Permit • a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00309
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/23/2008
PARCEL: 2 S 112AA - 01000
SITE ADDRESS: 14100 SW 72ND AVE ZONING: I -H
SUBDIVISION: NELSON BUSINESS CENTER LOT: 001 JURISDICTION: TIG
PROJECT: WILLIAMS CONTROL INDUSTRIES IN
Project Description: Install (2) new shower stalls.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: F1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WILLIAMS CONTROL INDUSTRIES INC
14100 SW 72ND AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 7/23/2008 $72.50
[TAX] 12% State Surch 7/23/2008 $8.70
Phone : Total $81.20
Contractor:
3 MOUNTAINS PLUMBING
20345 SW PACIFIC HWY STE 103
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 925 -1342
FAX 503- 925 -9104
Reg #: LIC 169499
PLM PB99
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 B : - ` . _i Permittee Signature: /�rX
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.
07 -18 -2008 10:39 3 MTNS PLUMBING 5039259104 PAGE2
. '1. ' Permit Application OCV) Building Fixtures � ` " I c,li ()I..1.14.-1: I 'I. 1.).\1_,) 1.).\1_,) City of Tigard 1 IrA % Received 7 / Q U r. / Pcmilt No.: 3Q
41 13125 SW W Hall Blvd.. Tigard. OR 97223 - D Y g A i 0 g�
`\ Vy: evirw other v.-until Nu. i
�
Phone: 503.639.4171 Fax: 503.598.1960 503.598.1960 ,v� ,„,..,,c, c, Q, g 60 i t/�
T 1 c :Ali f7 Inspection Line: 503.639 0 1 eady/By: hau. ® see rime 2 l5rr
Internet: www.tigard- or.gnv C \ G� Notified/Method: /a" Supplemental Information
TYPE OF WORK � • FEE* SCHEDULE.
❑ New construction ❑ Dcmol(fton For .v Gird in urination use Checklist
Description Q. 1 Ea. (boil
Ip wddition/altcration/repiacement ❑ Mier: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- fancily dwelling 121:nmrnercial /industrial SFR (2) hath 350.00
12 Accessory building ❑ Multi- family SFR (3) both 399.00
❑ Master builder Each additional bath/kitchen 45.01)
❑ Other:
Fire sprinkler ( sq. ft) Page 2
• .1OB SITE INFORMATION AND LOCATION ._. - , - _.....__.
Site utilities
Jub Site address: t if lG / o '5 al 41� -
LAJ i 'C , Catch basin or arcs drain I6.GU
City /State! /.IP: ,7? c 5 ` c7 4 +ya q Drywell, leach line, or trench drain � 16.60
Suite/bldg./apt. no„ Project name: Footing drain (no. linear ft.: _J Page 2
W t 1a C /q I-1 y L'�..)Tf2o_ee" _- Manufactured home utilities 110.00
Cross street/directions to job sitc: /rJ pu 5 Tl2/ PS ld � n ���
C leinloles 16.60
Rain drain connector 16.60
Sanitary sower (no. linear 2: ) Page 2
~
Sturm sewer (no. linear IL: : _) Page 2
Subdivision: tall no.:
Water service (no, linear 6.: _) Pup 2
G _.._._... ..._... ^ _. Fixture or item
Tax map /parcel no 02 iJ � -� / /',�'\
�r C ( L1 ---- .-- -..... Absorption valve 16.60
y DESCRIPTION' 1)1 WORK Beddow prcventer Pugc 2
i'l G� fLP 5/14--mie / el /4.4065 ,---,f Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16,60
Drinking fountain 16,60
nr PROPERTY OWNER ❑ TENANT ,
Ejectors/sump 16.(10
Name: l X:)«� Oft Ms e1)10 /ObUST2ffs /
Expansion lank 16.60
Address: 14 I op ` dt .j "0„4.-0 /tat, Fixture/sewer cap 16.60
City /State/ZIP: l l ea A .2 O a. q 7 2 - 9 q Floor draio/tloor sink/hub �. 16,60
Phone: ( ) Fax: ( ) Garbage disposal 16.60 -
❑ APPLICANT . ❑ CONTACT PERSON
1lose bib 16.60
Ice maker 16.60
Bu.SineSS name:
. .. ... _............ _ . _.. .... .. _ ..... .. Interceptor /grease trap _ _ 16.60
Contact name: Medical gas (value: .$ ) _ Page 2
Address: 66 C Itri Y 5t ..f Primer 16.60
Ci.ty /Statc/ZTP: ON / , Roof drain (axnnlercial) 16.60
_ v l ) 7( Sink/basin/lavatory 16.60
Phone:
( ) I�ax:: ( 4_ `)
;� Tub /slower /shower pan � 16.60 33,
E-mail: �/ r ))Final 16.60
•
. . . . CONTRACTOR Water dose) 16.60
Business name: • 3 / l / 1 / 4 111 5 ... / ' T � . . Water hcalcz - ^ 16,60
Address: t q5 51t) R C/ ' I.C. itWi (03 Other:
City /StatetLll': / _ ri 147 e D /� i�fv Subtotal S _ l Minimum permit fcc. $72.50 J S
Phone: (5j f�5 - /.56.9.. Fax: ( ) 74.5 wy Residential backllow minimum permit fee: $36.25 '7 / /
CCI3 Lie.: T i Plumbing I .ie. no.:e6 q Plan review (25% of perm fee)
_.., : . _ _ ........... _.... - s State surcharge (12Y ofpermit fee) 40n 7
Authorized signature: _ ae:-^'
. Y K FOTAI. PERMIT FEE d
r71 , .24,....24,....24,..... Print name: ! /i �1 I ^ �- / `t $(4.1 4 D ole: Th
/ ( This perm application expires if a permit is not obtained within
L _..... . .............._ f - 180 days after it has been accepted as eumplrtr.
•Fre methnctntrwv ;et by Tri- l'.nnn)v Rnildmn Inalnelry S. rvie* Riurli
CITY OF TIGARD
BUILDING DIVISION a PERMIT #: PLM7008.00308
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 7123/20011
Phone: (503) 639 -4171 .411:1411
Inspection Requests (24 Hrs.): (503) 639 -4175 s ° _—
INSPECTION WORKSHEET FOR DATE: 7/24/2008 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 14100 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: WILLIANIS CONTROL. INDUSTRIES IN
DESCRIPTION: Install (2) new shower stalls,
OWNER: WILLIAMS CONTROL INDUSTRIES INC, PHONE #:
CONTRACTOR: 3 MOUNTAINS PLUMBING PHONE #: 503 - 925.1342
Inspection Request Scheduled For: Date Pour Time:
7/24/2008
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 073120 01 503 -6M -8676 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GDvv A" Date: `) I2Lt tOT Phone #: (503) 718-