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Permit - f CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2004 -00176 - c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/29/2004 SITE ADDRESS: 07307 SW BEVELAND RD PARCEL: 2S101AB 01604 SUBDIVISION: HERMOSO PARK ZONING: MUE BLOCK: LOT: 016 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: 2 FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 2 TUB /SHOWERS: SEWER LINE: 50 ft WATER CLOSETS: WATER LINE: 250 ft DISHWASHERS: RAIN DRAIN: 50 ft Remarks: Site utilities for new office building. Other fixtures are (1) manhole, (1) rain drain connector and 210' of footing drain. FEES Owner: Description Date Amount PAT GILROY 5100 SW MACADAM AVE SUITE 240 [PLUMB] Permit Fee 11/29/2004 $472.00 PORTLAND, OR 97239 [PLMPLN] Plan.Review 11/29/2004 $118.00 [TAX] 8% State Surcharl 11/29/2004 $37.76 Phone : 503 225 - 5559 Total $627.76 Contractor: HOLLINGSWORTH PLUMBING 13624 DUANE ST OREGON CITY, OR 97045 -2869 REQUIRED INSPECTIONS Phone : 503 Sewer Inspection Water Service Insp Reg #: LIC 65325 Storm Drain Insp PLM 26 - 324PB Crawl Drain Rain Drain Insp Final Inspection 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 que: to 0U" by calling (503) 246 -6699. • Issued By: J = :. Permittee Signature: IL _1 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Site Utilities 49,03 -coo f �D Plumbing Permit Application • FOR OFFICE USE ONLY City of Tigard EG D E iew Permit No.: 1312SW HaBlvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 !) � r ittoet ryu t ∎ e Da teBy: 1 t // Jo C Other Permit No.: 24- Hour Inspection Line: 503.639.4175 N'C) t c ti . ° W Date Ready /By: �_ mn El See Page 2 for Internet: www.ci.tigard.or.us r` 1• /id Supplemental Information g _ � . w Notified/Method: pp Feu i�; s.:�r;K' tiz�M ::1 � a �.' _ "�';'� ;M'� ;�.3:�.1�: °r.� .;<.m'�. _ n' �:`�` "`�:' 2 Wiz' ° . ' = . � - ; - �' 7i;� :��:.ue,; � t` .. . ' x : *`tw F a ' : .. ` .,i '�, ,, � * iWit WORI{; y . -SIW 1 r -; a " ; . i f ; E S CHEDU"LE . „ ..4.' New construction 8`l viii "Bemolition 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) ` te,11, s GA,aTEGORY bI ONS -,CTIO r?i': : , ..i• u.ki .. ,t, .; t as ':j SFR (1) bath 249.20 ❑ 1- and 2- family dwelling Commercial /industrial SFR (2) bath 350.00 • ❑ Accessory building El Multi SFR (3) bath 399.00 Each additional bath /kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 Fi� �,..g , f :S a 1 = ,. . 0kr.a. Lf384", "J 'is 3sLti:.is`,r.',4eS * "at.."�;Fa'e.�i:4'u - : ^P:..: " zwr..0 �p : ' d n:' ' , - 'f » Jf �'` t iA r` k a �titeB SITEa INFORMATION AN4 LOCA ON ti " : 7 ,,_ r S ut ,q Job site address: 73o,1 S W III -v E�.N� Catch basin or area drain Z 16.60 3. ,, `� City/State /ZIP: Ti h /kco DR_ of -- I 'L-L3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: a 1. ay �/ 00 1C-.4.-- ('p. Footing drain (no. linear ft.: 2_l' Page 2 mi. g0 t Manufactured home utilities 110.00 Cross street/directions to job site: /s Manholes I. 16.60 ,4 - 77_ 3 ELI E-L.Pe Rain drain connector I 16.60 /4 , 100 Sanitary sewer (no. linear ft.:. ) Page 2 �"�.0: Storm sewer (no. linear f ) Page 2 /1/ 1• Subdivision: Lot no.: Water service (no. linear ft.: 50) Page 2 y (� r � v Fixture or item Tax map /parcel no.: ,Ak' �t i , ;3,i�.. .5 , �t 'r"= ?:3,.,ay ' n x: n;,a v's[ e;:` 2s7�:= '�a:' ":i4:5•ak �: --� .;* ,�.