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Permit C ITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2002-00104 J�l.. DATE ISSUED: 5/10/02 10/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15205 SW 74TH AVE PARCEL: 2S112DB 00600 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P BLOCK: LOT: 014 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: 2 FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: 700 ft Remarks: Site utilities for new 14,000 square foot office building. FEES Owner: Type By Date Amount Receipt DENNY MEYER PLCK CTR 5/10/02 $130.75 27200200000 7340 SW LANDMARK LANE PRMT CTR 5/10/02 $523.00 27200200000 TIGARD, OR 97223 5PCT CTR 5/10/02 $41.84 27200200000 Phone 1: 503 - 620 -2086 Total $695.59 Contractor: • KENT'S PLUMBING 1702 DIKE RD WOODLAND, WA 98674 REQUIRED INSPECTIONS Phone 1: 360 - 225 -5761 Sewer Inspection Water Line Insp Reg #: LIC 151122 PLM 37 -451 PB Storm Drain Insp RP /Backflow Preventer Final Inspection 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: /, / /�� f y/4 ) Permittee Signature: `� ,� 1 • Call (503) 639 -4175 by 7:00 P.M. for an inspection needed then t business day ( d 6 r- ©®24 i&Z, -6r- e,, az,.. - Plumbing Per�mitApplicatio� ‘, N : i U 1,1 L ., . .. .., . L� l Date received: J 1 9 - Permit no.: / Zr/L l , ' AO/ y } r , , City b Cit of Tigard `J 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 Bg Ci ,i. . ..—.L..,... y ....4,10 Date issued: By: Receipt no.: Land use approval: Casefile,no.: Payment type: .. TYPE OF PERIVIIT,, ❑ 1 & 2 family dwelling or accessory ACommercial /industrial ❑ Multi - family ❑ Tenant improvement (3- ❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: JO); SITE INFORMATION � .a FEE SCHEDULE (for special information use checklist) :.'� ` . , O ` Job address: i '? _ 0 5 •S T-11 A Ve J .. r { Description Qty. Fee(ea.) Total Bldg. no.: a Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: 251115 f3 4 SFR (1) bath Lot: to 00 Block: Subdivision: SFR (2) bath t" Project name: Meyc 5 / SFR (3) bath City /county: T,S� red ZIP: en L. c4 Each additional bath/kitchen Description and location of work on premises: OP/c.c. r t, is ran ou.se. Site utilities: V an f- SPA a 'or Me e-r Si n Catch basin/area drain - Est. date of completion/inspection: Drywells/leach line /trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: E. i J1 Manholes Address: 1 2 TD 1 (6 1D Rain drain connector t --L City: : w 4 ) II, i lip State:0 G ZIP: ' 7 4 Sanitary sewer (no. lin. ft.) 7 Phone ,S -r Fa , E -mail: Storm sewer (no. lin. ft.) ? C ' CCB no.: (S''' // 4 D-1 I Plumb. bus. reg. no:51 -4517, Water service (no. lin. ft.) 7. 1 City /metro lic. no.: 0 -K•07/ 3 -3 I _p of Fixture or item: \ Contractor's representative signature: Absorption valve Back flow preventer I Print name: Date: Backwater valve i 1 ' CONTACT PERSON Basins lavatory Name: J O ie S n n aret�.S Clothes washer Dishwasher Address: 'To . 7 $ y Drinking fountain( . City: j f Ct rtL I State:O (Z,1 ZIP: C1 1 a $1 Ejectors /sump Phone: 5 5 U � . 6 20.z.• ., Fax: (par • 310 3 - E -mail: Expansion tank +,. OWNER Fixture /sewer cap A Name (print): �>✓n n 1 Floor drains /floor sinks/hub �( 1' t r Garbage disposal • Mailing address: 1 3 4 a 5 Ini LW/de/ars k Let_yi - e Hose bibb City: T - t' � a, r el I State: 042- !Zip: q7 as 4 Ice maker Phone:. o'b • to 24 9z. oo( Fax: 1E-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 pr jp.. I own as per ORS Cha•ter447. Sink(s), basin(s), lays(s) h Owner's signatur - 4:_, i:a��� e a' ( /. te: 6 2 Sump ENGINEER • S Tubs/shower/shower pan ' Urinal Name: N 1 tr G t n ineer' q Water closet Address: () ' S A . C t�kA Water heater City: Ti5C,r/il I State :0 (Z, I ZIP: 01722 3 Other: Phone: ( a. 0 g(,, I Fax: Ipe 4.3b3 to I E-mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ Notice: This permit application Plan review (at _ %) $ ❑ visa ❑ MasterCard expires if a permit is not obtained credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ _ Name of cardholder as shown on credit card accepted as complete. — $ Cardholder signature Amount 440616 (6/00 /COM) 1 PLUMBING PERMIT FEES: .•. _:� T PRICE -TOTAL 'New Land 2 farnilytdwellings oiity FIXTURES, (individual) QTY (ea) = AMOUNT' (includes all plu nbmg fixtures in PRICE TOTAL Sink 16.60 the dwelling and the fi_rst100 ft QT ,(ea) 'for each" utility conne'ction). _ • Lavatory 16.60 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,Perfortiied Gas piping requires a separate mechanical Fixture.Type " New Moved Replaced Removed/ permit. . • `Cgpped` MFG Home New Water Service 46.40 Sink MFG Home New San /Storm Sewer 46.40 Lavatory Tub or Tub /Shower Hose Bibs 16.60 _ Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures (Specify) 16.60 Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Sink: 2" Sewer - 1st 100' , 55.00 S S 07) 3" Sewer - each additional 100' 46.40 _ 4" Water Service - 1st 100' f 55.00 S r Water Heater Water Service - each additional 200' 46.40 J' Other Fixtures (Specify) Storm & Rain Drain - 1st 100' ' 55.00 5 3-, if ? ) Storm & Rain Drain - each additional 100' 46.40 Z7 8, cla Commercial Back Flow Prevention Device 46.40 ,ti/ &,',U Residential Backflow Prevention Device* 27.55 Catch Basin z 16.60 3 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 o 8% STATE SURCHARGE 0 _ - " REVIEW 25% OF SUBTOTAL rt Q Required, only if fixture qty. total is > 9 t,„,4,.% . -.sin /3 1 • TOTAL "` . ' $�!s - i * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. * * All New Commercial Buildings require 2 sets of plans with isometric or riser diagram for plan review. • is \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 f 5-0' OS Date Requested 1 / /z' AM PM BUP Location 7 y Suite MEC Contact Person h Ph (36_0 51 1-11 PLM c —.0 d / L i Contractor ALL.— Ph ( SWR BUILDING Tenant/Owner .'1 -i � .f ELC Footing 4 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 yr', Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam • Under Slab 7 , r _ Rough -In (j Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: L< 'ASS PART" l IL MECHANICA ryr� Post & Beam V Rough In Gas Line v v 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 ADA ) c� �c Approach /Sidewalk Date I ! ;Y U Inspector 1 Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL