Permit 'CITY OF TIGARD PLUMBING PERMIT
:. COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/9/2008
PARCEL: 2S104BB -07900
SITE ADDRESS: 14300 SW BARROWS RD ZONING: C -C
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUB LOT: 002 JURISDICTION: TIG
PROJECT: ALBERTSON'S
Project Description: Replace /relocate only fixtures. Other fixtures: ice maker, dipper well, coffee brewer, espresso.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: j
OCCUPANCY GRP: B FLOOR DRAINS; 3 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 4
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ALBERTSON'S INC #576
PO BOX 20 Description Date Amount
BOISE, ID 83726 [TAX] 12% State Surch 1/9/2008 $19.92
[PLUMB] Permit Fee 1/9/2008 $166.00
Phone : Total $185.92
Contractor:
TAPANI PLUMBING
21707 NE 206TH AVE
PO BOX 1458 REQUIRED ITEMS AND REPORTS
BATTLE GROUND, WA 98604
Contact # : PRI 206 - 687 -3983
Reg #: LIC 60958
PLM 37 -269PB
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 By: A �J / � ; Permittee Signature: ,
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' Penult App I • - • -.' -° ' t � l
Building Fixtures - E! V D
• F oK oFFiCE USE ONLY
City of Tigard Received Permit
II a 131 SW Hall Blvd., Tigard, O} AN 23 2008 Da i /9��g - 10 �W 1
y �- g � g � Plan Revie ''
_
Phone: 503.639.4171 Fax: II 5 V PTIGARD Date/By: Other Permit No..
• Inspection Line: 503.639.417 Date Ready/By: Iuri ®See Pa e 2 for
TIGARD Internet: www.tigard -or.g 0� ®�tVUU1Vh7IQ� Notified/Method: / Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ 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)
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 ❑Other: Each additional bath/kitchen 45.00
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /44 30 0 5 (.,) 0 4 R-2o 1 5 2 P, Catch basin or area drain 16.60
City/State/ZIP: r sG ;a-rr- � � 9 7 ZZ 3 Drywell, leach line, or trench drain 16.60
7
Suite/bldg. /apt. no.: I Project name: STJ+2 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: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
/" i /Vt 0 t)L- / t- P 17 A-7 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY tat I ❑ TENANT Drinking fountain ..1
'^�'t J Ejectors /sump ..1
Name: Expansion tank 16.60
Address: _A-A A11(,- - Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 7 16.60
Phone: ( ) Fax: ( ) Garbage disposal • 1
❑ APPLICANT ❑ CONTACT PERSON Hose bib 6.1
Ice maker 1 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) • 16.60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 3 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: j ?N= r `�1.../..-1 ,_,4 b Water heater 16.60
Address: Other: PSP�' ,r. �,LLL
pp, l3oX 23 co
City /State /ZIP: Ii it 9 , ( 4 6-0 tzs p R,z-S5a /0 Subtotal /6'..0y) 6/F rrt fr... l, t° o ww t> /
Minimum permit fee: $72.50
Phone: (3Z,0 ) ( 3 9 g 3 Fax: (3bo ) 6,57_11,4 9 y Residential backflow minimum permit fee: $36.25
CCB Lie.: 6 n 9 5-g Plumbing Lic. no.: 3. _ ,73 Plan review (25% of permit fee)
/ State surcharge (12% of pemlit fee) / 9% 0 7--
Authorized signatu /95 9
� �i /.L - [ R. I TOTAL PERMIT FEE
Print name: ��u4 N, s 1 4- L12_ D Date: / - 9. _o g 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.
L \Buildmg\Permits\PLMF- PermitApp doe 12/27/06 440- 4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: , Permit Fee:
Footing drain - 1" 100' 55.00 0 to Z000 $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: $50,001.00 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 Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" i that meet the qualifications above.
3 3
- 4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains 1
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:
\Building\Perm is\PLM- PermitApp,doc 12/27/06
„ • -
CITY OF TIGARD ..
A
BUILDING DIVISION PERMIT #: PLM2008-00008
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: - 102008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ,44 111.
INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7:02AM PAGE: 48
SITE ADDRESS: 14300 SW BARROWS RD CLASS OF WORK:
SUBDIVISION: RUSSELLS SCHOLLS FERRY SUB LOT #: 007 TYPE OF USE:
PROJECT NAME: Al
DESCRIPTION: Replacelrelocate only fixtures. Other fixtures: ice maker, dipper well, coffee brewer, espresso.
OWNER: ALBERTSON'S INC 1/676, PHONE #:
CONTRACTOR: TAPANI PLUMBING PHONE #: 3606p-3983
Inspection Request Scheduled For: Date: 1/1812008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 063601-01 208-949-1995 N
Corrections/Comments/Instructions:
c ,--ci1_-A- kt--
PASS n PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
I FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: CrhAA-ka-Wir- - Date: ) I i q' hZ Phone #: (503) 718-
. _ .
CITY OF TIGARD .,-
A ,
BUILDING DIVISION . •. PERMIT #: P1_M2008- 00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/9/2008
Phone: (503) 639- 4171W\
Inspection Requests (24 Hrs.): (503) 639 -4175 '! Z.
•
INSPECTION WORKSHEET FOR DATE: 1/16/2018 TIME: 7 :00AM • PAGE: 21
SITE ADDRESS: 143010 SW BARROWS RD CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUES LOT #: 002 TYPE OF USE:
PROJECT NAME: ALBERTSON' S
DESCRIPTION: Replace/relocate only fixtures. Other fixtures: ice maker, dipper well, coffee brewer, espresso.
OWNER: ALBERT SON'S INC #576, PHONE #:
CONTRACTOR: TAPANI PLUMBING PHONE #: 206 -687 -3903
Inspection Request Scheduled For: Date: Pour Time' U 7 ) W p q 11'1 s~J�009
Code # Inspection Description Confirm # Contact # Message
3E9 Plumbing final 063319 -01 360 - 90$6036 Y
Corrections /Comments/ Instructions:
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C Ji_�a,c. k- L ri 1 11 0.w-4- C A- 0 r - 5,16") CO3.c-
cjv T v 3 C0 ,,.R .,l( S c ,A.< SO3 - 7 1 - 2(3
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
ri FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ODkni. -r--A 11..x, -- Date: I I 11,-.1/0C) Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200t3 -00008
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/912008
Phone: (503) 639- 4171LiPpil
Inspection Requests (24 Hrs.): (503) 639 -4175 :_l.
INSPECTION WORKSHEET FOR DATE: 1/10/2008 TIME: 7 :00AM PAGE: 47
SITE ADDRESS: 14300 SW BARROWS RD CLASS OF WORK:
SUBDIVISION: RUSSELL'S SCHOLLS FERRY SUS LOT #: 002 TYPE OF USE:
PROJECT NAME: ALBER S.ON'S
DESCRIPTION: Replace /relocate only fixtures. Other fixtures: ice maker, dipper well, coffee brewer, espresso.
OWNER: ALI,BERTSON'S INC 76, PHONE #:
CONTRACTOR: TAPANI PLUMBING PHONE #: 20&687 -39B3
Inspection Request Scheduled For: Date: 1/1O/2QO8 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Piumbing underslab 062950 -01 360- 510 -2184 Y
Corrections /Comments /Instructions:
•
PASS I 1 PARTIAL APPROVAL El CANCEL w ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES SESSED 'vt; u k)
1 V° a 'VI ' 1)1 Inspector: Date: Phone #: (503).718 -