Permit CITY TIGARD PLUMBING PERMIT
1 ,, ; DEVELOPMENT SERVICES DATE P #: PL 200500208
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S136DA -02600
SITE ADDRESS: 11140 SW 68TH PKWY ZONING: C -G
SUBDIVISION: MLP1999 -00011 LOT: 002 JURISDICTION: TIG
Project Description: Plumbing for new veterinary clinic. Other fixtures: (1) expansion tank, (7) hose bibs, (5) primer, (1)
roof drain, (1) trench drain.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 2 BACKFLOW PREVNTRS: 2
OCCUPANCY GRP: B FLOOR DRAINS: 7 TRAPS:
STORIES: WATER HEATERS: 3 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 19 URINALS: GREASE TRAPS:
LAVATORIES: 5 OTHER FIXTURES: 15
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 5 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WEBSTAR VI, LLC Description Date Amount
610 GLATT CIR.
WOODBURN, OR 97071 [PLUMB] Permit Fee 7/29/2005 $992.60
[PLMPLN] Plan Review 7/29/2005 $248.15
Phone : 503 - 981 - 0155
[TAX] 8% State Surchari 7/29/2005 $79.41
Total $1,320.16
Contractor:
WOODBURN PLUMBING
LELAND FOSTER REQUIRED ITEMS AND REPORTS
PO BOX 252
WOODBURN, OR 97071
Phone : 503- 981 -4053
Reg #: LTC 51140
PLM 24 -156PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: _��,7 ,7 Permittee Signat rt e
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
11 l9 O sw bi Pa wa.
' Builaing Fixtures , 2: ; , v' - p e r ; y
Plumbing Permit Application � FOR OFFICE USE ONLY •
City of Tigard Received S I/ -0S - e- g . , Pernut No !� 7// _04
D Plan Re
13125 SW Hall Blvd., Tigard, OR 97223 e w , a `�
Plan Revle
Phone: 503.639.4171 Fax: 503.598.1 ?$q /�a, + � ! Other Permit N
er ermo.
i °IN � DateBy: $7'2$ 0 R... S' -6 n 1v�
24 Hour Inspection Line: 503.639.417 1 1 2005 or � Jur;S 'J
�. Date Ready/By: See Page 2 for
Internet: www.ci.tigard.or.us Notified/Meth / Supplementallnformation
yCII�T,Yp�O�yF TIGARD �� ��
gritl21td4� IMON. Akiilgt_ � K0 40 i r' ® � FEE'' "SCH • • .
EDULE ' New construction ❑ Demolition ., / ' /L, . �o r special information use checklist
Description 1 Qty. I Ea. 1 Total 1 !`
El Addition/alteration/replacement ❑ Other: UUU New 1- 2- family dwellings (includes 100 ft. for each utility connection) ��►
- .CATEGORY OF CONSTRUCTION " • . SFR (1) bath 249.20 l
❑ 1- and 2- family dwelling 4Commercial/industrial SFR (2) bath 350.00 T
❑Accessory building ❑ Multi - family SFR (3) bath 399.00 J
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
_ JOB 'SITE INFORMATION AND LOCATION , - , Site utilities
Job site address: //// D � , l/*-/ • o g p Catch basin or area drain 16.60
City/State/ZIP: '72-7c1,47 d Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: / P roject name: a /rad, ., �r� Footing drain (no. linear ft.: ) Page 2
Cam" C ��� Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: I 51 (ID Pi - 0 94 0p Fixture or item
Absorption valve 16.60 .. //
DESCRIPTION OF WORK Backflow preventer / Page 2 46 .`(O
Backwater valve 16.60
Clothes washer Z 16.60 33 . A-v
' Dishwasher 16.60
Drinking fountain 16.60
CI PROPERTY OWNER _ ❑ TE "
Ejectors /sump 16.60
Name:
Expansion tank jfa 16.60 I It .1-P
Address: Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub / 4 16.60 1 ! to ,
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APP LICANT klose bib 16.60 . /14 2. 90
• 0 PERSON
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
5
Address: ,timer 16.60 S1 .00
City/ State/ZIP: oof drain (commercial) / 16.60 1 i .66
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 5.1 L 5 Z'y 16.60 39S• 40
Tub /shower /shower pan / 16.60 16 .40
E -mail:
Urinal 16.60
C , CONTRACTOR ' • ' �
• Water closet J C'• 16 g 3• O
( Business name: . 1 ryj/ // - Water heate 3 16.6 /� 530 ./...._...e..:4?/- ■ Z /_�
Address: �, O• Z5? 7/ � �
her:�Vcl.�a ✓�, 4✓ +t IG.(� c�
City/ State/ZIP: "�,,,, aJAv� ole 9 7. 7 / ( ) Subtotal
Minimum permit fee: $72.50 Q (op
Q ,Phone: ( j 9a /. L/ 5 ? Fax: ( ) Residential backflow minimum permit fee: $36.25 /
CCB Lic.: ! Plumbing Lic. no.: 24 - /54, Plan review (25% of permit fee) Ay • /5
/ State surcharge (8% of permit fee) 79. Authorized signa ill � 40, � TOTAL PERMIT FEE /35,0, /4,
Print name: Ze 4 ova/ F -s e le Date: 5 / g e5.5 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
�- c3 8lt 9 , 3' 4 C 6 ' // *Fee methodology set by Tri- County Building Industry Service Board.
i:\ Building \Permits\PLMF- PcrmitApp.doc 12/03 440.4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard - 1► •
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities. ---.Qty: • ; Fee (ea) • Total • S quare Footage: Permit Fee:-
Footing drain - 1'` 100' 5,55.90 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Storm &Rain Drain - 1st 100' 55.00 Valuation: Permit Fee:
$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 first $5,000.00 and $1.52 for each • Fixture or Item • Qty Fee (ea)'' To t a l additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow 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 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
•
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"yes ", please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
. Quanti - by (Fixture) Work Performed
Fixture Type: Replace
New Moved Existing Capped Comments regarding fixture work:
Baptistry/Font
Bath - Tub /Shower
- Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher - Commercial
- Domestic
Drinking Fountain
Eye Wash
Floor Drain/sink - 2"
- 3"
-4"
Car Wash Drain
Garbage - Dom6Eic
Disposal - Commercial *Note: If the fixture work under this permit results in an
•
Industrial increase of sewer EDUs, a sewer permit will be issued and
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall
•
Sink - Bar/Lavatory
Quantity Total
- Bradley
Commercial Isometric or riser diagram is required if fixture quantity
- Service total is >9.
Swimming Pool Filter
• Washer - Clothes
Water Extractor Plan Review
Water Closet - Toilet Plan review is required if fixture quantity total is >9.
• Urinal
Other Fixtures:
is\ Building \Pemuts\PLM- PermitApp.doc 3/03
CITY OF TIGARD
BUILDING DIVISION _ PERMIT #: PLM200b -00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
7/29/2006 Phone: (503) 639 -4171 / u�e�j� IIII1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/7/2006 TIME: 7:06 }` 'A PAGE: 8
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999 -00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Plumbing for new veterinary clinic. Other fixtures: (1) expansion tank, (7) hose bibs, (5) primer, (1)
roof drain, (1) trench drain.
OWNER: WEBSTAR VI, LLC, PHONE #: 503-991- 0155
CONTRACTOR: WOODBURN PLUMBING PHONE #: 503-991-4053
Inspection Request Scheduled For: Date: 6/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 031283 -01 971-235-1353 N
Corrections /Comments /Instructions:
V f '
/
kifi F I j / Ir . a r L . - .R.. 1 _. i, ..... . ____4 /...t. "4 04„ ..1 I F i r I fr IA%ff
'' '
, /
1
LI _ iim p r " FAII .I.-- ---
/
*Ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
n y,
Inspector: � � ' Date: / . Q Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION , .. PERMIT #: PLM2O05-00208
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/200 ;
Phone: (503) 639 -4171 ivv�dio.dmi I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/26/2006 TIME: 7:OOAM PAGE: 63
SITE ADDRESS: • 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999 000'11 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL. CE
DESCRIPTION: Plumbing for new veterinary clinic. Other fixtures: (1) expvnt:ion tank, (7) hose bibs, (5) primer, (1)
roof drain, (1) trench drain.
