Permit C ITY OF TIGARD RD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00223
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/19/2008
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 600 ZONING: C -P
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: Capping and installing fixtures for TI. Capping (2) lavatories. Other fixtures include: (1) hub drain,
(1) ice maker, and (1) Primer.
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES: 3
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SHORENSTEIN REALTY SERVICES
ONE SW COLUMBIA #300 Description Date Amount
PORTLAND, OR 97258 [PLUMB] Permit Fee 5/19/2008 $116.20
[TAX] 12% State Surch 5/19/2008 $13.94
Phone : 503- 412 -4800 Total $130.14
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 By �` Permittee Signature: i /G/A../
CaII 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.
, _, /
. %` , �..Frorr : _ 05/16/2008 15:44 #522 P. 002 /003
"E
. ,
Plumbing Permit Application
MAY 1 6 2 008 ''
Building Fixtures FOR OFFI F U SI ON 1'
City of Tigard CITY I • Date /By: Received ' . , �- Permit No.: eZ 9c�' J.- 33
13125 SW Hall Blvd,, Ti ard, OR "� r �� 37 /
g G D VI SI®I� I
+ q Plan Review CA P�.eI
Phone: 503.639.4171 Fax: 5 .3:59 9 Other Permit No.:
Inspection Line: 503.639,4175 Date /B y:
Inspection IC A It 0 Internet: www,d d - or, ov Date Notified/Method: Ready/By: Juris: Supplemental See Page 2 for
• g Notified/Me '�� Supplemental Information
, TYPE
OF WORK s. I I �± � ": ::i:i i i -e,,: >;:;
❑ New construction ❑ Demolition For special information e checklist.
Description I Qty I Ea. I Total
, Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
- :'_CAT1iiGORlI> OR;'CONSTRUCTION
SFR 1 a
,;; __., :..,:- et. € .:::....:..:. ...: <:::,i,sa. ,,;,..:,.,. ..._ ... „ .... � rn' 249.20
❑ 1- and 2- family dwelling Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑Master builder Each additional bath/kitchen 45.00
e s9
Fire sprinkler � sq. ft. ) Page 2
'c -s,. i S FORMATION: AND
'{ �.I:i1,CATION. = ��> • ci � ?• Site utilities
Job site address: Mae /j) filth h,/,!, � Catch basin or area drain 16.60
iit9 i
ffiJJ1 Pro j ect name: lPW City / State/ZIP: N ���HHH�vuv Drywell, leach line, ortrench drain 16.60
l/ p t, no.: 4s / /f�, .� Footing drain (no, linear ft,: ) Page 2
• Lei! I . g
rlSUrt d g ./a
Manufactured home utilities 110,00
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: Lot no.: •
Water service (no. linear ft.: _) Page 2
Fixture or Item
Tax map /parcel no.:
!:n s, ,; .::asrsa! ! : :a ; : - s: :, x:. aiu =a:{ Absorption valve 16.60
Knnr.ni�2a. ^,. 5:".i:.., .•.+ �).U,,1,,,.,,:::; �rvi'• �+ r. <
- aDESCR1PfON'OF sW OR[c.:.f , .- l :
.::H:. ,. W2i�'
,w;<' � ,•.. - f >,. ,.,.,.,, : , ..,.... ..�,r,:,.•:,,: �:a... -. m, m;,,. ..,:,. a: ra:,; rr`.`,,., .,:i-ti':.; >.,r'- r;,,. Bacldlowpreventer Paget
. ,, • •, him) /[ �Jz J - 4J , f J ffJ/7+ Backwater valve 16.60
•
tee i / 1 ) �,jq ild 1 L Iv rni if .0/ Clothes washer 16.60 ,
1 Dishwasher 16.60
,it'r: {s F:E :,,y =,,,r.1 4 iyt " „ ; ;.wctc' :: 1 ,1: Drinking fountain 16.60
ni)5 ? { 1� , Ut ti i / {� /�y{ . g :. ?I%' tai i �:V i•'� I�1��' I � r ,•..n'(T <.
