Permit CITY OF TIGARD
PLUMBING PERMIT
rl DEVELOPMENT SER PERMIT #: PLM2003 -00464
..111<:0,411i DATE ISSUED: 9/4/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114A0 00100
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of (2) backflow prevention devices. One is located in cafeteria storage area and one is for pop
machine in cafeteria.
FEES
Owner:
Description Date Amount
SCHOOL DISTRICT 23J
13137 SW PACIFIC HWY [PLUMB] Permit Fee 9/4/03 $92.80
TIGARD, OR 97223 [TAX] 8% State Tax 9/4/03 $7.42
Total $100.22
Phone :
Contractor:
ENVIRONMENTAL DEVELOPERS INC
5905 N INTERSTATE AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone RP /Backflow Preventer
hone : 503 285 2062
Final Inspection
Reg #: PLM 26 -263PB
LIC 35443
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
Issu By: 1 A (/yL G/ Permittee Signature: c 44% / /
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next buoaness day
r A.s. Dt.)J02 LA 11 I./1- 1 ll,ii..K1) 14 0 (.1 1
Building Fixtures
, Bead Niivibin Per_g... .10Enit A on'
,
Date/13v: ' Plumbing b , , •
13v: 1 Permit No.: fUr79,93 -65046
City of Tiar
gd Planning Approval Sewe
Datellay- I r
I Permit No.:
13125 SW Hall Blvd. I Plan Revicw • ' 1 Other
Tigard, Oregon 97 223 Date/Sty: 1 Permit No.:
Phone: 503-639-4171 Fax 503-598-19.60 ,, c ,, , I Pest-Review lzu.d Use
interatt: warTti.Ci.tgazci Dat
or us ,,,..:4itifilii.,. 1 allay.
Casc No.,
...*;Vil;;D:, 1 Corot furis. i E See Page 2 for
)4.hour Inspection Request: 503 - 639-4175 ''' - ' '''' '' I NazntiMethod; i Supplemental Informanon. 1
,4 rfg:'_in , : - .77moa- 2 -, ,_ , mile.,01. - „,„Nyis„.55. - ir i gp&I. ifiga.mli
7 New construction 1, Demolition 1 L Descr1 don all res(ee..) 2 Total
-----
rn AciriitiOrliaiteration/r lacement Other
I : '''''''V:It..'4,iree4:e:TNrTaiktkpg9.:W;;)?....PrI411.A75-p.§t:
L;ifrtegggigniit'l IA': .70.111MINZ.Moitigg::;MINAITra ..„.. .1.2;1.Ell'.1-. liWs '
I SFR (1) bath , 249,20 '
i 1 & 2-Fan il- dweilin ' Commercialdndustrial I
, SFR (2) bath 350,00
, DAccessory Bui kiln. II Multi-Family --1
.._4 i SFR (3) bath 39900
7 Master Builder Other: I L, ach additional bathilc,itclien
i'', -, ) F;re sprinkle' • ss . f _ _ P a , e 2
i Job site addres '.'#' 5 . u..1. - -• _ _______r
r-- I Catch basin/ataa. drain 16.60 i
I Suite #: i_plq./A.t.______
Dryvielneach linciettch drain - 16.60
______
i L2ain(sL141 Nee 2
i Cross street/Directions to job site:
i tvianuLccured h orn utaiti 110-00
_
1 FlOaraoles 16,60 ,
H
, 1 Rain dram ionnec:or 1 16.60 [
t , 1 ----i
7
Sanincy trouts (to. linear ft ..4 Page -
1 -----
_ ,
_i Lot #: 1 L sewer (no. linear ft.) I Pye 12_1._ 1
1_,Stabdivislor..
— I L iv arer s no. lantarft. s p
Tax ma k;
--
47 717 - : - tz
- . 1 -..14.44, .4
-- ., -- 4 -- ,I. -,2%--,..,.. -..•,.. . ,1
-- . Ab.lorptioti vaxe 16:60
I—. Pa'e 2
_ Back valve —.. MIN 16.60
- - 1
r.._.........._______— ) aothes washer I t 16.60 1
1 _
— . -- - 1, 1 4- Dtshwasher 16.60
i -.----- _
Drininr, f_____ilLintaLn_ 16.60
b tlii4P.A..._' '3,7-7,-,. -WaTil. -2 (1. - . E •--.[ --- 7 - 6,0 I - i
Name: 1 : Ex ansion tank 1 16.60
— 1
- _—.
• Address: — Fixturefsewer ea 1 1660
._
' City/State/Zip: /fl
d
Floor rainuor sink/hub
,- 16.60 1
-- ' t Ga.-bage disposal 16.60 7
---,--
i Phone: I £'X. i Host bib 16.60
L7, .4t,m"..etiT;A .%'-;:- '-' I Ice maker' 16.60
_
Name: IzterceDtor/g,rease tap 16.60
Address: 1 [ MedicAl ea:i - value: $
-- -4 rPrirrter ' ' ' 16.60
1 City/State/Zip: _
, - , - Roof drain (commercial) — 1 - 16,60
Phone
t ' I Fax: 1 Sink/ba.sinflavatory 16 60
E,-,ImuI: 1 Tubisbowcalshowv pan 16.50
------1
1.24.toi vdeE „ct. urmai
_ . I
--- -- -----1.
Business NArne:altheo nook 0.-= e.5 . Eilap oat,' , water closet 16.60
"--- , - - - --1 L Water heater
-Address:59e6 A --,<)-reesr c._ I Other:
1 City/State/Zip Pog.1 I-4 a/L '7I1 7 ; ,
, ; Other.
opiii• ..•
,
H
I'vfiaimura Permit Fee S 50 I $
Avanor / tzed -0- Ri7,sidmno Bzezin=7, Fee 536 25!
_ .,_, , ,d,, ‘„4 kit) ___" ' Dar.,.:: i --
---
--- i - --- ---- 1, Plan R.r.'i'ew (2% of Pcx Feel .." S 7/ 2.--
■
(51114)&0E4) 4 I .0 _Tre,I4?___ --
1---- State Sureit (Ph of Permit Fee'Ll $ ---- 77;.--,,-,
(Plea3e print namc l TOTAL PERNITT FIE:
N owe: This part& sspplicatto a crpires i.f m percht is adt Obtained -, ..i th E 13 AI I Zt RV crimrsarsdal bsaitiinp require 2 sots o f pbaus ,4111 isometric or
180 days aft...-1 it has been accepted 'is complete . riser <flag tor plan revtew.
'Fee triethodlogy scl by Tri.Counr" 3u dig Tuthistz Service &lard.
i \LIsts -2 , ':11il. .P(r/n5 01"rl'i