OWNER: WEI3STAR VI, LLC, PHONE #: S03981 -0155
CONTRACTOR: WOODBURN PLUMBING PHONE #: 503 - 4053
Inspection Request Scheduled For: Date: 5/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # . Message
399 Plumbing final 030649 -01 971 - 235.1353 N
Corrections /Comments /Instructions:
2 II
_../*. _A
e=,,1"2/,77 , ,//Y
1
r-
(1..PASS s? APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 11/1,' ) � Date:,' 4 . Phone #: (503) 718 -)
1
CITY OF TIGARD i
BUILDING DIVISION - PERMIT #: PI.M2005 -00208
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/21)0' ,
Phone: (503) 639 -4171 400
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 1/9/2006 TIME: 7:01AN1 PAGE: 60
SITE ADDRESS: 11140 SW GOTH PKWY CLASS OF WORK:
SUBDIVISION: IMILP1999-00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Plumbing for new veterinary clinic. Other fixtures: (1) expansion tank, (7) hose bibs, (5) primer, (1)
roof drain, (1) trench drain.
OWNER: WEt3STAR VI, LLC, PHONE #: 503- 981 -0155
CONTRACTOR: WOODBURN PLUMBING PHONE #: 503 -981 -40 3
Inspection Request Scheduled For: Date: 1/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 02452301 503 - 981.4053 N
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
► /-�
/
CITY OF TIGARD ;
BUILDING DIVISION PERMIT #: PLM2%000208 5
13125 SW Hall Blvd., Tigard, OR 97223 AIL DATE ISSUED: 05
Phone: (503) 639 -4171v
Inspection Requests (24 Hrs.): (503) 639 - 4175!:::'
INSPECTION WORKSHEET FOR DATE: 9/8x2005 ry TIME: 7:05AIVI PAGE: 13
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999 00011 LOT # 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Plumbing for new veterinary clinic. Other fixtures: (1) expansion tank, (7) hose bibs, (5) primer, (1)
roof drain, (1) trench drain.
OWNER: VVEBSTAR VI, LLC, PHONE #: 503 - 981 -0155
CONTRACTOR: WOODBURN PLUMBING PHONE #: 503-981-4053
Inspection Request Scheduled For: Date: 9/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 017131 -01 503.849 -3466 N
Corrections /Comments /Instructions: _ .
•
li 0 c/l -
. ilY r___
,,, ,..
_, , ____ , .,,, 4-7 ,t,,„,,,,,,:,...,....„:„__
T ) ,i , 4 , 4 . & , K
jj r _
•
❑ PASS i`V PARTIAL APPROVAL El CANCEL [11 NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: j "-Ni Date: 1 ., . . Phone #: (503) 718-
CITY OFTIGARD
BUILDING DIVISION
PERMIT #: PLM2005-00208
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 7/29/2005
Phone: (503) 639-4171 7 'I'I'
Inspection Requests (24 Hrs.): (503) 639 -4175 . _ ' 9
INSPECTION WORKSHEET FOR DATE: 8/25/2005 TIME: 7:12AM PAGE: 8
1
SITE ADDRESS: 11140 SW 68TH PKWY CLASS OF WORK:
SUBDIVISION: MLP1999-00011 LOT #: 002 TYPE OF USE:
PROJECT NAME: CASCADE VETERINARY REFERRAL CE
DESCRIPTION: Plumbing for new veterinary clinic. Other fixtures: (1) expansion tank, (7) hose bibs, (5) primer, (1) i
roof drain, (1) trench drain.
OWNER: WEBSTAR VI, LLC, PHONE #: 503.981 -0155
CONTRACTOR: WOODBURN PLUMBING PHONE #: 503 - 981 -4053
Inspection Request Scheduled For: Date: W25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 014297 -01 503. 849.3466 Y
Corrections /Comments / Instructions:
2 " (o e st, C ' S4 .11.4...A T,., - to sfi P e►vt.--t t a v-
1' G,/1 , 1 u .1? c,. ∎ J '�.e�1 v .. ga/T - b ✓a—.A. , LIL_C. a vz+1 Ca 1-0k 'C,
c7 Y o , e , L4 , --.AA- 1./t7 p 1 I. ‘. G ./171 c\
❑ PASS (A PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 Iry 4 l i b 5 i Date: $") 21" Phone #: (503) 718-