Permit CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00318
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/28/2008
PARCEL: 2S 112AA - 00300
SITE ADDRESS: 14200 SW 72ND AVE ZONING: I -
SUBDIVISION: NELSON BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: GERBER
Project Description: Converting water closet to shower.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 0
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GERBER LEGENDARY BLADES Description Date Amount
14200 SW 72ND AVE
PORTLAND, OR 97223 [PLUMB] Permit Fee 7/28/2008 $72.50
[TAX] 12% State Surch 7/28/2008 $8.70
Phone : Total $81.20
Contractor:
KENNEDY PLUMBING
13985 SW FARMINGTON RD
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 643 -5535
Reg #: LIC 10967
PLM 34 -42PB
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 _ � Permittee Signature: 1
41/
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.
i
Plumbing Permit Application
Building Fixtures
j� 1 vE FOR OFFICE USE ONLY
City Tigard of Ti and Received
lihi Permit No.: A
II 3
13125 SW Hall Blvd., Tigard, OR � 7 Z2 A
Date/By: �f / �, f)
6 Plan Review
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Phone: 5 03.639.4171 Fax: 503.598.1961 3 'L Date/By: Other Permit No.:
v L
Inspection Line: 503.639.4175 J 4 (� Dat Read /B iurs: et See Pa e 2 for
TIGARD �� O � 1 ! , v� Y Y l;
Internet: www.tigard- or.gov ,�{{ss� 1 ' Not ifled/Method : Supplemental Information
TYPE OF WORO ` MG OW FEE* SCHEDULE
❑ New construction aolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
A ddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
� CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ I - and 2- family dwelling ® Commercial /industrial SFR (2) bath 350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 14200 SW 72 Avenue Catch basin or area drain 16.60
City/State/ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: _) Page 2
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
Fixture or item
Tax map /parcel no.: -
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Cr hv 41 /G yr) f' Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Gerber Blades Expansion tank 16.60
Address: 14200 SW 72 " Avenue Fixture /sewer cap 16.60
City /State/ZIP: Tigard, OR 97223 Floor drain /floor sink/hub 16.60
Phone: (503)403 -1194 Fax: ( ) Garbage disposal 16.60
® APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Kennedy Plumbing Interceptor /grease trap 16.60
Contact name: Roy Pierce Medical gas (value: $ ) Page 2
Address: 13985 SW Farmington Road Primer 16.60
City/State/ZIP: Beaverton, OR 97005 Roof drain (commercial 16.60
Phone: (503) 643 -5535 I Fax: : ( ) Sink /basin/lavatory 16.60
Tub /shower /shower pan / 16.60 //�4
E -mail: Urinal ( 16.60
CONTRACTOR Water closet 16.60
Business name: Kennedy Plumbing Water heater 16.60
Address: 13985 SW Farmington Road Other:
City / State/ZIP: Beaverton, OR 97005 Subtotal
Minimum permit fee: $72.50 --- ..., r• A
Phone: (503) 643 -5535 Fax: ( ) Residential backflow minimum permit fee: $36.25 I t a/
CCB Lic.: 10967 Plumbing Lic. no.: 34 -42PB Plan review (25% of permit fee)
t State surcharge (12% of permit fee) $ , `7 v
Authorized signature: Arte TOTAL PERMIT FEE
$ Lao
Print name: Sherry Hess Date: 7 -28 -08 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 Building Industry Service Board.
1:\ Building \ Permits \PLMF- PermitApp.doc 12/27/06 440- 4616T(10/02 /COM/WEB)
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PLM2008.00318
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2008
Phone: (503) 639- 4171�r
Inspection Requests (24 Hrs.): (503) 639 -4175 W 1 I
INSPECTION WORKSHEET FOR DATE: 8/28/2008 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 11200 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: GERBER
DESCRIPTION: Converting water closet to shower.
OWNER: GERBER LEGENDARY BLADES, PHONE #:
CONTRACTOR: KENNEDY PLUMBING PHONE #: 503 -643 -5535
Inspection Request Scheduled For: Date: . 8/28/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 074798-01 503-643-5535 N
Corrections /Comments /Instructions:
C 01/44%4._ C.) 1---w-A-----A. fr
•
igi ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1
Inspector: CIO \(4n M \\ -- Date: g 2.521 041 Phone #: (503) 718- 1
i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008 -00318
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2008
Phone: (503) 639- 4171afe, g 1
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' l- 1.1.. I
INSPECTION WORKSHEET FOR DATE: 8/1/2008 TIME: 7:O0AM PAGE: 39
SITE ADDRESS: 1420() 72ND AVE CLASS OF WORK:
SUBDIVISION: NELSON BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: GERBER
DESCRIPTION: Converting water closet to shower.
OWNER: GERBER LEGENDARY BLADES, PHONE #:
CONTRACTOR: KENNEDY PLUMBING PHONE #: 503- 643 -5535
Inspection Request Scheduled For: Date: 8/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 073570 -01 503 -643 -5535 N
Corrections /Comments/ Instructions:
4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _J \ -\ - Date: T1 I \ OT Phone #: (503) 718-