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Permit 1 C ITY OF TIGARD PLUMBING PERMIT Ilk DEVELOPMENT SERVICES PERMIT #: PLM2004 -00405 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 39 -4171 DATE ISSUED: 11/24/2004 SITE ADDRESS: 16185 SW 108TH AVE PARCEL: 2S115AA -01100 SUBDIVISION: WILLOWBROOK FARM ZONING: R -25 BLOCK: LOT: 027 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: 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: 1,569 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Site utilities for new 108 unit apartment complex. WATER SERVICE ONLY. FEES Owner: Description Date Amount OT2 LLC C/O OSSEY DEVELOPMENT CORP [PLUMB] Permit Fee 9/24/2004 $751.00 5437 ROSALIA WAY [PLMPLN] Plan Review 9/24/2004 $187.75 LAKE OSWEGO, OR 97035 [TAX] 8% State Surcharl 9/24/2004 $60.08 Phone : 503 620 - 4373 Total $998.83 Contractor: COMPLETE COMFORT SYSTEMS INC 12300 SW 69TH AVE. TIGARD, OR 97223 REQUIRED INSPECTIONS Phone : 503 Water Service Insp Water Service Insp Reg #: LIC 152736 Water Service Insp PLM 34 - 356PB Water Service Insp Water Service Insp 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699. Issued By: f> - Permittee Signature: 'tea Call (503) 639 -4175 by 7:00 P.M. for an inspection needed th • next business day • Site Utilities Yb t .9co L/ -BOO 7 • Plumbing Permit Application FOR OFFICE USE ONLY City of Tigard , EePermit N o . 13125 SW Hall Blvd., Tigard, OR 97223 �, 2004 Phone: 503.639.4171 Fax: 503.598.1960 w ��,� 'i� Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.417 it • Internet: www.ci.tigard.or.us F T MD ! I Date Ready/By: hat ®See Page 2 for us Notified/Method l (� . Supplemental Information �. k ' v P e �. adf '47� r b�: •�. � � ti t WE AF tilt s . - * HED E t ... . j s..., s }+ •�x 4 ' `w T� ii. i .ma r k i 6 i u "'b n c< .SC11Cr+l��L` . ziNew construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement 0 Other New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) re > 6{ i R ' a `--� .7 .Er -� k F ��.� .�� ` e SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building 2rMu1ti- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft) Pa e 2 ' A, „ = " . 9« S7 o) . P.9 � A,L�iI? 1(1C FP.N g Site utilities Job site address: L4. Ills" (tV I'c Catch basin or area drain 16.60 City/State/ZIP: �` j � t�' / 7 ' ' / I Drywell, leach line, or trench drain 16.60 v Suite/bldg. /apt. no.: I Project name: t i e L ' 42 4, Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: lc. *'�4 , "L),,,, / Cc+ . Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: t(„ if Page 2 75 /. 00 Tax map /parcel no.: Z S!!S44 , /Zao Fixture or item 700, /oov, !!oa • :..O 1 , Absorption valve 16.60 / f (.,04-7 - t� K • l • F Backflow preventer Page 2 c• - v "f 42c. � D/ e_..' Backwater valve 16.60 0/3 L (! Clothes washer 16.60 / Dishwasher 16.60 1 * 7 c l s x t� t. ::::tamn . 16.60 Name: ©1 Z LL.C. Expansion tank 16.60 Address:el 6 2 tszvo-ii,- s.� ��„"e _"'- ,[ 1 // � .� (' • Fixture/sewer cap 16.60 City/ State/ZIP: S 37 R ( Q.. a L4 t r ., d, t3 `teals Floor drain/floor sink/hub 16.60 Phone: (,Sf-U?) 4 . 4 3 - i3 Fax: ( 3) 6Zo , ( Z4 ' Garbage disposal 16.60 `. cep Y _ ' 'i r . . .zn W : c . * x> Hose bib 16.60 , :k .z.0 . _ 4 _ . ierN :o, Ice maker 16.60 Business name: Interceptor /grease trap 1 6.60 Contact name: /( ,∎ c i /• t� , _Y 1 . 6%'� Medical gas (value: $ ) Page 2 Address: �+ Primer 16.60 City/State/ZIP: ge--04 -e--- T Roof drain (commercial) 16.60 Phone: ( ) I Fax:: ( ) Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 u i Urinal 16.60 ,-.� 4 :?:44, ± e ¢ - , , . . �. 4. , Water closet 16.60 Business name: 4.____e_14.., '4 •,,i 4 s , a..�c . Water heater 16.60 o i �O - Address: iZ ../t`= �,dv ' • V Other: City / State/ZIP: %, �Z � eZ 7 Subtotal 761,0) - J Minimum permit fee: $72.50 Phone: 6.-- 4 7' F ax : ( ) y Residential backflow minimum permit fee: $36.25 ° Z G : ic. no.: 3./. 3SG776 Plan review (25% of permit fee) 4'7, 75- /v.