Permit CITY TIGARD PLUMBING PERMIT
' • DEVELOPMENT SERVICES PERMIT #: PLM2005 -00201
J 1l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/11/2005
4
PARCEL: 2S109AD -AS025
SITE ADDRESS: 14810 SW GREENFIELD DR ZONING: R -7
SUBDIVISION: ARBOR SUMMIT LOT: 025 JURISDICTION: TIG
Project Description: Temp sales trailer.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: CMS WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: 100 ft
Owner: FEES
WEST HILLS DEVELOPMENT Description Date Amount
15500 SW JAY ST
BEAVERTON, OR 97006 [PLUMB] Permit Fee 5/11/2005 $165.00
[TAX] 8% State Surcharl 5/11/2005 $13.20
Phone : 503 641 - 7342 Total $178.20
Contractor:
COMPLETE COMFORT SYSTEMS INC
12300 SW 69TH AVE. REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Phone : 503 - 598 - 4798
Reg #: LIC 152736
PLM 34 - 356PB
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: -- P, Permittee Signature: \\ ► �J . �
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.
5 /04 S ,0 �c A1 66 a'^- 6- '
'' Plumbing Permit A J V Q.�
® Received - 774.20 City of Tigard % Pit N
13125 SW Hall Blvd., Tigard, OR 97223 A AV Plan Re v j � )rV� e rm o.: FOR OFFICE USE ONLY '� I
hit 2005 Plan Review _
Phone: 503.639.4171 Fax: 503.598.1961 /�mrttNi 1 � ti, � Date/By: �1n1�..[l/E!J Other Permit No. r`{ y�7 � �p,�
i1 .
24- Hour Inspection Line: 503.639.417 1 rY OF e �-�� Date Ready/By: la See Page 2 for
Juris.
Internet: www.ci.tigard.or.us , T�GARC" `° Notified/Method: ) C .-- Supplemental Information
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' ® New construction m ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
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GO1�TS TIti:1 * . « t::, SFR(1)bath 24 .20
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® I_ and 2 - family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building [1] Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: ft.) 2
n,•.;:€: =,s;= .'_,rr ;.•;<.; ,• Fire sprinkler ( 9 ) g
x��< �;�s� >,a �;.,;. : =r:;> i - �,u .., . , - . s F sq. �t. Page
':_ ;.` , ar (' ,, :., ` :::)fOB.SI`1'EFINFt5R A ND LO tTIONi };• `,,. Q �, :. ;; ;:_.
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Job site address: 1 i v
.... � SW C---) r.-�� G £ �. -/. Catch basin or area drain 16.60
City /State /ZIP: T I GARD t OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: 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.: - /00 I ) f Page 2 55.00
Storm sewer (no. linear ft.: lam) / Page 2 5 C� Od
Subdivision: ARBOR SUMMIT I Lot no.: 25 Water service (no. linear ft.: L .) ( Page 2 � �v
Fixture or item
Tax map /parcel no.:
»x Absorption valve 16.60
^:. ,i ;g„ ., ,; : •,; "• f , : .. �: : M, , .
2: :,:�az. �;axv "��:, : ; -ice, T�':�
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:',..A.:.,::,. . __ , . � .� _.. � � 3����: , ��r - . .. ,.. ,�. �. _. � " ". , i ,. i. ;. ,. , .. . . .:� - Backtlow preventer Page 2
NEW CONSTRUCTION TMQ M (e- 7 -,e // f Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
-: w„ ,;•.:_,, :a� Drinking fountain 16.60
a,- y R PROPEIiTi4. OWNER 1 1,. , r f , - ,, -,AIVT .,... ,," `/ ;
E /sump 16.60
Name: WEST HILLS DEVELOPMENT
Expansion tank 16.60
Address: 15500 SW JAY ST. Fixture /sewer cap 16.60
City /State/ZIP: BEAVERTON, OR 97006 Floor drain /floor sink/hub 16.60
Phone: (503)641 -7342 Fax: (503)641 -7661 Garbage disposal 16.60
- :;.ar s= $ .`: r,,�.;....,.. ':: aa:a::, • ---!,-,;,„ Hose bib 16.60
:. 4. 4E-fO :; _ >+ �`• CONTACT 1' tslf4
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mo.- � <- z:r.3 ^,s �r,<�asz� r���,. b, m,.. x. +3�P _�;.n.,.:�:..:r -, . >a,.:�:r���, �ro sa»�r.,•.�set:•a:� r_... Ice maker 16.60
Business name: WEST HILLS DEVELOPMENT
Interceptor /grease trap 16.60
Contact name: RICK LANIER Medical gas (value: $ ) Page 2
Address: SAME AS ABOVE Primer 16 60
City /State /ZIP: Roof drain (commercial) _ 16.60
Phone: ( ) 1 Fax:: ( ) Sink/basin /lavatory 16.60
Tub /shower /shower pan 16.60
E mail: RLANIER @WESTHILLSDEVELOPMENT.COM
Urinal 16.60
.,
sC NTRA 5R'::
`���•` �`� Water closet
16.60
Business name: COMPLETE COMFORT SYSTEMS (CSI) " 16.60
Address: 12300 SW 69 AVE Other:
City/ State/ZIP: TIGARD, OR 97223 Subtotal
Minimum permit fee: $72.50 0 0
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 (f `J"•
CCB Lic.: 137663 Plumbing Lic. no.: 34 - 356 PB Plan review (25% of permit fee)
// State surcharge (8% of permit fee) /5 ,
Authorized signature: ate` lid . -i TOTAL PERMIT FEE /7$ „a z)
Print name: PAUL STOLLEN Date: 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.doe 12/03 440 -46t6T(I0 /02 /COM /WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200 a0 o1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/ 005
Phone: (503) 639 -4171 �< 'I���rq�pltf�Il�
Inspection Requests (24 Hrs.): (503) 639 -4175 =�� __..
INSPECTION WORKSHEET FOR DATE: 5/16/2005 TIME: 7 :09AM PAGE: 60
SITE ADDRESS: 14610 SW GREENFIELD DR CLASS OF WORK:
SUBDIVISION: ARBOR SUMMIT LOT #: 025 TYPE OF USE:,
PROJECT NAME: ARBOR SUMMIT
DESCRIPTION: Temp sales trailer.
OWNER: WEST HILLS DEVELOPMENT, PHONE #: 503- 641 -7342
CONTRACTOR: COMPLETE COMFORT SYSTEMS INC PHONE #: 503 - 598 -4798
Inspection Request Scheduled For: Date: 5/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 006895.06 503 - 319.7654 N
Corrections/Comments/Instructions:
%( n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .
I Date ! Phone #: (503) 718-