Permit A
CI TY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00501
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/3/2004
SITE ADDRESS: .U4-11 SW BEVELAND RD PARCEL: 2S101AB -02201
SUBDIVISION: BEVELAND ZONING: MUE
BLOCK: LOT: 2 -3 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM 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: 100 ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: No plumbing fixtures roughed in at this time.
FEES
Owner:
Description Date Amount
ZIMMLER DEVELOPMENT LLC
7165 SW FIR LP SUITE 100 [PLUMB] Permit Fee 11/3/2004 $110.00
PO BOX 230698 [TAX] 8% State Surcharl 11/3/2004 $8.80
TIGARD, OR 97223 Total $118.80
Phone : 503 - 598 - 3440
Contractor:
CH KRUSE PLUMBING
5802 A NE 88TH ST
VANCOUVER, WA 98665 REQUIRED INSPECTIONS
Phone : 360 Sewer Inspection
Water Line Insp
Reg #: MET 5137 Final Inspection
LIC 111654
PLM 37 -396PB
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: ,�,� Permittee Signature:
rill\, .- .
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
11/03/2004 11:13 FAX 5035981960 CITY OF TIGARD [] 001
3uilding Fixtures CE ED
Plumbing Permit Appli FOR OFFICE I SE ONLY
City of Tigard WI v 3 �o ®� D` ry / / "Y - l Y S Permit NR(,� d 40.5 -4
13125 SW Hall Blvd., Tigard, OR 97223 `11GP`P ' Plan Review other Permit No,:
Phone: 503- 639.4171 Fax: 503.598.1960 ,;11 ' U 1 i ',' i h "5_U!gj,'`i ''`• Date/By:
24- Hour Inspection Lane: 503.639.4175 , .. DM A ®` ^' � _ )1 Date Ready/By: JOf° H See rage 2 for
Internet: www.ci.tigard•or.us By NOtitled/Method: � supplemental informed. -.. 'I ;',!: ,,1,1 '.6' ' ". • ;i,, :.:A",;..,;::1,17.77,77.71.
. d .I I �' `.RW('�R�S� � .... .... ..., I,:,.i. �i� : : I ' . I', ....... .r�.i..i
i' ` =. I: i I �,, ^ :I I ,..• . ' • :- .. ...... it ? ..I I' - .
�� :,:I,il ' �,61 ; aLI: :n:::;:, :.,:: , , ..;...1 I:: ` : For s p ec ial i RL(pn use checklist
❑ Demolition
r s ichecklist
ow construction - Description { Qty. I Ea. I Totti
❑ Addition/alteration/replacement ❑ : New 1- 2- family dwellings (includes 100 tt. for each utility connection)
. ,. ,i , ... 1 . I . a 249.20
1:':i: 'r; ' g . .
..;(• • G4N •-• • ,-1.. ' ' QI,VI! .,
i.l '; ;I', � SFR {l) bath
gai'i:i;ll „Ii;l i...;l '' +•.. F : :...".::: kl ^: • C ommercial /industrial SFR (2) bath 350.00
❑ I- and 2-family dwelling ^-
SFR (3) bath 1111 399.00
O Accessory building ❑ Multi-family 45.00
Each additional bath/kitchen
❑ Master builder ❑ toter' Fire sprinkler (__^ sq• ft) _I 1 Page 2
r :r:..:.. .:....:.. . . ..:r ' 1'51t.3a#)B'� I � . ,.. ' Site utilities
Job site address: , ii 2 S. V EV _ C Catch basin or arca drain 16.60
City /State/Z.IP: l 1 G 0642.0 Q 2 all '2-,`Z Dry well, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ___) Page 2
Suite/bldg /apt no.: Project name: 1 1S B'e l E Uq>JO X065 Msn ufactured home utilities 110.00
Cross street/disecrions to job situ Manholes 16,60
Rain drain connector 16.60
• Sanitary sewer (no. linear ft.: / ,) Pag 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: , ( ) Page 2 ,53 cO'
Subdivision: Lot no.:
_, Fixture or Item
Tax map/pateel no.: . valve 16.60
!.; i .;'i ; .(i ! :, i' il:j T r fl(4; :10F • R! ikie. I'�I :! 1: -1i i • ; `fl i i !i i i! ; . B ac ldl ow reventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
. .. I•.:• p,;l;h" , II , !fi i 1 1....H ,'.lie p ;..01:i,j, ii: :::tn king ai 16.60
..;.a'I'''lii e 'In :111: ',. ' I.: !
