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Permit CITY OF TIGARD PLUMBING PERMIT ' I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00215 ' I--I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/26/2005 PARCEL: 2S 101 AB -01606 SITE ADDRESS: 07357 SW BEVELAND RD 100 ZONING: MUE SUBDIVISION: HERMOSO PARK LOT: 017 JURISDICTION: TIG Project Description: TI: 3 sinks, 1 floor drain. Other fixtures: 1 ice maker. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 3 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Owner: FEES TOM CLARKE Description Date Amount 12448 SW ORCHARD HILL RD LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 5/26/2005 $99.60 [TAX] 8% State Surchari 5/26/2005 $7.96 Phone : 503 293 - 1226 Total $107.56 Contractor: HOLLINGSWORTH PLUMBING 13624 DUANE ST REQUIRED ITEMS AND REPORTS OREGON CITY, OR 97045 -2869 Phone : 503- 655 -5050 Reg #: LIC 65325 PLM 26 -324PB 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 vyittexpire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days..- ATTENTIO: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. TIse rules a forth in ©AR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 -246- 99 or 1- 800 - 332 -23. Issued By: Permittee Signature: _X 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. Building Fixtures si o i4 e -0160 P lumbing Permit Application i 104 , FOR OFFICE USE ONLY . v i Other d / � � ■ City of Tigard Receive g y .1 , 3 r - Z� Date/By: Permit �'/ � 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �• - , S cL ' �� - CX) JL Phone: 503.639.4171 Fax: 503.598.1960 4171-117% I D ateBy: r Perm t 24- Hour Inspection Line: 503.639.4175.' I s: _ ' _ Date Ready /By `hJ See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: ti / Supplemental Information ,�, «r:� • =a . _ �, .,. �t .:.., -» a.; :.:..rs� .., -: .' ; - tea. s,ttr =..w .,- ..._..m .»,..__e.._ _ ;: �`t) • €' `. r ,+;.figeax:: '� „:� »�'a'. .: " "IW i a n'�t; s '.«» �' a 3 N " , tx , p , ' . g.., Ok W OTiKr s. N om; . ;� F EE ,S DiIt ❑ New construction El 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) V r "" CATFsC'r ifi OF COI STI T�C'T OIV,1 ( ' J . SFR (1) bath 249.20 1 ::�:'�'� s.. �r 5. ,e�.'"�:a..-.�'.'z�tk,.�.'z���w .w+�. ��..�3r-�%�o-.a . . :.. - - � .. ' .�.Sri - . ; *,°3A ❑ 1 - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building El Multi-family SFR (3) bath 399.00 • Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: ' .: ,. , .: : ;r .� _ �x� ^° n om . , ,. _ Fire sprinkler ( sq. ft.) Page 2 t 'JOB ,SItT NFO RR'I�3iftW �1D OC �i`I'i 0 P: r � 5" a , . �0,, , * AA€ " .: 1;�. ; is ix WAV.z t ., : ..® * Site utilities Job site address:47 57 5 t.t,/ , Catch basin or area drain 16.60 City/State /ZIP: --r; e• 4 04 may- Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 1 Q Q Project narru y Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 1 10.00 Cross street/directions to job site: t.,�,LG�t/ S -t _ C Manholes 16.60 j • , 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 PVC '. �'. ' & DESCRIPT i„afR i A . , = Backflow preventer „ Page 2 Backwater valve ( 16.60 Clothes washer 16.60 Dishwasher / 16.60 ,,.: ,. ‘':; ..- .. '. ass *. # . =5 Drinking fountain 1` 16.60 e �_.�_���. H, f` :� a��. ,� -g..� �,a,�K � �z �.: .a.. V �A Ejectors /sum 16.60 Name: _. Expansion tank 16.60 Address: 7 cif•n �'} oP / L)t Fixture/sewercap 16.60 City/ State /ZIP: , , ! - r a2.c_ t �6-�-"�-�� , 0, 70 , 5 Floor drain or sink/hub J 16.60 Phone: (5) 3) „2f 3 - 4,2 dt- 6, Fax: ( ) Garbage disposal 16.60 VaC.. i ��� PTIM- n.< sy , " etelT _t, 4 �, ,.,' ..,, r Hose bib 16.60 Via:, ` � �IICAbYT�3 ;t� v��s�: ,�,, � =C(JN ' °GT RSONx�:� - „. _ i #. _ .tv , � ,,,t1 , .,,s v , 1._ ,� ;_. .- , ,,, -4 � d ,, - . Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 I City/State /ZIP: Roof drain (commercial) 16.60 Cr- .-- Phone: ( ) Fax: : ( ) �Sin k 9basin /lavatory 16.60 Tub /shower /shower pan • 16.60 E -mail: Urinal 16.60 • � ' W� � - , GONTR - ..; , 7 , W ;d :A 1 L _ . _ Water closet 16.60 Business name: d"-,re-1. y , / � 7 Water heater 16.60 Address: t2zT ` Other: 6 City/State /Z ' �j Subtotal "� ��� 89 �� � Minimum permit fee: $72.50 //_� Phone: 3 _6SJ S5: Fax: ( _m�. )1 Residential backflow minimum permit fee: $36.25 9q , 0 LO CCB Lic.a��Z� Plumbing�c{c e'J2.l�'�? .� / Plan review (25% of permit fee) 1'0 State surcharge (8% of permit fee) 7 96. Authorized si• o • -�. 0 . '� _:-._ _�_� TOTAL PERMIT FEE /01 y 6. Print name : /J j.r_. / - : , ' I - Date 25"e,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. MBuilding \Permits\PLMF- PermitApp.doe 12/03 440- 4616T(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard . 1 Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: *Si tl'litie x Q t y )> -Meth a .'` =F' ... . � a ` `� � � � �T�i �' �,�, u a �e Foota e' ' � , P e�>�u t F ,�, ,�.��� __•._ . .�.�w . -.4 . -�.. , .. n .3�� ��..� r�,�. _ sue . �q��� �- y . Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 w 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 ' '''''' :. ,t3 : '` %< - - , ,. >,:� •-- Est` ,< , �:;i:.�� ;°" :� IfV al (S uat on 'E '' "; Permit ree; .::.- ::':. ,,. 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 �° ',r. °' �. ;, - °_ ; additional $100.00 or fraction thereof, to and ' a 'a 'e, Or Item „ alat , au a!:' , = : : , 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or 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: 7 '5-7 5 W AIL---- Are you capping, moving or replacing existing fixtures? If " "yes", please indicate work performed by fixture. Failure to 011.c ' w I --o036:5 accurately report fixtures could result in increased sewer fees * . s �Quantrtyby (R►xtur g?k e formed F4 ur e l� ` " r r . � wo t� ,, 5 � r ) .- v _ ' Mo ea 41 � , ct g �cap� Comments regarding fixture work: Baptistry/Font fir.. ait Free- CJ IR 1i Bath - Tub /Shower - Jacuzzi/Whiripool C ' t ,S eC, ti Zd e-h t ry e,... Car Wash -Each Stall -Drive Thru • Cuspidor/Water Aspirator Dishwasher - Commercial j( / • - Domestic Drinking Fountain Eye Wash . p Floor Drain /sink - 2" V f -3" - 4" Car Wash Drain Garbage - Domestic • Disposal - Commercial *Note: If the fixture work under this permit results in an Industrial Ice Mach./Refrig. Drains Y � r increase of sewer EDUs, a sewer permit will be issued and 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 0 - Sink - Bar/Lavatory Quantity Total - Bradley - 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 ' x . • . , Other Fixtures: • is\ Building \Permits'PLM- PermitApp.doe 3/03 1 CITY OF TIGARD BUILDING DIVISION :, A PERMIT #: PLM2005.00216 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2006 • Phone: (503) 639 -4171 mold) i ii �ri Inspection Requests (24 Hrs.): (503) 639 -4175 ...'.� U.. INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: 80 SITE ADDRESS: 07367 SW BEVELAND RD 100 CLASS OF WORK: SUBDIVISION: CLARKE BUILDING LOT #: 017 TYPE OF USE: PROJECT NAME: BEVELAND STREEET COFFEE SHOP DESCRIPTION: TI: 3 sinks, 1 floor drain. Other fixtures: 1 ice maker. OWNER: CLARKE, TOM PHONE #: 603- 293.1226 CONTRACTOR: HOLLINGSWORTH PLUMBING PHONE #: 503 -666 -5050 Inspection Request Scheduled For: Date: 11/2/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 020067 -01 603 -793 -2621 N Corrections /Comments /Instructions: J . _ . /O /�� *01 / / 7 IPA / ` � fir 1------- .f Vi ' ASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r kii " ), Date: /1 2 Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM200S -00215 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2005 Phone: (503) 639 -4171 op„yp I Inspection Requests (24 Hrs.): (503) 639 -4175 :_.. INSPECTION WORKSHEET FOR DATE: 5/27/2005 TIME: 7 :10AM PAGE: 52 SITE ADDRESS: 07357 SW BEVELAND RD 100 CLASS OF WORK: SUBDIVISION: HERMOSO PARK LOT #: 017 TYPE OF USE: PROJECT NAME: BEVELAND ST. COFFEE HOUSE DESCRIPTION: TI: 3 sinks, 1 floor drain. Other fixtures: 1 ice maker. OWNER: CLARKE, TOM PHONE #: 503-293-1226 CONTRACTOR: HOLLINGSWORTH PLUMBING PHONE #: 503-655-5050 Inspection Request Scheduled For: Date: 5/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 007902 -01 503- 793 -2621 N Corrections /Comments / Instructions: / • / -5% • A • D 1 1(1 14 0. PASS ❑ PARTIAL APPROVAL dcANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /7r20 Date: Phone #: (503) 718-