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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00100 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/9/2007 PARCEL: 2S 113AD - 01800 SITE ADDRESS: 16650 SW 72ND AVE B12 ZONING: I -L SUBDIVISION: OREGON BUSINESS PARK I LOT: 011 JURISDICTION: TIG PROJECT: JOHNSTONE SUPPLY Project Description: TI - other fixtures: (2) primers. (1) 44." CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: S2 FLOOR DRAINS; 4 TRAPS: STORIES: WATER HEATERS: 2 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 3 URINALS: 4 GREASE TRAPS: LAVATORIES: 5 OTHER FIXTURES: 2 TUB /SHOWERS: 3 SEWER LINE: ft WATER CLOSETS: 4 WATER LINE: 0 ft DISHWASHERS: 1 RAIN DRAIN: ft Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 -WMI PORTLAND, OR 97224 [PLUMB] Permit Fee 3/9/2007 $448.20 [TAX] 8% State Surcha 3/9/2007 $35.86 Phone : Total $484.06 Contractor: DEAN WARREN PLUMBING PO BOX 14701 PORTLAND, OR 97293 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 492 -9514 FAX 503- 296 -2218 Reg #: LIC 154919 PLM 26 -736PB 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 thes- es or • t questions to OUNC by calling 503.246.6699 or 1.800.332.2344. I - ued B Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that b ness 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. Plumbine Permit Application City of Tigard R EOnved ? 0 7 Permit No.: ? -OD�DO :1 13125 SW Hall Blvd, Tigard, OR 97223 ��Y v Plan Q Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.: pa, d^ 7 -cow Inspection Line: 503.639.4175 C�f' .1 I C; A I` I) Internet: www.ti d-or. ov Date ec Ready/By. r S See P 2 for Bar fs Noti6ed/Mahod Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 New construction ❑ Demolition For spedol information use checklist. Description Q Et-Addition/alteration/replacement ❑ Other: New 1- - 2 2-f . for Ea. Total - family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 24920 ❑ 1- and 2- family dwelling El .Commercial/industrial SFR (2) bath 350.00 El Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑� Fire sprinkler ( sq. fl.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: /66 ca 5 W 7 y Catch basin or area drain 16.60 City /State/ZIP: Pct-t 02. 5' 7l yt/ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: ►--5 f e>y.� Footing drain (no. linear R: 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 R: ) Page 2 Storm sewer (no. linear R: Page 2 Subdivision: I Lot no.: Water service (no. linear R: 5 c) Page 2 Fixture or item Tax map/parcel no.: S l - l QOd Absorption valve 16.60 //JJ DESCRIPTION OF WORK Back flow preventer Page 2 "- .j- t Backwater valve 16.60 Clothes washer 16.60 Dishwasher 1 16.60 / C ; c `-> ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 n Ejectors/sump 16.60 Name: /Veie..l 4 Expansion tank 16.60 Address: /$ rej C IA, 1 tic / e A. 10-4/ Fixture/sewer cap Li 16.60 6611" City/State/ZIP: Floor drain/floor sink/hub '1 . 16.60 66 `'/% Phone: ( 52) ) G 1 K --6 1 0 a I Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 n) Ice maker 16.60 Business name: D.,- G1/4,- / ' /✓h 3 Interceptor /grease trap 16.60 Contact name: j- /Q & Medical gas (value: $ ) Page 2 Address: P, o. / fl. /1(yal Prima '2 16.60 3 3 j% City/State/ZIP: ('&-&. dn, S ?). s 3 Roof ... • . .. �. erccial) 16.60 Phone: ( 5 )..36- N 15Z Fax:: ( ) . • \i 6- 6, 16.60 cg4.6 E-mail: Tub/shower .. . a pan 16.60 Urinal 4 16.60 66 'La- CONTRACTOR Water closet 4 16.60 66 Ha Business name: / O... acv W1,. Oh 5 Water heater 2 - 16.60 3 3 . ya Address: fi, a , IL 1 )e- / Other: - - City/State/ZIP: P..a.f-(j„( o9't- 571 5 3 Subtotal Minimum permit fee: $72.50 Y tiD Phone: (a1)) 236 - Yin.- Fax: ( :5Cj 296 --2-2-/q Residential backflow minimum permit fee: $36.25 CCB Lic.: [ 5-14 S1 S Plumbing Lic. no.: 26 -3 36P/� Plan review (25% of permit fee) / State surcharge (8% of permit fee) ? Authorized signature: -74 C ( TOTAL PERMIT FEE z./ei I Print name: ,,p IL j I Date: '3 -g -7 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: &riidingTaminrPLM- PamitApp.doc o6126 4404616TO 0/02/COM/W®) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities ot Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 55.00 0 to 2,000 5115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 5160.00 3,601 to 7,200 5220.00 Sewer - 1st 100' 55.00 7,201 and greater 5309.00 wer each . . : onal 100' 46.40 8ta S lilkiYi` s' I /► 53.00 .� / Medical Gas Systems: Wa - Servicc - each •"^final 100' 1V .40 3.2 'w Valuation: Permit Fee: Storm &Rain Drain - 1st 100' S .: • 51.00 to 55,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 55,001.00 to 510,000.00 572.50 for the first 55,000.00 and 51.52 for each ea additional $100.00 or fraction thereof to and Fixture or Item • Fee ( � T otal including $10,000.00. Commercial Back Flow Prevention Device 46.40 510,001.00 to 525,000.00 $ 148.50 for the first 510,000.00 and 51.54 for Residential Badkfow Prevention Device each additional 5100.00 or fraction thereof to (minimum permit fee 536.25) 27.55 and including 525,000.00. Rain Drain, single family dwelling 65.25 525,001.00 to 550,000.00 5379.50 for the first 525,000.00 and 51.45 for Inspection of existing plumbing each additional 5100.00 or fraction thereof to specially requested inspections - per hour 72.50 and including 550,000.00. Subtotal: 550,001.00 and up 5742.00 for the first 550,000.00 and 51.20 for each additional 5100.00 or fraction thereof Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and Quaotityby (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Race engineer. Previous Calmed Added Existiat ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780-0040. Bath - Tub/Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool Car wash - Each Stall ❑ Any multipurpose fire sprinkler system. ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Wato Aspirator Submit 2 sets of plans with any of the above. Dishwasher -Commercial 1 -Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" i-f that meet the qualifications above. -3" / 1 - 4" Car wash Drain Comments regarding fixture work: Garbage - Domestic Disposal - Commercial - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall 4.3 *Note: If the fixture work under this permit results in an Sink - Bar/Lavatory * . S - Bradley increase of sewer EDUs, a sewer permit will be issued and - Commercial I I fees assessed for the sewer increase must be paid before the -mice plumbing permit can be issued. Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet K Urinal 4 • Other Fixtures: isu 3uildingTenniu\PLM- Pe,mitnpp.doc 0922/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 -00100 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 Phone: (503) 639 -4171 p l oll Inspection Requests (24 Hrs.): (503) 639 -4175 _..�� `: INSPECTION WORKSHEET FOR DATE: 5/17/2007 TIME: 7:00AM PAGE: 33 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK! LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: 71- other fixtures: (2) prirners. 4/16/07, ADDING (1) MOP SINK. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503-236-4152 Inspection Request Scheduled For: Date: 5/17 /2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 048514 -01 503307 -2105 N Corrections /Comments /Instructions: 607 / A) U A % _= = - / A ,DDS , 'c..-4 0 -,- c.,4) L___9r /4-52- _.& Ar--€.--.2- S c_c_e__,--- \ 3.. y ....__, v i 0 ,---vd -- ": e-...■•t---t 1 . 02..0.___ ( A--- - 1. 1 " -- e . ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: " Date: (7k -) / J Phone #: (503) 718 - 2- CITY OF TIGARD . • BUILDING DIVISION PERMIT #: PLM2007 -00100 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 Phone: (503) 639 -4171 +a' Inspection Requests (24 Hrs.): (503) 639 -4175 ...' 1 L INSPECTION WORKSHEET FOR DATE: 5/16/2007 TIME: 7:OOAM PAGE: 31 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: TI - other fixtures: (2) primers. 4/16/07, ADDING (1) MOP SINK. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503-236-4152 Inspection Request Scheduled For: Date: 5/16/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 048394 -01 503 -307 -2105 Y • Corrections /Comments /Instructions: 2 _4/# .4 ■■ 1, ir" IGIAIlf-d -4 _ ■ .1 PO C ifige „ , if ❑ PASS VPATIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r: /� % w ' Date: / / Phone #: 503 Inspector: G' 1/ G1 �1 ( ) 718 - _ CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 -00100 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 ' Phone: (503) 639 -4171 ' VIV Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 4 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: TI - other fixtures: (2) primers. 4/16/07, ADDING (1) MOP SINK. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503 - 236 -4162 Inspection Request Scheduled For: Date: 4/17/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 046640 -01 503. 307 -2105 Y Corrections/Comments/Instructions: 00 v'o.4 L,.h../ k /Sy e (1.0 ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: QTO 1 -)--i ! — Date: `71 III .] Phone #: (503) 718- CITY OF TIGARD ° �: BUILDING DIVISION PERMIT #: PLM2007-00100 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ; INSPECTION WORKSHEET FOR DATE: 4/16/2007 TIME: 7:00AM PAGE: 56 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: TI - other fixtures: (2) primers. • OWNER: PACIFIC REALTY ASSOCIATES. PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503-236-4152 Inspection Request Scheduled For: Date: 4/16/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 046475 -01 503-780-9486 Y Corrections /Comments /Instructions: �' S,1" 1, hal j,--t ✓u -mow e. • cgl PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- CITY OF TIGARD `•_:; BUILDING DIVISION PERMIT #: PLM2007 -00100 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/9/2007 Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 4/9/2007 TIME: 7:01AM PAGE: 14 SITE ADDRESS: 16660 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK! LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: TI - other fixtures: (2) primers. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503.236.4152 Inspection Request Scheduled For: Date: 4/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 046192 -01 503-307 -2105 Y • Corrections /Comments /Instructions: �/ r%. , RL ✓ t (-oo Col t,- 1 )4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0 Date: L I f q !/ 7 Phone #: (503) 718- CITY OF TIGARD . " BUILDING DIVISION PERMIT #: PLM2007 -00100 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 . Phone: (503) 639 -4171p 'll Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/6/2007 TIME: 7:04AM PAGE: 8 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: TI - other fixtures: (2) primers. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503-236-4152 Inspection Request Scheduled For: Date: 4/6/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 046128 -01 503 - 307 -2105 Y . Corrections/Comments/Instructions: Nod" ,e- l ii' vim,, 11.1" CZ L sI, 4- c- t 2 4 S' IA 'PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS NI FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Ill ‘1>∎N\ s "" Date: y l L 109 Phone #: (503) 718- CITY OF TIGARD - . , A • BUILDING DIVISION PERMIT #: PLM2007 -00100 .... 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 . Phone: (503) 639 -4171 ill� Inspection Requests (24 Hrs.): (503) 639 -4175 1 INSPECTION WORKSHEET FOR DATE: 4/2/2007 TIME: 7:02AM PAGE: 1 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: TI - other fixtures: (2) primers. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503-2364152 Inspection Request Scheduled For: Date: 4/2/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 045852 -01 503-780-9486 Y Corrections /Comments / Instructions: C .e - --1- ,-« 1 13 cTL e-a ()L., D 1 tj . PASS Ca PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6r3 kv/....✓; ((f `^'L— Date: 4 02 /0 Phone #: (503) 718- • CITY OFTIGARD BUILDING DIVISION PERMIT #: PLM2007 -00100 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 Phone: (503) 639 - 4171 711r Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/15/2007 TIME: 7:01AM PAGE: 10 SITE ADDRESS: 16650 SW 72ND AVE B12 CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK 1 LOT #: 011 TYPE OF USE: PROJECT NAME: JOHNSTONE SUPPLY DESCRIPTION: T1 - other fixtures: (2) primers. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: WARREN PLUMBING, DEAN PHONE #: 503-236-4152 Inspection Request Scheduled For: Date: 3/15/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 305 Plumbing underslab 0448B6 -01 503-307 -2105 Y Corrections /Comments /Instructions: ) & / 1/( J -- / / 1 // Arr - ❑ PASS ,3RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ] Date: 3 /5 7 Phone #: (503) 718- —2 3"