Permit III _
CITY O F TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT
PE
COMMUNITY PLM2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/17/2007
PARCEL: 2S113B0 -00600
SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P
SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG
PROJECT: CLEAN WATER SERVICES
Project Description: Installation of 100' of storm drain for cooling of electrical room.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: F2 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 100 ft
Owner: FEES
CLEAN WATER SERVICES
2550 SW HILLSBORO HWY Description Date Amount
HILLSBORO, OR 97123 -9379 [PLUMB] Permit Fee 5/17/2007 $72.50
[TAX] 8% State Surcha 5/17/2007 $5.80
Phone : 503 -681 -3600 Total $78.30
Contractor:
HYDRO TEMP MECHANICAL INC
28465 SW BOBERG RD
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 582 -8525
Reg #: LIC 63907
PLM 26 -357PB
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 uestions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss d By: i - / � 0 � � .I 1 Permittee Signature: ..,(4a % i i/ , �jAr
o r -
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.
Plumbing Permit Application OR OFFICE USE ONLY
City of Tigard i Permit No. A R6 ice,
q 13125 SW Hall Bl l:Y-', -. a pi* Review
- Phone: 503.639.4 I :'.: "Jig I i1 .1 TIG ARD Inspection Line: 503. '.4 5 Internet: www.tigard -bog b 1 7 2001 7 "
For special in ormation use checklist.
Addition/alteration/replacement ■ New 1-2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF I SFR (1) bath 249.20
■ and a SFR (2) bath 350.00
■ • • • SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION Site utilities
' Catch basin or area drain 16.60
City/State /ZIP: ,pUR ktAir r 0/266 b Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: &OS 0E , 5 o7 2 noting drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/ irections to job site:
Manholes 16.60
P 2-007 - 0003 ti Rain drain connector
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: 'q r '
E Subdivision: Sc ulE�2 1 f1r ' )IF�1 r'ot no.: Water service (no. linear ft.: _ )
Fixture Or item
Tax map /parcel no.: 2 5 115)30-0
Absorption valve 16.60
DESCRIPTION OF WORK
: ..
Dishwasher 16.60
PROPERTY OWNER l ❑ TENANT I • „
Eject
Name: 6 ( LL/ A) W4-7 G / �E (! � L s .. ors/sump • 16.60 n tank 16.60
Address: 0 St.,) H I I'_ o kt) 140 • .
City/State /ZIP: 141 L /� 6 / o R_D not c 7 I q3 / y • • • . 16.60
Phone: (5-05) (e e l - 3 4„ so Fax: ( ) Garbage disposal 16.60 0 APPLICANT ❑ CONTACT PERSON
Ice maker • .1
Business name:
Interceptor/grease . 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City/State /ZIP: Roof ' ' 16.60
Phone: ( ) I Fax:: ( ) 16.60
Tub/shower/shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: y bF- �l" -- T(s m P "Kee HA l c Jj� Water heater 16.60
Address: 2-8 l i SW E • A i Other: N M iMZIIM_ ...S7 OD
City/State /ZIP: (A) 1 LSO 10 ✓ J iE Ore q 70 70 ' ' 53700
1
Phone:
p zs V
�� ) .5y2. -8 ZS Fax: („9,13) sgZ ' lLj J 4 Residential backflow minimum permit ', .
CCB Lic.: , ' • 0 (2 . 6 -// e Plumbing Lic. no.: 24„-3 . 2 E ' L
State surcharge (8% of permit fee) ✓ i n
Authorized signature: CL P 7 / !'
A': ,, i TOTAL PERMIT FEE V 0
Print name: BRRBA-R►¢ 'c4FPou) / Date: — 1 - This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I:\ Building \Pemdts\PLM- PemitApp.doc 06/26/06 440- 4616T(10/02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: f LM2007 -00)06
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: €511717007
Phone: (503) 639 -4171 a1 li`'
Inspection Requests (24 Hrs.): (503) 639 -4175 'I � ,I
..
INSPECTION WORKSHEET FOR DATE: 9/24/2007 TIME: 7 °00AM PAGE: 48
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: Installation of 100' of storm drain for cooling of electrical room.
OWNER: CLEAN WATER SERVICES, PHONE #: 50 6R1 -3600
CONTRACTOR: HYDRO TEMP MECHANICAL INC PHONE #: 582 - 8525
Inspection Request Scheduled For: Date: 9/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 056154 -01 503. 519 -1903 N
Corrections /Comments /Instructions:
.r.ec yt,)
Ex PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ?;) ti ►.n_ ' i �� Date: � Z� k Phone #: (503) 718-
CITY OF TIGARD . ;
BUILDING DIVISION PERMIT #: PLM2007 -0020(
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1712007
Phone: (503) 639 -4171 �' i�pftjih
Inspection Requests (24 Hrs.): (503) 639 -4175 ..
INSPECTION WORKSHEET FOR DATE: 6/14/2007 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK:
SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE:
PROJECT NAME: CLEAN WATER SERVICES
DESCRIPTION: Installation of 100' of storm drain for cooling of electrical room.
OWNER: CLEAN WATER SERVICES, PHONE #: 503 - 681 -3600
CONTRACTOR: HYDRO TEMP MECHANICAL INC PHONE #: 582
Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing undersiab 050220-01 503 - 510 -1803 N
Corrections /Comments /Instructions:
i
�f /L .Ll� it11 _
_
4.,‘ . ■14_.■71e/
•
PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / v Date: (J Phone #: (503) 718-