Permit y
C I TY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2009 -00003
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/6/2009
PARCEL: 2S 102C B -03500
SITE ADDRESS: 10050 SW GARRETT ST ZONING: R -12
SUBDIVISION: SUNNYWOODS APARTMENTS LOT: 010 JURISDICTION: TIG
PROJECT: GOOD SHEPHERD
Project Description: Relocate w/c and lay, install new shower pan.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
GOOD SHEPHERD LUTHERAN HOME
831 SW 17TH AVE Description Date Amount
PORTLAND, OR 97205 [PLUMB] Permit Fee 1/6/2009 $72.50
[TAX] 12% State Surch 1/6/2009 $8.70
Phone : Total $81.20
Contractor:
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 643 -7619
FAX 503- 643 -7620
Reg #: LIC 12889
PLM 34 -4PB
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 By: a utL � Permittee Signature: a j _S) (AK) 11 ea 1
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.
Jan 06 09 01:17p Beaverton Plumbing Inc 5036437620 p.2
llutbine Permit Application
Building Fixtures it ECEIVED roR oFricra USE ONLY
Itcecwcd
City of Hall 2 1, h • C�9 Pen" N o.: eI1YLZO44 3
Dlurnty: -
n 13125 SW Hall Blvd , Tigard, OR 97223 Pisan Review
( o Phon 503.639.4171 Fa 56 3.598 - O Date/11y: Other I'cuuil NO.:
TICARp Inspection Line: 51/3.639.417:5 II NNW i ;nc ea
hdy /lf
J, �i 5rr I'u}e 2 fur
Internet: www.tigardwt.gov 'V 0, ll Notified /Method: I Supplerncruul ln(urnretiurr
TYPE: OF W Ip1NGv Jar FEE" SCIIEDCLU
-
El New construction Demolition
For special injnrrnatiorr use Checklist. _-
Description I Qty. I I :a. I _ Total ..
Addition/alteration/replacement El Other: . - -' New I- 2- fnniily dwelling? (includes 100 _ ft, for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
T, ❑ Commercial /industrial SFR (2) bath - 350.00 -
❑ Accessory building, Multi Itlmily \PR (3) bmh 390.00
I :uch additional hraali/kilchen 45.00
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Pare
.10B si INF'ORMA'TION AM) LOCATION Site utilities
-- '
Job site address: 1011511 SW GA RRIi'1 "'I' 4 "C
Catch basin or area drain I6.(r(1
City /State /ZIP: TI(:ARD, OREGON Drywell_ leach line. or (tench drain 16.60
Saito /hldE apt. no.: 1) Project name: (;o() DtiI II'.I' S RI) I nntin(', drain (no. linear 1t.: ) Pay,e 2 �
Manufactured home utilities 1 10.00
Cross street/directions to job site:
.._--- Manholes 16.60
-- -.._.... . - _ Rain drain connector 16.60
Sanitary sewer (tau. linear F.: ) Page 2
Start sewer (no, linear I), :, ) Page 2
Water service (n0. linear It.: ) I'age 2
Subdivision: I, no,; __ . ,. .,.,..-___ -- __ ....
-- - - Fixture or item
- 1 - :es map/par nu.:
Absorption valve 16.60
DESCRIPTION OF WORK ___ Backfl w prev vier Page 2
MOVE EXISTING TOILET AND SINK OVER AND INSI NEW SIIOWER Backwnler valve I6.6(1
VAIYE AND GRAIN FOR NEW SHOWER PAN Clothes washer 16.60
- -- - -..__
Uishwusher 1600
- "...'.," Drinkinc, fountain 16.60
® PROPERTY OWNER ❑ TENANT -- -
---• - Ejectors/sump 16.60
Name: GOODS11I;1'AI(D -
Expansion lank 16.60
Address: 10050 SW GA RRETr ST UNIT •'D'• Iixu a re/sewer c .. Nip I (i,b0
City/State/ZIP: 'FIGARD, OREGON 97223 Floor drain /tloor sink /hub 16.60
Phone: ( ) Fax: ( .,_ 1 Garbage disposal 16.60
"' f Ipso bit) I 1(1.60
1,81
APPLICANT ❑ CONTACT PERSON --. -- - -
lee maker 16.60
13asiness name: BEAVERTON PEIIMRING, INC
-_._.. _ "_ ................ .. InTerceptot'/grease trap 16.60
Contact mime: CASEY STEPFIENS -- Medical gus (value: $ ) Page 2
Address: 13980 SW TIIALATIN VALLEY IIW Primer 16.60
City /Sick /71P: BEAVERTON, OREGON 974105 Rnofdrain (commercial) 16.60
Phone: (503) 643.7619 Fax: : (503)643.7620
Sink/basin/lavatory I 16.60 1 6,((I
-- -- uh/showt r /shower pan I 16.60 16.60
I -maiI: beuvplumh(a?aol.enm -- ° -- - --
! _ Urinal 16,60
CONTRA CTO M 4 Wlier closet 1 16.(10 16.611
Business name: Beaverton I'Innibirig, Inc Water' healer - 16.60
Address: 1398(1 SW'I•ualatin Valley Ilwy - Other:
City/State/ZIP: 13cuvcr•ton, Oregon 97005 _..____•,,.
