Permit C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00071
DATE ISSUED: 2/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112DD - 00200
SITE ADDRESS: 15862 SW 72ND AVE 200 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: NATIONAL MORTGAGE
Project Description: Plumbing fixtures. Other: primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 3 TRAPS:
STORIES: WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS:
SINKS: 1 URINALS: 2 GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES: 1
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI Description Date Amount
PORTLAND, OR 97224 [PLUMB] Permit Fee 2/20/2007 $282.20
[TAX] 8% State Surcharl 2/20/2007 $22.58
Phone : Total $304.78
Contractor:
ADDISON PLUMBING
1407 HOMESTEAD PLACE
MOLALLA, OR 97038 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 785 -1840
FAX 503- 829 -9701
Reg #: LIC 151754
PLM 3 -449PB
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 Hiles or dired questions
to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu By: � Permittee Signat >
Call 501639.4175 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.
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Plumbing Permit AppliCai�i;.t ,� t,.1 ir rt =�
)it ���� ( _ l_ iil: ()\1)
City of Tigard DDate/By 7 op Permit No.:p v o� it
�U�
• 131 SW Hall Blvd., Tigard, OR 97223
0 Phone: 503.639.4171 Fax: 503.598.196V t 20 j 2001 Plan Review Permit N(/ ' /'/
Date/By: Inspection Line: 503.639.4175 ) ® Page � t'T
11GARI) v Ready/By: g e2for
Internet: www.tigard- or.gov ` gg + �. 1 -+I otified/Method: Supplemental Information
TYPE OF WO C 1+ TTQTO FEE* SCHEDULE
❑ New construction Y� lion For special informanion use checklist
Description 1 Qty. I Ea. 1 Total
® Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler (- sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 15862 SW 72 Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 200 I Project name: National Mortgage 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 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
Remove: 1- break room sink, 4- water closet, 4- lay, 2 -shower, 1- laundry sink Backwater valve 16.60
2- water heater. Clothes washer 16.60
Dishwasher 1 16.60
® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: Pactrust Expansion tank 16.60
Address: 15350 SW Sequoia PKWY #300 Fixture/sewer cap 16.60
City/State/ZIP: Tigard, OR Floor drain/floor sink/hub .2 " 3 16.60 .
Phone: (503)624-6300 Fax: (503)624 -7755 Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 1 16.60
City/ State/ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 5 16.60
Phone: ( ) I Fax: : ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 2 16.60
CONTRACTOR Water closet 4 16.60
Business name: Addison Plumbing Water heater 1 16.60
Address: 1407 Homestead Place Other: /7
City/State/ZIP: Molalla, OR Subtotal
Minimum permit fee: $72.50 ) �� _ _
�
Phone: (503) 785 -1840 Fax: (503) 829 -7469 Residential backflow minimum permit fee: $36.25 , AF!
CCB Lic.: 151754 Plumbing Lic. no.: 3-449PB Plan review (25% of permit fee)
State surcharge (8% of permit fee) n 2 , 2, , 51(
Authorized signature: crlp.2i 4 � ?5(
TOTAL PERMIT FEE 30
I Print name: Jay Moore Date: 02 -20-07 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.
I:\ Building \Permits\PLM- PermitApp.doc 06/26/06 440- 4616T(10 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2007
Phone: (503) 639- 4171 v.dii�
Inspection Requests (24 Hrs.): (503) 639 -4175 ` ". .
INSPECTION WORKSHEET FOR DATE: 3/28/2007 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 15862 SW 72ND AVE 200 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL MORTGAGE
DESCRIPTION: Plumbing fixtures. Other: primer.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADDISON PLUMBING PHONE #: 503 - 7851840
Inspection Request Scheduled For: Date: 3/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 045587 -01 503-740-8116 N
Corrections /Comments/ Instructions:
-'fit; / LT Pa ✓4f + t l (ii,.e✓ P 11 Gr, --,dk,
J - n Jet C lG a✓ti iv y w a mac. ,� w-�I P 1" ...�b -x'1„ Cc �d e A/ .. ti..l r z Opp Cie .2.44.«
F✓a At. L-JN -J GAO rat % tr. I „
Cato r
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: t 1 l Date: 3/2-81 7 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION v PERMIT #: PLM2007- 00071 ��
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F:..
INSPECTION WORKSHEET FOR DATE: 2/28/2007 TIME: 7:02AM PAGE: 1
SITE ADDRESS: 15852 SW 72ND AVE 200 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: NATIONAL MORTGAGE
DESCRIPTION: Plumbing fixtures. Other: primer.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADDISON PLUMBING PHONE #: 503.785 -1840
Inspection Request Scheduled For: Date: 2/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 044101 -01 503- 740 -8116 Y
Corrections/Comments/Instructions:
/ / / --
6 ,/ „7.77-,-„,.
" ''RA. RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspec t Date: ' / , Phone #: (503) 718 - 9-fr