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Permit ,� CITY OF TIGARD PLUMBING PERMIT '' 1 .: COMMUNITY DEVELOPMENT Permit #: PLM2009 -00127 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/27/2009 Parcel: 1S135AB01004 Jurisdiction: Tigard Site address: GREENBURG:RD :320 =1 Subdivision: Lot: 0 Project: Russell Project Description: Install (1) dishwasher. Owner: FEES LINCOLN CENTER LLC Quantity Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 1 ea Dishwasher 05/26/2009 $16.60 CALIFORNIA ST 49TH FL 1 12% State Surcharge - 05/26/2009 $8.70 PHONE: Plumbing 56 ea Minimum Fee Adjustment 05/26/2009 $55.90 Contractor: - Plumbing MILWAUKIE PLUMBING CO PO BOX 393 CLACKAMAS, OR 97015 PHONE: 503 - 655 -9161 FAX: 503 - 655 -1726 Type of Use: Class of Work: Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules Issued By: / t` i I 1 i �� Permittee Signature: aL ♦ Cali 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. ,, . R! r O (1, v P lualnbing Permit Alication 4 I. a l Building Fixtures MY2 2 2009 I.4.)1; ()Hui' t• l O \1 1 . `' g City of Ti ll and / e °� ry - p ® Rccc'veo Permit No ": ip - -- y 13123 SW Hall Blvd„ Tigard, OR 97223 CITY [ OF t IGAR b../By � QLmGCr�Et . �)( . • Phone: 503.639,4171 Fax: 503.598.1960 tan Review Other Permit Na: e2C)O9. 2 o 1I Inspection 1 „inc: 503.639.4175 ,9 JILDIN G DIVISION( a R Ii,i.'\ Kh] Date Ready /By: la ,Sec Pap 2 fur Internet: www.tigard- or.goV Notified/Method: Supptementhllaformadoa ��� �. �,�..,. : :. r, SAa:xry :r a ..., :., -: n , . "....... .. , � ,,. ,.n: .r...� S PY.! 'nri bra „' r . ;r', : :r� :. :9. .. �� �, � u' vn': r d74 4 :11. : :: •M � :.�t :. ..�,- ,. -.�;. , . r � u: �r N1 .1'' ',N1 iSY''.y+l'. :_F' d 1'29e),4h"� V , AF1S:1.%. ' t, �!R v.,r,.,,, r { f,d 4 lPr_ , r r ,,, "S R W 1 4 �. ,d? ie r!"" L,,. I +Ri r P .¢ IN . , 14 ,'-µ ; ' yy '' , N'a H,� M ;. F F ' 1]s rt1' �'! y ) . {M1 : ',w� i / I.4 A :. ) a :'YFI frJr { IR f rd'?a('.;+i� o- t�i (', 1 " �� ( I d t 1. s q t 5I pv r h, r.Q.r ' !y.,r nt 7 u t, N. M o t 1' I r<�r yl;'d iraSN4f ta'�4�rw w; soar,+ /u,, fi 1s,4r..I�� I ��, t +�.�r�Aiv�tdix :, raw < t R �d or , _at,e� ", r ?t ' r- .,. -,r, , t t �rrtc, �" -,:�; >IV ,arrlWr . � '� .:" , ' ,.������# � I� � � � � � ��r��: ��E� ��� � ' �i��s ����� ��r,�r,rr�ax��,�rw,,. i a��, ��.�ltr} 1,ss El New construction ❑Demolition For, special information sae checklis . - ISe I Qty" I E_41 Total 74 Addition/alteration /replacement ❑ Other: New t - 2- family dwellings (includes 100 ft, for each utility connection) l,i ,t t�y ae �l 1 bllr q. .I i` R t i r •fi t f ; r j dW j1' e (Txe f ^ ^' $1 e : g?i„C v 0r,� � t . ( ) 'err t � 11rlrA'w: ante. itirirrwly ahti iiMiidai.:•, sSsilty,h�Aiiittriii; M1 ` M1 , :12�Jt ru. i 1;,.nv SFR I bath 249,20 ❑ 1- and 2- family dwelling YI Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 349.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: �yyG s'u? RFt '61a' :r xy,a e,¢,t4srutt4" `,i " W w ti t {a, :Nx ..',' , a r t tYt !r lEi, raaFkt Fire sprinkler ( sq. ft.) Page 2 r1 i Mr II}r 14 1 "' tl M1 . / r J r 7 (1 r yr { 1 ri, " M1 { 7 MI ! ,f'. 1 , i,kx / ,',•al.tti iiiltaaituSewi rilsrririiuida, r i . + u'.s ls 4101ra,riIivGNIrGI z r,:n.Y,..ttr a4�t,.tiGli1 fti 1,r' ., nt t . t r S ite utilities Job site address: IC 210 SLC) 0 v_e _ )Li �-�] - Tic cud Catch basin or area drain 16.60 City /State /ZIP: � I `" ' l)tywell, leach line, or trench drain 16.60 Suite /bldg. /apt, no,: f Project name: + �� - 0 I 9 k Footing drain (no, linear ft.: _) Page 2 �'' Manufactured home utilities 1 10.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: 1 ,,C , ` J S LIZ O 1©c - j Lot no.: Water service (no, linear ft.: ) Page 2 A v , Fixture or Item Tax map /parcel no,: P "� ' „(k , w R w' to xpoxrt (p ( py6� #k�r r Ry 81eM 1 eo rin ir Absorption valve 16.60 u y� pM 1 AM T ' S ` )6 �' qy tK #3 I , , F 6 ' . . , r ,"d gig, .k +, C Z r rl.. rb,41i1 ttii: 4;.4ukt' tkhlt; aiN�, a s� > ;gk M . sCo-± a +)4 Backfluw presenter Page 2 M I _ '�y lk i ��y I - La : Backwater valve 16.60 o ' g 0 ✓ '(1 i_� C 1 1 r ' e Q� • Cloth washer 16.60 � Dishwasher , 16.60 kR " ,,ul_xa r yq� y 7 :x :ryji ° :crNS t!96Al, dYdyrlB.wtr, , :. , :�;Wrrar a»t a;� Pti' p`; 'ft '' vry ?i`.a "'i1 r toxrm lrn4r are .wr :. r; :, Drinking fountain 16.60 r itaI�libr" . a4,., u: 4• Litici;iiiv,ei�ri&il1hM�Yr61��i i ' ' ,P S'1 lv�lW,,til��sk1:�i? tiipY 1 ° '', �r ! Ejcctots/sumQ 1 6.60 Name: Expansion lank 16.60 Address: Fixture/sewer cap 16.60 - City/State/ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ' N P rid bait �rcr s{I s �' r �wr. , f l ttmr t i Ft Hose bib 16.61 510644ARAimtiWI,a :i/14:Mk. Ali' °.IX9�'K NSWUaskt.%Lmw:^ 1' It tti:hsi+14X'iI M , Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /$rate /ZIP: Roof drain (commercial) 16.60 Phone: ( ) F'ax:: ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 `7�;, t v 7a v '� xtt' r lm ' , ; 14.4 Si +ttA ',1 r F. ' } v , E v r^1 r 1 r ra r. nr 9 4Mai4 :� i r V a 4 i `t r ' r n } `ail I, 16,60 �ls:���,l+�a�r�,u�rt�� `� � �vnri�+��xlrarmicf," ti.s t9t i��Y�����t'.i;. � �.�� a >, a °.c! ).. � Water close _ Business name: l l l -p T)) -( `�h l �\i h, \61,0_,,..,.,,,I, ...P k tt M�i• Water heater 16.60 Address: ROB (t Other City/State/ZIP: _f )t(' k aryl l.(' S , 9 ( 2 v110 L4_ -• subtotal Minimum permit kx �(p. Q ( ; $72.50 Phone: ( Sp'-) 62 (:- J S -q IL, \ Fax: ( q 6 ua 4 Residential backflow min imum permit fee: $36.25 1 d, 'S fees) . of pem i1- Plan review (25% of permit fee) CCB Lic, : -� Ica • 1. 6 Plumbing Lic. no.: _I (12% tit -1 (j ■ I Site surcharge (l2 Authorized signature: P A 1 �� - l • It TOTAL PERMIT FEE , Print name: • I'kv� �1 l,(� I () (-I late: s -0 9 This permit application expires if a permit Is not obtained within " 1� � 0 180 days after It has been accepted as complete. S i tA) 2 - 310 - *Fee methodology set by Tri- County Building Industry Service Board. 1 ,\Hermit: \vt.X1F- PermtlApp.dvc l2'27b06 4 1oT(10 l d 08800000GL ' oN/ 80 :17 L '1.S/80 :17 L 8002 ZZ INN (I ad) NO NA Plumbint Permit Application - City of Tigard Page 2 - Supplemental information Fec Schedule: o S stems: , ... ,. . ,_,. � , �, :, ,. , ..mw „,:m.,, � .v �.,:., r ,... n .,, x ResldentiAl Fire u ., rkr ra . w n np , ,\a �p., ^ :� Y'/?. h '.:1 RS ,yy rV '' ,- _,.G,.r rl}'' ' .,, 1l r e nr u g,Mr r v 7v: , ... " , .RY' . n :yjfn¢[{ ors x , y u �!tPa , Y. ,. ( tvi +h r} r�l�'i1iN u� o y r ,'1 Ra, t4w S'' r 'iii ,�,p' �, p �1i, t ll 4 k� rT �x.:r i 4, j� "' t a dl r,.•( r d• rtV �* d + 1x1', M 11 A A . »r,;; r., go _-: ,ik'' ,w, ui d lluWii mil+S�i.62. fa�i94 { tWreai �F�ak...,.t,•, in;a, r „n. d.;., ., 4a,r ,w sl , h�, . ,M. ''' '' r,w n 4V r4 ' ,Taal n Footing drain - 1' 100' 55.00 0 to 2,000 $115.00 Footing drain • each additional 100' 46.40 2,00 l to 3 61x) 160.(81 3,601 to 7,200 $220.00 Sewer - 1st I00' 55.00 7,201 and . rester $309.00 Sewer - each additional 100' 46.40 Water Service- 1st 100' 55.00 Medical Gas S stems: Water Service - each additional 100' 46.40 � _ .. io iatl "'�:''r ;g: ?;yi. i� r ";'ilti%;3� 77!1„ , a4rx; l.` ,aga) p ith. °sa t¢4r,Y � it,v.:,,,. ; „,, „,. ;r,,;;.„ .IdY f'4.',E t!t!?ltent,1 ,.:H, ::, ,,,,ti ! re11101 'iNAA► tk nt 14 /41 r� ,, � . Storm & Rain Drain • 1st 100' 55,0() $1.00 to $5,000.00 Minimum fee $72.50 _ Storm & Rain Drain - each additional 100' MO { p h 46,40 $5,001.00 to $10.000.00 $72.50 for the first $5,000.1x1 and $1.52 for cach h,BM:h' ` ",,i r +{ „f�4;m7,r. f/j , V ,r, yy ,J,�� tip u t y 1 ,! 1 �1 7111 ii "�!��`Ttity,+{B �,f : " w'7 additional $100.00 or fraction thereof, to and iii,,0 :. ,..,,,,,r 0,,, r, „,, n,,, i�. i . . tf.), R r'i i iS k6.t4'a Oi 1t414th 1 .!i :iakl; d including $ I0,000.00. Commercial Back Flow Prevention device 46.40 $10,001.00 to $25,000.00 5148,50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100,00 or fraction thereof, to minimum . emit foe 536.25 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 inspeeliim of existing plumbing or each additional $100.00 or fraction thereof. to s.. iall ..uaated i .. Lions - . • hour 72.50 _ and includes $50 ,000.00, Subtotal: - �_ $50,()41,00 and up $742,00 ac additional for thc first $50,000.00 fi i and thereof for each additioonal $10s0.0.0or $100.00 or fraction th crcn f r: r iw lxmt w Mf uµ r, r a w arse t t MV9 G r � r Commercial Fixture Work: i Yr ;',4 r dl >. 1�. } ?A'w�' 3 '";�, 3 TT Na,3�.1: t?° Y( r, Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accuratel re. ort fixtures could result in increased sewer fees*. ❑ Any new commercial building with water service 2" and � systems dcsi eel and stamped licensed :,.r , Ne: ; =.*:.P.iil ,0 f , . E 9 g tic, r... :.,.;. �9e x,9C. :.;y .. i . Pi ?7 7YUer ''.4 : x., <[rdr -gvry greater, except . y. gn aped by �r re ?..iii NS9 r l +' 4e. .4111 6 ! r • f 1 t i, „ . :. ,, , , i ; 2 t �'r` 0 ,t i , "dC i.".5 L 3j1iii :Vi.' 6 i:.;. a:it i 1 ` ( Y r i t i { r 4 t;i i;i14 0 a n all it,i1L fL , . p engineer. '* M iittiitit∎n 4 3 ,�sutdru.wnur Oitiigq;� ildi+i d14 hA a�� zgh4;,Q >+r4.r ,n„ ,. di ❑ New exterior plumbing site utilities l ire arty crimple( structure Ba.tist /Font - -- as defined in OAR918. 780.0040. l3ath -Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi /Whirl ..I ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall r- .. ❑ Any complex structure as defined in OAR91 l - 780 -0040. -Drive Thru -11111 C ,idorfWaterAs.irator -- . Submit 2 sets of plans with any of the above. Dishwasher - Commercial - -MIMI f �� - Domestic �� -- !t 1 +t �2YY� 'i I ;tf,�,9 �^''\I #.r ' '.�'7d1#1 d,rti' N 117 r.. Drinkin Fountain - -� � lr4 ,i, ' ,tnt� ..,:3�,5 , .,,$r, 7. X 1 4 +.;, a d E,m�v ,�:, 1 . ,'..so �'1» l -mum • Isometric or riser diagram is required for new buildings • Floor Drain/sink - 2” I=.111 that meet the a ualitications above. -3' 4” MIME Car Wash train ME= Garbage - Domestic INNS. Comments regarding fixture work: Disposal - Commercial - -�� - Industrial M -- - IceMachiRcfri_.Drains Oil S..l rator Gas Station) Rec. Vehicle Dum. Station -� -. Shower -Gang NM -- -Stall MI= Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results In an - Commercial IMMO Increase of sewer EDUs, a sewer permit will be issued and - Service - =NM - fees assessed for the sewer Increase must he paid before the Swinunil _ Pool Fitter MEE - -- plumbing permit can be issued. Washer - Clothes -NM Water Extractor - - -- Water Closet - Toilet - -- Urinal NUM Other fixtures: MIMI i. \Building \ .unL\ pl,M -PS mil A(( dec. I 127/16 Z d OE800000SL' /80 :VI '!s /80 :b1 800Z ZZ AIM( 183) HOad