Subtotal 49,80
Minimum permit l'ee: 571.5(1
Phone: (503) 643.7619 Fax: (503) 643.7620 Residential huckllmr minim m permit fix; 536,25 72.56
' ..
CCR Lie.: 012889 Plumbing Lie, no.: 34 - 4P11 flan review (25% olhermil Ice)
--- ._._... Slate snrchaige (17 %ntpermrt tee) it 70
Authorized sig,naturo ( .
`L� (ti1 .- �_ 1 . . 'TOTAL PERMIT PI $1,20
Print name: Susan Dean llate: 1/6/24)09 This permit application expires if permit is not obtained within
180 days after it has been /leer pted as complete.
"Fee methodology set by'rri- County 1)uiltiing,, Indu::Iry Service Bard.
I wuiroiI i niI:OII.nnF- rm mo App u. 12/27/1)6 440 , 11,16r( I o,a7/Comrwn n)
; __Jan 06 OS 01:17p Beaverton Plumbing Inc 5036437620 p. 3
Plu Permit Application - City of Tigard
('age 2 - Supplemental Information
Fee Schedule: Residential Fire Sumar•ession Systems:
Site Utilities Oty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1' 100' 55,00 0 to 2,000 $115.00
I'uotint•, (Train - each oddilionnl 100' 40,40 - ,001 to ),6110 - $ I (,0.110
3,011 to 7,200 1 1 5220.00
Sewer - I s1 100' 55.0(1
7,201 and grealcr 5.100.00
Sewci - cacti additional I00' 40A(1
Water Service - 1st 1011' 55.0 Medical (;as Systems:
Water Service - c:lch ddddional 1011' ..- 46.40
- Valuation: Permit Fee:
,Stol'tll & Rain 110'31,1 - IA IUU' 55.00 __ _ SI.00 in $5,(100.0(1 Minimum lee $72.5(1
Stott!' & Rain Drain - each additional 100' 46.'10 55.001,110 IQ $1(1,000,00 $72„50 for the first 55,000,00 and $1.52Lir e _Ii _
Fixture or Item Qty. fee (ea) rata( additional $100.00 or fraction thereof, to and
includlnr, 510.000.00
Commercial Back How Prevention Device — 4640 $10,0111,0010 S25,000.00 $148.50 for the first S10,000.00 andi S1.54 liar
Residential Rack How Prevention Device each nddiiional $101),00 or Ibeunn thereof; to
(nlinintumJmermit fee $:16.25) 27,55 and including $25,000.00.
Rain Drain, single Iilmily dwelling 65,25 $25,0(11.0(110 $50,000.00 $779.50 fur the first $25,000.00 and $1.45 iut
Inspection of existing plumbing ui each mid it ional $100,00 or Ii (hereof, In
speei lily requested inspceliuns - per holm 72.50 and iu 1) hi t E 650 (1(i(LU(1 „ � T V
sublutrtl: 150,001.00 and up $742,00 lit, the first 550.000,00 pad $1,2(1 I'or
each a idiliuual $100.00 of Tract ;un thereof.
• Commercial Fixture Work: Plan Review for Plumbing Installations
Arc you capping, adding or replacing fixtures? If "yes ". Plan review is required for any ol'the following
please indicate work performed by fixture. Failure to PIe ise chat all that apply.
accurately report fixtures could result in increased sewer fees ❑ Any new commercial building with winter service 2" and
()infant_ by (Fixture) Work Performed greater, except systems dos;gn0(1 and siantped by licensed
Fixture Type: Replace engineer.
_ Previous Clipped Added r ?wiJing ❑ New exterior plumbing site utilllies for any comples .slriivtllre
Baptistry/Font as delined in OAR918- 780 -0010.
bath -T oh/Shower ❑ Medical gin and vacuum systems for health care facilities.
- .1acnzzi /Whirlpool ❑ Any multipurpose lire sprinkler system.
Car Wash -latch Stull ❑ Any coin plea structure as defined in OAR9I -780. 0040.
-Drive Thru
(uspidor /Wafer Aspirator Submit 2 sets of plans with any of the above,
Dishwasher - Commercial
-I )omesl ie
I)rinkinl Fountain Isometric or Riser Diagram
live Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2” that mccl the qualifications above.
-
• 4 .,
Cur Wash Drain
uilrhage - uomeslic Comments regarding fixture work:
Disposal - Commercial _ Moving existing toilet, and lavatory to
- Industrial
lee Mach. /Rcfrit;. Drains to new location in same bathroom
Oil separator ((ins Sint um) insta.11in new shower stall. drain
Rec. Vehicle Dump Station and valve
Shower - (i:mt',
-Stall
Sink - liar /Lavatory I
- Itradlcy * Note: lithe fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must he paid before the
^ Swimming Paul Filler plumbing permit can he issued.
Washer - Otlhes
Water 1f.etraclnr . -
W:uer('Insel - 'toilet 1
Urinal
Other Fixtures:
itla, itain h xi n.I.,I'I.54- 1 12/2'ISt
CITY OF TIGARD
BUILDING DIVISION
Inspection Requests (24 Hrs.): (503) 639-417 PERMIT #: pw2009.00003
13125 SW Hall Blvd., Tigard, OR 97223 A 1/4(DATE ISSUED: 1/6/2009
Phone: (503) 639-4171 . ifootli I lit\
AO- 1
-
INSPECTION WORKSHEET FOR DATE: 112212009 TIME: 7 PAGE: 1.5
SITE ADDRESS: 10060 SW GARRI-... I r ST CLASS OF WORK:
SUBDIVISION: SUNNYWOODS APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: GOOD SHEPHERD
DESCRIPTION: Relocate wk and lav, install new shower pan.
OWNER: GOOD SHEPHERD LUTHERAN HOME, e
c ar PHONE #:
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 60-64'3-7619
Inspection Request Scheduled For: Date: 1/2.2/2009 PHONE
Pour Time: ....v k \ . • '-' k
Code # Inspection Description . Confirm # Contact # Me- -ge
399 • Plumbing final 079912-01 603-E43-7619 Y
Corrections/Comments/Instructions:
/ RI
1
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' 7T1e /36
PASS n PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
El FAIL 0 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: WA Date: 1 /1/Vd
Phone #: (503) 718-
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BUILDING DIVISION PERMIT ~°~~"=~~~""~~° ~�"°"~~"~~"~ : PLh42009'00003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/6/2009
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 u��W '�1.
INSPECTION WORKSHEET FOR DATE: 1/14/2009 TIME: 7:01Ah1 PAGE: 20
SITE ADDRESS: 10050 8yVGARFlF1 F GT CLASS OF WORK:
SUBDIVISION: SUNNYWOODS APARTMENTS LOT #: 010 TYPE OF U
PROJECT NAME: GOOD 8MEPHERD
DESCRIPTION: Relocate w/c and lav, nstU new shower pan.
OWNER: GOOD SHEPHERD L.UTHERAN HOME, PHONE #:
CONTRACTOR: BEAVERTDN PLUMBING INC PHONE #: 5O,3-6437G19
Inspection Request Scheduled For: Date: 1/14y3009 r '" e:
frvi A_/
C�ode# / |npeotion Description Confirm # (�ontaot# K8e�`agz
'
320 P|Urnbing/#uBbin 079087-01 503-341'6589 Y
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Corrections/Comments/Instructions:
•
.
.
PASS 0 PARTIAL APPROVAL 0 CANCEL r7 NO ACCESS
| | FAIL 0 CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
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V/ � ("Lc__ / / /�[/ o / /��1 �~�
Inspector: Phone #: (503) 718-
•:
CITY OF TIGARD ,., • .... ;-
BUILDING DIVISION " A43 PERMIT #: pu
13125 SW Hall Blvd., Tigard, OR 97223 1 k" SUED: 1/012009
Phone: (503) 639-4171 147144141 e ‘, • 1 oto
DAT IS
Inspection Requests (24 Hrs.): (503) 639-4175 . - f...... V
IA % 1
INSPECTION WORKSHEET FOR DATE: 1/9/2009 TIME: 7 PAGE: 27
SITE ADDRESS: i0059 SW GARRETT ST 4- el t ----i----0-0-1 CLASS OF WORK:
SUBDIVISION: SUNNYWOODS APARTMENTS LOT #: 010 TYPE OF USE:
PROJECT NAME: GOOD SHEPHERD
DESCRIPTION: Relocate rile and lav, install new shower pan.
OWNER: GOOD SHEPHERD LUTHERAN HOME, PHONE #: offl
CONTRACTOR: BEAVERTON PLUMBING INC 7 PHONE #: 603.643.7fi9
i/
Inspection Request Scheduled For: Date: 1/9/2009 Pour Ti e: v owitY — t
Code # Inspection Description Confirm # Contact # Message C,:i. 11
320 Plumbing rough-in 079541-01 911-6456259 Y o q:0
Correct ny omments/Instructions: i '42141C--- -5 4.
(2-5 &A,, 1 ci kiv ",/ 47J
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I/12,70g Fr 0
6
1 6 \S1-
0 PASS PARTIAL APPROVAL Lt2 CANCEL El NO ACCESS
X FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
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Inspector: il (1(4 Date: -2 q Phone #: (503) 718- \it
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