i. Tl'i`V t11 \L'R� ; : :o ': tYa. t iL'1\A �.: :: "1
tulwn;JC:�46tTM,1•'�.i: .•...•.fSr�: ...ee ,-.._, r.. Sbisar: 5. .yr.p,r.,tY.ii;:u;::»«:.h.,,.;I v-., and '.�".:,->;PI °i��Je::,:,. a.nzw k
41112 w- - >,.. •.. n .. /... �,.�. :t<a:.,.:a.,k��1 >::lxv;p. Ejectors/sump _ 16.60
N ame: �r.►� �jllAyWifeJ, Expansion tank t� 16,60 �pp
-- Address: Fixture/sewer cap 4, 16.60 , 3, + /l!�
City / State/ZIP: Floor drain /floors' . C)7 � I 16:60 o, 6g,
Phone: ( ) Fax: ( ) Garbage disposal < 16.60
:;•, . ,,,q r= i"£3:au SF s';i: - >r.:. ,Ytgglaa;3luat,:rk:��iiFS�?k9.: ;:vt:•;:V; F.ii,- 4 _ :�A„i 'g,q, Hose bib 16.60
if.�as,t. z `. i . .AM V , .. i :.,..: i td:.d il i ; r,<r r," = ?,lnE r-'1', r )
,,; q: a: Frn:: SO= �J�- r�. r: r..; oc.. v> au r: n 3s n, aPf' �RSr_' ts., �;: �x fi'�f4in �;Si, €rH!x- ..,. ..,, » .., »., rw .. n ..,7 ?:h:+�9;rk �/ !n/
I ce mak 1 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 eithA.4 / _ J 16.60 4,0.-
j
City /State/ZIP: CLACKAMAS OR 97015 Roof drain (commercial) 16.60
Phone: (503) 655 -9161 Fax: : (503) 650 -7050 Sieklbasinllavatory f 16.60 1 �,
Tub /shower /shower. pan 16.60
E -mail: TAMIG@MPPLUMBING.COM
rK : u;t:cv� "'Y;!r#:. L't,rri# - :.,v-�'',: ; :• ; .:.= z Nr:�- - _ Urinal 16.60
,.1, ?=1";- Y- i�� e f e :. -. r:,! F� . :
- ,.,. r;;s .rte , :., -�.� . . v ,.� .., � :,# ' . `; m ,�,:. : t.
fig r�wi' �:' wl�!` :l�S,,;ir;,,.1�a:::,;ai�L:ar.r„ eta ,,:ex::::..,,:.N_._,....__... - ....�.,..L,;�s., N, x�,, ��... .. :v!<r: >r >sar4.'a�,c:::,.: :,•h Water closet . 16.60
Business name: MP PLUMBING CO., INC. Water heater v 16.60 )) ,
Address: PO BOX 393 Other:
City/ State/ZIP: CLACKAMAS OR 97015 Subtotal il
Minimum permit fee: $72.50
Phone: (503) 655 -9161 Fax: (503) 650 -7050 Residential backflow minimum permit fee: $36.25
CCB Lic.: 5002 Plumbing Lic. no.: 3 -17PB Plan review (25% of permit fee)
State surcharge (12% of permit fee) /5„.
Authorized signature: adrift- it y - TOTAL PERMIT FEE l��
Print name: TAMI RILEY j Date: j + /� ��� 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.
IABuildina V'a.nitall'LMF- PermitApp,doc 12/2706 440- 15I6T(I0J02 /COM/WEB)
Accumulative Sewer Tally / ` tY G0 e-00.2-3
Tenant Name: Ae/ /M6 /X-.)U This SWR#
Address: This PLM #:
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4 ,
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6 ,
- Drive Through 16 .
Cuspidor/Water Aspirator ' 1
Dishwasher - Commercial 4
- Domestic 2 ---
Drinking Fountain 1
Eye Wash 1 --...
Floor Drain /sink - 2 inch 2 / 3 ,
- 3 inch 5
- 4 inch 6
- Car Wash Drn 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32 -
- Industrial (over 5 HP) 42
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6 .
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar /Lavatory 2
- Bradley 5
- Commercial 3 2 / 3
- Service 3 _
Swimming Pool Filter 1
Washer - Clothes 6 •
Water Extractor 6
Water Closet - Toilet 6
Urinal 6
TOTALS W
Total fixture values: divided by 16 = 'EDU
HISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR# /
PLM# EDU# SWR# PLM# EDU# SWR#
is \dsts■swrtaly.doc
CITY OF TIGARD -,-
t ...
BUILDING DIVISION PERMIT #: PLM2008-00223
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/19/2008
Phone: (503) 639-4171 _, i "NOV U
Inspection Requests (24 Hrs.): (503) 639-4175 ,,,-1441fr '-....
INSPECTION WORKSHEET FOR DATE: 6k1/2000 TIME: 7:01AM PAGE: 27
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Capping and installing fixtures for TI. Capping (2) lavatories. Other fixtures include: (1) hub drain, (1)
ice maker, and (1) Primer. NO CHANGE IN EDUS.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: MP PLUMBING CO PHONE #: 503-655-9161
. ...e
Inspection Request Scheduled For: Date: 6/412008 Afro Pour Time: AAN\
Code #. Inspection Description Confirm # Contact # Mes ge
320 Plumbing rough-in 070817-01 503-655-9161 Y i
qet)
Corrections/Com ents/lnstructions:
,r 9 •
142ptf cY- A0
. .
- p<ziekss n PARTIAL APPROVAL CANCEL 0 NO ACCESS
—
. 0 FAIL n CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
. 2‘12i
Inspector: C/C----
Date: ' Phone #: (503) 718- -
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: PLM200B-00223
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U19/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 8/25/2000 TIME: 7:00AM PAGE: '16
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER11WO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE.
DESCRIPTION: Capping and installing fixtures for TI. Capping (2) lavatories, Other fixtures include: (I) hub drain, (1)
ice maker, and (1) Primer. NO CHANGE IN EDU'S.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503
CONTRACTOR: MP PLUMBING CO PHONE #: 503655-9161
Inspection Request Scheduled For: Date: 8/25/20013 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 071831-01 603-655-9161
Corrections/Comments/Instructions:
Cok-Vv-
•
PASS EI PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
I FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: v Date: A-A% Phone #: (503) 718-
. „ •