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Permit t CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00163 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/18/2008 PARCEL: 1 S135DD -05100 SITE ADDRESS: 11970 SW GREENBURG RD ZONING: C -G SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: CODA Project Description: Replace (2) lavatories and (3) water closets; Cap (7) lavatories 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: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 0 URINALS: GREASE TRAPS: LAVATORIES: 9 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES LANDING SQUARE LIMITED 5250 SW LANDING SQUARE #14 Description Date Amount PORTLAND, OR 97209 [PLUMB] Permit Fee 4/18/2008 $199.20 [TAX] 12% State Surch 4/18/2008 $23.90 Phone : Total $223.10 Contractor: ATLAS PLUMBING CONTRACTORS P.O. BOX 1352 RIDGEFIELD, WA 98642 REQUIRED ITEMS AND REPORTS Contact # : PRI 360 - 887 -8054 • FAX 360 - 887 -8504 Reg #: LIC 165718 PLM PB149 • 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:d Permittee Signature: OA/ /ipfL, j C /9-77 O A/ 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. 04/17/2008 10:52 FAX 13608878504 004 Numbing Permit Application I wilding Fixtures ( t 1 1 < l 1 1 I tl 1 . I . : i < <\ I \ 1 11 4 - Tigard R g� � j r "F df Permit No.• n 1 " ECEIV ED 13125 SW Hall Blvd., Tigard, OR 97223 ��r70� 'dd�(o3 Phone: 503.639.4171 Fax: 503.598.1 ^ 7 q � R 1 E 2008 p ly " " Omer Permit No.: i 1 Inspection Line: 503 639 4175 Internet www ugard- or.gov L 1 i : ® Date Ready/By: e thood S. See Page 2 for s a 7/G s lafermtuaoa ��a.�}. - - ',�,is m „i.:= _ .� - Sr-� � .s. �w �.:t . _,ens �ri; r=s �- 3 En. " El New construction _ I Demolition V For special information use r �'Addmon/alteration/replacemeni ❑Other Description I Qty. - I Ea. I Total T Y � �r_ , -� New 1 - 2- family dwellings (includes 100 ft. for each utility connection SFR (1) bath l 249.20 © 1- and 2-family dwelling 'Comtnercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 0 Master builder 0 Other Each additional bath/kitchen 45.00 , : a Ire 7; .. _ Fire sprinkler ( sq. ft) I Page 2 = �. iG33.'Z - 3 ...53 - �. �� T � - 'F M"$ �'{c'�- -c3 -' Site utilities J o b site address: 1( °170 5 0 U r ee H J N r j R c( Catch basin or area drain 16.60 City /State/ZIP: -' y Q ( rot j j g / 7 Z 7. Drywell, leach line, or trench drain 16.60 o Q Footing drain (no. linear ft.: __) Page 2 Suite/bldg. /apt. no.: I Project name: C street/directions to job site: A/ ` i 5 Manholes 16.60 Manufactured home utilities 110.00 Cross street/directions 1 L7 i I Si ^. Pca'v4 r� T 1. V P Z O O S- 000 9. Rain drain con>ector 16.60 Sanitary sewer (no linear ft.: _) Page 2 Storm sewer (no. linear ft.:.__,) Page 2 Subdivision: 1 Lot no.: Water service (no. linear ft.: i ) Page 2 Tax map/parcel no.: 1 Fixture or Item % 7 ,- _ Absorption valve 16.60 - Backftaw preventer Page 2 R o f is c r? - 3 / ex/ 5 f`-r > W j 4-1 ' dos C 1-s, Z Backwater valve 16.60 t5 ) /aJa'/ «;e. , 4 C.a. - i' C4R /,',. Clothes washer 16.60 Dishwasher 16.60 w` T ' .T '" . f _ - Drinking fountain 16.60 g . ter w�,ac� � - ��- Name: //A/ � ' � / - Ex pa n sion t an 16.60 / G � /T� Expansion tank 16.60 Address: j .0 Sed 4.441/4//✓ J( {!,/L& /y Fixaue/sewer cap 16.60 City/State/zlP: • / e i0 , 9 9 Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ��"' Hose bib 16.60 . ��d� a: _': , _. Ice maker Business name: p _ 16.60 [� 5 prU wt to v v �j t � o(Rj/ �c . 13' Interceptor /grease trap 16 160 Contact name: f e c / t ' S .. J e l Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 P19, ��9 � y0 Phone. (340 ) t� 3 Q 7 S Fax:: ( ) Sink/basin/lavatory (�/' 9 / 16.60 I Yr "". E -mail: Tub /shower /shower i('E(�4CEoL�' 1 16.60 7_ ti' { 3 : -' :-,, .� - r _ ,. Urinal 16.60 . t . 6:...-- _ - - 1 . 1`E - - water closet 3 16.60 y 9 i"J Business name: 4 (ct 5 P f . wt 6 yt) Coin 4- /"c. c f-j r > Water heater 16.60 Address: r 0 . L3„ )(-- l 3 5 Z - Other: City/State/ZIP: i tj y. � r a 101 t l l , 9 $ b y(L Subtotal . �lf Minimum permit fee: 572.50 g, a Phone: (% ) q 3'7 _ ea ' 9 Fax: ( 76, 727 _ cerco Y Residential backflow minimum permit fee: $36.25 �7 CCR Lie.: /4 5 ' 7 / ir �J /�'d /0q Plumbing Lie. no.: pa / y 5 Plan review (25% of permit fee) ,,.23 , 90 Authorized signature: / f ,/�, 2/der State surcharge (12% of permit fee) - --�� _ , TOTAL PERMIT FEE i . '; 9 Z Print name: l r u J c 5 tea 8 ' w.e r Date: y-y7 -Cs i' This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 0 2 ,g3 /0 *Fee methodology set by Tri -County Building Industry Service Board. 1:113uiidi gWermitsl ,Aff-Permvnpp.doe 1227106 4ao.461srt1arolCOM/WEH1 , „� Accumulative Sewer Tally Parcel # 1S135DD 0510 Tenant Name: CODA This SWR# Site Address: 11970 SW Greenburg Rd. This PLM# PLM2008 - 00163 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 Bapusery/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 Drn 6 0 0 0 0” 0 Garbage Disposal - Domestic (to 3/4 HP) 0 0 0 16 .,`;•_ °`„ 0 0 - Commercial (to 5 HP) 32 0 0 0 0 0 - Industrial (over 5 1 -1P) 42 0 0 • 0 0 0 Ice Machine /Refrigerator Drain 1 0 0 •• 0 0 0 Oil Sep (Gas Station) 6 0 0 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 7 14 0 -7 -14 - Bradley 5 0 ,_ , 0 0 0 0 - Commercial 3 0 • 0 0 0 0 - Service 3 _, ;., , 0 0 0 0 0 Swimming Pool Filter 1 0 , _ 0 • • ,,' 0 0 0 Washer - Clothes . 0 0 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 7 14 0 0 -7 -14 Current Fixture Value -14 divided by 16 = -0.9 Current EDU 1 EDU = $ 2,800 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change -14 divided by 16 = -0.9 over (under) $ (2,520.00) Enter EDU Change Here -0.9 Notes. Credit for capped fixtures. Authorized Name /Signature: — ,�Z, Date: 4/18/2008 Building Division Note: The property owner shall retain the ORIGINAL sewer rally 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 sy development charges. I: \ Budding \Sewer Tally \SewerTallySheet- 2008.xls 06/30/07 .04/17/ 10:52 FAX 13608878504 1 ® _ PLU�BlNG CONTRACTORS RECEIVED 31020 NW 51 Avenue PO sox 1352 APR 1 72008 Ridgefield, WA 98642 CITY OF TIGARD Fax: 360 -887 -8504 BUILDING DIVISION Atlasplumbingllc @yahoo.com FAX TRANSMITTAL FORM To: City of Tigard Attn: /2 ,4 FroT Travis c&( 72 / ?S Date 17/08 ,4/ Z G 7Z- Phone: Fax: 503 -598 -1960 Number of Pages: 3 Including cover page Message: Here is business license application for the temporary job that we will be doing in Tigard. Also a plumbing permit application and payment authorization. If you have any questions please call Sarah at 360- 607 -4087. Thank Y Travis Zea Estimator 360 -430 -5765 CITY OF TIGARD . BUILDING DIVISION PERMIT #: PLIVI2008 -00163 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2003 Phone: (503) 639 -4171 ..11m�iigr Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/29/2008 TIME: 7:00AM PAGE: 30 SITE ADDRESS: 11970 SW GREENBURG RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CODA DESCRIPTION: Replace (2) lavatories and (3) water closets; Cap (7) lavatories OWNER: LANDING SQUARE LIMITED, PHONE #: CONTRACTOR: ATLAS PLUMBING CONTRACTORS PHONE #: 360 - 867 -800/ • Inspection Request Scheduled For: Date: 5/29/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 070497 -01 360430 -5765 N Corrections /Comments /Instructions: `i PASS n PARTIAL APPROVAL [Ti CANCEL n NO ACCESS FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: V U \ v �`^�`--'" Date: ) 2°1 O`1 Phone #: (503) 718- . • _ CITY OF TIGARD .. A BUILDING DIVISION PERMIT #: PLIv12008-00163 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2008 Phone: (503) 639-4171 e Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/28/2008 TIME: 7:00AM PAGE: 32 SITE ADDRESS: 11970 SW GREENBURG RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CODA DESCRIPTION: Replace (2) lavatories and (3) water closets; Cap (7) lavatories OWNER: LANDING SQUARE LIMITED, PHONE #: CONTRACTOR: ATLAS PLUMBING CONTRACTORS PHONE #: 360-887-8054 Inspection Request Scheduled For: Date: 5/28/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 070427-01 360-430-5765 Corrections/Comments/Instructions: 0 ; C t 0 rer ww") b■-.) %/ 4 .-/ - 1 S-4 r ) 014 44a r. ks. N.) ex, 1ov-co,. Tc 64-eV Q/ ry vi rl PASS ri PARTIAL APPROVAL 7 CANCEL n NO ACCESS VI FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: (56\ Date: 512 vioT) Phone #: (503) 718- _, ._ . _ _ + � CITY OF TIGARD ~ ��mm m n�,n uu����nm�� ' ' ''' BUILDING DIVISION PERMIT #: �M2��[�1(3 13125 SW Ha|| Blvd., Tigard, OR 97223 DATE ISSUED: 411812008 Phone: (503) 639-4171 ii,o4PNRA Ili" Inspection Requests (24 Hrs.): (503) 639-4175 Al Wr 11— 1 INSPECTION WORKSHEET FOR DATE: 4/22/20013 TIME: 7:O0Ah4 PAGE: 53 1 1 SITE ADDRESS: 11970 SW GREENBURG RD CLASS OF WORK SUBDIVISION: ` LOT #: TYPE OF USE: PROJECT NAME: CODA DESCRIPTION: Replace (2) lavatories and (3) wate c10neN Cap ( lavatorie OWNER: LANDING SQUARE LIMITED, PHONE #: 1 CONTRACTOR: ATLAS PLUMBING CONTRACTORS PHONE #: 360-8878054 Inspection Request Scheduled For: Date: 4/22/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 P1umbingrnuohin 068686-360-430-5765 U1 360-430-5765 N 1 Corrections/Comments/Instructions: ' . fl PARTIAL APPROVAL El CANCEL __ NO ACCESS F FAIL ri CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: 07) '»Jw*~j` ' "»~--- Date: Date: 4\ 21't0 Phone #: (503) 718-