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Permit CI TY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2005 -00070 � fI I 13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/1/2005 SITE ADDRESS: 10500 SW GREENBURG RD 100 PARCEL: 1S135AB-01006 SUBDIVISION: LINCOLN PLAZA ZONING: C -P BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Relocate (1) sink. Owner: FEES EQUITY OFFICE PROPERTIES TRUST Description Date Amount ONE SW COLUMBIA ST #300 PORTLAND, OR 97258 [PLUMB] Permit Fee 3/1/2005 $72.50 [TAX] 8% State Surcharl 3/1/2005 $5.80 Phone : Total $78.30 Contractor: MCKINSTRY CO 5400 NE COLUMBIA BLVD REQUIRED ITEMS AND REPORTS PORTLAND, OR 97218 Phone : 331 - 0234 Reg #: LIC 40981 PLM 37 -22PB 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 -O-U. calling (503) (503) 246 -6699. Issued By: (� ; , � Permittee Signature Call (503) 639 -4175 by 7:00 P.M. for an inspection the next 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. P1umbin . P ° , j' ii .'.- ,' i r , ? i! �.! ,� .9 � �.: � t r FOR OFFICE '.USE s n , City Of Tigard Received 7� _ �7 Permit No.. _ S 5/ 2&1 13125 SW Hall Blvd., Tigard, OR 9722 1NS �� / DateB `' view Phone: .503.639.4171 Fax: 1 0� r I ., Date/By: i Plan Other Permit No.: 24- Hour Inspection Line: 503 .4175 ',I D ate Ready/By: lwis. ® See Page 2 for ww. Internet: wci.tigard.or us (-AV -flu i Z u Notified/Method: '-'r I( , Supplemental Information 14 i , ! t ✓3 _ c i �. ';v,. �FE1E* ,' ` er ;i . y - s ..s , .ti . - tat r a.t. Y . - ;.v - ;..,. 0,.r�cr.-r. . € .,,r, , ... , Ga � 1 .� ; ra2,,.�. '�u, <, `" ,', _,.a r., -��: �a.�.v,�_. , ,. a...._ . . - ...__.,._,... l=1 New construction B u I -- / ❑ Demolition For special information use checklist Description Qty. Ea. Total g Addition/alteration /replacement ❑ Other: New 1 -_2- family dwellings (includes 100 ft. for each utility connection) ` i, TIEGOIt OF CONSTIRIJC'FiON t ' = SFR I) bath 24920 ❑ 1- and 2- family dwelling Commercial /industrial SFR (2) bath 350.00 El Accessory building Multi SFR (3) bath 399.00 ❑ Multi -famil Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: g d 6740 Fire sprinkler ( sq. ft) Page 2 � L ;(UB STTI , U A D OCAT r - - Si u Job site address:. io Sbc sL,. j. r -i (� e Catch basin or area drain 16.60 City/State /ZIP: • r0 of___, Drywell, leach line, or trench drain 16.60 Suit 1dg. /apt. no.: �� Project name:s�'e� " '�'� � Footing drain (no. linear ft.: ) • Page 2 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: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no Absorption valve 16.60 " , D E S G 1 J ' I O OF WORKA. ` ' 1 " � " 4 ,� .i ak,. 1 _ ,.) . - . _ T , 2_ < N g .;,,- ,„ ;;,.0 � ..,n .. , _ - Baclllow preventer Page 2 e Er AT C e , . Back valve 16.60 Clothes washer 16.60 Dishwasher • 16.60 � '''''' Drinking fountain 16.60 ' - PROPiIi iiirA : ) , , - n > £ENA IT ii a,3„ ., . ,_. 5,..,.. gym.. r,... -mss r, > , ,,r=. Ejectors /sump 16.60 Name: C� 4%) t t 1 0 c�( Cv L.) () Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City/State /ZIP: Floor drain/floor sink/hub . 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ,� � � ��� �.�- � r H bib 1660 1 v AP�I.II~ f , a 0$1 �� •R : a�sr�r��v��x m.a �= � ��, Ice maker 16.60 • Business name: 1/IA C k ' a 7 .4 C Interceptor /grease trap 16.60 Contact name: pas..---, P Q Medical gas (value: $ ) Page 2 Address: SG/0 , . Co) (0 ,,•..�,'Qt,,.4-- V,tl l Primer i6.60 City/State /ZIP: Pte- -- [�✓�,"L Oe- 9 7 z. ( ej Roof drain (commercial) 16.60 Phone: . f - z( 4 4 O S + asin/lavatory ' 16.60 (� ) . 3 Fax: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 �� CONTRAC OR' - r Water closet 16.60 Business name: G k,, ms s c . t ' / Water heater 16.60 Address: .- "i 00 -;& 6- z04' (vA r Other: Subtotal City /State /ZIP: f p.a_r- __. 0,____ 9' 7 2. ( Minimum permit fee: $72.50 ,..,,f, Phone: 5:-. ?� '') -- 3 1 ... 8 2... y Fax: ( ) © - Residential backflow minimum permit fee: $36.25 ? U v CCB Li 4 a F p L Plumbing Lic. no.: - J7° Za PE Plan review (25% of permit fee) �� / �� State surcharge (8% of permit fee) J Authorized signatur TOTAL PERMIT FEE . 7 �. !) Print name: P . - / �_ Date:.- l -CD5 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. i:\ Building \Permits\PLM- PermitApp.doc 12/03 440- 4616T( l0 /02 /COM/WEB) CITY OF TIGARD • BUILDING DIVISION PERMIT #: PLM2005 -00070 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3!1/2005 Phone: (503) 639 -4171 4W,11101II'It Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/28/2005 TIME: 7 :10AM PAGE: 74 SITE ADDRESS: 10600 SW GREENSURG RD 100 CLASS OF WORK: SUBDIVISION: LINCOLN PLAZA LOT #: 002 TYPE OF USE: . PROJECT NAME: STEWART TITLE DESCRIPTION: Relocate (1) sink. OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #: CONTRACTOR: MCKINSTRY CO PHONE #: 331 -0234 Inspection Request Scheduled For: Date: 3/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 002908 -01 206 -266 -3693 N Corrections /Comments /Instructions: K/ :q 14-PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I Date Phone #: (503) 718 -