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Permit
• C ITY O F TIGARD PLUMBING PERMIT T r DEVELOPMENT SERVICES PERMIT #: PLM2005 -00324 e•JIII DATE ISSUED: 7/25/2005 • 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 BD - 00105 SITE ADDRESS: 12805 SW 77TH PL ZONING: I -L SUBDIVISION: LOT: JURISDICTION: TIG Project Description: Additional fixtures: (1) primer. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: 2 . GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: • ft Owner: FEES B R + G CO LLC PO BOX 23009 Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 7/25/2005 $166.00 [TAX] 8% State Surcha 7/25/2005 $13.28 Phone : Total $179.28 Contractor: PARFITT PLUMBING 12172 SE 222ND DR BORING, OR 97009 • REQUIRED ITEMS AND REPORTS • Phone : 503- 658 -5068 Reg #: LIC 85121 PLM 3 -274PB • 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. Permittee Signature: / By: : Issued Call 503 - 639 -4175 by 7:00 a.m. for an inspection tha busi r ess day. This permit card shall be kept in a conspicuous place on the job site unt' completion of the p oject. Approved plans are required on the job site at the time of -each inspection. -) t „Z3' . • ■ — Oil) ej" Ai Plum Permit Appl :, ; a R Datereceived:'7 �()Y • Permitnoli 1��� `` Op y I1 1�y'Y ,- ,; L City Of 2 5 SW Hall B� LV 3W S� .;i i S ewe r perm no.: B uilding permit no. Address: 13125 SW Hall a_'d� a 2 City of Tigard Phone: (503) 639 -4171 Project/appl. Expire date: a9.2 4' / Fax: (503) 598 -1960 JUL 2 5 2005 Date issued: By: Receiptno.: Land use approval: CITY OF TIGARD Case file no.: •''... Payment type: k n tt . i --";;,':,'3'.=, e + i t 0 a a • ? r q - m , .1, - F� . :*�, ' x ;; T 1 PE O F PLRM , ; .. '.';:4',`,4; i '‘..'..'..10 > :t� `��e. tom � - �.. - - �. .�. • 9 n. f �. �m� �, , ❑ 1 & 2 family dwelling or accessory ❑ CommerciaUindustrial 0 Multi - family ❑ Tenant improvement ❑ New construction 0 Addition/alteration /replacement ❑ Food service ❑ Other: , .. xY� ii ` ,JOB SITL INFORMA ON , 0 , n s a - ; SCII EDULE (f''''''''''''''' o secial nforn use checkl Job address: 19 oe; S w .7 •7 T Hume, Description Qty. Fee (ea.) Total New 1- and 2- family dwellings only: Bldg. no.: I Suite no.: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: IBlock: I Subdivision: SFR (2) bath Project name: SFR (3) bath City /county: Tt6 I ZIP: Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est. date of completion/inspection: Drywells / leach line /trench drain ,. �^ r �� •,. Footing drain (no. lin. ft.) t.. ' „ "„.t; 3 APLUMI ING� • ,,CONfRRACTOIt;.:, 4- z- , -, -', '1 Manufactured home utilities Business name: rr /i.70/474/4/0:- Manholes Address: a 0 <,/5.. 2_2_Z oft, Rain drain connector City: &yii'_-(/l.{h— I State: Cm_I ZIP: 5,7007 Sanitary sewer (no. lin. ft.) Phone: S �s?y6 I Fax: e- ,Z4,9j E -mail: Storm sewer (no. lin. ft.) CCB no.: Plumb. bus. reg. e, Water service (no. lin. ft.) BIZ/ r- I g no: 3 'z j P� Fixture or item: City /metro lic. no.: 4j c� 3 Absorption valve Contractor's representative signature: Back flow preventer Print name ,Je I 4 - ,, Date: 7-/s O''; • • A.4 $4 K CONTACT, i i.RSON . .w,ta ' _ ,: Bas' 'IA . vato u 1., A , b 0 Name: Clothes washer Address: Dishwasher Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: Fax E-mail: Expansion tank . °`x':' 4 0A OWiNI I ,h;a, 90: z r . er cap Name (print) oor drain floor sinks/hub A r a I /6 '6 Mailing address: ar:. _e .isposal Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) i /6, 6 L) 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. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump } =' k i A', •..4 - ' 7M LN'GINLI ) . � d 1 # u , Tubs/shower /shower pan - Name: Urinal Water closet •_ Address: Water heater City: State: ZIP: Other: Phone: Fax: E -mail: Total I 0 Na all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ / 6 6 ` 6,6 Notice: 'Phis permit application o Visa 0 MasterCard Plan review (at _ %) $ . expires if a permit is not obtained .-� Credit card number- / / within 180 days after it has been State surcharge (8 %) $ Expires TOTAL $ / 7' Na of cardholder as shown on credit card accepted as complete me $ Cardholder signature Amount 440-4616 (6/00/ OM) • PLUMBING PERMIT FEES: -t `z� 4bI ;' `,, i , fi 5. , 'x A a PRICE ,' ' ITOTAL- `= ' New 1'andt2'fartiil" ?dwelliiids l on"' ^ ,. ' : ' � , ,.. %:FIXTURE i ndividual't } ,:; ; z. _ + t . r: $ ,, , ,(..,, , , i 9,- y r „q .,.:%,,,, �} 7. ( ) QTY,,, <y .(e a )� AOUT MN r , ,,(includes all plumbng fixtures ins PRICE TOTAL Sink 16.60 the •dweliing ft' QTY r,`.r,(ea1'r , Lavatory 16.60 f utili ,;� fit, 611 :;,,,, .n 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 8% STATE SURCHARGE ..,�, -a_ .., 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 - ' 'i' tluantlty Work Performed Gas piping requires a separate mechanical >Fxtur New, r Mo v ed Repla :Rem /" , permit. . - r -Kn) x_ g ta _i'. sCpped 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) s 16.60 Urinal Dishwasher ' Garbage Disposal .. Laundry Room Tray Washing Machine Floor Drain /Sink: 2" Sewer , 1st 100' 55.00 3 „ Sewer.- each additional 100' , • 46.40 4" Water Service - 1st 100'. 55.00 Water Heater Water Service - each additional 200' 46.40 Other Fixtures (Specify) 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 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 e z ' ) g . i Quantity Total is > 9 ° _ - :;2 r _ *SUBTOTALx n ; . • 8% STATE SURCHARGE m ' • '• s. **PLAN REVIEW 25% OF SUBTOTAL rug", 4 k� , Required only if fixture qty. total is > 9 r, to • TOTAL t $ s t a s "r sn. • * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25+ 8% state surcharge. ' ** Ail New Commercial Buildings require 2 sets of plans with isometric or riser . diagram for plan review. •w _ "` • . 1 :\ dsts \forms\plm- fees:doc412/26 /01 ;-:.°._ ' -. f 1 0 _ PARFITT PLUMBING, INC. 12172 SE 222 Dr. Boring, OR 97009 RECOVED Phone: 503- 658 -5068 Fax: 503- 658 -2497 JUL 25 2005 CCB #85121 CITY OF TIC�/�R© BUILDING DIVISION A CD w4 L -� ,, we-I Worner ! A Ille V. ., R 1 � r1 �x t3 nr.'F !' Ks!B�L *uc'`'�i�F �Li y ` fit ;a: VI T k 1111111111111 Men's Locker Room k r ' fzD Q - x . at.- a i K nr V: - +. at" J 1 S W •7 1' d,,. ; ',tit! •:, . tt ig mi .• .�'.r'i lgvalll MSWt W<s , CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005 -0032e1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/25/2005 Phone: (503) 639 -4171 a�jpupip�ilfl Inspection Requests (24 Hrs.): (503) 639 -4175 '.� INSPECTION WORKSHEET FOR DATE: 9/19/2005 TIME: 7:06AM PAGE: 57 SITE ADDRESS: 72806 SW 77TH PL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: TEREX UTILITIES WEST DESCRIPTION: Additional fixtures: (1) primer. OWNER: g R + G Co LLCM PHONE #: CONTRACTOR: PARFITT PLUMBING PHONE #: 503 - 658-5068 Inspection Request Scheduled For: Date: 9119!2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 015898 -01 503-668-5205 N Corrections /Comments /Instructions: l 2 / _ • 0 PASS [ 1 PARTIAL APPROVAL n CANCEL NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ° Date: 1 i . , Phone #: (503) 718 -