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Permit C ITY OF TIGARD PLUMBING PERMIT ti =l DEVELOPMENT SERVICES PERMIT #: PLM2002 -00211 II I 1 SW Hall Blvd., Tigard, OR 97223 (503) 639 -41 DATE ISSUED: 6/11/02 SITE ADDRESS: 15500 SW 72ND AVE 200 PARCEL: 2S112DD -00200 SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: 1 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing tenant improvement, moving (2) water closets, replacing (1) sink, (2) lays, (1) 2" floor drain, and (1) hub drain. No EDU changes. FEES Owner: Type By Date Amount Receipt PACIFIC REALTY ASSOCIATES PRMT CTR 6/11/02 $116.20 27200200000 15350 SW SEQUOIA PKWY #300-WMI 5PCT CTR 6/11/02 $9.30 27200200000 PORTLAND, OR 97224 Total $125.50 Phone 1: Contractor: KSM PLUMBING INC DBA SUNSET PLUMBING PO BOX 23263 REQUIRED INSPECTIONS TIGARD, OR 97281 Phone 1: 503 - 657 -0010 Rough -in Insp Top -out Insp Reg #: LIC 141154 PLM 34 -366P6 Final lnspection 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 ' . suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted • the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through ,. R 95 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling 23) . G -1987. Issu . By: A • / , 1��< ' //�� Permittee Signature: .. A �� CaII (503 .39 -4175 by 7:00 P.M. for an inspection neede• t e next business day , Plumbing Permit Application Datereceived: , a `/Permitno.: N [ `a��?l / '. ..,. � City of Tigard 4 ' ' g Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: 'TYPE OF PE011T O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement O New construction O Addition/alteration/replacement 0 Food service 0 Other: .1011 SITE 1NFOR11ATlON FEE SCIIEIMEE (for special inforiiatiun use checklist) Job address: / ' Scc, S' L .72_ — NZ Description Qty. Fee(ea.) Total New 1- and 2- family dwellings only: Bldg. no.: I Suite no.: O Tax map /tax lot/account no.: (includes (1) b �ft.foreac6trtilitycoanectioa) Lot: I Block: I Subdivision: SFR (2) bath Project name: SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est date of completion/inspection: Drywells/lea lin.e/trenc.h drain Footi ng drain (no. lin. ft.) Manufactured home utilities Business name: /45Lt /., r ,,,.. / 45 S..w S °* 1 Manholes Address: ? o , A,X 2> 2 ( 3 Rain drain connector City: -7-at &f Z I State a I ZIP: ' 7 2 S / _ Sanitary sewer (no. lin. ft.) Phone:60 .(57 = i° I Fax: 6s7 -5-80 E -mail: Storm sewer (no. lin. ft.) CCB no.: /4/ / may/ Plumb. bus. reg. no: 3 366 i Q Water service (no. lin. ft.) City/metro lic. no.: Co 30 / Fixture or item: Contractor's representative signature: / Absorption � � i � .1/ Back flow valve preventer Print name: L / !fl 11 Date: .//. C / Backwater valve Basins/lavatory Name: Clothes washer Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank Fixture/sewer cap Name (print): Floor drains/floor sinks/hub 2 address: Garbage disposal Mailing Hose bibb City: I State: I ZIP: Ice maker Phone: 1 Fax: 1E-mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) 3 Owner's signature: Date: Sump Tubs/shower /shower pan - Urinal Name: Water closet Z Address: Water heater City: 'State: I ZIP: Other: Phone: I Fax: 1E-mail: Total - Not all jurisdictions accept credit cards, please call jurisdiction for more infaatioa Notice: This permit application Minimum fee $ r 61( 61( m O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ 9. 3 0 Name of cardholder as shown on credit card Expires as complete. TOTAL $ /aS • $ Cardholder signature Amount • 440-4616 (6/00ACOM) ... . PLUMBING PERMIT FEES . A. PRICE • TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection) 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 16.60 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 3" 16.60 PLEASE COMPLETE: 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink 1 " MFG Home New San/Storm Sewer 46.40 Lavatory 2 Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Z 16.60 Urinal Other Fixtures (Specify) Dishwasher Garbage Disposal Laundry Room Tray Washing Machine . Floor Drain /Sink: 2" 1 Sewer -1st 100' 55.00 3" Sewer - each additional 100' 46.40 4" Water Service - 1st 100' 55.00 Water Heater Water Service - each additional 200' 46.40 Other Fixtures (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 K L 4,-r 2t ^ f k I Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially - 62.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL ' Isometric or riser diagram Is required if Quantity Total is > 9 *SUBTOTAL 8% STATE SURCHARGE **PLAN REVIEW 25% OF SUBTOTAL ' . • Required only if fixture qty. total is > 9 TOTAL $ * Minimum permit fee Is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $38.25+ 8% state surcharge. ** Ali New Commercial Buildings require 2 sets of plans with isometric or riser diagram for plan review. . iAdsts\forms\plm- fees.doc 12/26/01 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested 7 17 AM PM BUP Location 573 7 Suite .:.2dd MEC Contact Person Ph ( ) 6 - 7 - OD / O pLM c7 — CO a Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain Access: �� ELR Crawl Dra Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 1=1 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour► BUILDING Inspecon.Lir'tb: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested 74 AM PM BUP Location /6" v 7e; d Suite 20 0 MEC Contact Person Ph ( ) ' S7 Od /v PLM v C)<; 1 ' Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: (/ Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: ma PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE D Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date )- Inspector 29 Ext Other: Final DO NOT REMOVE this Inspection ord from the Job site. PASS PART FAIL CITY OF TIGARD 24=Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639417 MST BUP Received Date Requested 7—f ics- G 1 ' AM PM BUP Location / 5--f-e/ D 5 d 7 Suite - f-e' -1/ MEC • Contact Person "ca 7 Ph ( ) '5 D 0 76 PLM eGo Z - .2/ Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailin g Firewall / 111 liWA Fire Sprinkler Fire Alarm - °17 Susp'd Ceiling 1 i , Roof G. Other: Final eijkOZ PASS PART FAIL 411= M1- • Pos Beam Under Slab Rough -In Water Service c/ Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: ASS PART MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ p required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date 7 / `/ G Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL • ne Line: ( T -���� BUP Received Date Requested 1 / 5 4- 2 - AM PM_ BUP Location L5-0 d Set) 7- Suite MEC Contact Person Ph ( ) CC/ PLM 2 "' DO Z /1 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm •� /" " a� / / _l Susp'd Ceiling Roof Other: Final _ PASS PART FAIL Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan er: ina PASS FAIL MECH L Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA � Approach/Sidewalk Dat Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST _ BUP Received Date Requested 7 3 G 7 ' AM PM BUP Location 1.) --5---0 v Sw 7 2 -~1 4•-f 0411 i 3 Suite Z MEC Contact Person Ph ( ) 65 PLM 264 Z-00 Z Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation / Drywall Nailing Firewall 41116.1ffer) Fire Sprinkler ` Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL Cr ige , am Under Slab Rough -In Water Service Sanitary Sewer `. Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Ot ina ASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call f• r reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector ir k/ Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST X1' / BUP Received Date Requested ' /4 g PM BUP Location l S d v 7 d /reil /1 Suite 2 © C ) MEC /1 Contact Person Ph ( ) Co 7 - dam/ 0 PLM — a / Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post &: =am •ug • a er Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fi PART FAIL CHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA /� Approach/Sidewalk Date / ro . Inspector 1 v Ext PP Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL