Permit CITY TIGARD PLUMBING PERMIT
4_4141111'11‘ DEVELOPMENT SERVICES PLUMBING
PLM2005 -00153
13125 SW Hall Blvd., Tigard, OR 97223 503 639 - 4171 DATE ISSUED: 4/22/2005
PARCEL: 25101 DC -00200
SITE ADDRESS: 13535 SW 72ND AVE 150 ZONING: C -P
SUBDIVISION: 72ND AVE OFFICE BUILDING LOT: JURISDICTION: TIG
Project Description: Add 1 sink commercial.
CLASS OF WORK: ALT 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PACIFIC NW PROPERTIES LTD PTNSHP
9665 SW ALLEN BLVD STE 115 Description Date Amount
BEAVERTON, OR 97005 [PLUMB] Permit Fee 4/21/2005 $72.50
[TAX] 8% State Surcha 4/21/2005 $5.80
Phone : 503- 626 -3500 Total $78.30
Contractor:
POWER PLUMBING CO
P BOX 19418
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Phone : 503- 244 -1900
Reg #: LIC 52378
PLM 34 -150PB
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: f / Permittee Signature: ' .,e '∎11
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.
Apr 20 2005 1:28PM HP :c 'W�: 1 - a - 0 p, 1
APR 2 0 1005
Plumbing Permit Application FOR OFFICE USE ONLY
c.ITY OFTIG' -e
City of Tigard BUILDING DI gip , no 7 i-1. 05 U � Permit Nop d _ 53
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' ` ��
Phone: 503.639.4171 Fax: 503.598.1960 . > i Oth P No, ►� d• ('i
�..., Dete - "UG v
24- Hour Inspection Line: 503.639.4175 _ l r'''' ;r '.f i 1 � Dam Ready/By. r lc See Page 2 for
Internet: www.ci.tigard.of.us Notlfed/Methad: L A Supplemental Information
i� :: �, ".�s'I� .::
;i:. �' ,� - ,nF�E,'�i1 5„ 191',,; �� . � �.� _ ,x,'��.i%"�' ^^�",� �'1{i'',� �'v� 1= " ^�^ ' / �.
-, - .: :',.,' , 't''4: ;; ;t j.7; ._..y5 ' ifd 7 . '.`'+{ z?i N;, �' , ,_•fit'..: : :..,... :`' :r ZUg .4 ,
❑ New construction ❑ Demolition For 'pedal information use checklist
Description 1 Qty. 1 Ea. 1 Total
!I Addition/alteration/replacement ❑ Other. ' New 1- 2- family dwellings (includes 100 ft. for each utility connection) ■
r_ 7,"''CI-4 , - •"?1;.°1! =r;r' ;a: { 11,t + : ,, y(�: $; �: lr. _? F SFR (1) bath 249.20
` 47, :J ,. :'. q; r�ac ia5�'- iHtt. i ur..6 ?n) P 1i ";1 { i ifio..4i: -:era:
❑ 1- and 2- family dwelling ornmercialftndustrial SFR (2) bath 350.00
❑ Accessory building 0 Multi -family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other. Fire sprinkler ( sq. It) Page 2
,;, .j
> 4 , :. ;:.:1g7T. T c t_�- t t w` I Site utllitlea
a:l,l�. C , G,a. , %men.. .it LIC: -;.4 }f+•`., , :- F..- ..,r:,A.. ke: _4414 -
Job site address: ) J I SID 1 _ / (,w . 1 Catch basin or area drain 16.60
City /State/ZIP: -r , r Drywell, leach line, or trench drain 16.60
Footing drain (no. linear R ) Page 2
s
Suite/bldg. /apt no.: 6 Project name: : j::ai .. .' ! •
Manufactured home utilities 110.00
Cross street/directions to job site: Uri Z � _� \ Manholes 16.60
4 ()Mk �I /"rtv Rain drain connector 16.60
11. A i . T) e . Sanitary sewer (no. linear ft.: ) Page 2
1 Storm sewer (no. linear ft.: ) Page 2
Subdivision:
Lot Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: 1 n valve 16.60
',: ,a:;'... bz . 1 , 1 ' �.� . F4i '„. :ir r+ .. Z / ,.� t 5 AbSOrpt O
: _ :t : t3alIi'+: i . i :.1.C:' >il r t t " ;; & , t .., �' c r _ 15..1 ,; _1 � . Y ' i, BackfloW preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
z •_ t Drinking fountain 16.60
. `ice- �'' 2.,tv- `' 1.t ?(A/4„4 r1. - Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: (' )
Garbage disposal 16.60
�� �s Hose bib 16.60
°.cR' � rxaz�m -- 71F
IM . t zaa a�> IE( sk _ rs + Ice Maker 16.60
Business name: P 4 _ J . Ai .. / Interceptor /grease trap 16.60 •
Contact name: a _ y . ° A Medical gas (value: S ) Page 2
Address: P 6 Y 7 I Cu4 1 Primer 16.60
Roof drain (commercial) 16.60
City/State/ZIP: P � � i � O tt ti Sink/basin/lavatory r 16.60 IL, 10
Phone: ( )
-
Phone: -/ O I Fax ( ) � T tt 7�tL� Tub/shower /shower pan 16.60
E-mail: ppp Urinal 16.60
ti - r ; 're.:ta -r r � > ., +. `
r 16.60
'� ' ' .. `. C - " � �i��is5'e.�t�: - �r``2:� _ „ F7� 1 ' Water
_ / AnTIMPCIIIIIIIMII Water heater 16.60
n t Other-
Address: , 1 ! ! i�
� 1 Subtotal �� �%
City /State/ZIP: .1 3 ,50
P6Y'i - � �. �.Z Minimum permit fee: E72.50
G 12.
Phone: ( ) � LI -� � CI d Fax: ( ) a-�� ' a �Z Residential back low minimum permit fee: $36.25 � � Plen review (25% of panic tbe)
CCB Lic.: 5 L Plumbing Lin no.: 3� �1 fa
State surcharge (8% of permit fee) 5
Authorized signature. TOTAL PERMIT FEE "V •�
n + .ST we, �"��+ rs"��
[ P name: Date: This permit application expires if a permit is not obtained within
/� 4 J 180 days alter It has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
ilaultding1Pamit $WLM- PermiIApp.dae 13N3 • 410-4616T(IO/02/COWW®)
CITY OF TIGARG • _
BUILDING DIVISION PERMIT #: PLM20D5 - 00153
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/22/
Phone: (503) 639 -4171 44, A' , ���,1i�1� °�
Inspection Requests (24 Hrs.): (503) 639 -4175 �_'
iP �INSPECTION WORKSHEET FOR DATE: 5/20/2005 TIME: 7 :11AM PA B0
SITE ADDRESS: 13535 SW 72ND AVE 150 CLASS OF WORK:
SUBDIVISION: 72ND AVE OFFICE BUILDING LOT #: TYPE OF USE:
PROJECT NAME: CREDIT UNION HOME LOAN
DESCRIPTION: Add 1 sink commercial.
OWNER: PACIFIC NW PROPERTIES LTD PTNSHP, PHONE #: 503.626 -3500
CONTRACTOR: POWER PLUMBING CO PHONE #: 503- 244 -1900
Inspection Request Scheduled For: Date: 5/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 007360 -01 503-936-5929 N
Corrections /Comments /Instructions:
k ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / 7 { Datei_ 5/5-19/ 0'- Phone #: (503) 718 -