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Permit r "" A CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2005 -00022 I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/19/2005 SITE ADDRESS: 07157 SW BEVELAND RD PARCEL: 2S101A6 -02100 SUBDIVISION: BEVELAND ZONING: MUE BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: 1 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Other fixtures: (1) expansion tank, (2) hose bibs. FEES Owner: Description Date Amount ZIMMLER DEVELOPMENT LLC 7165 SW FIR LOOP # 100 [PLUMB] Permit Fee 1/19/2005 $265.60 TIGARD, OR 97223 [TAX] 8% State Surcharl 1/19/2005 $21.25 Total $286.85 Phone: Contractor: CH KRUSE PLUMBING CARL H KRUSE 1519 SE 104TH CT REQUIRED INSPECTIONS VANCOUVER, WA 98664 Phone : 360 Rough -in Insp Top -out Insp Reg #: LIC 00066704 Final Inspection PLM 2629j 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: >1 F.t/ ' Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day r �® Plumbing Permit Ap • Wit- . :v Received FOR OFFICE USE ONLY �J City of Tigard �� 00 � Date�By/ /1. /26` Permit No.: � , -d X ? 7 - 13125 SW Hall Blvd., Tigard, OR 97223 ``®� •, Plan Review l t � ` Phone: 503.639.4171 Fax: 503.598.1960 J ,��t: /`.. 4 , `f� lra Date/By Other Permit No.:3' 5 * Q/ 24- Hour Inspection Line: 503.639.4175 a•1 J Internet: www.ci.tigard.or.us 0 � , ° = ..� - Date Ready/By: lu "s S See Page 2 for Noti Itr Supplemental Information TYPE 0 ;fit, 1, `K FEE* SCHEDULE E New construction ❑ Demolition For special information use checklist Description I 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 ❑ I- and 2- family dwelling I 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: -7 I 7 5 < GJ iSebei ,/ h/dam A / Catch basin or area drain 16.60 City /State /ZIP: 7 1 / 4 7,, / Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: kat C RA Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street /directions to job sit C=sl iami r S 71 09 1 a! Manholes 16.60 VI Ae fir- Pkajtil 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 Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 h �Ta Ur new /747, 4H / 2 44 5 , Backwater valve 16.60 �o o �� S� fff"'��[[[ 1�(� b/d Clothes washer 16.60 y Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors sump 16.60 Name: Zih 'im /Pv.- P & ( f figP/141/- Expansion tank i 16.60 i6 C 0 Address: Fixture /sewer cap 16.60 City /State /ZIP: Floor drain/floor sink/hub a... 16.60 37. L. 6 Phone: ( ) Fax: ( ) Garbage disposal 16.60 Hose bib a, 16.60 f.„,2 d ❑ APPLICANT ❑ CONTACT PERSON ' Ice maker 16.60 Business name: C, }-I i✓ „ 5- ) , , /l, rn h'l'k,i Interceptor /grease trap 16.60 Contact name: ."" 411 4 Medical gas (value: $ ) . Page 2 Address: --?_._ _ =- - - - - _ - Primer 'a-- 16 33,Z 6 City/State/ZIP: - /4.A.,. g'-- Ail C. ‘'! Roof drain (commercial) 16.60 Phone: (% S 7 3- f 3'3'7 Fax: : ( � ) ,57 3. s 3 03 Sink/basin/lavatory 16.60 ((,q° Tub /shower /shower pan 16:60 E -mail: / Urinal I 16.60 / 0 ,. 6 CONTRACTOR Water closet 3 16.60 c/ g, - v Business name: G J , I ,�1 ' E / c 1 / �i C � , 7 Water heater t 16.60 /6 , 6 D Address: ('� �� Other: City /State /ZIP: Subtotal 6 6 Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) .2,1 ,2y Authorized signature: TOTAL PERMIT FEE Print name: �t ��{� Date: / . J 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\PLM- PermitApp.doc 12/03 4404616T(l 0/02/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 - l st 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 ,? a $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 additional $100.00 or fraction thereof to and . Fixture or Item Qty Fee (ea), Total. 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: Are you capping, moving or replacing existing fixtures? If "yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. Quantity` by (Fixture) WorkTerformed Fixture Type: Replace New Moved Existing Capped . Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi /Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" ° a 1, -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach.lRefrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory �{ Bradley Quantity Total Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:\ BuildingWermits \PLM- PertnitApp.doc 3/03 ' CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005 -00022 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/19/2005 Phone: (503) 639 -4171 t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/8/2006 TIME: 7 :00AM PAGE: t SITE ADDRESS: 07157 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: BEVELAND LOT #: 003 TYPE OF USE: PROJECT NAME: ZIMMLER & GRACE. DESCRIPTION: Other fixtures: (1) expansion tank, (2) hose bibs. OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360- 573 -4337 Inspection Request Scheduled For: Date: 11/8/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 395 Misc. inspection 020620 -01 503 -209-542 Y Corrections /Comments/ Instructions: e / Or AdAwmi ism /I jJr; SS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 4 Inspector: Date :f 6 Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005 -00022 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/19/2005 Phone: (503) 639-4171 it Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 36 SITE ADDRESS: 07157 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: BEVELAND LOT #: 003 TYPE OF USE: PROJECT NAME: ZIMMLER & GRACE DESCRIPTION: Other fixtures: (1) expansion tank, (2) hose bibs. OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360 -573 -4337 Inspection Request Scheduled For: Date: 11/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 396 Misc. inspection 020474 -01 503- 209 -6425 Y Corrections /Comments /Instructions: / // fileremire 67-72, , I PASS RTIAL APPROVAL ❑ CANCEL _ NO ACCESS I FAIL I/ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: / Date: 1/ Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005- 00022 13125 SW Hall Blvd., Tigard, OR 97223 ; t l • DATE ISSUED: 1/1912005 Phone: (503) 639 -4171 '` 4'�i� �I� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 67 SITE ADDRESS: 07157 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: BEVELAND LOT #: 003 TYPE OF USE: PROJECT NAME: ZIMMLER. & GRACE. DESCRIPTION: Other. fixtures: (1) expansion tank, (2) hose bibs. OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: CONTRACTOR: CI KRUSE PLUMBING PHONE #: 360 -573 -4337 Inspection Request Scheduled For: Date: 11/4/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 395 Misc. inspection 02033601 503.2095425 Y Corrections /Comments /Instructions: / / / 4/72 — • El PASS (ARTIAL APPROVAL ❑ CANCEL I I NO ACCESS FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ✓ Date: /'l• <(� Phone #: (503) 718- r • CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005 -00022 13125 SW Hall Blvd., Tigard, OR 97223 _ '* DATE ISSUED: 1/19/2006 Phone: (503) 639 -4171 ..rr it4 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 112 SITE ADDRESS: 07157 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: BEVELAND LOT #: 003 TYPE OF USE: PROJECT NAME: IIMMLER & GRACE DESCRIPTION: Other fixtures: (1) expansion tank, (2) hose bibs. OWNER: ZIMMLER DEVELOPMENT LLC, PHONE #: CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360-573 -4337 Inspection Request Scheduled For: Date: 10/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 019442-01 603-209-5425 Y Corrections /Comments /Instructions: ?I) I PASS ❑ PARTIAL APPROVAL I1 CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: T\ Date: 9 - 0 Phone #: (503) 718- CITY OF TIGARD PLM200S00022 BUILDING DIVISION PERMIT #: 1/19/2005 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: Phone: (503) 639 -4171 4091, � Inspection Requests (24 Hrs.): (503) 639 -4175 10/24/2005 7:02AM 88 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 07157 SW BEVELAND RD SITE ADDRESS: BEVELAND 003 CLASS OF WORK: SUBDIVISION: ZIMMLER & GRACE LOT #: TYPE OF USE: PROJECT NAME: Other fixtures: (1) expansion tank, (2) hose bibs. DESCRIPTION: ZIMMLER DEVELOPMENT LLC, OWNER: CH KRUSE PLUMBING PHONE #: 360-573-4337 CONTRACTOR: PHONE #: 10/24/2005 Inspection Request Scheduled For: Date: Pour Time: CQ # Irpe %tion fma Deiscription S�3�O r [�1 S8 &4- 25 Message 3 ulil ing Corrections /Comments /Instructions: F a,,, W P ,,,,,_. L-� � 1, �� I —o > - 0,4 / 1 0 �.� ►, �,.sA. , .vtt, --rO _ C1,-.4 I • , c DL/ el -(.44 a. , �cer�`Cta�l� 1 pYdv'r -L - o Cap Pr; L61.c✓, 1141,cjaf • PASS I I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS X _ FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: di Date: / O /Z�/ /Jccm Phone #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 • BUP Received Date Requested a C AM Prvl BUP Location __= 7 Suite MEC Contact Person Ph ( 3/ 9) S7 3 -" ' 2i 7 2 _ . Z - Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Acces : _,� ` ELC Ftg Drain �r��" ELR Crawl Drain Slab In ,oe ion 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: /� - Fi nal PASS PART FAIL PLUMBING P• :e.m ervice Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: cF i P 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: D Unable to inspect — no access Fire Supply Line ADA ) / Approach/Sidewalk Dat �T 6 Inspecto Ext Other: Final • , DO NOT REMOVE this inspection .record from the Job site. PASS PART FAIL