Permit .... ,., . W.
14 q CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2009 - 00002
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/6/2009
PARCEL: 1 S126DC -03300
SITE ADDRESS: 09900 SW GREENBURG RD ZONING: C -
SUBDIVISION: LEHMANN ACRE TRACT LOT: 005 JURISDICTION: TIG
PROJECT: COLUMBIA BUSINESS PARK
Project Description: Replaceing 180' of water service.
CLASS OF WORK: OTR 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: 180 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ATHERTON REALTY PARTNERSHIP Description Date Amount
MARTHA ATHERTON
2100 S WOLF [PLUMB] Permit Fee 1/6/2009 $101.40
DES PLAINES, IL 60018 [TAX] 12% State Surcha 1/6/2009 $12.17
Phone : 847 -298 -8600 Total $113.57
Contractor:
MRP SERVICES
PO BOX 33585
PORTLAND, OR 97292 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 253 -1393
FAX 503- 241 -6565
Reg #: LIC 106824
PLM 3 -265PB
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 OU NC i : 503.246.6699 or 1.800.332.2344.
Issu 3 _ �L�� Permittee Signat -. _ �, y „L�'�
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.
11/.02A2015 04:19 FAX 5032413636 MRPSERVICES 2001/003
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phintbin2 Pet u
-mit AlicatiSECEIVE I FOR OFFICE ISE ONLY.
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:. • P , Phone ' 503.639.4 17 1 Fn.: 303.59cm oF TinApou Date/Plan Review
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I]1 peel ion Lime. 503.639.417:
TIGARti " " , Date Rradyitly: !illy. I El See Page 2 for
lificriiil• "" BUILDIN ., i • • : Nontiodavicthod' ;.-1 ( G. I Supplemental Information
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1 TYPE 01- Ni : ".1AK •..''' • •:' - • '') • li:) • : - ::),:)... - ::',. ' FEE" SC.1-11E1111.,E
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E Isi,.-m: consirLILLion (II Demolition For special information us' elwoklivt i
... De5cription j QIN 7 1,',,, T mia;
, X Addit,,,,R,,,,,,,,,,,,,,,,I,,,,,,,,,I pi Other.
l New I- 2-family dwellings t Includes 100 It, lOr each utility conneel ion )
1 CA CON
, S.T11g70011N.)).1) . 11:)';]:,.:,•'.'• 'tili''' ,.'. SFR (I ) bath I
. . .. .i..„....,,,,..e..„ „..,..).„,i;k,,P...1.,1;■.',".,....,„; -2.•19 277--
• I - and 2-laniily dwelling k. Cummercial/incins(rial SFR (2) bath 350.00 1
H - . (3) bath 399.00
i E A eces$nry building n multi-famil
Each additional bath/kitchen 45 OU
Nliisier builder 0 Other:
Firc sprinkler („.„),..). sq. fi ) l'ile 2 1
J013 Sill. 1NFORMATi6 !,)Il ii....):...i,.4.).1.,kr),..*, g.::::,:41,,,,11,),: Site utilities 1
1 lob site addres:;. (21, 00 Sl N „ f . 0 k i I r. 9 7 1, Catch basin or area drain I 6.60
I
City/State/?.I1: it 1 I\ or /-1 Drywell, leach line or trench drain 16.50
/
S , r l'outing drain (nu. linear FL • ) i I 'age
uitcb1(1 no.: [ Pi o nEn'oC C D LiA &IA ' ,
___._._...._ . . .
,... manfachAicd hon,-.. vnia,,, 1 i I, ou
i,ii,-...,i,,,, u, i,,b .siw: ___.. _____
...._ ._ Manhole 6 6
s 10
1 1 Ram drain connector
—
I Sanitary sewer (no, linear ft.: ) Nue 2 1 ,
Storm sewer (no. linear ft.: ____))) Pag -■ 1 e _
Subdivision: Lot
176
Water service (no. ±._ 14
o. linear ft.. ) I Ff) 1 l •
no,:
• '' " Fixture ur item
—
[ Tax tnrip/pnrecl no.: -
_. Ab vdlye 16 60 i ■
-- L . . DESCRIPTION OF. 'WORN. , „'. . ' I..... :),,..,,,,.. :. ..',,,....• , :,■.re,:. .
