Permit ' CITY OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00421
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DATE ISSUED: 11/3/2008
TICA! 1 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112DD 01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 150 ZONING: I - P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Cap breakroom sink, replace (2) lays and (2) water closets.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 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
Owner: FEES
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI Description Date Amount
PORTLAND, OR 97224 [PLUMB] Permit Fee 11/3/2008 $83.00
[TAX] 12% State Surcha 11/3/2008 $9.96
Phone : Total $92.96
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP#3
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 289 -7095
FAX 503- 283 -9514
Reg #: LIC 120893
PLM 34 -412PB
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 calling 1 • 46.6699 or 1.800.332.2344.
Issue By: .. ir ! Permittee Signat „ .. !i?� `lam
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.
Accumulative Sewer Tally Parcel # 2S112DD -01600
• Tenant Name: Spec Space This SWR# N/A
Site Address: 15495 SW Sequoia Pkwy #150 This PLIM# 2008 - 00421
Fixture Value Previous Previous Credits Capped fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptistry /font 4 0 0 0 0 0
Bath - Tub/Shower 4 0 0 0 0 0
- Jacuzzi /Whirlpool 4 0 0 - 0 0 0
Car Wash - 1:?ach Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor /Water Aspirator 1 0 0 0 0 0
Dishwasher - Commercial 4 0 • 0 0 0 0
- Domestic 2 • 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eve Wash 1 0 0 0 0 0
Floor Drain /Sink - 2 inch 2 0 0 0 0 0
- 3inch 5 0 0 0 0 0
- flinch 6 0 0 0 0 0
- Car Wash Drn 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 1 -IP) 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 0 0 0
- Industrial (over 5 1-IP) 42 0 0 0 0 0
Ice Machine /Refrigerator Dram 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 - 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar /I..avatory 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Commercial 3 0 1 3 0 -1 -3
- Service 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet - 'I oilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 1 _ 3 0 0 _ -1 -3
Current Fixture Value -3 divided by 16 = -0.2 Current EDU 1 IDU = S 3,100
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -3 divided by 16 = -0.2 over (under) S (620.00)
Enter EDU Change Here -0.2
Notes: ** *CREDITS * **
Authorized Name /Signature: Debbie Adamsk Date: 11/3/2008
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\ Building \ Sewer Tally \Sewcrl•allyShcet- 3100.xls 06 /19/08
iNav 03 2008 10:22AM CASCADE PLUMBING 5032839514 p.2
Plumbing Permit Application l t11R 01 1((:1'. I'VI. c)N,.'
City of Tigard % -.
III • 13125 SW Hall Blvd., Tigard, OR 97223 w\ \'; ., , view
1 ' Phone: 503.639.4171 Fax: 503.598.1960 \�� o C)' Other Permit No.:
'� y:
Inspection Line: 503.639.4175 �� OQ bate Ready/By See Page i f or
lemental lnformation
l' I C 11 I � ltInternet www ngard or gov Noufiad(Method e Su FP
ti " r x s` ?.W •" . a G 5 ° ;' 7 , r. .�5 .1. hs..� ,S .C e ` T x F+mii St i nn s• 4t a :. },ice.? i� . C..:,.............,.1.1.' K. •.
❑ New construction ❑ De
»IF . . ` , -., ' ` .' ' -4-•s ,.... .. •
« : s For : , eclat us auswee on use checklist
moliti a Des orianon Wiall Ea Total
.lriit . inner /alteration/replacement ❑ lei New 1- 2- family dwellings (includes 100 ft. for each utility connection)
�x es x t 4 p x z :, 249.20
' :�i us: a d i rtal g r ° i.'T,' A' c ' `F 9 1 a A S (1) bath
�.it4'i� _ "..:,.�, ���au� � a � ._
❑ 1 -and 2- fatuity dwelling ' !es lercial/industrial SFF (2) bath 350.00
1 SFR (3) bath 399.00
❑ Accessory building ❑ Multi - family l 45.00
Each additional bath/kitchen
❑ Master builder 0 Other: Fire sprinkler ( _ sq. ft.) Page 2
g i y - A - 1 e � S:s' a 3 • 'i,. x• „>5 . � .T : us .7 ; y '� , rchs r.;s .. _
t87 ��x".��� ' S util
1 xr ' ', 0 al 4 ��' Catch basin or area drain 16.60
Job site address: 1
City /State/Z[P: .-Tioicui
Drywell, leach line, or trench drain 16.60
•- - p� 2
� C G d� 5 Footing drain (no. linear ft: _)
SuitelbldgJapt no.: , I Project name: 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
1 Lot no.: Water service (no. linear ft.: 1 Page 2
Subdivision Pi Kture or item
Tax map /parcel no.: d & Y/ '7-� " D / 1II Absorption valve 16.60
."'W;-• C VP*: n •`l ` "µ r t i+ rr F e u . - N" T -.=' Backflow preventer Page 2
r , i G Backwater valve 16.60
� 1 6.60
ry ,� t, . - Clothes washer
< < Q, � i ' Ws'r.� u/t Dishwasher 16.60
��� M i ergs .. x } y n -1 Drinking fountain 16.60
naps. , ,t � j x r d )t x w l. "..* s14,: '. s i`.C14 `.: .i; '' i c x.. � 16.60
l + .: " :.war ::. xsis ! !&r. . s ,1' ,u,,• , . � ; Ejectors /sump
Name: Expansion tank 16.60 -
Address: F ixture/sewer cap 16.60
Floor drain /floor sink/hub 16.60
City /State/ZIP: 16.60
� y g Phone: ( ) Fax: � r p4 r: .. } y, ' "�T Hose bib Garbage disposal 1 16.60
• I.° a c °4 ks "3 ? r- , , , >. i +I Ice maker 16.60
Business name: / U i CA) Interceptor /grease trap 16.60^
Contact name: / L C Medical gas (value: $ ) Page 2
Address: A 3 � . J-fa ' r / 2 ' 3 Primer 16.60
City /StatelZTP: p���
r? Q 9 -7„4/ 7 Roof drain (commercial) 16.60
G ��•�
Phone: (�) b J - 70•5 ` Fax: : ) ! � Sink/basin/lavatory 3 L6.60 Tub/shower /shower pan 16.60
E-mail Urinal 16.60
C ts' }, y ,� . s. ' ! p•7H� r t r _� �''. i `?"l;' - - A` M . j P '.r Closet c 16.60 1 4 -
.., # -� .,� ,r.., "'�',t r: 16.60
Business name:
� _ _ I , i • : : : 1 4• Water
heater
9,40 � r -- - -
Address: - ( l�e- Other:
// /� '"„ - Subtotal
City /State/ZIP � �f i cit e_ 3.4 Minimum permit fee: $72.50 0
Phone: 620.5 ) 9'f 1
-75 Fax: (543) " 1 1 j i4 Residential backflow minimum pemlit fee: 536.25 p
CCB Lic.: (9.0 "7 , O 4 ` Plan review (25% of permit fee)
J v Plum ling Lic, no.: �
State surcharge (12% of permit fee) q
Authorized signature: LA. / iA. •• TOTAL PERMIT FEE •21 (p
D ate: I This permit application expires ifa permit is not obtained within
Print name: � i ►'►ems 180 days after it has been accepted as complete.
C e � 06 � 06 p ;Fee methodology set by Tri-County Building Industry Service Board.
I tBuildinglPemi
� rmil S 1 d slPLti1•Permn . App� �C 440-461 eT( I aoucOM/WEB)
" 03 2008 10:22AM CASCADE PLUMBING 5032839514 p.3
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Residential Fire Su s 'ression S stems:
Fee Schedule: ; .. ray r .l i.
_,. , .., :�`1cr ..�.
