Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00003
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/5/2005
SITE ADDRESS: 10220 SW GREENBURG RD-6e0 4/s PARCEL: 1S135AB-01004
SUBDIVISION: T-WO LINCOLN - TOWN OF METZGER ZONING: C -P
BLOCK:rtfREE LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: 2 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: 0 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 2 RAIN DRAIN: ft
Remarks: Moving: (2) dishwashers, (2) garbage disposals, (2) Ice machines, (2) sinks. Replace (2) water heaters.
Capped (1) sink.
FEES
Owner:
Description Date Amount
EQUITY OFFICE PROPERTIES TRUST
ONE SW COLUMBIA #300 [PLUMB] Permit Fee 1/5/2005 $182.60
PORTLAND, OR 97258 [TAX] 8% State Surcharl 1/5/2005 $14.61
Total $197.21
Phone:
Contractor:
MP (MILWAUKIE) PLUMBING CO
P.O. BOX 393
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone : 503 Rough -in Insp
Final Inspection
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.
Issued By: f /� Permittee Signature: phe\c
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
_ .01- 05 -'05 08 :05 FROM -MP PLUMBING CO. 5036507050 T -934 P02/03 ,/ U -119
Building Fixtures
,
Plumbing Permit Apnlicati t i C V F) FOR OFFICE USE ONLY
City of Tigard Raeeivea _ 1
13125 SW Halt Blvd„ Tigard, OR 97223 'JAN (' DateB : / p 6Y PermitNo,; a
ph S03:S34'2tT 7t "F '3S
033.I9SIT - -- - / >, s, . t'..
nt>�; Other Permit No.:
24- Flour Inspection Line: 503.639 4175 ■ a + ll +) L I)atdB'
Internet: www ct ttgard or us CITY OF TI ^ -+ pate Ready/By; 1 e, B1 see Page 2 for
I n Notified/ivfethod: Supplemental Information
} `A'0r ;' }'� � ' ,�Txr}`�1. ZA J ti :�t .2'� ' � yY`I�R , � , p�'� i �..��y 44 0 , ' x `i, ?t ltd �i �'r :,k' +. ,:s ,n.4.o,
) A-ack ,'#:&na, 2 4 y r {{ l ��1t.,y t yy�, i a��q1 t , �s s a � air I g 1 $ ' + . r tt a : ' < s Q 1j . ' , 1 '" � 7 :e . 1f2 . .l t Y :.. „ s':
74.U' 4C.C� Mt�� J' ��LS! �CIL'lt:��'.��l�Ili`.��52 i'o �1;1J.nl]:t� �3�� "V �W.,TJd�� � �'�,. J �\ ..: _. 1 �. � � a . .. �t. l!" - - � •
❑ New construction ❑ Demolition For special information use checklist.
Description 1 Qty. I ].a. I Total
ErAddttion /alteratron/replacement 0 Other: New 1- 2- family dwellings (includes 100 tl. for each utility connect',
r '�)q��!�a�':2 , (���+�'Cr'?�ts rv�ry° "' �
,�ra�.�,y. "k;�N��4�' �t y ��+,�id d � b4 [�k't �C
.: ,.P of � ,. 'hi °'`{ {' .rib . , a 1 p
7 ,,,.4,f:41,i4F::...' ro v :c' �t � i.'.� ' - -,' 1 i 4 , , R " ( ) 249.20
.q �d , a.. : ; "t f �a '",V. 11 l �ttt. �C lii i.Y SFR I bath
❑ I- and 2- family dwelling G Coxnme cial/industrial SFR (2) bath - - - 350.00
0 Accessory building ❑ Multi - family SFR (3) bath 399.00
Master builder Each additional bath/kitchen 45.00
ID ❑ Other:
s� i .tiw w,� f rZ 4` S U "' p V o w Jim ti 7++ ywh { W ! »`! r !�, �� ,�, � nA ,. Fire sprinkler
w 44nI y , r i�, : 1 •Sr q pi r �i �.,i sP (. sq. fl,.) Page 2
� t t IWAR (iti � , N
t�g.R�� 11, t��: , 4 :',IAR i,�, �ligIA I41((illt ��A�r� } p i a ! �i '
L'.�n�,J1- �.,.$: a 1�... n. 444444��' � s,. 1Sad. f :Li'f „_iiti.au.".Y7:s".R��i %( .t 1. a� .: ,}tai i a"�k Site utilities •
Job site address: / "..��� ,, .�z ,� Catch basin or area drain City/State/ZIP: 1' •, l , • 1rywcll, leach line, or trench drain 16.60
• fi i •1dg./apt no.: 7;t, Project name: /I Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
Manholes 16,60 _
Rain drain connector • 16.60
Sanitary sewer (no, linear ft.: ) Page 2
Storm sewer (no. linear ft,: ) Page 2
_
Subdivision: - I Lot no.: - Water service (no. linear ft.: ) P age 2
Fixture or item
Tax Wrap /parcel no.: •
9 •4"�#> �n�ftiSlY ,{ m, y oaf: ��� f u r �.. Absorption valve 16.60
' .. �' t�,• h'� W�Rki�0l,YptJ+�r�"E -!� i � 4 •tom' " r ��t � li�in^4z`�f�R'.'Si if.�,i '.� ,! . -„'��.
- 111 '' 1: >Kz ,. 2; i, Baokilow prevenva Page 2
-
Backwater valve 16,60
_
Clothes washer 16.60
Dishwasher 1 6,60
v $ � I/ �� y ,; iyorglt.: fden.:.• �y4 :
t a i 14 •., ,' t ''fit' S { { 7 a, 4 w' K . i a *.11 , ,a i a xp� .V. r a m e Drinking t Inking fountain 16.60
A Mil'1 4,. . 3M YrA : :'' f . i1 .'.i& L .'.' .�:..J.�_ t �`.t'L_ _. _ l a ` 1LF ,.��,. L:.
Name: Bjectors /sump 16.60
., • •,,-'• / Jr Expansion tank 16.60
Address: Fixture/sewer cap : 16,60 i4,41.
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( • ) Garbage disposal , 16 .60 ✓ At
tti� ��4 J+°�ti g t } 1 t .E /Kc 1r j. y!' u+ 1: sa t a i4 •C r r ):lase bib
tri q S �1 ' t " I q, '�t;��II 3` st t t 6.60
n 5� � ,� i ! �r S + ti' , AiteStO a f t'aL ' r .f.&6 t � f ,L IL 1 +t;'izett s C ,� i14 � , ,1!
�� Ice ma ker 16,60
• ! J .././ 4/ (nterceptorigrease Trap 16.60
Contact name: • /' _ Page 2
Add ress: Primer 16.60
City/State/ZIP; P-oof drain (conunercial) 16.60
Phone: ( ) ‘ li i F ax:: ( ) 4p. 20 Sink /basirJ .. 16.60 l i p
$ rpail: . " -- (O ! Tub/shower/shower pan 16,60
J t 1 ', 1 7 � i �' l St1�•� i � r ! J �a N ; e' u 16.60
�•z --' c% c3 ' - , yt a „;, , '� 3 1. :.•< 4 ° ' 1 e t ater closet 16.60
Business name: ;WIT, / A Water heater 16.60 r
Address: 19 x tjj Other: //
City /State/ZIP: ' Subtotal 2,1, !vL
�� ` ���/ , / Minimum permit fee: $72.50
Phone: ( ) �111E1Mr, ,/_ - / Residential backflow minimum permit fee: $36.25
CCB Lie.: /?' Plumbing Lie. no,: J.1, /`r ,---- review (25% of permit fee) __� �'�'
Authorized Stare surcharge (8% of permit fcc) J
signature: TOTAL PERMIT FEE
Print name: Date: permit This mit a lication expires if a permit is not obtained within
/� / ��� � 180 days after it has been accepted as complete. /97.2)
`Fee methodology set by Tri County Building Industry Service Boarc
iA eao 12/03
440 -Ae I cT(10/o2/COM! WAa)
Accumulative Sewer Tally Parcel # 1S135AB.Q1'004
Tenant Name: First"Frarrklirt ` _ This SWR# ',`
Site Address: 10220 SW Greenburg Rd # 600 This PLM #'PL 00003
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptisery /Font 4 0 0 0 0 0
Bath - Tub /Shower 4 0 0 0 0 0
■
- Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash - Each Stall 6 0 0 0 0 0
Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher - Commercial 4 0 0 0 0 0
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain /Sink - 2 inch 2 0 0 ^ 0 0 0
- 3 inch 5 0 0 0 0 0
4 inch , 6 0 0 0 0 0
- Car Wash Drr 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 m g-.';;" 0 0 0
- Industrial (over 5 HP) 48 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 ` S 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar /Lavatory 2 0 0 0 0 0
- Bradley 5 0 0 ;:, 0 0 0
- Commercial 3 0 ., 1 3 0 -1 -3
- Service 3 0 0 ;:; 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 x'" ' 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit : '. 0
TOTALS 0 0 1 3 0 0 -1 -3
Current Fixture Value -3 divided by 16 = - 0.2 Current EDU 1 EDU = $ 2,400
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -3 divided by 16 = -0.2 over (under) $ (480.00)
Enter EDU Change Here -0.2
Notes: Please forward this information to the property owners.
Signature: ,.-Z,e , . f .�`.,, , Date: ); ,• .)�' °,1:5�
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher
which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
i:\ Building \Sewer Tally \SewerTallySheet.xls 11/19/03
Ir CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLN12005 00003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/6/200+
Phone: (503) 639 -4171 � + i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/22/2006 TIME: 7:12AM PAGE: 77
s SITE ADDRESS: 10220 SW GREENBURG RD 615 CLASS OF WORK:
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER LOT #: 009 TYPE OF USE:
PROJECT NAME: FIRST FRANKLIN
DESCRIPTION: Moving: (2) dishwashers, (2) garbage disposals, (2) Ice machines, (2) sinks. Replace (2) water
heaters. Capped (1) sink.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: MP (MILWAUKIE) PLUMBING CO PHONE #: 503. 655 -9161
Inspection Request Scheduled For: Date: 4/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 005139 -01 503 -348 -0563 Y
Corrections /Comments/ Instructions:
/
j
•
7,4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
0 71 L Inspector: Date: / - Phone #: (503) 718