Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00381
>♦�l' DATE ISSUED: 8/14/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 BB -01500
SITE ADDRESS: 12232 SW GARDEN PL BLDG 1 ZONING: C -G
SUBDIVISION: CROW PARK 217 LOT: 003 JURISDICTION: TIG
Project Description: Plumbing TI, replace water closet & lay, cap & relocate breakroom sink.
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: 2 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SPIEKER PROPERTIES LP Description Date Amount
4380 SW MACADAM AVE STE 100
PORTLAND, OR 97201 [PLUMB] Permit Fee 8/14/2006 $72.50
[TAX] 8% State Surcharl 8/14/2006 $5.80
Phone : Total $78.30
Contractor:
MP (MILWAUKIE) PLUMBING CO
P.O. BOX 393 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Contact # : PRI 503- 655 -9161
FAX 503- 650 -7050
Reg #: LIC 5002
PLM 3 - 17PB
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- 0001'001T0�through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 - 246 -669 , r 1-A00-332-2344.
Issd pd By: ti = ) (� /�� Permittee Signature: � 1p:!
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.
08- 11 -'06 14:44 FROM -MP PLUMBING CO, 5036507050 T -336 P01/03 U -681
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P1umbinz PeIrnartapplllcatlton FOR OFFICE lc 1 USE ON i.l
City of Tigard at 1006 Rece g' [ ¢ 047 i Permit No.: t l : (e - 9 ( 4 411hk 13125 SW' Ball Blvd., Tigard, OR 97223 ``\\(* Plan Review
`
Phone. 503, 639,4171 Fax: 503 598.1960\U '} .; ; ,nrh r . �� ,V,t 1 1' 17ate /BV. Other Permit No,-
24- Hour Inspection Line: 503,639 4175 I fit ' '
Internet www.ci.tigard.or us ` Note Ready/By /M t Jura' S gee Pam 2
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on/replacement 0 Other:
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❑ 1- and 2- family dwelling r„ Commercial /industrial SFR (2) bath 330.00
0 Accessory building 1=1 Multi-family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
0 Master builder ❑ Other: -
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Job site address; ' ' `/• .. /per Catch basin or area drain 16,60
City /State /ZIP: ax d / 97,1fr3 Drywell, leach line. or trench drain 16,60
Suite /bldg. /apt. no.: Project name: j f4-/.4.1.,” Footing drain (no, linear ft.: ) Page 2
Cross street/directions to job site:
�� �r Manufactured home utilities 110 00
_Manholn3 16.60
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.:
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� w :.. ,,1ii . Backflow prevonier Page 2
vilw, Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16 60
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Ejeotors/sump 16.60
/ M Expansion tank 16.60
Address: /jjj, 1 ii. /r� /� // Fixture /sewer cap 16.60 i
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City /State /ZIP: Floor drain /floor sink/hub I6.60 _
Phone: ( ) Fax; ( ) Garbage disposal 16.60
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ill l V tH NV' / { �}�. n 1` Y,.� 4E Y1 X� 4 ,„ rw r 16:60
Ice maker 16.60
Business name: MP PLUMBING CO. -
Interceptor/grease trap 16 60
Contact name: TAM! Medical gas (value: $ ) Page 2
Address: PO BOX 393 Primer 16.60
City /State/ZI?: CLACKAMAS OR 97015 Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60 �!
Phone: (503) 655 - 9161 Fax: : (503) 650 -7050 - _ .
Tub /shower /shower pan 16.60
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": ,.. �..,, ,, N,: ,• g Urinal ... 16 60
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Business name: MP PLUMBING CO. Water heater 16 60
Address: PO BOX 393 Other, pm
City /State./ZIP: CLACt AMAS OR 97015 Subtotal , Y/
Minimum permit fee: $72.50 C�
Phone: (503) 655 - 9161 Fax: (503) 650 -7050 Residential backflow minimum permit fee: $36 25 ...
12. "- �
CCB Lic.: 5002 Plumbing Lie, no.; 3 -17PB Plan review (25% of permit fee)
Aut horized si ature: �� State surcharge (8% of permit fee) Of
&6•/ / � TOTAL PERMIT FEE r a
Print name: TA11d1 GEORG - D ate: 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 \Buddina1Por nita\PLM•PermttApp doc 06/05 440 -0616T(i0 /02/COM/WEB)
CITY OF TIGARD._ .. , _ ., Pirki U0(0 0 0381
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223
i DATE ISSUED:
Phone: (503) 639 - 4171' "�ryln�gV�l�"i
Inspection Requests (24 Hrs.): (503) 639 -4175 4 =ma. V
INSPECTION WORKSHEET FOR DATE: q / (o" TIME: PAGE:
SITE ADDRESS: t Z :3 C.... CD et Ct (Z CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: (7 LD (
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
-- 5� ' i ELM VV c
Corrections /Comments /_I.nstructions:
• 1:4_01,7_,A1-1-i-tjciD"
‘4 6L*Lir CA A ce,t ( i..1 o )- tilk cct) e-iNC e e- ok 6 Cc
j ' (A62 (A.-s )2_.o s 4- e. L)
� C & -e-( (, < tit) 4 t/1,0 8 It. --- c u- -'a
U I (C e,e-r 0 4')
6,1-Lejc (0 6-744 Simi, — 0-ti..___
\ •
4 . .
u'iv /
iv; -ASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \761‘ Date: ‚"23"0 Phone #: (503) 718 - 2.-Ni