Permit CITY TIGARD PLUMBING PERMIT
!'�� i� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00526
�'' .,��I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/7/2005
PARCEL: 1S135DC-02000
SITE ADDRESS: 11905 SW 91ST AVE 1 ZONING: R -7
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT: JURISDICTION: TIG
Project Description: Add 5 catch basins, relocate 1.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 6
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: ft
Owner: FEES
VILLA LA PAZ LIMTED PARTNERSHIP Description Date Amount
BY COMMUNITY PARTNERS FOR
AFFORDABLE HOUSING INC [PLUMB] Permit Fee 10/7/2005 $99.60
TIGARD, OR 97281 . [TAX] 8% State Surchari 10/7/2005 $7.96
Phone : 503 628 - 1137 Total $107.56
Contractor:
EAGLE ELSNER
PO BOX 23294 REQUIRED ITEMS AND REPORTS
TIGARD, OR 97281
Phone: •
Reg #: LIC 27112
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 -669 or 1- 0-332-2344. ��
Issued By: �7/w Permittee Signature:- G1 ,!t/
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business d y.
•
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.
•
•
Building Fixtures
•
Plullnbing Permit Apr ��E® ro OFFICE US ONLY : •
City of Tigard OCT O 7 2005 Date/B IOI7 /O5' 66 Permit No.T yti _a 0 .00 64,
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review J ^`��
Phone: 503.639.4171 Fax: 503.598.1960 / / G'i;. Date/B y Other Permit No.:
Inspection Line: 503.639.4175
24- Hour Ins I
p CITY OF TIGAR IGAF3' ; al,` , � _ � I ' Date Ready/By: i s: El See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DNISI • Notified/Method: Supplemental Information
TYPE OF WORK FEE* SC DULE
Di New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition /alterationlreplacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION 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 Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: // e j 3 Sc.� c ? f Sr Catch basin or area drain 4!/ 16.60
City /State /ZIP: / / ��L ` eve_ ! I - x 7-- Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: aa� Footing drain (no. linear ft.: ) Page 2
�/ Manufactured home utilities 110.00
Cross street /directions to job site: G v.¢ini6 uir� S a
'� Manholes 16.60
d 42 q. fr Ap._ 'Z A (. 4afidcs riA> Rain drain connector 16.60
2 , t.,� •j i kne , . -. g Occ. - (_ Sanitary sewer (no. linear ft.: _) Page 2
(j r Storm sewer (no. linear ft.: _) Page 2
Subdivision: 6i--.2,/...v �� Lot no.: Water service (no. linear ft.: Page 2
La �` ��'� Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
fl- a A. (,S'> C4--r-c4/ / • � .,� J ,; ;. , 3 ,a- � cvo (t l Backwater valve 16.60
\ Clothes washer 16.60
Dishwasher 16.60
O ,/ Drinking fountain 16.60
I?7 rROPERTY OWNER I ❑TENANT Ejectors/sump 16.60
Name: C P4/� Expansion tank 16.60
Address: Pte ag, 23 Z D � Q Fixture /sewer cap 16.60
City /State /ZIP: '7 /6y D / 72c ( Floor drain/floor sink/hub 16.60
Phone: (5 - 2 _ 7 . y Fax: 6,15) s99 623 Garbage disposal 16.60
- . APPLICANT i . [ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: L.AA L �9f ✓3 = Interceptor /grease trap 16.60
Contact name: CoLa SP/1/1.1 Medical gas (value: $ ) Page 2
Address: Y q, ,f 5"aJ mot-..{ .-rt. Dr. �3 o i Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
`4 \ r4 � i e7l el 7 0 0 Sink/basin/lavatory 16.60
Phone: (SO}) el Lc -q . Z."'1 I I Fax: : (.5e9) 6 ,E I fy
Tub /shower /shower pan 16.60
E -mail:
Ga.. S' 4.04 C./ ,i)C veove---7 = e= Urinal 16.60
CONTRACTOR , • Water closet 16.60
Business name: e 4 fipiii, Water heater 16.60 .
Address: pp 23 2- G''r'
Other:
City /State/ZIP: t d�1 O/Z q-7 1-6 Subtotal
�' 1 Minimum permit fee: $72.50
Phone: (�Di ) ti Fax: (fp ) Residential backllow minimum permit fee: $36.25 (J
CCB Lic.: y,7 / Z "f �e a Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) / (96
Authorized signature: tg �,/,--7
TOTAL PERMIT FEE 10 - 1 ,5 6
Print name: /? „,✓ This permit application expires if a permit is not obtained within
L ` ` % 5AAi / 1 Date: v....7 .....,513-- - 180 days after it has been accepted as complete.
*Fee methodology set by Tri - County Building Industry Service Board.
i:\ BuildingWerrnits 'PLMF- PermitApp.doc 06/05 440 - 46161/ 10 /02/COM/WEB)
•
Plumbing Permit Application - City of Tigard ,,
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Jtilities. Qty, Fee (ea) • ' Total . Square. Foota#;e:, `;. Permit 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
Medical Gas Systems:
Water Service - each additional 100' 46.40 Valuation' Permit Fee:
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
Fixture or Item Qty: . Fee,(ea) Total additional $100.00 or fraction thereof, to and
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
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: ° Plan Review for ComplexiStructur..es„.—
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees*. Please check all that apply.
