Permit A
C ITY OF TIGARD PLUMBING PERMIT
Ik DEVELOPMENT SERVICES PERMIT #: PLM2004 -00018
.,�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/16/04
SITE ADDRESS: 09370 SW GREENBURG RD 205 PARCEL: 1S126DB -02800
SUBDIVISION: PP1991 -018 ZONING: C -P
BLOCK: LOT: 001 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing TI, install (1) lay, (1) toilet and remove (1) floor sink.
FEES
Owner:
Description Date Amount
FRANKLIN COMMONS ASSOCIATES
BY NORRIS + STEVENS [PLUMB] Permit Fee 1/16/04 $72.50
520 SW 6TH STE 400 [TAX] 8% State Surcharl 1/16/04 $5.80
PORTLAND, OR 97204 Total $78.30
Phone :
Contractor:
NORTHWEST WATER WORKS
40110 SE MEADOWSONG RD
SANDY, OR 97055
REQUIRED INSPECTIONS
Phone : 668 Rough -in Insp
Top -out Insp
Reg #: LIC 113197 Final Inspection
PLM 3 -333PB
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
Issued By: 4' // /�/ � , �/�� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection neede. t e next business day
FROM :- t LI1THWEST WATER WORKS _INC PHONE S NO. : 503 668 +0375 Jan. 14 2884 12: 26PM P2
VI �.,_uW WJ uuz
... RECEIVED / /°flocs/ -0000z/
P umbriig Periuit jti 208h Ir'Orf or 1 iCE trsr rl.
Nl' •
City of Tigard T, m: ' �fli/f Ara rye r°-- i•tii oo - coo/ e
13125 SW tin Blvd.- Tiw of?; 972y23 1(3ARD
Phone: 503.639.4I71 Fax: 5O3. 't �pq ' OFT "- * ' =alt L 1 gr
1 ; thnB �:o. OtberForm :e Q 4
24- Hour Inspection Line: $03,63'; : �1N
, �. G DIVISION s 1 • - '1 . _ ,' Dace ate,: 1 Alrl�: 1 1n not PapA l for I
Internet: u'svwci.tigard•er.us "" : tiavlfrdddothod: ; Suppaernentnl
' .;11 �` i:pl` +' :: a >:f1�7' .' :4A "; , .hl°'l';' ' :::'':C , :;! . y! 1 1 & ;..
_';';: ter - .....W..�'1. ,:x.P :. c., : " .. �rk.�. .�; -. - .`; > J`. I'. . .. .. ;5 ° '.r:; ,• , , -
0 Ncw camsauatian ❑ panofitioa Far special +ialaaa+e use th 2e;Rlldg
Description E 'Q4'- l FA- f Tout _•
' Additionialt w. hnplacament • £1 Ober_ New t-2 .tatany dwellings (includes 100 ft for each lid Iiw comedian)
6 :,-y.;t e;: <.. VI . _. . ..: ........ 's °3 "6., SFR 1 bath 1 24920
Q 1- aul2- 8m0ydwelling LI COnumiliallindustriel SFR'(2)bath 350.00 -
o kconnoryttulding 0 Martd -f Iy sFR (3) bee∎ _ 399.00
Bade a eldildonel tusttt/dtiitrhear i A5.00
Q !Waster builder ❑Other: sprinkler (__ se- f) tsne 2
Fire 1 ; : ;i ' yi : • #i M1� '' . t>t ? 1'16 a f Yf03 .�4 [ .. 1• sac „ dime ,
.i• ..ihi {P'.`i.8.bi('ft :1 •91: :3. � . Ttleitr?,i,> 1 !�. ';::_! �:5;, .I.
Job sits addat r 0 .-412-0207Briff,ffrai tech basin or arm drain 16.60
Cicy/Stata'Z1P: . /:AA I / Dryaaeli, leach tine, or trench drain I6.6J I •
S5litaa'6Kl . L no: rojcel name: ! 1 Footing dtnin (no. linear ft.; : - ,
i Sr I �. i / r/ ,` . • ai. 1. d home utilities 110.00 ,
Cross a rca/directions to fob site: 16.60 •
A ._ • j in 0-27 1tai, drain connector in 16 -40
rg/� j f /. 5attttuy sour.. (xo. llncer f. __) , NV 2
•
3tsmr sewer (Iio_smearf : i Mg' 2
Wa:er sOrf x Op Inn= ft,: - ,..,..) PO 2 MINI
/� Q/�/� Mara or item
Tax 1laaptpaseel 11>,.; I � ! `'.. Abs::rptian tialve -16.60
I; `- ,eS ti, +t• r,�:1 5,,, ,. I ;Ifat;, p�If~. :i.. , , 42: ;; :_•'s::{ . ,,.. 416„ Page 2
Backwater valve ' 16.60
- Gleam wooher MIN :6.60
Dishwasher 11111 16.60
:. r • A 1 ',Ft-s -- ! - ,tl:...,r' iA3
l, 7. :11 Drinking fountain 16.60
-41-- '
,1 z"47 :{ ' si ?: €? t F : • -. - ' i, : l,. ':: ° 16.66
Noma: r - //i 0 14/10 ' � C / � - _ • f.xaaasioattank MI 1440
nava/sewer Cap bQ
16
C w i s t a t a r i j p ; I 40 a • • oO Floor dh'Aiuffloor sint</ub l rt 16.60 IF ' . ,0
Garbage dispo 1 16.60
Km= (� �: � ; f .vaik. ".P...'• I ,I HDae 16.64
1 - 1- ..3ii; l .._ :h�:M : ii∎ . " *9T �'; ;. . , ,•_' 1 1:1 - ;": i
le: rr�itr i 7060
\ i atie41c>s -.. '• ' i i - 41/ , ,/ if 1 I l6.60
coroestmrae= ;A/ 4 ` , /- 11:ra
)J Addrrs /3 /3 . 14 / . / u 16.60
u e1 : / . , ' • / ' 70h• Roo: drain (oommarisl) 16.60
Plan= . r ' / Fdut:: • I -• . 9 s SinkihasinAavatnry _l 16,00 , /
JII' i ...Ay • �♦ 1 b/,r xrlshDIae pan i 16.6
F.-math ihirsi 1 16.60 MIMI
". -_,.. ; `;W ` § �� ��Iacr;:01, -- :'i't:_:. >'s1r :ia;a:�:: W'sazrolosot ' -6.5D i
3 I/1 rrra/ 1. X 1 w heeler 16.66 .
Outer.
Subtotal '
: gi � Mum permit fee: slz_sa , SD
i ti+�._t7' I i / i /m n r-. 6)-3,_ E / '' Res ddtrntial to: dtrlow,raaintum per fee: 53625 i
Plan review (25% ok ptstnit fee) I
CAS 3dc.: / c / Piuoe>;yag i is rte.: - ...gip i Starr surcharge (a% of pcnnil fee) . - . $O
Authorized ffgDSasc. / / ��
,�' . . /. . ..r . � Aa .1 / TO T AL PER MIT FEZ Wt.w
Printnnme' 1'f ' - a r 1 Q . .j I)o= .,ffi r Tata permit application expirCS Irapermlltis not Obtained wthin
in days after Is not been accepted as complete.
*Tree methodology set* Tri- County BAIN:Hag Industry Ssrriec Beard.
t:vwluioerendutrtM- NraisAro.de0 :LAS 440 ost8S(107a icoWWL'B)
FROM : NORTHWEST WATER WORKS INC PHONE NO. : 503 668 +0375 Jan. 14 2004 12:27PM P4
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411411.11111111miers Rd.
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVJSIOI4 Business Line: (503) 639 -4171 MST
�/ BUP
Received ' 41 1/ 4 -' 4 -Tate Requested a. /12I0 PM ? & BUP
Location ' (--� Suite MEC
Contact Person � Ph
[� � " 3 7 -` PLM ' —r 40` !�
Contractor ciJ CL) a�;PJI.f,[� U� Ph ( ) SWR
BUILDING Tenant/Owner - /rte / AAA f-rrl df/1— ELC
Footing (�
Foundation ELC
Access:
Ftg Drain iV--'r 67A ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P ASS PART FAIL
PLUMBING -'
Post & Beam
Under Slab
Rough -In '
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
gr 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: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date / Inspector Oct
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OfIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP ~'
Received Date Requested — I `P AM PM BUP
9376
Location Suite d MEC �-- QO /
Contact Person h ( ) ¶cc 7 33 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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:
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:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
a
ASS PART FAIL
LE ICAL
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 111 Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA /— /1.0
Approach/Sidewalk Date U f Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL