Permit ti
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00095
' �J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/15/2006
PARCEL: 2S 101 AA - 09700
SITE ADDRESS: 12585 SW 68TH AVE ZONING: MUE
SUBDIVISION: PP1996 -024 LOT: 001 JURISDICTION: TIG
Project Description: Replace (1) commercial sink. Capped: (1) commercial sink, (1) water line & (1) RP device.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DANA, MARK R
12585 SW 68TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 2/15/2006 $72.50
[TAX] 8% State Surcha 2/15/2006 $5.80
Phone : Total $78.30
Contractor:
NORTHWEST CENTRAL PLUMBING
2870 SE 75TH AVE #206
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 642 -2067
FAX 503- 624 -5954
Reg #: LIC 72253
PLM 34 -197PB
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 By: -- 2 - Arl,. / 7 4- 1,t , Permittee Signature: _f_Q A 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.
02/14/2006 12:27 FAX IJ 002/003
Plumbing Permit Apnlica i CEIV Fon Ole ricl•: i' r ONLY
Cit y g of Tigard Received
J � a 1- Permit N• :' , •
13125 SW Hail Blvd„ Tigard, OR 97223 FEB 14 106 Des : - a/ 95
Plan Rev ew
Phone: 503.639.4171 Fax: 503.598.1960 ti •%-t!: -; Date/By: Other Permit No :
24- Hour Inspection Line: 503.639,4175 _.-.4. Dore Ready/33y: /B rur.
Internet, www.ci.tigard.or.us CITY OF r Fa Su Page 2 for ,
Notified/Method: d: Ai Supplemental Information
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❑ New construction 0 Demolition For special fr}formedon use checklist,
Description 1 O _ Ea. 7 Total
rldiuon/alteration/replacement ❑ Other: New 1.2- family dwellings (includes 100 ft. for each utility connection)
rl!W? ; !lult tnxpM
., •,:, •, ' a :,, . u ISn :,ct` I SFR (1) bath 249.20
❑ 1- and 2- family dwelling gCommercial/lndustrial SFR (2) bath 350.00
ID Accessory building ❑ Multi- family
SFR (3) bath 399.00
❑ Master builder I:] Other: Each additional bath/kitchen 45.00
n1 a mt!atru r.;�r cn l; , n,::r r r ,rc:, a :;. • ;v1 n Fi re s prinkl er (�_, s q. ft.) 2
:'�'I,;I ; 1 4 rr,t I 1 I ° , t ,M 1p ti r:•• Page •
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•r ' 'y .:• U' 'I' t j a g 7,11 1 t,, r y I TI'SP t ri I, t 7 A 1,1 i 1 , i Site utilities
Job site address; � '2.5 g S S W ('tb a • Catch basin or area drain 16.60
City /State/ZIP: T9 / co_ / �"j.Z 3 Dtywell, leach line, or trench drain 16.60 e
Suite/bldg. /apt, no,: J Project name: } 1 Footing drain (no, linear ft.: ) Page 2
Cross street/directions to job site:
Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: �) Page 2
Storm sewer (no. linear ft: Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: Lot no.: -
Tax map /parcel no.: ^ Fixture or item
Absorption valve 16.60
-
Ifg e .. , . I ; Backflow prev
s> 6trt `i..i ' . , .;l:;ti;i!d�„ `t �.L;ri' , , ., • tih:,,'1 n i, enter Page 2
Backwater valve 16 60
Clothes washer 16.60
Dishwasher 16.60
:,'I' ",'a th°Yr 'r� gtllr.- lieu "- p °,�ccii`i '' iri`LU al pl;','� {7;il;l "' iiiIj'liai'ii�` ''"t ,- , , : , � , :i a•; Drinking fountain 16.60
r, ',,. _ ,/ x,t Ir'rr li}Ilm',I;1snwnivaiii Ee ' xl�!',)1 ∎1 `1 ,t? 1J 4 ;1! ;111 Ili k aul 1, iE t
/� /� � &jcctors/sump 16.60
Name: l � 1 �T1QX • ... n rank 16.60
Address: St.+J D ~ v f Ftxtur ower cap 7 16.60 L{.01.