Quantity by (Fixture) Work Performed. ❑ Any new commercial building.
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service
-Drive Thru facilities where new fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food area. '
Dishwasher - Commercial . ❑: Any new residential building contajning three (3) or more
- Domestic - dwelling
Drinking Fountain
❑ Any NFP:4`l3 -D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4 „
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach. /Refrig. Drains •
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer = Clothes *Note: If the fixture work under this permit results in an
Water Extractor •
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
•
i:\ Building \Permits\PLM- PennitApp.doc 07/06/05
CITY OF TIGARD 0 -
BUILDING DIVISION PERMIT #: PLM2005-00526
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2005
Phone: (503) 639 -4171 �"� u7���w 111
Inspection Requests (24 Hrs.): (503) 639 -4175 J.W
INSPECTION WORKSHEET FOR DATE: 7/6/2006 TIME: 7:03AM PAGE: 31
SITE ADDRESS: 11906 SW 91ST AVE 1 CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
DESCRIPTION: Add 5 catch basins, relocate 1.
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 503- 628'1137
CONTRACTOR: EAGLE ELSNER PHONE #:
Inspection Request Scheduled For: Date: 7/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 032735 -01 503 - 969.3279 Y
Corrections /Comments /Instructions:
/ .
C 6 •
1
,; PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED . 46_161 Inspector: t iA 1 f Date: Phone #: (503) 718-
e•
CITY OF TIGARD „ .
BUILDING DIVISION e PERMIT #: PLM2005 -0052E
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2005
Phone: (503) 639 -4171 : ypiglp Mil
Inspection Requests (24 Hrs.): (503) 639 -4175 _ _�
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 112
SITE ADDRESS: 11905 SW 91ST AVE 1 CLASS OF WORK: I
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
DESCRIPTION: Add 5 catch basins, relocate 1.
I OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 503 - 628 -1137
CONTRACTOR: EAGLE ELSNER PHONE #:
Inspection Request Scheduled For: Date: 10/14!2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
34 6 Culvert/catch basin 01831501 503 -969 -3279 Y
Corrections /Comments /Instructions:
ff�
I�
L , .0. /
•
•
PI-PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL 1 I CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: 47 /0 Date: t i (' //7 Phone #: (503) 718-
•
•• . .„. .,
CITY OF TIGARD _ 0 .
BUILDING DIVISION PERMIT #: PLM2006-00526
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2006
Phone: (503) 639-4171 14 0VA i 1 \
Inspection Requests (24 Hrs.): (503) 639-4175 ,Wil. - IL ,
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 4
SITE ADDRESS: 11905 SW 91ST AVE 1 CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
DESCRIPTION: Add 6 catch basins, relocate 1. .
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 503-628-1137
CONTRACTOR: EAGLE ELSNER PHONE #:
Inspection Request Scheduled For: Date: 10/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
345 Culvert/catch basin 019557-01 503-694-5066 N 1
Corrections /Comments / Instructions:
■gr
- .11_ ■7 s 1 ' ` .1. - 0 -4 I VI ii I U P ■ .41 -. '
-......
•
(PASS 0 PARTIAL APPROVAL Ei CANCEL EI NO ACCESS
0 FAIL fl CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: ,k Date: )/2 )[Phone #: (503) 718-
r- ,
CITY OF TIGARD .,
BUILDING DIVISION - PERMIT #: PLM2005`00526
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2005
Phone: (503) 639 -4171 °� Ip��ji ll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: 4
SITE ADDRESS: 11905 SW 91ST AVE 1 CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
DESCRIPTION: Add 5 catch basins, relocate 1.
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 503-628-1137
CONTRACTOR: EAGLE ELSNER PHONE #:
Inspection Request Scheduled For: Date: 11/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
345 Culvert/catch basin 020151 -01 503- 969 -3279 Y
Corrections /Comments /Instructions:
d V (11-
a ,,,
o l.,,,,. 2 „,„
0/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / ' -/ 0 Date: i 2 1 "Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005-00526
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1017
Phone: (503) 639-4171
. aill
Inspection Requests (24 Hrs.): (503) 639-4175 ..„....„.7.1.- IL
INSPECTION WORKSHEET FOR DATE: 7/3/2006 TIME: 7 : MAM PAGE: 33
SITE ADDRESS: 11905 SW 91ST AVE 1 CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: GREENBURG OAKS
DESCRIPTION: Add 5 catch basins, relocate 1.
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 501620-1137
CONTRACTOR: EAGLE ELSNER PHONE #:
Inspection Request Scheduled For: Date: 7 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 numbing final 03257341 - 503-969.3279 N
•
Corrections/Comments/Instructions:
A lb Otve Afr 67)10 S - 1 4 ‘ze, a, vi /1:,, c ,,cr ets,c--0-2-3 kibcr
A -vAc, 101 le,
I I PASS II PARTIAL APPROVAL pi CANCEL 111 NO ACCESS
txt FAIL El CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: <To \-v \ Date: ---) 131 g( Phone #: (503) 718-
. . . .