-' _a` i" Absorption valve 16.60 g lligi . t ' , rDESCRI, T1.O OFtWORK,, t t .ki�+t,rk u ,, p g _� >h,� ;, - � ,�F - „- . , . - s.��r�,��:,.�, �:,. � ., � � �' Backflow preventer Page 2 -F' - - t✓ liorl�, . t - Backwater valve 16.60 5-47 4 r/ `t £ 5 Clothes washer 16.60 Dishwasher 16.60 "; W "_[ s'�"; .,. U- r : ,v:<�', :aacsx.,ar:.,� ; 5 °a �r::,a - ':u , :?ni:t ; = "e ;;,"=t"' ?.F= ' = r�° „�,��rrr ;. r i '" >, *� , 4 E ; � Drinking fountain 16.60 ; 3 O : f 4 P `�O isI R t, e I f' r e ®riii∎ A fil i y .. �. - i. •..,:,,1 4,, i4 i .. Am ,. •:,,..n, i. , . i, e: Ejectors /sump 16.60 Name: l AT ` l 1 L4.. D`( Expansion tank 16.60 Address: 5 sw MAcAI�Ar►x SOcr - 1--`K, Fixture /sewer cap 16.60 City/State /ZIP: F'o p . N- , D R _11 23C\ Floor drain /floor sink/hub 16.60 Phone: (503) 'Z7,5- $551 Fax: ( ) Garbage disposal 16.60 ' ; ,_ =ea ss w" " z Vi: ;. r, s= ' .z s, acv,: K:,$ ! Hose bib 16.60 � ` "' + k tiSt A�P PLICANT� , , . j" ,a c6 t CONTACT PERSON , . ,;,, ^� i$ x,35., t ;,,T ,. , ,- . €r,,I,,„ .: x, _ ai .r ,, t .[:..fi ,L ,.ti y refSsr;?.; '4':1 .. ,' . ' . . �, iij Ice maker 16.60 I Business name: iv eg_si 000STl Ocnof3 CD O DR, Interceptor /grease trap 16.60 Contact name: TD C L-A2y.4... Medical gas (value: $ ) Page 2 Address: 1 met et 8 SW DKCHAPi) t-lu- R.A. Primer 16.60 City/State /ZIP: L.at c ' )t DO- 9-70.3.5. Roof drain (commercial) 16.60 Sink/basin /lavatory 16.60 Phone: (57:$3) - 7 93 . 2C, Z I Fax: : (,-b 3) 2 9 3 - t 53 (. Tub /shower /shower pan 16.60 E -mail: o �, 9 .5 _ ( 2_,j Urinal 16.60 ` i ; , ns , ,.�',s . ;t ...,, n ,: -;,s ��Fy:. =::x _ ' ;' : :3: i _ * ;a .• z <C " 'N;: V .; ` fr t t tinfU CONi,Miai r " .'' " . t� ' } a. l > " ,t'�' ...t " �`�.; W ater closet 16.60 Business name: IaO /06,4 D 2 7- L/ /" Gu/16,.,t,)6 Water heater 16.60 Address: /'/ - DU r " +i`._ '7 Other: N City/State /ZIP: ,&_ao CITY ©/L 970e/S -a$69 Subtotal ' � ! Minimum permit fee: $72.50 DO Phone: (5b 5v) 6 55 - = �� 1 Fax: i �) Residential backflow minimum permit fee: $36.25 �p�' OC) cal Lic.: Lo 5_1P 5 Plumbing Lic. no.: a J (5 3471 �J � Plan review (25% of permit fee) g • ? I / � J /" r. ,, / State surcharge (8% of permit fee) 7. 4 P Authorized signature: _ _ � ,,.� (l -lY) TOTAL PERMIT FEE a,�_ 70 Print name: s � S 1114, Date: .9./2_./ jock. 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:\Buitding\Permits\PLMU- PermitApp doc 12/03 440- 4616T(10/02/COM /WEB) 1 Plumbing Permit Application - City of Tigard t4 Page 2 - Supplemental Information ` ._ Fee Schedule: Residential Fire Suppression Systems: .� -�. - ,� rl; �..> . �. �;: �� , :':.� ~� °�,�, rte;; =•;, �, • i '° " ' ' , i + 3' f Qty ee (ea) T otal `S' flare FOiki e a e Fee.. S e�; •V� .1 , �. , x r ado i .,t, A ati ;q�. P Footing drain -1'100' 1 55.00 55:60 0 to 2,000 $115.00 Footing drain - each additional 100' 0 46.40 Qf . gd 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' • /' 55.00' -6 , CIO 7,201 and greater $309.00 Sewer - each additional 100' .6 46.40 Water Service - 1st 100' 55.00 J5� 00 Medical Gas Systems: Water Service - each additional 100' 46.40 7 0- k ?h' °':." �a °�� . '�"„;' °" V 1 , Storm & Rain Drain - 1st 100' / 55.00 s.1, $1.00 to $5,000.00 • Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 9A. r0 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each mms .tgw ee i additional $100.00 or fraction thereof, to and 5 �� � �� �, ;,� �_� ��I" Qty E`ee (ea)� �Totalr� ' n :. re„O u r lt4' � ?,,., , �, - ti � ?II A ;,,. x 1gr ; 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 $5,0,000.00 $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 and including $50,000.00. . specially requested inspections - per hour 72.50 . $50,001.00 and up . . $742.00 for the first $50,000.00 and $1.20 for Subtotal: - 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 * . if `'s"' i j F1xtu Quanti 4byi(Frxtifr W rk P�e rform ed r , 9 re.T pe a A • �� S" k n ifr, M if `it:olacei l p,44;;14.9 • tiAt i e = q v fi e& o E s ,c 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" 3" ' . , • • - 4" 1i • r r I Car Wash Drain • Garbage - Domestic t • Disposal - Commercial *Note: If the fixture work under this permit results in an Industrial increase of sewer ED a s ewer permit will be issued and Ice Mach. /Refrig. 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 - Quantity Total - Bradley Isometric or riser diagram is required. if fixture quantity - Commercial - Service total is >9. , , y - 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:\ Building \Permits\PLM- PermitAPP.doc 3/03 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2004 0017f 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11J29/2004 Phone: (503) 639 -4171 iztl Inspection Requests (24 Hrs.): (503) 639 -4175 :_.. INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 101 I I SITE ADDRESS: 07307 SW BEVELAND RD CLASS OF WORK: SUBDIVISION: GILROY BUILDING LOT #: 010 TYPE OF USE: 1 PROJECT NAME: GILROY OFFICE BUILDING DESCRIPTION: Site utilities for new office building. Other fixtures are (1) manhole, (1) rain drain connector and 210' of footing drain. OWNER: GILROY, PAT PHONE #: 503 -2255 -5559 CONTRACTOR: HOLLINGSWORTH PLUMBING PHONE #: 503- 555.5050 I Inspection Request Scheduled For: Date: 9/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 015654 -01 503-793-2621 N Corrections /Comments /Instructions: d//(d ,k PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 ) /- " I k_ Date: `' / 7 J6 Phone #: (503) 718 - CITY OF TIGARD 24 -Hour BUILDING \, Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Received Date Re•uested ! a — Z r AM PM BUP Location 0 AL"— �� �_.: Suite MEC Contact Person Ph ( ) " / c f . - a a- J PLM O?DO DO ('`] 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 Other: Final PASS PART FAIL PLUMBING ` Post & Beam • •er Slab - oug - n Water Service Sanitary Sewer Rain Drains 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. 0 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line / �/,, j �j 1 Inspector / �'!r E4 Ext Approach/Sidewalk Date � ` Other: ,r Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL