Permit CITY OF TIGARD
PLUMBING PERMIT
x I DEVELOPMENT SERVICES PERMIT #: PLM2004 -00500
`'` E �' ll 13125 SW Ha Blvd. Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/3/2004
/57 PARCEL: 2S101 AB -02100
SITE ADDRESS: ..A W BEVELAND ST
SUBDIVISION: BEVELAND ZONING: MUE
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: OTR 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 LOOP 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: 1, ___ - ,011 1 Pr, Permittee Signature: -
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
11/03/2004 11:13 FAX 503598196 G -I.TY OF TIGARD E 001
- Minding fixtures
Plumbing Permit Application
200
City of Tigard CITY OF TIGARD Received / ' / P N
13125 SW Hal] Blvd., Tigard, OR 97223 BUILDIN 4 10N 15 atcBV , `/ �� /17 _ L .` v /'� 5 ---( " )
Pfau Review
Phone: 503. 639.4171 Fax: 503 . 59 8.1960 = d,� { ,,: i•; , DateBy; Other Pcr it'No,:
24- Hour Inspection Line: 503.639.4175 _��.. II Nate
Internet: www.ci.tigard.or.us s -- Ready/By: 'i / _ S See Pas l for
�� Notified/Method: � -t l(�( Supplomnntallnio • matlan
.i `I:� I: ; "i '1,111; 11 ::I' I ° li( !•" :,,
1 , ..1' '.I i pF : ,Nif . 4: ,:.I.� . is, f :' ?,I "' . »` E.
: II: I: �, II.�,i�:l: :.:.::.::.::: � .. ill,';.:: . . ,. , ..� ,.. . I . .. � !- ...,
E . • . SCI�A[7L
�.�. .�, .� � i., �� � :�. .:.: c ..,.., � is .
[ construction ❑ Demolition Far special information use checklist .
Description I Qty. 1 Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
' 1:i'i' ;I'! :, ':'1: i :1',I .. R !i.. .GON T1 I1h. a •t Ii i.li:I' ;:: i ; ;: ; .. a.' SFR (I) bath 249.20
❑ 1- and 2- fancily dwelling C Commercial /industrial SFR (2) bath 350.00
-
El Accessory bwlding ID Multi-family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
( s9 ) Page
I .I: is 'i�
.. �::,,� . : ':1'::`1: , . .... (MR'°!i`�� . � . A
9'Idi+�` ' 1 :::: ::.:.: I. .::: ' ::
. , Site utilities
�
f � Job site address: -, - ,fair � ?j --+,,' , -1.,m, O Catch basin or arcs drain 16.60
1 ( City / State/ZIP: I t G AQ.f) Q Q. 0 11 7.- ... Drywell, leach line, or trench drain • 16.60
Suitc/bldg. /apt no.: Project name: 1 I SS `$ t'a/ E.t_ea 30 Suost
Footing drain (no. linear ft: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: /' .) Page 2 S'-)--•Gt)
Storm sewer (no, linear ft.: ___,) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: _ I ) Page 2 ) -3---,, d°
Tax map/paroel no.: Fixture or item
1'1 ■iq,l " 1 6 . ¢ i i °i. ia!, a Absorption valve 16.6
:, I`Il ; ; 0. , : r• : 4 y . .� }, .., LI D ... ... TI , biz: .. ,, • . • ! :;::1:6.1::i.,!;!:!,:.!,,,!‘,...,.:.: a)-l';
- , ]3acldl w preventcr Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
'i <ii'ill
:'ii'ri'• �;? . .��p p ,. :j;l`,;'i4 'I;iy I ' .Iq' �: p c;l Drmldngfountain 16.60
I'I `I ' . ;i Pi "Il n.. I ILI . i .. Nt'1.1aii :'
- Ejectors /sump 16.60
Name:
Expansion tank 16.60
Address: Pixdae /sewer cap 16.60
City /State/ZIP: - • Floor drain /floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16,60
y .: E .:� iOivzACj •
::ir. .. .. ��.: I ' ii 1 r 1, I: 1660
. �,� . � I :.�1 .. . ? ., . II.... • x : : ' � �''�'
Ice maker 16.60
Business name: le.2 ,ma 1 t t.lv`t{( 6 Interceptor/grease trap
Contact name: M l..102.\-/ ep grease tra 16.60
Medical gas (value: $ ) Page 2
Address: 5 (2.. - 2.„. -,4 N, - . c5°J-i 1.1, S '7 Primer 16.60
City / State/ZIP: VPs .(, Wilt 9 % F; G5 Roof drain (commercial) 16.60
v
Phone: (3 6. ® ) S. 1 � ?) - 1 (4 ) 5 - S? 0 Sink/basin/lavatory o 16.60
Fax:
Tub/shower/shower pan 16.60
E-mail:
i...
i'� I. ,..:: ..., . 1 ' �:'0 Urinal 16.60
:' Water 1. ..r:;., p 'te•il L:i ... ..., � �' � d: � is W r closet 16.60
Business name: V42,L,L5 } i,(,m 1 C, Water heater 16.60
Address; 52,0 _ A N , a , Q_, g'1 /4 S- Other.
City/State/ZIP: \I /N-1\1(.. C c l $ (o( S Subtotal
Minimum permit fee: $72.50 il
Phone: (�) 5 a1'3 _L! 7 -j - 6 - 7 Fax: (Y0.0 ) S 5303 Residential backflow minimum permit fee: $3625 j / 2. 0
CCB Lie.: 5 I "J - 7 Plumbing Lie. no.: 3 - 1,'19 t, P p Plan review (25% of permit fee)
Authorized signature: Cr() y- ° ne ` k.
State surcharge (8% of permit fee) j � \\ � v
l'AL PERMIT FEE 1f �
Print name: NI L . 1 . R . 1 S L 1 t . Z.1 DC2 Date: I 1 _'3 _o Q 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.
is tBuilding \Pam;te \PL.MP- PemiUpp.doc 12/03 44O4616T00 /02/COMN/EB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2004 00500
t 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/3/2004
I Phone: (503) 639 -4171 a sivWM��i�iN�ili , ''\
• Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/25/2005 TIME: 7 :12AM PAGE: 66
SITE ADDRESS: 07157 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: BEVELAND LOT #: 003 TYPE OF USE:
' PROJECT NAME: ANDRUS
■ DESCRIPTION: No plumbing fixtures roughed in at this time.
OWNER: , IMMLER DEVELOPMENT LLC, PHONE #: 503 -59 &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 007664 -01 360-518 -1375 N
Corrections /Comments/ Instructions:
i At i
r 6 �� � iliw L
. .4 r . I Are < < -rm.
C
PASS EI PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date : / A5 /b 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 R,uested ! AM PM BUP
Location Suite MEC
Contact Person Ph ( 36D) S �3 (337 PLM o4�J 9i — 6 ()J
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
f ,.
Other: •
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fjpal
PART FAIL
11 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 El Please call for reinspection RE: ; Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk- Date MOP' 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 (S � 1 Suite MEC
Contact Person Ph ( (6) 6 433 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
Insulation 77
Drywall Nailing '
Fi rewal I j
Fire Sprinkler
/ - ' . _ -
�i�_. /AV-
Fire Alarm
Susp'd Ceiling /�
Roof Other: , J �" ��y • ��1'Z
� w je Fi nal L1/A/ ' /(W2-
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
R - •
ater S e
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fin !
S PART FAIL
CHANICAL
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 � )
Approach/Sidewalk Date )/,
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: 1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Received Date Re•uested ` l —1.6 AM PM BUP
Location 71 '�(J -e — ��f i12 Suite MEC
Contact Person r X 1 - y -/NjJ r Ph (, 3 7 3- ,3 3 7 PLM v 7` -06,SZ D
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Air �—
Roof //7
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
ani ary 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: Unable to inspect — no access .77/1/V
ADA Date 1 ! " i Inspector Ext
Fire Supply Line / /
�
Approach/Sidewalk
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 Res uested // AM PM BUP
Location —' =A Suite MEC
Contact Person fit,,, Ph ( ( 3) 3/ S • ) 313' PLM Oc� - a SD()
Contractor (Q/ Ph ( ) SWR
BUILDING Tenant/Owner 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL / / ---
Post & Beam
er
c
Hough-In
Water Service -
L Sewer /1//1/1
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F -
( PART FAIL
00CHANICAL
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 Ell Please call for reinspection RE: Unable to inspect — no access
Fire. Supply Line 1 "L ADA Approach/Sidewalk D Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL