWR
BUILDING Tenant/O wner 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 / � h 6 �� _ S J ��`�� � el •
Susp'd Ceiling (f /
Roof
Misc:
Final
PASS PART •• FAIL
PLUMBING
Post &
re Titre" MD
Top Out
Rain urains
Final
—Pi4'W 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 [ ,] Please call for reinspection RE: [ ]Unable to inspect - no access
Fire Supply Line
ADA /
Otheoach /Sidewalk Date / / /( 7 /®/ Ins 2r/ ' // - /G�i'� - Ext
Final
PASS .. PART FAIL DO NOT REMOVE this inspection record from the job site
cITY. TIGARD BUILDINCJNSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 .Business Line: 639 -4171
BUP
Date Requested / �( 2 AM PM
BLD
Location ( S h D ZQ7 )4-e" Suite MEC
Contact Person Ph / a-9 Z 7 PLM 206 / q
Contractor Ph SWRc ?OO J — O ? Pr
BUILDING Tenant/Owner - 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 f -7�
Framing ! / I. /I . l,// �- r ., �.=�,� / 7� S� 0-7-t 72-0/
Insulation
WJ Drywall Nailing 04 t��
- - a c c c : e'. p d hr 6°4 .
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final -
PASS PART FAIL
PLUMBING
Post & Be-_m
To.
O.t -
Rain Drains
Final
PASS 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 Date /0 /� - 2- / / Ins Z , ) 1" Q ✓'�' Ext
Other
Final
_ PASS PART FAIL DO NOT REMOVE this inspection record from the job site.