// , Authorized signature: ��/ _ State surcharge (8% of permit fee) o� �' -' ccc��� / / TOTAL PERMIT FEE Lg J! Print name: /�. / AIR mot Date: C / z / / Q / This permit application expires if a permit is not obtained within J ( 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. is\ Building \Perrnits\?LMu..permitApp,doc 12/03 440- 4616T(IO /02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: e we o F Sgua�re Footage ; : . P ermi t Fee: Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 _ 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' / 55.00 55 - Medical Gas Systems: Water Service - each additional 100' 46.40 /Re P F ie." j '' Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and e ( v ' Fee a ` 4a7 k m including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or - - and including $50,000.00.. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: -7S/ each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . ` 04 gi r ! EtRiTEPFACZ7 � U Comments regarding fixture work: Ba.tis. /Font Bath - Tub /Shower - - -- - Jacuzzi/Whirl.00l _ - -- Car Wash -Each Stall - - -- -Drive Thru - - -- Cu .idor/Water As .irator - - -- Dishwasher - Commercial _ - - -. - Domestic - - -� Drinkin: Fountain - - -- Floor Drain/sink - 2" - - -_ - 3" - - -- - 4,. - - -- Car Wash Drain - - -- Garbage - Domestic - - -- Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach. /Refri:. Drains - - -- Oil Se.arator Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Du . Station plumbing permit can be issued. Shower -Gang - - -- -Stall - - -_ Sink - Bar/Lavatory - - -- Quantity Total - Bradley Isometric or riser diagram is required if fixture quantity - Commercial -_ -- total is >9. - Service - - -- Swimmin • Pool Filter _ - -- • Washer - Clothes - - -- Water Extractor - - -- Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal _ - -- Other Fixtures: - - -- i:\ Building \Permits\PLM- PemtitApp.doc 3/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested o- 5 AM PM BUP Location / ( jC Suite MEC .3� 3 Contact Person u2, /[/�l./ Ph ( ) c 1 3 o 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: i t ( SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall 10 111111r 4110 9 Fire Sprinkler Fire Alarm Susp'd Ceiling Roof —t1 Other: - Final J PASS PART FAIL % i J PLUMBING Post & Beam (-- Under Slab Rou h -In ater Servi - Sani ary Sewer / Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fina of ir 'P T FAIL • HA AL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA Date Ext Approach/Sidewalk P1 Inspector J Other: ` Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST a0 BUP Received Date Requested l �� 1 AM / PM BUP Location I e g < U Suite MEC �[ Contact Person �.�- 11�I/�Cb41 Ph ( ) ? - - 7, PLM a 7 - 6 d 1 (6 $ Contractor Ph ( ) SWR BUILDING Tenant/Owner idP �• ' ELC Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler —r' Fire Alarm Susp'd Ceiling Roof Aff Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fi riyogo PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fir- Alarm Fina ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PAS PART AIL SITE _ Please call for reinspection RE: Unable to inspect - no access A D Supp�f' /�/ tom Appro- - Si• =wal Date Inspector /) Ent Oth . Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (5 3) 639 -4171 MST — BUP l� ��� Received Date Requested Vial AM PM B UP Location 1 -- Suite MEC Nip, Contact Person \L2J11•(...) Ph ( ) / )93 -6 36,7 • , DO -- -t.:- - Contractor '� Ph ( ) R 6 Ye BUILDING Tenant/Owner � !.5_,Qe2T -� 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 q Insulation Drywall Nailing Firewall •7 Fire Sprinkler Fire Alarm 4 Susp'd Ceiling �� Roof rrimired,,s_,... Other: Final / PASS PART FAIL p PLUMBING _ Post & Beam Under Slab Rough-In Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL 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 111 Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL