Permit CITY TIGARD PLUMBING PERMIT
11 DEVELOPMENT SERVICES PERMIT #: P -00085
+- : �'J�1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/7/2005 7120%5
PARCEL: 2S114AA -00100
SITE ADDRESS: 09000 SW DURHAM RD ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Business /Tech TI. Capping (5) fixtures
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: El 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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
TIGARD - TUALATIN SCHOOL DISTRICT 23J Description Date Amount
6960 SW SANDBURG ST
TIGARD, OR 97223 [PLUMB] Permit Fee 5/18/2005 $83.00
[TAX] 8% State Surcharl 5/18/2005 $6.64
Phone : 503 431 - 4000 Total $89.64
Contractor:
OREGON CASCADE PLUMBING
PO BOX 12127 REQUIRED ITEMS AND REPORTS
SALEM, OR 97309
Phone : 503 - 588 - 0355
Reg #: LIC 127
PLM 24 - 33PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or, direct questions to OUNC by
callin 03 -246- .99 or 1-801-332-2344. '
Issu d By: ,_4, ' /, ; � ., Permittee Signature :y ,✓1N3 IAA
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit App_ i � t IV E
FOR OFF USE ONLY ._
City of Tigard 2� Date/By
It 6 `� k J) Pernvt No , , l Sf� 8E.
10
13125 SW Hall Blvd., Tigard, OR 97223 MAR (� y _•M __
Plan Review
Phone: 503 639.4171 Fax: 503 598.1960 / NINw„�w111 �1 14�\ Date/By Other Permit No -
24- Hour Inspection Line. 503.639 4175 9!
Internet. www ci.tigard.or us CITY ®F TI A --� Notified/Met Date Notified/Method. hod S S y Jun See Page 2 for
upplemental Information
LI ',= ,I, I i _ . I I N M I . T.l ,W 1 R,, 4 0I I _ 'FEE SCI3ED, . F , ,
�u`f. >�w .' {, � '. k.•4. M�. -y't- ;fir « 'k - � � % , }�
,� nl i 4�'. �`�a''= �..°.'t" . . ,.x.. -,..t '�i .'$ ��� :nom �, -r ,,, i r � r' . >sY -
'�I�.4. .�'u':3a^" �X'3�.sr,"�, = �# � , "� &`�` k` .' ., r .., K..�. . ,.,. .. r�� f.:' .. - �'4 �. �-s... !e .��'- ^.� t� „. _
111 New construction � Demohtion ,7)( 1�, L ( For special information use checklist.
C " Description 1 Qty Ea. Total
r '.- I ' ddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each tility )
• ' •. ;s ;, ,, eATEGORY "O , 1 , - ,s ' " ,, . v SFR (1) bath 249 Blu/ connection
❑ 1- and 2- family dwelling ❑ Commercial /industrial. SFR (2) bath 350 00
El Accessory building CI Multi-family SFR (3) bath 399 00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other:
-'� ;uxrff =:. K w . „ =:c , =a'z, •.. r s ¢ _. - -�1 ° Fire sprinkler ( sq ft) Page 2
� t l r ,,�•> ” k JOBW SITE EO „ A ND°%LO CK O ' ; „ ,x •,, ' x ° '° � ,
. -tea . f ,.,,,,,, �' : .s ,, —.,,,,. , ,,..,,,,,,,A i • „... ...,„,,d , . •. ,�'„ :' Site utilities
Job site address: j t L(-4-) (-- AA. Catch basin or area drain 16.60
City/State/ZIP: C Op— Drywell, leach line, or trench drain 16 60
� f Footing drain (no linear ft . ) Page 2
Suite/bldg. /apt- no : P oject name: ' 4 h(,nka�5 ��el t
Manufactured home utilities 110 00
Cross street/directions to job site:
l Manholes 16 60
1 1 ,A {ie.A 5 7 Rain drain connector 16 60
Sanitary sewer (no. linear ft.. ) Page 2
Storm sewer (no linear ft ) Page 2
Subdivision: Lot no.: Water service (no linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
r : .t, =,= u ; . , v ,, , ;f: , - 6 , , ris=OR I; ,. O,,,, ,0 4 ` ' ��, : .: i.
<, , �� :: ,•,_' r mss; •., � a'�r' Backflow preventer Page 2
t4,0 �� - t tl,"4 - Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
I
,:,r _._ -.. f,.n „� *k °, a., Drinking fountain 16.60
i` .; •ROP '' Q,W , ZzIk �s k :..: a 4 is *ki i
.,'„:emu sa , ,4 , . •, . ,...n,, _� �± � � r4. _.:,iik ` , ,i ` ?t Electors /sump 1660
Name: T ,,,,,. ) 1 ( �' Expansion tank 16 60
Address: b LC(400 ) 6' . - t 1 ( c Fixture /sewer cap 5 16.60 S5 0
City/State /ZIP: 11 ( 0 p_. . ^” . u Floor drain /floor sink/hub 16.60
Phone: (x -5'3) l 3 ( Ct pd 3 Fax: (i-2 3) �3 ( • -c 1( Garbage disposal 16 60
i 1 � ..i - . _- ; .• , - : .._ ,. , R ;:'• -> .•' r; r> .,.: 1 • , j ,: = Hose bib 16 60
if ` 'e`y E . , [ =i1 . F 0 -:,, .: < " l - fiw: • i `CON; E ; —
Ice maker 16 60
Business name: , w � � 1-76,14 3 v( Interceptor /grease trap 16.60
Contact name: Medical gas (value $ ) Page 2
Address: C 1 P 6 v - ,' � - Primer 16 60
City/State /ZIP: l
�' 1 � � L o p--
Roof drain (commercial) 16 60
C
r � Sink/basin /lavatory 16.60
Phone: (66)) tt r(( 65 `t] Fax: : ( ( D ) `C (' r'. J 0
l
l Tub /shower /shower pan 16 60
E -mail:
r I I°" I t '' N?#IWI":I •; . ,; .nI "k> -,•,x» w; I;a , . I- n,,,,: t,,,:,, x,x<4v:,, : Urinal 16 60
<; M , , i r CONTRACTOR= a r ``,,.:I s g< ;.. V ,, », • ,•NG4. ,, , ,_
;°a�..� "�=',a= .:,°�`' °.�`,;�', r>31 t -. ':�'�,:<i.��' „ ��,• i ": _. �A'u`:' : �•�[ �i= � � �F�.' '1v.-M; Water closet 16 60
Business name: O' Gam— f _ Water heater 16 60
Address - a '! ..1_ - -- - - Other.
City/State /ZIP. -� — ®� Ch SO Subtotal
�r` `? vvt ! I I - 1 _ ter Minimum permit fee $72 50 00
Phone: 6-0 ) 5 , 0 ? m ax. �) Residential backflow minimum permit fee $36 25
CCB Lic.. _ �� Plumbing Lic. no : Plan review (25% of permit fee)
, (,(= 'n ( �-y State surcharge (8% of permit fee) , &it
Authorized signature: ature
Mi r 1. t `SU TOTAL PERMIT FEE $ p /04
Print name: KL.IS Date. 31 (6( os' This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tn -County Building Industry Service Board.
11BuI1dmg1PermIts\PLM- PenmtApp doc 12/03 440- 4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
• •
Fee Schedule: Residential Fire Suppression Systems:
az ":
tS.#04:1. , Q ty -lak - aaa , Asin 9.15saikaa; :(:$:e ,: - '-
Footing drain - 1' 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 $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
a1uation:' Permit Fee:
Storm & Ram 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
" ,"4EKtalrf-- additional $100 00 or fraction thereof, to and
.,..,,P11011Irph`priff itaE-laaa- 'ala,aai-o' 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,includmg $25,000.00
Rain Drain, single family dwelling 65 25 $25,001 00 th'$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 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*.
tw Moved Comments regarding fixture work:
Baptistry/Font
Bath -Tub/Shower
-Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher -Commercial
-Domestic
Drinkin: Fountain
Eye Wash MIIIIIMLWA111111 -
Floor Drain/sink - 2" milimilaymm
MI=
1
Car Wash Drain 11%
Garbage -Domestic WIIIMM=1.11111PrAr
Disposal -Commercial 11WIMMIEW„
*Note: If the fixture work under this permit results in an
-Industrial EraliiM111WA
Ice Mach./Refrig Drains I increase of sewer EDUs, a sewer permit be issued an
Oil Separator (Gas Station) d
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 'WAWA' Isometric or riser diagram is required if fixture quantity
-Commercial
-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
•
\Building \Permits \PLM-PemutApp doc 3/03
FTS ARC
CITY OF G
0
BUILDING DIVISION PERMIT #: PLM2005.00085
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/7/2005
Phone: (503) 639 -4171 A m�iH�lp „ �l
Inspection Requests .(24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/16/2005 TIME: 7:06AM PAGE: 60
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL •
DESCRIPTION: Business/Tech TI. Capping (5) fixtures
OWNER: TIGARD - TUALATIN SCHOOL DISTRICT 23J, PHONE #: 503 -431 -4000
CONTRACTOR: OREGON CASCADE PLUMBING PHONE #: 503 -685 -0355
Inspection Request Scheduled For: Date: 8/1612005 Pour Time:
Code # Inspection Description Confirm # C ntact # Message
399 Plumbing final 013600 -01 503 - 932 -21556 Y
Corrections /Comments /Instructions: / '
7 1 ---\_.--
L -./ ' ' , r
frijir /rte
i
‘[... P-AS .
ES ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: YKW Date: , .I 1 Phone #: (503) 718 -