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Permit R CITY TIGARD PLUMBING PERMIT ; �I , DEVELOPMENT SERVICES PERMIT #: PLM2003-00062 ., �i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/27/03 SITE ADDRESS: 16550 SW 72ND AVE B -09 PARCEL: 2S113AA -01000 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L BLOCK: LOT: OOC JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing tenant improvement: cap (1) toilet & (1) lay, rough -in (1) sink, (2) lays, (2) toilets, and (1) 2" floor drain. FEES Owner: Description Date Amount PACIFIC REALTY ASSOCIATES 15350 SW SEQUOIA PKWY #300 -WMI [PLUMB] Permit Fee 2/25/03 $149.40 PORTLAND, OR 97224 [TAX] 8% State Tax 2/25/03 $11.96 Total $161.36 Phone : Contractor: DEAN WARREN PLUMBING 3111 SE 13TH PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone : 236 - 4152 Rough -in Insp Final Inspection Reg #: LIC 172 PLM 26 -83PB 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. Issued By: Permittee Signature: ,"/ ,G/[19 70 CaII (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day i -,...- 1\ Building Fixtures &_)4.07005 --coo 70 Plumbing Permit Application OFFICE USE ONLY Date received: ' IRS D, Permit no.: �Ll/Ar�9-eXL?'D � i � j City of Tigard 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 PERMIT 0 1 & 2 family dwelling or accessory VI 0 Multi- family lir Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Food service 0 Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: / 6 � �v 'AZ nci 4 Description Qty. Fee(ea.) Total Bldg. no.: 7 I Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: (Block: I Subdivision: SFR (2) bath Project name: OCB us _ ?ilex .T Koamor web o rl&t/, SFR (3) bath City /county: `nc/c, o I ZIP: .77,Z...24/ Each additional bath/kitchen Description and location of work on premises: DE_t - .et . 614 We+ Site utilities: C 'f , 1-V44v, i S /4 Ew Catch basin/area drain OrVit Est. date of completion/inspection: Drywells /leach line /trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: DE.,4 K 1,j4 ry -t - ?(bG- . Manholes Address: 3 L 1 1 s. E, 1T Rain drain connector City: pD at 4,43,1 o I State: OR_ I ZIP: 9 0 Z Sanitary sewer (no. lin. ft.) Phone: 234, -415 L I Fax: 236 -/7731 E -mail: Storm sewer (no. lin. ft.) CCB no.: Q / 7Z Plumb. bus. reg. no: 2.4-y3 Water service (no. lin. ft.) City /metro lic. no.: (std Fixture or item: p g ` . Absorption valve Contractor's representative signature: jG ssc�'- - Back flow preventer Print name: 7f,kL R/4 -J413 Date: -Zr-o. Backwater valve CONTACT PERSON Basins /lavatory Name: i q--/oiF Clothes washer Dishwasher Address: 3 / i j s Z /3 Drinking fountain(s) City: PcR - 77_:/ I State: eiIR1 ZIP:972aa_ Ejectors /sump Phone: 6 /SL Fax 6 - E -mail: Expansion tank OWNER Fixture /sewer cap 2." Name (print): Floor drains/floor sinks/hub 2, /. Garbage disposal Mailing address: Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: I E -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) 1 -5 ,2- I - 3, Owner's signature: Date: Sump ENGINEER Tubs /shower /shower pan Urinal Name: p4. p i Water closet Z' Address: - Waterfieater / City: State: ZIP: r: • Phone: Fax: E -mail: Total Minimum fee $ / Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application $ CI Visa 0 MasterCard Plan review (at _ %) expires if a p ermit i s not obtained Credit card number: State surcharge (8%) 9 p within 180 after has been g ( ) .... $ ! / hi 0 d ft it h TOTAL $ / /p j , 3<p Name of cardholder as shown on credit card accepted as complete. Cardholder signature Amount 440 -4616 (6/00 /COM) PLUMBING PERMIT FEES: 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) - AMOUI Lavatory a 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 Z / 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" 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 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 $36.25 + 8% state surcharge. ** AII New Commercial Buildings require 2 sets of plans with isometric or riser diagram for plan review. . i:\dsts \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 3 " 7 AM PM BUP Location / (e SS /- u-e_ Suite & _9 MEC Contact Person PGZc.L./2. Ph ( ) — 4 PLM 3 -400 (c Contractor Ph ( ) SWR BUILDING Tenant/Owner K ELC Footing Foundation ELC Ftg Drain Access . Crawl Drain f / - , / ELR Slab Insp ion 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: a Fi I AS 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 I 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 D / Inspector Ext Other: Final D I 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 `3 _a AM , PM n BUP Location leg ,s --moo �� Suite �C.� - q MEC Contact Person � ilZ 4 / , Ph ( ) e 36 — q /S_PLM 3 - DO O 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 PAS . • : - T FAIL "' eam <1 1.gr Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fi POP PART FAIL HANICAL 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 ✓}� 2 ADA Approach/Sidewalk Date �� Inspector % 1 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 efr el- Z4 Date Requested 7 3 a AM PM BUP Location / 6i 5V S i/o ✓ Suite 6'-9 MEC Contact Person ..\ l.(J At,W(2 -• Ph ( ) 7— 3 L ' �l 2 PLtd 3 - "ZW 4 Z- Contractor P ) SWR BUILDING Tenant/Owner 4 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 erCUMBINA Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: L1 PART FAIL • ANICAL 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 nextinspection. 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 f 30/0 3 Inspecto Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL