Permit //4/p ---- 74 ...L .
111 n IT 1 1 rOF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00475
DATE ISSUED: 10/22/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135AA OSC40
SITE ADDRESS: 10430 SW AKILEAN TERR ZONING: R -4.5
SUBDIVISION: OAK STREET CONDOMINIUMS LOT: JURISDICTION: TIG
PROJECT: OAK STREET CONDOMINIUMS
Project Description: Install commercial backflow device. For common area of Building #2, addresses: 10430, 10434,
10438, 10442, 10446, 10450, & 10454.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R1 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: ft
Owner: FEES
OAK STREET TOWNHOMES LLC Description Date Amount
12670 SW 68TH AVE #400
TIGARD, OR 97223 [PLUMB] Permit Fee 10/22/2007 $72.50
[TAX] 8% State Surchar€ 10/22/2007 $5.80
Phone : 503- 639 -3104 Total $78.30
Contractor:
MULLEN COMPANY, THE
1601 SE RIVER
O R 97123 RD
HILLSBORO, OR REQUIRED ITEMS AND REPORTS
HILL
Contact # : PRI 503 640 - 01 13
Reg #: LIC 92689
PLM 34 -260PB
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.
Issued y: £ S / / / /' Permittee Sign-lure:
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 Applicatii0 t
Building Fixtures 9 n• r' , r .
y { ` : FOR OFFICE USE ONLY
City of Tigard Received
t 2001 7 Date /By: /D 70 5 Permit No.: P� 'Z 7- i de - 4
I - q 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598. 0 I �ateBy:
Y Other Permit No.:
� .. $;
T 1 G A R D Inspection Line: 503 T 1 �V I �r
a ate Ready /By: ®See Page 2 for
Internet: www.tigard- or.gov t (AO •fed/Method: `� Supplemental Iuformatiou
TYPE i1; ►,'o 1 li�� FEE* SCHEDULE
❑ New construction E Demolition For special information use checklist
Description Qty. I Ea. I Total
❑ Addition/alteration /replacement ❑ 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
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: . �s` Catch basin or area drain 16.60
City /State /ZIP: / 6 y D ' 4 NJ L � :'_ � Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: , I Project name: QG 1c S �-Q e T ��3-/6 rdS Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
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: Lot no.: Water service (no. linear ft.: _) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION ESCRIPTION OF WORK Backflow preventer I Page 2 72. SC
j: f ./- g� R7IT L ? Backwater valve . 16.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER I 'El TENANT Drinking fountain 16.60
/ �_ Ejectors /sump 16.60
Name: C9 i< 5h ec . IG..+,,hd '.GS 4- G. C /� .- Expansion tank 16.60
Address: 12 70 s L./ ai M ..e ,../ / , / -4- - a yO C J Fixture /sewer cap 16.60
City/State /ZIP: ! r a ,,„,. / ( Q r` ' 7 !/ 2 3 Floor drain /floor sink/hub 16.60
Phone: (6 13) 6 3, _ 3/G y Fax: (S�3) f s•' S aS / Garbage disposal 16.60
APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: 7 / , 4 S 2T / �,,i Interceptor /grease trap 16.60
Contact name: l '<f4,7 (.. /s - _ Medical gas (value: $ ) Page 2
Address: '2 -70 57 6-5-. ��Tv- -t yp � Primer 16.60
City /State /ZIP: 9 Roof drain (commercial) 16.60 71.22 3
Phone: ( )t.3 9 _3 Fax: : (s a/
Tub/shower/shower Sink/basin/lavatory 16.60
�) 8 " �� Tub /s pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name �' - _ �` l/ •C n Water heater 16.60
Address: /6,0/ SE ,i V e„r 6_ , Other:
City /State /ZIP: L/ Subtotal
�i���c! G Minimum permit fee: $72.50
Phone: (503) CYG - 6// 3 Fax: (Sa.3) 6ya - 94/s3 Residential backflow minimum permit fee: $36.25 �2 • SO_
/� .3 ~2067 Plan review (25% of permit fee)
CCB Lic.: � 2 � '"/ Plumbing Lic. no.: ,� /
State surcharge (8% of permit fee) S,
Authorized signature:
TOTAL PERMIT FEE 8', 3n
Print name: Date: 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 \PLMF - PermitApp doc 12/27/06 440- 4616T(I0 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard ,: • . - - .. '
Page 2 - Supplemental Information
Fee Schedule: Residential0e Suppression Systems:
Site Utilities Qty. _ Fee (ea) Total ,- '._,Square Footage: . • : Permit Fee: -
Footing drain - ls' 100' 55.00 - .0,to,2,000 • - ' ' $115.00
Footing drain - each additional 100' 46.40
%, 2,00 f to 3,600 n,• • - rye $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 •
Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee:
$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 1 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 �e 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
Subtotal:
$50,001.00 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 Plumbing Installations .
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
•
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed .. .
Fixture Type: Replace engineer.
Previous Capped Added • Existing • ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780-0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above: '
Dishwasher - Commercial - .
• - Domestic
Drinking Fountain ' 1 .,, Isometric or:Riser.Diagram -
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
3"
-4"
Car Wash Drain ' s
Garbage - Domestic ' . Comments regarding fixture work: , • •
Disposal - Commercial
- Industrial -
Ice Mach. /Refrig. Drains „
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
• -Stall ,
Sink - Bar/Lavatory - • -
- Bradley *Note: ` If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter - , plumbing permit can be issued.
Washer - Clothes
• Water Extractor •
' Water Closet - Toilet
Urinal
Other Fixtures:
is \Building\Permits\PLM- PermitApp doc 12/27/06
10- 22 -'07 17 :31 FROM- T -175 P001/001 F -382
‘1•0t I r #r I I'ei v
•
COMMUNITY DEVELOPMENT
11"R>,5 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
Plumbing Signature Form
IMPORTANT PERMIT NOTICE
MULLEN COMPANY, THE
1601 SE RIVER RD
HILLSBORO, OR 97123
Permit #: PLM2007 -00475
Date Issued: 10/22/2007
Parcel: 1 S135AA -03800 / D dv ? �� !/1/t -�
Site Address:
Subdivision: OAK STREET CONDOMINIUMS
Lot:
Jurisdiction: R -4.5
Zoning: TIG
Project Name: OAK STREET CONDOMINIUMS
Description: Install commercial backflow device.
Your company has been indicated as the plumbing contractor for the permit referenced 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. Please mail the form to: City of Tigard, Building Division,
13125 SW HaII Blvd., Tigard, OR 97223, or you may fax the form to: 503.624.3681.
If you have any questions please call 503.718.2433.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
OAK STREET TOWNHOMES LLC MULLEN COMPANY, THE
12670 SW 68TH AVE #400 1601 SE RIVER RD
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone #: 503 -639 -3104 Phone #: 503- 640 -0113
Reg it LIC 92689
PLM 34 -260PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x J_ ,71 /ems
Signat• - of Aut orized Plumb Name (printed)
CITY OF TIGARD -
BUILDING DIVISION' PERMIT #: PLM2007- 00475
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/24/2007 TIME: 7 : 00AM PAGE: 37
/ "130 14
SITE ADDRESS: CLASS OF WORK:.
SUBDIVISION: OAK STREET CONDOMINIUMS LOT #: TYPE OF USE:
PROJECT NAME: OAK STREET CONDOMINIUMS
DESCRIPTION: Install commercial bacIdlow device.
OWNER: OAK STREET TOWNHOIMIES LLC, PHONE #: 503- 639.31pq
CONTRACTOR: MULLEN COMPANY, THE PHONE #: 503
Inspection Request Scheduled For: Date: 10/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 05(3254 -01 503 -969 -9325 Y
Corrections /Comments /Instructions:
D a ■c-st. � r __Co v, T'e rT «e .e3✓ �.
L.-AAA-) 0 9 1 -. 41
K PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: p d LVniw A Date: 1 O VILA VD 7 Phone #: (503) 718-