Loading...
Permit C ITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2004-00308 A1 411 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/12/2004 SITE ADDRESS: 11565 SW DURHAM RD 100 PARCEL: 2S110DC 02400 SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B 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: Medical gas Project Value: $3,870 FEES Owner: Description Date Amount DOUGLAS FRY 2423 REMINGTON CT [PLUMB] Permit Fee 7/12/2004 $72.50 WEST LINN, OR 97068 [PLMPLN] Plan Review 7/12/2004 $18.13 [TAX] 8% State Surcharl 7/12/2004 $5.80 Phone : 503 - 348 -2237 Total $96.43 Contractor: NORTHWEST CENTRAL PLUMBING 2870 SW 221ST HILLSBORO, OR 97123 REQUIRED INSPECTIONS Rough -in Insp Phone : 642 - 2067 Top -out Insp Reg #: LIC 72253 Misc. Inspection PLM 34 - 197PB 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 questions to OUNC by calling (503) 24 �\ //, / Issued By: I _ � + iJ Permittee Signature:, , / A/" Call (503. ' -4175 by 7:00 P.M. for an inspection needed the next business day Building Fixtures RECEIVED Plumbing Permit Application FOR OFFICE USE ONLY .' 1 2004 / , LL. City of Tigard 'JUL Date/By: / / /Q Permit No.. i ez 3 g 13125 SW Hall Blvd., Tigard, OR 97223 y GGG Plan Review Phone: 503.639.4171 Fax: 503.598 -1. q, OF � IGARD �Naip t Other Permit No.: �1I0�i I Date/By: 24- Hour Inspection Line: 503.639.4 1 ��-�`,�_ 0111 Internet: www.citigard.or.us BUI DIVISION c7 Date Ready/By: I 0 See Page 2 for g Notified/Method: / (2. Supplemental Information L ,",x . : `. : < . ,' ; ., °'�., r . i a "-'* , " ,: ; : r, 1 ; HE *s SCI3EDULF " °t T; 10'FORK .' a ,5 F g,. ' �i' �' ��. �.�``:'""�§i:�'.`.�t"r-';� '�:e'' �... �.� �z�9�:.,.�. a �i: : ":rd�::.a3.rw�- ,.:'.:.i7�.<i': :tu�xa � „�`�:...- , ",:-�.�:<<r _ ❑ New construction ❑ Demolition For special information use checklist. Description Qty. I Ea. I Total ❑ Addit ion / alteration /replacement [Other: I V\CD 4 A5 New 1- 2- family dwellings (includes 100 ft. for each utility connection) a:,� '.i ti. �y . ?;�; �;�., i�..:� _, g ; �,.. �rrei '�;.;s ".:r.::�.'s: >:,^n, ^.: ��. 'x;�.m":. R:� ;vx r,. ;; , y: �` 2 ' : ` = °;�?'° " 4 �", CA G drreONSTRUC 011 ^ X � i sY ` ° ' V " SFR (1) bath 249.20 D .....$ Vii_ .. . ..iA_ < ❑ 1- and 2- family dwelling ® 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 JO S TE 1NEORMA iD�O CA 9 r 4„, ' ^��€ � ��. ��;..,as�x -.� _ ,�.� u.�.,v,,.,� , � r =.�.�, ..W. �f Site utilities Job site address: ' 1 5 G 5 :C ,-- 2N ,A,,,, a b Catch basin or area drain 16.60 City/State /ZIP: 1 c A g_ D O /� ¶ 7 1.14 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: ° f Project name: Footing drain (no. linear ft.: ) Page 2 12 S I�v.l i . l 7 Manufactured home utilities 1 10.00 Cross street/directions to job site: I 7o. d 6 4 kw Manholes 16.60 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.: .: .r.. ; ,.,.- ,, •ter; r; .. . : ; ' a:; Absorption valve 16.60 ESIC ,t ,, , , Pi OF WO RKS z„. s r ��*; ,. ,.. '�.� . ,:_a .rw .vr * . ., 'i Backflow preventer Page 2 /../ I T/to it S c Q X1 G IJ L I t'J ee s To (3) Backwater valve 16.60 200 S Clothes washer 16.60 Dishwasher 16.60 �� -° ��� re c t } P.RO ERTY aWNERr r I ' "'4 ' "` TENA,,iT t ' '�:'e� ..,., ' x.�*'. ..u: � ,...,,.e :un: »..�.,�i'i'z.s: �. ", .:ra.��ii"�...� ,,, ., a.: �u is .,,._ .r.,.,.�� Drinking fountain 16.60 .�z,.�' ; ` Ejectors /sump 16.60 Name: Pe . rat Expansion tank 16.60 Address: A4,9,5 /5 1 )c,"revo e__ Fixture /sewer cap 16.60 � City/State /ZIP: 41 c /2_ 1 0 /3 . q'? (s (Q Floor drain/floor sink/hub 16.60 iC. a ) , Qi 1 �� Garbage disposal ,1'6.60 Phone: dJ�TJ o'7' ll Fax: ( ) s r.a;° a . R a f. f 16.60 s€ 1 4; AP LICANT `1 a CW ;AC+ Il E � V��:•�, °.� , �. .j. Ice maker 16.60 Business name: N Li f 2 gc.1 3 t e NJ D Bi i c.,..) Interceptor /grease trap 16.60 Contact name: ) A 21, `jB C.J.c IC A Medical gas (value: $,3 7)O Page 2 Address: f..� ff' Primer 16.60 i5oo ,, L.,.) (SC Avg /oZ City/State/ZIP: Y Cie.7c.Ai D ® a 7 209 Roof drain (commercial) 16.60 Phone: (f� ) Fax: (5 07) 2 Sink/basin /lavatory 16.60 3 23 3 - 4)C a ° 71 - 4 145 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 lr z . _. .,',,. , �;�, , x >n'"m �,'�E' ',�'.3< �z - 'a„ ^ ..: e :' : ,� � ` kr` :s ;; . tisA5' F;;i t4K- 4 =rE. :W.l'?r r= #4 f i a 0 v. ". CONTRACT `�,, � '�" 1 : ` r , , k 1 ' , i: Water close 16.60 Business name: N ( 05-I3-rPngL Water heater 16.60 Address: Other: Subtotal City/ State/ZIP: (LAS is ,,,,... 0 n " Minimum permit fee: $72.50 Phone: ( 3 ) 6,,i 2, _ _40 (,...../ Fax: ( ) 34 - I61 7 - P3 Residential backflow minimum permit fee: $36.25 7a...ST CCB Lic.: 7 ."Z 5 Plumbing Lic. no.: Co$% TQ Plan review (25% of permit fee) / g, Authorized signature: MAD �,� State surcharge (8% of permit fee) S g ,c TOTAL PERMIT FEE t Print name: -.DA R l r? Oi / A Date: This permit application expires if a permit is not obtained w�i n i 1...> 180 days after it has been accepted as complete. . *Fee methodology set by Tri -County Building Industry Service Board. !:\ Building \Pemtits\PLMF- PemtitApp.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: " Q S• i Eee (ea) M 'lota Permxt ee ; : r - -_�•� :_ � �S care I'oota e � F.., Site_Ufil�i`t�es� _ � -a.�� �.�� „e�:� -� � � ;. Footing drain - 1S 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 p , -'.- « luatioa a 4" p Permit`Fee:: 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 Flk "tUreOr ` Qty: „ „Fee(ea� " `Total ` additional $100.00 or fraction thereof, to and �: �. 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 and $74 . 00fo t e fi 5 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 $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer f L iiQusntity lyy(Fiature) Wort Performed' /Frxture1ype 't t x � llljj f v2 Replace I . k I New uvea x >$n c p a 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" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains 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 Sink - Bar/Lavatory Quantity Total - Bradley 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: i :'Building\Pemuts\PLM- PermitApp doe 3/03 "Z-//4 9 OV E ; t. /454,5 S c.) RICk /e/ /o John L. Whitcher, P.E. Reed Street Engineering 4260 Reed Street West Linn, OR 97068 (503) 656 -8398 E Mail: whitcher @aracnet.corn June 30, 2004 To: Dawn • Norwest Contractors Post Office Box 25305 Portland, OR 97298 Dawn: Thank you for calling us to work on this project. Attached are three original sealed copies of the Doctor Schwindt medical gases permit drawings. The fee for this is $ 900. (Nine hundred dollars) This is your invoice. Please remit to the above address. incerely yours, IV • ohn L. Whitcher ,- . • • OtFICF COPY- '• g H o • w Z c , ' , N U ° { GENERAL NOTES: m o I 1. INSTALL MEDICAL GAS SYSTEMS IN ACCORDANCE WITH NFPA99 AND ALL 0 H o ° z APPLICABLE FEDERAL, STATE, AND LOCAL ORDINANCES. Z Z a • 2. INSTALL MANIFOLD AND OUTLET STATIONS IN ACCORDANCE WITH 0 • 2 •••• • • I MANUFACTURER'S INSTALLTION INSTRUCTIONS. , •V• • •••••• Ill • I 3. ALL OXYGEN AND NITROUS OXIDE EQUIPMENT MUST BE CLEANED • • • • • •+ • AND RATED FOR OXYGEN SERVICE. • • 1 , °° •• • • • e • • 0 •� 4. BY A LICENSED INSTALLER. • � 4 • MEDICAL PIPING MUST BE INSTALLED —• • • • • • • • • MATERIAL: • •••• • A ID E 2), 3/8" TUBING • • • • • ` B OXYGEN NITROUS (02 1, 2 N 0 • " OD TYP OD E K OR TYPE L OCR -OXY K OR L OCR -OXY COPPER TUBING • •• • • i • • . •• •• • • i��� .... • •••• • ii •••• ° • °,,s KEYED NOTES: Liali . . II � p * f� , Ol GAS MANIFOLD (N20, 02) E O2 GAS SHUTOFF (ZONE VALVE: N20, 02) ,,l E O3 GAS OUTLET STATION oil r to o •.C. - O4 GAS ALARM, SEE ELECTRIC til ,. di N \ L "' 1 I !'O�A Did j j. ' EC E 11 vim' N IL ,/ r --- © Tt►... Nw►••bt.. o�N '�J9� c y ®�� S �I r se cnvi �; r►, Sa�t� -+oto ,$ 3.3. � (I. y N�P� -q' c. JUL 1 2004 �•� _ a �_. ® G ✓ Main., �y•rtlw �� �Qi• 4) NoT'�.I h0. 1 et . Co i4"�I�D� C \ 'II I ��:-Y. �.% V °� CITY OF TIGARD � / :I d D�t�dl t� Ox9c✓ �v d 3t g Li.i A' ' ' C O BUILDING DIVISION 4 F ' " i ;44 Se, b0 T 3 9/ N FP �ag c , © i�u��� ti J 1 r' Sli,�-Jo,r S ?• /2.3 NFP4°Ac C rn TYPICAL ,I I)� /2" 02O �, L� _ V , r� � FCC N � ✓ ~ t — � +CITY OF TIGA CD TYPP ©L A �� � P ROFf s � Conditionally • �� ); otid� 'o� ionalf Approved......... , �' 15765 ��h l' Fo r o scribe ...............( )' yth evvorkasde din; � , 1 � \ 1 PERMIT N LM _ 0 '` `� See f_ @tter t ® : F DATE AUGUST 8, 2003 ollo ............. 1: OREGON ti Q� ................ Attach............ 1 IS, v �N , 21 �� � r � N0. REVISION DATE • • • •........... t I' 4 ,(� of ISSUED FOR 06/29/03 Job Address: /75 L 1 • ` , � `, \ PERMIT t_______6 YY to T � [" 1 �� S H EET OFFICE COPY NO. GAS PIPING PLAN ' J UN 3 0 (� M1 I a CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested /d — 7 AM L' a; BUP Location l l S Suite IO MEC Contact Person r G� _� Ph ( ) 4./2-- 0206 7 PLM c 21a,__Y — DO Contractor Ph ( ) SWR 3o 8 BUILDING Tenant/Owner � F� /L i ��. S _ Aug_ ELC Footing Foundation ELC 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: G � Final PASS PART FAIL PLUMBING Post & Beam — Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: NON. C c L/ ff1 0. 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 ` Please call for reinspection RE: El Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date /62 b Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST 9 BUP Received Date Re • nested ` AM PM BUP Location Suite MEC Contact Person Ph ( ) PLM 'DU' — & 3o Contractor Ph ( ) l P - -a6C07 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 Adair Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof / Other: Final PASS PART FAIL - - PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer • Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: rn SS PART FAIL MECHANICAL 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 fl Please all for reinspection RE: Unable to inspect — no access Fire Supply Line ADA r Approach/Sidewalk Date / 0 Inspector 272 Ext Other: Final DO ' i T REMOVE this inspection record from the Job site. PASS PART FAIL