Footing drain • 1" 100' 55.00 _ 0 to 2,00 r S115.00
46.40 2,001 to 3,600 5160.00
Footing drain - each additional 100' 3,601 to 7,200 $220,00
Sewer - 1st 100' 55.00 ' 7,201 and greater 5309.00
Sewer - each additional 100' 46.40
Water Service -1st 100' 55.00 - Medical Gas S stems:
Water Service -each additional 100' 46.40 i2r rT -:' " t '' r: ' y f , .'.
,..,:c.:-.:4:2,J...,-,1;4 - 1t,a, .err. ;
Storm & Rain Drain - 1st 100' 55.00 51.00 to $5,000.00 Minimum fee 572.50
Storm & Rain Drain • each additional 100' _ 46.40 $5,001.00 to 510,000.00 $72.50 for the first 55,000.00 mid 51.52 for each
additional $100.00 of fraction thereof, to and
Commercial Back Flow Prevention Device
F > i '? -;?-3. a"''''' f. y� i,r p . including $10,000.00.
4 �, n= >N946r.4 s i.
Co 46.40 $10,001.00 to-525,000.00 5148.50 for the first $ 10,000 00 and 51.54 for
each additional $100.00 or fraction thereof, to
minimum ii l mi tlf a $ 3 6.2 ntion Device 27 55 and including 525,000.00.
i r t fee 5 525,001.00 to 550,000,00 5379.50 for the first 525,000.00 and 51.45 for
Raain Drain, single family ly dwelling 65.25 each additional 5100.00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
reciall re•uested in-. Lions - .- hour 72.50 550,001.00 and up 5742.00 for the first 550,000.00 and 51.20 for
Subtotal: each additional $100.00 or fraction thereof.
<r e iF. "w7U! r" ' r pR :,ti 7 ' 't r °1'; n
Fixture Work: #� , . ;: * _�.,t t;., �:..., ...; ,. _
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.
❑ Any new commercial building with water service 2" and
accurate! re sort fixtures could result in increased sewer fees
f greater, except systems designed and stamped by licensed
; k 4 ;- en sneer,
'' , i ,'z� ' , `, , , "� . 4,',;10,,:-=.'.:,-A . ' .. , "l 4 ti. !4 ,: ❑ Any new exterior plumbing site utilities.
_ B ap t .,r y/P .., r a.... ,.t rt, Z.
Baptistry/Pont _ ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub/Shower ❑ Any multipurpose fire sprinkler system
- Jacuui/Whirlpool _ ❑ Any complex structure as defined in OAR918 -780 -0040.
Car Wash -Each Stall
-Drive Thin Submit 2 sets of plans with any of the above,
Cuspidor/Water Aspirator +� a � { ^
Dishwasher Commercial _ .;xw . i.., ,,, ..i .. l'' , 'zs ' ' ., t f . �� ti .. ; < :
Domestic 0 Isometric or riser diagram is required for new buildings
Drinking Fountain _ that meet the ualificatians above.
Eyre Wash
Floor Drain/sink - 2"
_ Comments regarding fixture work:
-4" .
Car Wash Drain
Garbage -Domestic
Disposal -Commercial
- Industrial
Ice MachJRefrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower - Gang *Note; If the fixture work under this permit results in an
- St a ll increase of sewer EDUs, a sewer permit will be Issued and
Sink - Bar/Lavatory 31 1 fees assessed for the sewer increase must be paid before the
- Bradley plumbing permit can be issued.
-Commercial
-Service
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet .
Urinal ,
Other Fixtures: .
I: t8uiWlneerteiMPt:M.PenakAppAoc 09/21dae
•
CITY OF TIGARD 7 t--...- BUILDING DIVISION PERMIT #: plA7009 421
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ' t3 /2008 V.
Phone: (503) 639 -4171 / , 'dypuli�lll�"l 410 •d'r
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' �''.
INSPECTION WORKSHEET FOR DATE: 2/9/2009 TIME: 7:00AM PAGE: 15
SITE ADDRESS: 15495 SW SEQUOIA W 2' 150 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: SPEC. SPACE
DESCRIPTION: Cap breakrnom sink, replace (2) lays and (2) water closets.
OWNER: PACIFIC REALTY ASSOCCATES, PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE #: 503.289.7095 _ _ J
f l ie tr(
-fr....
Inspection Request Scheduled For: Date: 219/2009 Pour Time:
Code # 7/fnspection Description Confirm # Contact # Me a 't/"
399 Plumbing final 080405.01 503.808 -0214 1 --le o
ki 44. 114
Corrections /Comments/ Instructions:
/O‘, 3 6
l' \
H ,,
ti
1
, 1767, - s - s ---- ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
n FAIL H CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Dater Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION
q5 „_ ' PERMIT #: PL�dt200B (t ?1
13125 SW Hall Blvd., Tigard, OR 97223 J , 'TE IS • D. 11/3/2QO3
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 � 0� ��(✓
V 1 1> f/"
INSPECTION WORKSHEET FOR DATE: 713/2009 TIME: 7 • PAGE: 2
SITE ADDRESS: 15495 SW SEQUOIA PKWY 150 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE 7
DESCRIPTION: Cap 151031100M sink, replace (2) lays and (2) water closets . 41 � ��1 b
O
(I r
OWNER: PACIFIC REALTY ASSOCIATES, `b PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE • . 503 - 289-7096
Inspection Request Scheduled For: Date: 713/7009 - 1 - Pour T• e: /
V
-- 21 T * d
Code # Jnspection Description Confirm # Contact # Mes G�""
399 Plumbing final 0802W01 503888 -0214
Corrections /Comments /In ructions: S
(/‘' - . /.2X,S
-0
1 I PASS ❑ PARTIAL APPROVAL ❑ CANCEL (1 NO ACCESS
I =AIL 'VA CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
����`�
Date: V Phone #: (503) 718- /
Inspector: D ( )
CITY OF TIGARD, Atit A ® •
BUILDING DIVISION PERMIT #: PI_M`Of;t3 00 ?1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30008
Phone: (503) 639 -4171 I�i ti Ilil` 6
Inspection Requests (24 Hrs.): (503) 639 -4175 ..JAI
INSPECTION WORKSHEET FOR DATE: 1/16/2009 TIME: 7:01AM PAGE: 8
SITE ADDRESS: 15495 SW SFOUOIA PKWY 150 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: SPEC: SPACE
DESCRIPTION: pap brealgoorn srniy, replace ) lavi:~ !nd (2) Water closet
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CASCADE PLUMBING CO, PHONE #: 503 - 289 -7095
Inspection Request Scheduled For: Date: 1/1612009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 079791 -02 503 - 888 -0211 N
Corrections /Comments /Ins ctions:
(A)( c_. .6 o r/-:C
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
FAIL n CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
Inspector:
`' Az
Date: ` i I bc, Phone #: (503) 718 . )1
CITY OF TIGARD . /
BUILDING DIVISION PERMIT #: PLM2008-00421
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2008
Phone: (503) 639-4171 4 440
Inspection Requests (24 Hrs.): (503) 639-4175 AU' 11.
INSPECTION WORKSHEET FOR DATE: 1 1/4/2008 TIME: 7:00Am PAGE: 8
SITE ADDRESS: . 15495 SW SEQUOIA PKWY 150 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: Cap breakroom sink, replace (2) lays and (2) water closets.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE #: 503,289,7095
Inspection Request Scheduled For: Date: 11/412008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 077630-01 603-914-7389
Corrections/Comments/Instructions:
PASS Lil PARTIAL APPROVAL 1] CANCEL 1 I NO ACCESS
n FAIL 0 CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
\
Inspector: Jt Ll'"A- Date: I 4\ cis Phone #: (503) 718-