:'!:.• '!.'IANx ';' ;i1.i:' ,
o-i�:��u.� i 'i'.��!; :! , I I ;'t , i . �,�� �' . �.. �...... .. , h, :•�.. .i' ,_,.,, 16.60
Name: Expansion tank 16.60
Address: fixture /sewer cap 16.60
City /State/23P: Floor drain/floor sink/hub 16.60
-"' Fax: ( ) Garbage disposal 16.60
P ..; ,,. (,...,.,,.I•I} '. ; i,i., I:�; , I•Iosebib 16.60
'I� - �i:i':i
'I
,!.. "� I p i L.: ,. t'''I' � ., , , .... .I • , •... .. _ ice maker 1660
Business name:
^ '�l�l ' ' J , Y, ���,� ,. ;,,:';:' k�t.Ad-g (1 i3L _ Interceptor /grease trap 16.60
Contact name: M ue'/ Medical gas (value: $ ) Page 2
R �_
Address: S 4,o --Ac NI .F.-._ . 45`J1 L4 431 Primer 16,60 •
° t b (,5 Roof drain (commercial) 1 6.60
City /State/Z1P: \if\N. , �
(360 ) S "13 ° LI 331 r Sink/basin/lavatory bSink/basin/lavatory 16.60
Phone: (360 (3c S'13 - S3 0 3
Tub/shower/shower pan 16,60
E -mail: Urinal 16.60
.I . . 1.10 i .i-111.1..!:': I.,. ,
. .1.11.;1.,,.14.; '�y j . . . _air. : Ij:, -: •
.i i'':I
+ 'I:'. � � �1': Water closet 16.60
Business name: e.O_L L5 E. �,.. n - rbt 1 , 0 ... , Water heater 16.60
-
Address: 52:00Z - A M, E , e) co 1 4 `S-f Other
_ Subtotal
City/State/ZIP: U N-1\1 1 C \.eji ° $ (0(0 S Minimum permit fee: 572.50 d
Phone: (3(00) 513 -y 33
Fax: (3(ot) ) 5-13-,S303 Residential backflow minimum permit fee: $36.25 /r
5 l '.1 Pl umbing Lie. no.: 31 _ Z t. Pa,
Plan review (25% of permit fee)
CCB Lie.:
p _ (8% State surcharge ($ of permit fee)
Authorized signature: (flea tlr TOTAL PERMIT FEE / Ci s , it
Print name: MV SLKN EI ()ESL
]]ate: 1 1 - 3 _0 kl 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 13uilding Industry Service Board.
i kPumirs1P1,Mp_permitApp.doc 17/03 440 - 46I6T(I0 /02/COMM'EB)
CITY OF TIGARD z;
BUILDING DIVISION .. PERMIT #: PLM2004 -00501
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2004
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/255/2005 TIME: 7 :12AM PAGE: 65
SITE ADDRESS: 07117 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 2 - TYPE OF USE:
PROJECT NAME: ANDRUS
DESCRIPTION: No plumbing fixtures roughed in at this time.
OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: 503 - 598 -3440
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360- 573 -4337
Inspection Request Scheduled For: Date: 5/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 007666 -01 360.618.1375 N
Corrections /Comments /Instructions:
•
7 &PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 Date: Phone #: (503) 718-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date equested ( AM PM BUP
Location 7 ) t' - - Suite MEC
Contact Person Ph (/- 'oo) 57.3 - PLM,,71D6 L 5 /
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
- Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING y ° �. `�,
Post & Beam
Under Slab
Rough-In
--.-�
ter
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F 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
Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line n / ,/
ADA
Approach/Sidewalk Date O' Inspector Ext
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
BUP
Received Date Requested ,2 — We; AM PM BUP
Location - 7 I 1 ' 11 Suite MEC
Contact Person 4 ` Ph ( 36e) )5 — L(33 7 PLM t (
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /` L"
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
'fTil -,
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: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dat / / Inspector Ext /- 5
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
BUP
Received Date Requested f AM PM BUP
Location .(I_�- �!L� Suite �! MEC
Contact Person o Ph (c3 ) ) ,'73 — T337 PLM 4,60 D j
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Other:
Final /AS
PASS PART FAIL .
PLUMBING .° ° i „/1 o st &Beam
Under Slab
Roush -In
Sanitary ewer
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 - Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA p j Approach/Sidewalk Date ` ih 6 V Inspector Ext
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
BUP
Received Date Requested AM PM v BUP
Location 7 I I S Suite MEC •
Contact Person G ,JT / Ph ( R4/,') Si e 13 7S PLM —0p301
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:,
Ftg Drain - ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing 7-12
Firewall / Z
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Roug - n
Water Service
""Sancta )Sewer
Rain rains
Catch Basin / Manhole
Storm Drain •
Shower Pan
Other:
.
PART FAIL -
HANICAL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA ((G
Approach/Sidewalk Date Inspector N Ext
Other:
Final • DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
r.
BUP - Building Permit EL C - Electrical Permit
' Inspection Description Date Passed By Inspection Description . Date Passed By
Footing /Setback Underground cover
Foundation walls _ Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain ^ Electrical final
Underfloor insulation
Post /beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing
Firewall Inspection Description Date Passed By
Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
•
MFG Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing Inspection Description Date Passed By
Suspended ceiling Post/beam mechanical
Engineered soils Gas line
Welding Lab Final Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
Fireproofing Lab Final Mechanical final
Final inspection
PLM - Plumbing Permit
BUP — Fire Protection System Permit Inspection Description _Date Passed By
Inspection Description Date Passed By Plumbing underslab
Sprinkler underfloor /slab Crawl drain
Sprinkler rough -in Post/beam plumbing
Sprinkler final Plumbing top -out
Fire alarm final RP /backflow preventer
Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By _ Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils Inspection Description Date Passed By .
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \ forms \InspRecordBUP.doc 04/17/01
1 . r _ 1 I ..
CI TY OF TIGARD - PLUMBING PERMIT
I , DEVELOPMENT ■
SERVICES
PERMIT #: PLM2004 -00501
'' ll 13125 � SW " Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/3/2004
SITE ADDRESS: t _" 5 BEVELAND RD PARCEL: 2S101AB 02201
SUBDIVISION: BEVELAND 7/ -7 ZONING: MUE
BLOCK: LOT: 2 -3 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM 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: 100 ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: No plumbing fixtures roughed in at this time.
FEES
Owner:
Description Date Amount
ZIMMLER DEVELOPMENT LLC
7165 SW FIR LP SUITE 100 [PLUMB] Permit Fee 11/3/2004 $110.00
PO BOX 230698 [TAX] 8% State Surcharl 11/3/2004 $8.80
TIGARD, OR 97223 Total $118.80
Phone : 503 -598 -3440
Contractor:
CH KRUSE PLUMBING
5802 A NE 88TH ST
VANCOUVER, WA 98665 REQUIRED INSPECTIONS
Phone : 360 Sewer Inspection
Water Line Insp
Reg #: MET 5137 Final Inspection
LIC 111654
PLM 37 -396PB '
0
gb
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: S ,� ; ,� Permittee Signature: 1 �� 1 `�'� , �` " = �
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day