Permit *AK/05 t
A -- CITY OFrTIGARD
DEVELOPMENT SERVICES PERMIT #: PLM2003 -00084
. � I I DATE ISSUED: 3/19/03
13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 113AB -00800
SITE ADDRESS: 15995 SW 74TH AVE 150
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 8 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Fixtures for TI.
FEES
Owner:
Description Date Amount
DUNCAN, JOHN A AND [PLUMB] Permit Fee 3/18/03 $166.00
7060 SW LEE PALMER WAY [TAX] 8% State Tax 3/18/03 $13.28
BEA VER TON, PLMPLN] Plan Review 3/18/03 $41.50
EA O OR 97007
Phone Total $220.78
Contractor:
POWER PLUMBING CO
P BOX 19418
PORTLAND, OR 97280 REQUIRED INSPECTIONS
Underfloor /Underslab
Phone : 503 244 - 1900 Top - out Insp
Reg #: LIC 52378 Final Inspection
PLM 34 -150PB
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
Issued By: 4 APB, Permittee Signature:
all (503) 639 , 175 by 7:00 P.M. for an inspection needed the next business day
Ai, :,
• CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2003 -00084
'` ^KII 13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/19/03
SITE ADDRESS: W 74TH AVE PARCEL: 2S113AB 00800
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 8 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Fixtures for TI.
FEES
Owner:
Description Date Amount
DUNCAN, JOHN A AND
JANICE LEE [PLUMB] Permit Fee 3/18/03 $166.00
7060 SW PALMER WAY [TAX] 8% State Tax 3/18/03 $13.28
BEAVERTON, OR 97007 [PLMPLN] Plan Review 3/18/03 $41.50
Phone : Totai $220.78
Contractor:
POWER PLUMBING CO
P BOX 19418
PORTLAND, OR 97280 REQUIRED INSPECTIONS
Phone Underfloor /Underslab
hone : 503 244 1900
Top -out Insp
Reg #: LIC 52378 Final Inspection
PLM 34 -150PB
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
Issued By: Permittee Signature: 0071 Q ij ,_
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
kc201�3 - -
Plumbing Permit Application
r , `r �� Datereceived:1 ... Permitno.: / _ ki
t,i'>t I ,, City of T 's E' V B uildin permit no.:
A i I Sewer permit no. • 3.m9; Building p
Address: 1312S SW Hall Blvd, Tigard OR 97223
City of Tigard Phone: (503) 639 -4 (71 1 1 200J Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: Receipt no.:
yr -p( OF TIGARD C ase file no.: Payment t ype: .
Land use appro niVISION y
TYPE OF PERMIT ,
❑ 1 & 2 family dwelling or accessory - ommercial/industrial ❑ Multi- family , l: enant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other:
JOB SITE INFORMATION FEE SCHEDULE (for special infor ation use checklist)
Job address: So / y ='�- Cta /5b Description Qty. Fee(ea.) Total
Bldg. no.: /S f 1'
Tax map/tax I Suite no.:
New 1- and 2- family dwellings only:
/tax lodaccount no.:
Lot: (Block: (includes 100 ft. for each utility connection)
p SFR (1) bath
I Subdivision: SFR (2) bath
Project name: Ex C.e L T lam, N.LS SFR (3) bath
City /county: ^'ri Q�l> e 1Z, I ZIP: Each additional bath/kitchen
N Description and location of work on premises: Site utilities:
. Catch basin/area drain
�"1 Est. date of completion/inspection: Drywells /leach line /trench drain
` , Footing drain (no. lin. ft.)
l PLUMBING CONTRACTOR - Manufactured home utilities
• Business name: -p L ,J.N ?(,......,3 i ..c Co , Manholes
Address: (DC ! l SW 00N .t `T ivb eAaL t? LA . Rain drain connector
• City: purr- --- I State: elk' ZIP: q Sanitary sewer (no. lin. ft.) '
Phone: Vyry...l q,t, Fax: 2i,erkk2,5— E -mail: • Storm sewer (no. lin. ft.)
