Permit ,t
CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00387
R.I 13125 SW Hall Blvd., T igard, OR 97223 503 - 639 -4171 DATE ISSUED: 9(712005
PARCEL: 1 S 135AA -AC001
SITE ADDRESS: 10390 SW 90TH AVE ZONING: R -4.5
SUBDIVISION: ASHBROOK CONDOMINIUMS LOT: 001 JURISDICTION: TIG
Project Description: Building 4: 5 townhouse units. Other fix. expansion tank and hose bibbs.
CLASS OF WORK: NEW GARBAGE DISPOSALS: 5 MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 5 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 5 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 5 URINALS: GREASE TRAPS:
LAVATORIES: 10 OTHER FIXTURES: 15
TUB /SHOWERS: 10 SEWER LINE: ft
WATER CLOSETS: 10 WATER LINE: ft
DISHWASHERS: 5 RAIN DRAIN: ft
Owner: FEES
MATRIX DEVELOPMENT Description Date Amount
12755 SW 69TH AVE, SUITE 100
TIGARD, OR 97223 [PLUMB] Permit Fee 9/7/2005 $1,162.00
[PLMPLN] Plan Review 9/7/2005 $290.50
Phone : 503-620-2020 [TAX] 8% State Surcharl 9/7/2005 $92.96
Total $1,545.46
Contractor:
COMPLETE COMFORT SYSTEMS INC
12300 SW 69TH AVE. REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone : 503 -598 -4798
Reg #: LIC 152736 •
PLM 34 -356PB
•
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 -6 9 or 1- 800 - 332 -2344.
Issued By: Permittee Signature: 4'? 7 1 ? ' -'
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.
. .. 0 3 ci -) ciO mac.
Plumbing Permit Arppli.ca:tionVED FOR OFFICE USE+ONLY
t-it,. IL-
City of Tigard Received�� _� 1-- Penmt 7 , 7
13125 SW Hall Blvd., Tigard, OR 97223 . • Date /By: CI 1 1�Qli �V �� 7 r
Phone: 503.639.4171 Fax: 503.598.196
+1 . . vi ew y
0 �- O 8 200 Other P ermit No
L I l j�i Plan Re Date /By: y0 cA ekg 1� 0 - e � 1
24- Hour Inspection Line: 503.639.4175 i� Juris:
r.us _ �.. , Date e d /Met o: Supplemental See Page l Information
Internet: www.ci. tigard.o
CITY Y OF TICaAF�Li Notified/Method: 11 ( Supplemental Information
n ., c 0`; ...M nra
9 I t an
- -� � lir FEE rv L
'I1YE _W 5G U
New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. Total
❑ Addition /alteration /replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
a. O COa
' GAI O RI F NSTRUCT ION.e. -t 4 ` " = =• ` SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building &Multi- family SFR (3) bath 399.00
❑ Master builder 111 Other: Each additional bath/kitchen 45.00
„� , _„ =•:m...: �r..: .
, .; Fire sprinkler ( sq. ft.) Page 2
E` "`'7',1 "" = ; J ., . O . B, S . 1NFORt�fAT10 :; ' l .
'.�;. - €��' ���,�s�.a; .,. ;n... q . ��.. :, ; • = a�x., . . ,' Site utilities
Job site address: 103‘7,0 SG-) 9'0 1 .21-- /f UL Catch basin or area drain 16.60
City /State /ZIP: T ^ t ro t 0 k Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: „lc h prop k OCOtnuviUN1� Footing drain (no. linear ft.: ) Page 2
70 iUC at K rI S4. Manufactured home utilities 110.00
0
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
Subdivision: 64 4r q
Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
�R:;i o . DESCR WORK: ' �
.. i.,.,:��;i�'��r.:., �:: :�` :; ,i9 . ,,....,.,. .mss;•..., =a ..- . ,. _. ..... ,,�� ° < f >•" ,._;.;. Backflow preventer Page 2
A J ) r,o,uS k_ _ (U,041,,.:,n y e r "4�'7L /► Backwater valve 16.60
G
•SC 171G4. �t�✓ " ` l?i1 J t`/ l A0PZ05 - 0 077 Clothes washer 5 16.60
fDaAis e Dishwasher 16.60
.,,: •,: , -, :• . ,,. . , Drinking :. i i ?; PRO - ,.OW '' a: ,
: g
fountain 16.60
�/� " " "' "` Ejectors /sump 16.60
Name: R G 1 ' \ N01/11>e S Expansion tank N- 16.60
Address: \ %"70 S C,D Cn'i t% P V W 1 a� Fixture /sewer cap 16.60
City /State /ZIP: ' VrTA \r t OR 9 7 aa3 Floor drain /floor sink/hub 16.60
Phone: (503) s9 S _ c 5 Fax: (5O3) 6d0 - 99 CS- Garbage disposal Or 16.60
:4 :. _" �, - - ,., •: hose bib 16.60
❑ API'L,CAN$ ' ` ^ > C O NTAC T I 'E • RSO N
-,. ,. `.`•;. ,. • =:,., _, .r_„ r ° i'i4.: . •:•., . ; ........ •. Ice maker 16.60
Business name: R C 1-E04A.eg Interceptor /grease trap 16.60
Contact name: -- u aJUL w; \ Medical gas (value: S ) Page 2
Address: ������ Primer 16.60
/,� C-,
City /State /ZIP: Roof drain (commercial) f 16.60
Phone: ( ) ;, t,i
V� ✓ Fax: : ( ) Sink/basin /lavatory 57 /0 / 16.60
` \o v� I Tub /shower /shower pan 1' 1 16.60
E -mail: `� VA/ //�� J.1C lam. �(ok�NS}O.Vt_1- es ..A)e-T Urinal 16.60
•, ;CONTRACT OR...: i°,"� '`/r, ``
��" <,i Water closet I
ate c oset 16.60
Business name: G S Water heater s 16.60
Address: /(2 300 .SC.J 69'`t- Ave Other:
p �� Subtotal
City /State /ZIP:
�1 lard, Oie / 7a� A Minimifm permit fee: $72.50
Phone: (s03) 5 9$ - 9711 Fax: (co3 ) 639- Otos Residential backflow minimum permit fee: 536.25 11 teal • 00
-
3 433-6 Pa Plan review (25% o f pe rmit fee) a10 v
CCB Lic.: /:S� 'J,3 f Plumbing Lic. no.: � /-
Authorized signature: \ ` q State surcharge (8% of permit fee) q� ,C j , //
g 1,�p., TOTAL PERMIT FEE /S-27/5, `4
Print name: \) W A t,) Date: $ - 5- p 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 \Permits \PLM- PermitApp doc 06/05 440 -46! 6T( I 0 /02 /COM /WEB)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE ' ECEIVE
COMPLETE COMFORT SYSTEMS INC SEP 21 2005
12300 SW 69TH AVE. CITY OF TIGARD
• TIGARD, OR 97223 BUILDING DIVISION
Plumbing Signature Form
Permit #: PLM2005 -00387
Date Issued:
Parcel: 1 S135AA -AC001
Site Address: 10390 SW 90TH AVE
Subdivision: ASHBROOK CONDOMINIUMS
Block: Lot: 001
Jurisdiction: R - 4.5 •
Zoning: TIG
Remarks: Building 4: 5 townhouse units. Other fix. expansion tank and hose bibbs.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for
the plumbing permit to be valid, please have the appropriate individual from your company sign below and
return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
MATRIX DEVELOPMENT COMPLETE COMFORT SYSTEMS INC
12755 SW 69TH AVE, SUITE 100 12300 SW 69TH AVE.
TIGARD, OR 97223 TIGARD, OR 97 223
Phone #:503- 620 -2020 Phone #: 503 -598 -4798
Reg #: LIC 152736
PLM 34 -356PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X/ --
1 ature of Authorized Plumber 7 j p
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
I 1 � BUILDING DIV PERMIT #: PLM2005.00307
' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639-4171 °
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'
INSPECTION WORKSHEET FOR DATE: 7/18/2006 TIME: 7:03AM PAGE: 1
10390 SW 90TH AVE
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE:
PROJECT NAME: ASHBROOK CONDOMINIUMS
DESCRIPTION: Building 4: 5 townhouse units. Other fix. expansion tank and hose bibbs.
Addresses: 10390, 10392, 10394, 10396 & 10398 SW 90th Ave.
OWNER: MATRIX DEVELOPMENT, PHONE #: 503- 620.2020
CONTRACTOR: COMPLETE COMFORT SYSTEMS INC PHONE #: 503 -598 -4798
Inspection Request Scheduled For: Date: 7/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 033263 -07 503. 2097386 N
Corrections /Comments/ Instructions:
# -at -.-- /// 5
•
•
i
p: - ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
p /
/14 / J
Inspector: v Date: it Phone #: (503) 718 - �'
CITY OF TICARD
BUILDING DIVISION PERMIT #: PLM200&00387
13125 SW Hall Blvd., Tigard, OR 97223
Adokoq DATE ISSUED: 9/7/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ,414, I L I_
INSPECTION WORKSHEET FOR DATE: 7/12/2006 TIME: 7 PAGE: 44
SITE ADDRESS: 10390 SW 90TH AVE CLASS OF WORK:
SUBDIVISION: ASHBROOK CONDOMINIUMS LOT #: 001 TYPE OF USE:
PROJECT NAME: ASHBROOK CONDOMINIUMS
DESCRIPTION: Building 4: 5 townhouse units. Other fix. expansion tank and hose bibbs.
Addresses: 10390, 10392, 10394, 10396 & 10398 SW 90th Ave.
OWNER: MATRIX DEVELOPMENT, PHONE #: 503.620-2020
CONTRACTOR: COMPLETE COMFORT SYSTEMS INC PHONE #: 503-598-4798
Inspection Request Scheduled For: Date: 7/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 032950-07 503-209-7386 N
Corrections/Comments/Instructions:
•
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El PASS IV PARTIAL APPROVAL El CANCEL n NO ACCESS
AV,
I I FAIL Til ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Ai . &
Date: j4 Phone #: (503) 718- -3'
- .
CITY OF TIGARD Tjf /L"`/' BUILDING DIVISION PERMIT # : Z OC�, 0 G p
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Allisp Inspection Requests (24 Hrs.): (503) 639 -4175 ,_-_._:_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 4a 1 4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: �
D
il __
ESCRIPTION: 1,4-- S • ` - ,
F
• OWNER: -1 , " ,___L_____„ ( c PHONE #:
CONTRACTOR: PHONE #:
i nspection Request Scheduled For: Date: 3 - f 4° Pour Time:
Code # I nspection Description Confirm # Contact # Message
320 Inspection (4.:5 o9 3, S 2 '
12c3 ‘0^- Corrections /Comments /Instructions:
\ (.
‘ ,
S-- . 6 '
_
\ ,i. j!,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
LA a
Inspector: Date: / Phone #: (503) 718-
1 1 ,