--- • 4 i 2
i nlrigid _. .1O _i0 \mac LI q Backwater valve 16.60 _
'::•-
Clothes washer I 6.60
DiShwaShCr 16,60 i ---- - 1
. , . Li rnopatvy OWNER : . .., .;.... . Drinking fountain 16.60
---
---I
Name: ttliU,Mtlk fAASINIS PA Expansion tank 16.(10
i--
• ..... .
Address: Fixture/sewer cap
Cit)/Statert.11' Floor drain/hoot sink/hub 15.50 i
_. _ .. .
Phone: ( ) Fax: ( ) Garbage disposal
.. 16.00 ....
. ....
1/1 ,kpel.lcANT .. ::: ':: Nose bib 16.60
Ice maker 16,60
Business mune; i d I i T 1 I
,_ , l
.1. in ) 60
Interceptnr/greast trap 16
C on att
tact !t le: ii I ( . • ' il age __.___
• _ Medical giis (value: S ) P 2
) Address. '' f ' • :.. Air ir i■ v
Primer 16 51) I
i 1
C:it■;/1 .1","..•4-- Ail 1 i p 0 fmripap.. Roof drain (commercial) .._ .. 16.60
, ink/basin/lavaioi y 16 h()
P 1011C: t , ) ,. ". . . A dit 7 MEMIgar61,0 ' ( .
_ Tub/shower/shower pan 16 60
I--mail . . . -,,.;. i i ..-- r. iWt - /4 ti
, ... Urinal 16.61)
-.,-, ' •,-, 1 ii'd ilii. ...•. 1l1',till..: 1 11 1 1.:
., ' • • ,•CONT1349 ' .1.,• 11 '..i 1, /i11 11 11. 1 111,11,11 1 •(11 11 •1e{t 1 11,I , •:,••••;;•ti'0 , 1 1 tlf : W closet 16.60
• . . ... ,.„).),),. ,.,.. ,..- :-)-- {'Z'ACOlg • O .,..4: o:' ,V.;Wr ,L.;..g.„);;,;.L'ociUL,;i;..;..d.:'
Business name: , ''. / ir "iv . • Water licamt• 16.60 _I
, Address: Fp ii . ..ia - 7 Other
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l (.11i) fog., , Ar i , OAF fi r j ,„.„,„. ,
,,,,,,,,„,,,„ pconii il,2• $72 1)
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1 2.,' — , lid" Fax: (- ... J.....45... Re)iidenti41 ba,-,..I.: 11< minimum 1.10;161 11:1.: S,16
...._.._ ___.. .. . ....... ..... ... - --I
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CC13 Lie.. _i 0 ; MI Plumbing Lie. no.: •''' .41 p& Plan CS ICNV (25! a permit le c) !
---- - '------- - 1
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State surcharge (1 2% of po mit l',_,.) • 121
Fiji& • f
llthoniCd Si/pi/1111re ' i i i i . tA A x. ,.
1 PERmri I I
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Print l'affic' k . Date: I • Or This permit application tApires if a permit ot it is n obtained within
) „ j,, . .. y „. ,
180 days after it has been accepted as Mall/left,
'Fee methodology set ity Ti i-(Aintity Building Indust' SON 1 130L11 LI.
I lit■ildintrr,,,,,, Ii M-l'or.; A f'4,..+J(. 110 ;61 oTi I 0/0.2/COMAA:Ets:
11,‘.02i2015 04:20 FAX 5032413636 MRPSERVICES Z 002/003
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su ression Systems:
........_ - __.
Site Utilities . .Q.,,,......,. rec..(po: ... ;t9i70.; ...'i$,.i . e:. •• Permit Fee:
Foncin5 dram - 55.00 0 to 2,000 5115.00
•- • ___ . I
5160.00
i dr:tin - c.icelt ti(.1ci;tional 'iOri 46.40 2.001 to 3.600 ...... _..]
3,601 to '7,200 $2
$ewer - Isi 100 55.00
7,201 and greater S309.00
1 ,
....„.
'
Sewer - each additicina! 100' 46.40 -'
Water Service - 1 sH 00'
55.00
Medical Gas S stems:
i__
_ ..
- Viiiiatitini . ... '' ..:' .It■..ermit Fee:
--I
Water Service - emelt Adria iontil '00' 46.40
-. Storm & Ram Drain - ist 100' 1C:
11 00 to . 1 1 I500.00
Minimum fee 172 50
Storm & Ram Dram - each atairtmiD1 I 00 4ti.40 $5,001.0010 1 572 Ibr the iirS 55,000.0U arid 1 i , l i e d '
..
Fixture or Item Qty, .,Fe.:(e.0...• Total... : additional $!00 00 cc fitieuttii ih, le „,,.1
includin .510,000.00.
Commercial Back Plow Prevention Device 46.40 $10,001.00 lt.r $25,000.00 5148.50 fur the lirst $10,000.00 and 51.54 fo
Residential Back flow Prevention Device each additional 5100.00 or fraction thereof to
(rninintianZtinit tee 536.25 27.55 and Including 525.00000
Rain D f
rain. single mily dwell iri; 65.25 525,001.00 to $50.000 50 th
.00 5379. for e first 525.000.00 and $1 45 lur
- each additional 5100.00 or fraction Otereor i (I I
In5pection nt eximin tilambink icc
and ineltidin $50 000.00.
_..
specially rc spons - p hour . ,....., n.50
$50,001,00 and up I 5742.00 fur the firt,t $50.000.00 and S1 ?.0 for
I
.titilhiotal; 1
......_ I each additional $100 011 cr fraction tilt:11/4:0i
,
I ,....- ..-. .....
Fixture Work: A5112741:'Y'T. Or- litit441 ' , , stallations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
0
accurately report fixtures could result in increased sewer fees*. Any.new commercial buildiq with wilier service 2 - and
. - ..... . ..QuaMity,FM,WikeeM01.4Ntgat greater, except systems designed and stamped b■ licensed
010.4 1.ty.pe: . ' • , ' '.:::,'...:.!;:..;.:.• ;.?;!;;',•;;.:P.;'„,"Iil k.M: , engineer.
P"Iu'i" . CIPA ;;;f;!, '." E Any nev. exterior plumbing site utilities.
...BElis try/F _ ont n Medical gas and vacuum systems for health care facilities,
Bath - . fuh/Shower n Any multipurpose fire sprinkler system,
- .1acuni/Whirlpool .. E Any complex structure as defined in C)AR9 la-780-0040,
Car Wash -Each Stall ......_--....- '
-Drive 'I'Itru Submit 2 sets of plans with any of the above.
--.-
(.:u5pLdoc/W:txr Asputtior
Dishwnher -commercial
,. .■.:,';.,:....'.; ,j0040;ti.rle.or Kis erDiagram ,..,
-Domestic -
Drinkinf4 Fountain 0 Isometric or riser diagram is required for new buildings - Eye Wash ,
that meet thc_gualifications above.
,,,...... ..__
Floor Drain/soil, -
- 3
Comments regarding fixture work:
- 4-
Car Went Drain
..-..„_
GarbtiFc -Domestic
Dispo -Commercial
-Industrial -
Ice MachIRc.ftia. Drains ..... .-
Di) Separator (CiasStati
Rec. vehicle Omni, Station
Shower -Clang *Note: If the fixture work under this permit results in an •
-Stall increase of sewer EDUs, a sewer permit wilt be issued and
Sink -Rar/l.avatory
fees assessed for the sewer increase must be paid before the
- firatiley
plumbing permit Can be issued.
-Commercial
-Service .---
Swimming Pool Filter
Wi.tsher - Clothes ,..
Wider 17.ximcior
Water C.103ei - Toilei
Urim0
[ .. _ , ... . .,
1 Orlist Fixitilcs _I..
1,,0ultdIng Wcrmiu■I'LNI•Perniunpp,Jg, no/:Pn6
CITY OF TIGARD f - ` 4
BUILDING DIVISION t PERMIT #: Pf M200g -00002
r 13125 SW Hall Blvd., Tigard, OR 97223 l► DATE ISSUED: 1i6ft109
Phone: (503) 639 -4171 / �q��,olit g
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 1/7/2009 TIME: 7 :01Ai PAGE: 31
SITE ADDRESS: 09900 :sue GREENSURG RD CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 005 TYPE OF USE:
PROJECT NAME: COLUMBIA BUSINESS PARK
DESCRIPTION: Replaceing 180" of water service.
OWNER: ATI1ERTON REALTY PARTNERSHIP, PHONE #: B47..298.8600
CONTRACTOR: MRP SERVICES PHONE #: 503.253 -1393
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 079447 -01 503.6 -2626 N
Corrections /Comments /Instructions:
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„" - 2- ;''- - -'- -; 5 let_Z(0 (Ai ,,
•
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.i921' i' ,/ '
PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (6: (A/L--- Date: I Phone #: (503) 718 - g4"1-{