CCB no.: S 2.37 ' I Plumb. bus. reg. no: 347-,Sb Water service (no. lin. ft.) _
City /metro lic. no.: t Li ( Z Fixture or item
Absorption valve I1
Contractor's representative signature: i3� �
Back flow preventer
Print name: t S i GLGn t5S Date: . -. )o-o3 Backwater valve
,. / "1, CONTACT PERSON Basins/lavatory .-
Name: „So 0...4 GC G v3SJ� Clothes washer
Address: Dishwasher
Drinking fountain(s)
City: I State: I ZIP: Ejectors /sump
Phone: Fax: E -mail: Expansion tank
-- .1 OWNER Fixture /sewer cap
Name (print): C'l.CsL vZ,-j v ,v'.L� Floor drains /floor sinks/hub
Garbage disposal
Mailing address:
Hose bibb
City: I State: I ZIP: Ice maker
Phone: YSZ— OS`!O 1 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. 0%. s), basin(s), lays(s) f 1•(,, ( 13 2 , L
Owner's signature: Date: Sump
'' . Tubs/shower /shower pan O Jo,6a o
1L,L
Urinal
Name: Water closet
Address: Water heater 1 i (p, (,O /6,6o
City: State: ZIP: Other:
Phone: Fax: E -mail: Total )1,400 .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $
Notice: This permit application
❑ Visa O MasterCard expires if a permit is not obtained Plan review ( at A.5 % ) $ /f Sd
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ /3 • aZ er
Expires TOTAL $ A AD / 7 e
Name of cardholder as shown on credit card accepted as complete.
$ OCZ
Cardholder signature Amount 440 -4616. (6/00 /COM)
PLUMBING PERMIT FEES: ,
pR.t.c.g ,TOTAL ,:: :;t1e*Ii:a0d,24:(fill0410:11iii0".dilly:' , -:: ,",'-, '„,;", ,
FIXTURES (individual) ,,:, J, ,‘ ,.,. ¥,-. . ;Otfn ,(6) :.; ,i AMOUNT .,` :(i00001 atfplinliiitfiktmr*tin' , - - :: PRIC,E
Sink 2 16.60 132, iro 1,11e,dwalltng and the firstl00 ft QTY " (ea) MOUNT
Lavatory 16.60 fOreaCh-,utility:cdrinection) . , - . ' : f - ,.',' ..- •: - ':,;-„.
One (1) bath $249.20
Tub or Tub/Shower Comb. 16.60 Two (2) bath $350.00
Shower Only I 16.60 / („,c0 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 /6„6,3 , ,,,,- ,-,., ,• . , : _ , Quantity by Work Perf�rmed
Gas piping requires a separate mechanical ,Fixture Type: ''' , : . ..New. Moved-, 'Replaced, ` ,,,Removed/
permit. .. . . s - . --,-,,..- ,-•,.. , ,,Capped .,
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 ,
Urinal
Other Fixtures (Specify) 16.60 '
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
, Floor Drain/Sink: 2"
. .
i . Sewer -.1st 100' 55.00 3"
I
bewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater ,
Water Service - each additional 200' 46.40 Other Fixtures
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 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60 -.• ........._ /
QUANTITY TOTAL ., , c , , _
., . .,, - . 7
/ 49
Isometric or riser diagram is required if Pr I. ,• ,
%,i0OP Are"Prr -
Quantity Total is > 9 , „. „ . I re
*SUBTOTAL ,':::: ''
8% STATE SURCHARGE '.,
**PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9 -,,.. ' '' ':
TOTAL ! .;:::'.;;1 !' ,,:, ,' $
* 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 plans with isometric or riser diagram and
plan review.
•
iAdstsVorms\plm-fees.doc 10/10/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested 3 -c-27 AM PM ✓ BUP •
Location /4 4 7 7 Suite MEC
Contact Person Q Ph ( ) g36. PLM 3 - Od o
Contractor Ph ( ) (3. f 4D° 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
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan •
Other: •
F.
PART FAIL
�r - ' 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 '`�
ADA Approach/Sidewalk Datc -3 2 �� Inspector /277/ / Ext
Other: V
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
- TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
— INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested n � �° AM PM BUP
Location / 9 S 7 7' 'v Suite /-57) p MEC
Contact Person M-' Ph ( ) � � 6 - O ff " _I PLM 3-00o g
Contractor Ph ( ) SWR
BUILDING Tenant/Owner EIX —e-p ELC
Footing ELC
Foundation 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
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Oti ej:
.!r
P IS 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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE LJ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
Approach /Sidewalk Da Inspector G M Ext
Other:
Final D • NOT REMOVE this inspection record from the Job site.
PASS PART FAIL