Permit CITY OF TIGARD
PLUMBING PERMIT
. COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00365
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/17/2008
PARCEL: 1S135AB-00900
SITE ADDRESS: 10200 SW GREENBURG RD 700 ZONING: C -
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: Interior plumbing. Other fixtures: (1) hub and (1) primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
SHORENSTEIN REALTY SERVICES
ONE SW COLUMBIA ST #300 Description Date Amount
PORTLAND, OR 97258 [PLUMB] Permit Fee 9/5/2008 $83.00
[TAX] 12% State Surch 9/5/2008 $9.96
Phone : 503- 412 -4800 Total $92.96
Contractor:
MP PLUMBING CO
P.O. BOX 393
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
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 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B i` / Permittee Signature:
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.
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Plumbing Permit Application
Building Fixtures _ - Q�. Q 1, t of ric L USE O>\I
II - City of Tigard , �c T �� P e„>lltNo..
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+ • 13125 SW Hall Blvd., Tigard, OR 97223 p ." • eview •-�" � •
' Phone: 503.639:4171 Fax: 503.598,1960 - v� R `, y , Other PerrnitNo. L7/ L ckth?
Ins D .te
T t'G A R )7 P ection Line: 503.639.4175 Date eadylBy 7uris: gg See Page 2 for
: Internet: www,ttgard- or.gov
Notified/Method:
supplemental
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TYPE tiOF. R`ORK >F... , c = .:::'..,..m „ °...
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• ❑ New construction ❑ Demoliliion For special information use checklist
� Description I Qty. I Ea. I Total
t'P Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
:..::.... .......... ......... r,, :CATEGORYrOFCON3TRUC170N <'
•'' -- °' "''`� ";- ;,,,;,;_ SFR (1)bath 24920
„ .....1_ -and 2-family .,�dwel]i:...,�.......::.._, ,..... ,.::.....::.;: �,-:, _.:.:::.,::..::.- ..,.:.....,...
❑ dwelling 0 Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
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Fire sprinkler s Page 2
:;'JOB;' SITEi I1ITFORMATION :;AND' „T:OCAITON i;.,.,, ! -
° site utilities
Job site address: / J 9 lithe /i.t4 Catch basin or area drain 16.60
City/ State/ZIP: Jj ,Q4 / 97,37 Drywell, leach line, or trench drain 16.60
( Su ./ t. no.: Project Footing drain (no, linear ft.: ) Page 2
v it d g n....4. Proect name: 1 ��� d Manufactured home utilities 110,00
Cross street/directions to job site: ��
( t;4 r anholes 16.60
/ Rain drain connector 16.60
T 641; ]l7 Flt i-e ;itir c-1,1, Sanitary sewer (no. linear ft.: _) Page 2
r- Su( CC-j" 9,- 7. T 7 Storm sewer (no, linear.ft.: Page 2
I f' Water service (no. linear ft.: ) Page 2
Subdivision: Lot no,:
Fixture or Item
Tax map /parcel no.: -
,; ;r .... a:, < :' =' :r;ru. ;: t:,:r ; a,; ;,5:,: Absorption valve 16.60
ifi;i „L.i`r'i�xfl? tir nv', ;:ii. il3 Backflow preventer Page 2
zi -s F =. f �� ]D : �:;k':•tw':';..
ar: , ,- > { ; :.,,a:::..r.:....,. ..._... 4.:is ::...,,...,. <..;:;:,,1i:::. Yi i;:; :<:u: ,, .,
A/liir/ ` 71.. Ldin44 p4 ton Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
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RI, ,: {: - :te; �. " . s - ;:ts", ;; ?; ,:.:<, ,:, � ; .:: 1 ,x a n.: u;FIIa:'. Drinking fountain 16.60
:i�PROP&RTY•, "OWNER =`'''' :�t =� y .iTENANl''':'.:�a:'; `��t = ".t.-
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I,mt. ._ >. may.= -,, ..,.,..,.,ai:E:. .... tw r -iu.. EJCCt075/sump '
16.60
Name: f 4 / %'-4 1�..ezei2��+# Expansion tank 16.60
Address: ✓ Fixture/sewercap • 16.60
City/State/ZIP: Floor drain/floorsi ub e t ) ,,,, i 16.60
Phone: ( ) Fax: ( ) Garbage disposal i 16.60 J - , 1�
it
, : ; niS; - - )S = ; pdp A p f, ■/.��� . '3:t±2 ^;i.> :u :
�t 'r'r:s!` �„ ; „�:. Hose bib 16.60
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" " Ice maker 16.60
Business name: MP PLUMBING CO., INC. Interceptor /grease trap 16.60 •
Contact name: TAMI Medical gas (value: $ _) Page 2
Address: PO BOX 393 Primer ►-41/ 1 16.60 1l p , LOY
City/State/ZIP: CLACKAMAS OR 97015 Roof drain (commercial) 16.60
Phone: (503) 655-9161 J Fax: : (503) 650 -7050 Sink/bas' lavato 16.60 1 i • 1
Tublshower s ower pan 16.60
E -mail: TAM1G@MPPLUMBING.COM •
Urinal 16.60
,S''i" ;-�T i''?:aF� =„ ;mot yiki': ., ...4:�:.. c.S�;lJ'::" !;:T,; L'sa':t' JK >;:
l�' ^r::. 'i-H'?+:� .�i��llel� ^�j��:, a'iii'" .,.t �rlG `:ii� �'1:..
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. t.,. �., r..... �Yl:..,.,, �;`,,; �F,..-.,_ €_L,�..- :.,.r�,l�:f��u:::...... ._.a,..�_..._ t ':. , -..,_ t.:-.-,__., rt;.,§r::: �: r.= rt. �, rna :..t..,,; Water closet 16,60
Business name: MP PLUMBING CO., INC. Water heater 16,60 ii fit, v t
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Address: PO BOX 393 • Other: 1 .�
City/State /ZIP: CLACKAMAS OR 97015 _ S -
Minimum permit fee: $72.50 P� .. Phone: (503) 655 -9161 Fax: (503) 650 -7050 Residential backflow minimum permit fee: $36.25 A J g
CCB Lic.: 5002 Plumbing Lic. no.: 3 -17PB _ Plan review (25% of permit fee) /�
�A�i 17/7././y State surcharge (12% of permit fee) ,"l
Authorized signature: /f AIL TOTAL PERMIT FEE , 1 ■ 'j�.-
Print name: TAMI RILEY Date: 9. ,e.„,, This permit application expires if a permit is not obtain within
180 days after ii has been accepted as complete.
• *Fee methodology'set by Tri- County Building Industry Service Board.
I:\ Building /Permils\PLMF•PermitApp.doc 12/27/06 440- 4616T(10 /02/COM/WEB)
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��UUUU K�UN��� DIVISION - ^ PERMIT ~°~°"~~~°""~~° ~°"°"~~"~~"~ � PLhN2008-00366
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/17/2008
Phone: (503)G3Q'4171
Inspection Requests (24Hm.):(503)G3Q'4175 i t l ��
INSPECTION WORKSHEET FOR DATE: � TIME: � PAGE: 1D/Z[�2DOQ ��O17:014,4 RAGE� 9
SITE ADDRESS: � � 1 0 CLASS OFVVORK�
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�OO ����EE#0UR(��D7OO
SUBDIVISION: LOT #: TYPE L|N[�{)LhJCENTER/F|VELINCOLN � �
PROJECT NAME: � FARh4ERS|N8URMMCE
DESCRIPTION: � h`tohw/o!urpbing. Other fixtures: (1) hub and (1) primer.
OWNER: � PHONE #: SH()RENSTEM REALTY. SER\HCE8. 603-412-4800 CONTRACTOR.
• MP PLUMBING CO PHONE #: � 603,655°9161
Inspection Request Scheduled For: Date: Pour Time:
' 1CV2[/10O8 '
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077268-01 503-655-5181 N
Corrections/Comments/Instructions:
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�� p�8S / / PARTIAL APPROVAL �� CANCEL / ' NO ACCESS
FAIL 7 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: /~\ \--~-~ Date: IC) \)5t \�y�\ Phone #: (503) 718-
^'°` ' ' '\�,~ � ' .� .
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CITY' OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00365
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
A,
Phone: (503) 639-4171 ,.„.. lskiliir
Inspection Requests (24 Hrs.): (503) 639-4175 911772008
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/1/2008 7:02AM 17
SITE ADDRESS: CLASS OF WORK:
10200 SW GREENBURG RD 700
SUBDIVISION: LOT #: TYPE OF USE:
LINCOLN CENTER/FIVE LINCOLN
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Interior plumbing. Other fixtures: (1) hub and (1) primer.
OWNER: SHORENSTE1N REALTY SERVICES, PHONE #: 503-41')-4800
CONTRACTOR
• MP PLUMBING CO PHONE #: 503-666-9161
Inspection Request Scheduled For: Date:
"10/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 076167-01 503-666-9161 Y
Corrections/Comments/Instructions:
•
PASS El PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL fl CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 61)\ler..A..- Date: 1 \ 1 \ -0 (1. Phone #: (503) 718-
I