Permit •
CITY OF TIGARD
PLUMBING PERMIT
,� �;: DEVELOPMENT SERVICES PERMIT #: PLM2001 -00256
'•
--- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/20/2001
SITE ADDRESS: 13221 SW 68TH PKWY 550 PARCEL: 2S101 DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of plumbing fixtures. (1) each: sink, floor hub (drain), water heater and primer. No impact on sewer
EDU's.
FEES
Owner:
Type By Date Amount Receipt
TIGARD TRIANGLE I LLC PRMT CTR 06/20/2001 $72.50 27200100000
4650 SW MACADAM AVE STE 220 5PCT CTR 06/20/2001 $5.80 27200100000
PORTLAND, OR 97201
Total $78.30
Phone 1:
Contractor:
ASSOCIATED PLUMBING CO
P BOX 301362
PORTLAND, OR 97230 REQUIRED INSPECTIONS
Phone 1: 331 -0582 Rough -in Insp
#: L IC 57890 Top -out Insp
Reg Final Inspection
PLM 26 -412PB
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: 10 / 141114 Permittee Signature
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
424-1 0: 22AM FROM P. 2
, ! -- 1 4 4.. .• .
CY"
1
Plumbing pumbing Permi 1 1 lication
D --:-.,
-..,
itillo ate re xived: v 1K () Permit no.:?0\2/1)/..e..905
G10 cz>
City of Tigard ,-,---..:, ,
sew. no.: 13trilding permit no.:
4 " L Address: 13125 SW Hell Div • igard, OR 47223
Ci Phone: (503) 639-4171 Project 'appl no.: Expire date: r
Fax: (503) 598-1960 — _ j - • .., - Date isi.uoreeeipt .
Land use apprOval: -; ''. .. 1 - '' -,E, Cage E 0 no.: Payment typo;
1\ PL 01 1'110111
• C t
0 1 & 2 family dwelling or accessory C) Commr_rcialfiredustrial CI Multi-family 0 Tenant improvensent
0 New construction 0 Addition/alteration/replacement 0 Food service 0 Other:
• . ..1011.s ITIF.. 1NFORM,1 1 FEU St 11 roil Lk. tfr!.prcial inlortnation u,4; ciao:Mist; ,.
Job address: • f 3A 5 W (A T Pgta) I DescrIptloo Qty F(01.) Total
New 1- irk 2,-fantily dweRinget ouly:
Bldg. am: Suite no.: 50
Oarlocks 10)ft. far cad* utility opooloerfon)
Tax map/cax lot/account no.:
ShR (1) bath 1
Lot: Block: Subdivision: TC 9 ; , 3 SFR (2) bath
Project name: Syi c 00 Tr;an f orp• Pk. 8 1 .3 - SFR C3) bath •
City/county: 1; , tri rm.: 17 II3 Each ad& mai barb/kitchen i
De,scriprion and • . ; • • of wort cm pmmises: .., Site utfiffies:
e — Floor ti; t cco Catch basiii/area drain
--..... ' ti
Est. • . te of completloormspection: rtYwellsibtacb line/trends drain
Footing dr; tin (no. lin. ft-)
P11:11ItING CON I R %C
Manufactultd home utilities
Business name: A c•5 ce c ig, • P yin • ifil Manholes
1 Address: po A 3 lc z Rain • rain connector •
. City: fb t r„,,,- 1 s... a 1 Z1P: el7r/H5 ./ Sanitary sewer (oo. lin. ft.)
Phone: 50 31 o's's Fax:33 656 E-mail; --- Storm sewur (no. lin. EL)
CCB no.: 51050 Plumb. bus. reg. no: 4 - - 1,I ' L liter service (no. lin. (t.)
i Cityhaetro lic. no.: ; 8) 4 - • - Fixture or item: •
Absorpti
I Coneractoes tepreseutative • :, : I ilirl.fr--_,61111111 on vlv
Back flow sreventer -
POW mat: e IttlqicirwiPte- -ilim Backwater ,z7-------
coyrAci PLItSO■ t ashis/law tory
IIMMIIIMMI,11.11111111.111 • • washer
. shwasbe!
Address: PO ,C -. 01 6
Drinki • . A iuntain(s)
CRY: 25/rEIMIIIIIIMI $ EgargrilLEM •
Ejectordrump
l Mom 5o3 311 o61 Fax: 33) 0581 E-mail: ,- Ex ansion an
. CA% NI:A . Fixture/sewer c• i
Mailing Floor donne/floor sink aP --R! i
• Name (print): Tr-4,41i fort). PK.
Garbage I:lila-cal
iling rukhess: I 3 T " z I sw ' 69 PK . ,
ose bibb
City: e TS ZIP: 9721 3 Ice maker
Phone: Fax: E-mail: Lnerceptozgreasc trap , ,
Owner installationktssidential mint:mance only: The actual hurallation Primer(a) . i
• will be made by• me OC the rnaintotarice and repair made by eity regular Roof d(ain(commercial)
employee on the property I own as per ORS Chapter 447. _ s), ba:ErsT : 1ays( eiel I • ' , 4—
i Owner's signature: •. _ _ .. Dale: Sun •
E (11N IF It Tubalshowor/shower pan
Urinal
Name:
Water closet •
Adchess:
Water heata• .1
Cit stio.e1 -- ZIP: Other.
‘ ; Phone: IFax: FE-mail: Total
cli f e $ / 7 /
50
Ish. a Junsactimi weep trtdir CAC pimp all ultaittion or nev intormatko. N ot i ce: Thi i sp p t caz i o ,, Wrininlum 6 '
0 Vier 0 MasterCard Plan review (at %) $
expires if a perrnit is not obtained
I S --- 0
... --
1... Gemmel rember.
. within IA0 A ayir niter it has been &ar s ( ----
I ibolos TOTAL $ - 7 K.ao
accepted as cortipkte.
1 mom a eatehotdor as &awn on cgta card
$
•
. . .. 0 'M)
44Pilt511B114G PERMIT FEES:
PRICE ; TOTAL New 1-and 2-family dwellings only: •
FIXTURES (individual) QTY (ea) - AMOUNT (includes all plumbing fixtures in . PRICE . •'TOTAL
Sink i 16.60 the dwelling and the first100 ft. QTY . (ea) AMOUNT
16 for each utility connection)
Lavat «Y 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 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 /(Q. ipd PLEASE COMPLETE:
- 3" 16.60
4" 16.60
_ Water He 0 conversion 0 like kind 16.60 Quantity by Work Performed
requires a separate mechanical // -- Fixture Type: New Moved Replaced,. Removed/
permit. / 1 Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
Tub or Tub /Shower •
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
16.60 ))// �� Urinal
Other Fatures (Specify) (PO 1, Lam- /tp Dishwasher
lit/ - 11 Garbage Disposal
Laundry Room Tray
Washing Machi
Floor Drain/Si )
Sewer - 1st 100' 55.00 3"
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater I
Other Fixtures
Water Service - each additional 200' 46.40 (Specify)
Storm & Rain Drain -1st 100' 55.00 Ve.__I Al El. I
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
Isometric or riser diagram is required if
Quantity Total is > 9
'`SG�TOT P WO
8% STATE SURCHARGE
**PLAN REVIEW 25% OF SUBTOTAL - 5,32-
Required only if fixture qty. total is > 9
TOTAL $.? ( -) -Y
* Minimum permit s 72.50 + .'.• ..= a surcharge, except Residential Backflow
Prevention Device. '. is `• .25 + 8% state surcharge.
** All New Commercial Buildings require plans with Isometric or riser diagram and
plan review.
IAdstsVorms\plm- fees.doc 10/10/00
4 -24 -1995 0:21AM FROM P.1
° • RECEIVED
fl ssociated = Jsi - 3 203
p lumbing Co. COMMUNITY DEVELUMIEN1
i
P.O. Box 301362 Phone (503) 331 -0582
Portland, OR 97294 -9362 Fax (503) 331 -0581
CCB #057890
FAX TRANSMITTAL
Telephone (503) 331 -0582 Fax (503) 331.0581
TO: Ci or I lard
PROJECT: Trial), Corp . Pk. . i3)J 3 , Sup )c 55
ATTN: Permit fee c1a)j
DATE: 6') -0I
- Number of Pages Z Including Cover Page
MESSAGE:
?l ease Cal %lull F eAJ ead wjc dtr�
a • - •
IF YOU SHOULD NOT RECEIVE ALL PAGES, PLEASE CALL!
FROM: ehLck LcItmatn,,
Commercial • Residential • Industrial • Remodel • Repair • Service
3.,-v
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 — l( AM PM BLD
Location / 3 ZZ / Sw Sk �* Suite 575 MEC
Contact Person Ph 3)/ 05 PLM Z 6 / -- iO ZS-4
Contractor Ph SWR
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
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL C
C
MBI
t & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rai Drains
F
SS PART FAIL
LAICAL
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
Approach/Sidewalk ) / l
Other Date `A I nspector aV '� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.