City / State/ZIP: 71 1 64, Ct7,-*?-3 r drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
((�1� t ••• t nee bl P !t rm' u r Hose bib ,
4.� lsc � =io ilc {fI 1 t ...iv' r i ItL'i:, t :.f h ii'L,a • t r f: i ,., i' pr 16.60
1 ,. i , •..I . �,sit� Itii,i,fmiuLi i�,iiisra Y u'
Ice maker 16.60
Business name: i Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City / State/ZIP: Roof drain (commercial) 16.60
Si asin/lavatory 1 16.60 (e. VO
Phone: ( ) Fax:: ( )
ub/ahowcr /shower pan 16.60
E - mail' -
} HI' n , tt,t,, .. Urllrat 16.60
� \G•C :t it x el t4. " 141 "i i '' 4
): ..%: .•� , } • T
' � , a i ,i, H, Water cl se
,. „ �� � i �i di.. �r, �y fr: .� _ r :: ti , '��; I .. • �• � iC; .t 1;c.u•�n• nv,, •'�•� � .,, .,t:,,ad closet 16.60
Business name: Northwest Central Plumbing Co., Inc. Water heater 16,60
Address: 2870 SE 75 Avenue, Unit #206 Other:
City / State/ZIP: Hillsboro/ OR/ 97123 . Subtotnl 1
- -.,..
Minimum permit fee: 172.50
Phone: (503) 642 -2067 Fax: (503) 642 -5954 um Residential backflow minim permit fee: 136.25 in 50 ,
CCB Lic,: 72253 Plumbing Lie. no.: 34-197 Pit Plan review (25% of permit fix)
State surcharge (8% of permit fee) 5 .so
Authorized signature:
TOTAL PERMIT PEE _7 $ S. 30
Print name: John Co n 1 Dater,.14.10UP This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
•Fee methodology set by Tri County Butlding Industry Service Board
r\auddin\PermnsiPLM- PumnApp,dnc (INDS 4Q-461atono2rCOM/wEb)
F CITY OF TIGARD
BUILDING DIVISION ' PERMIT #: PLM's( %(i`cf00i},35
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/21006
Phone: (503) 639 -4171 47,70M11\ I
Inspection Requests (24 Hrs.): (503) 639 -4175 . �!�+ - '`:_..
INSPECTION WORKSHEET FOR DATE: 2/16/2006 TIME: 7:O7AM PAGE: 44
SITE ADDRESS: . 126136 sw 611TH AVE CLASS OF WORK:
SUBDIVISION: PP1995 -024 LOT #: 001 TYPE OF USE:
PROJECT NAME: ACCURATE PAYROLL
DESCRIPTION: Replace (1) commercial sink. Capped: (1) commercial :ink, (1) water lino & (1) RP device.
OWNER: DANA, MARK R, PHONE #:
CONTRACTOR: NORTHWEST CENTRAL PLUMBING . PHONE #: 5'03-642.2067
1
Inspection Request Scheduled For: Date: Pour Time:
A
2/16/2006
Code # Inspection Description Confirm # Contact # M- s. se
320 Plu rough - in 0270013 - 01 503 - 642 - 2067 Y
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k 1 k! h^-`_ Date: 7l) ( D 6 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00095
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/15/2006
Phone: (503) 639 -4171 r
Inspection Requests (24 Hrs.): (503) 639 -4175 1L.
INSPECTION WORKSHEET FOR DATE: 12/14/200 TIME: 7 :02AM PAGE: 40
SITE ADDRESS: 125t36 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP1996.024 LOT #: 001 TYPE OF USE:
PROJECT NAME: ACCURATE PAYROLL.
DESCRIPTION: Replace (1) commercial sink. Capped: (1) commercial sink, (1) water line & (1) RP device.
OWNER: DANA, MARK R, PHONE #:
CONTRACTOR: NORTHWEST CENTRAL PLUMBING PHONE #: 503- 642 -2067
Inspection Request Scheduled For: Date: 12/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 041088.01 503- 642 -2067 N
Corrections /Comments /Instructions:
, l
P
i /
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
B 1/
Inspector: 111? 1 v Date: la' ' 1 Phone #: (503) 718-