Permit .1 / 4, CITY OF TIGARD PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00413
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/24/2008
PARCEL: 2S 102AA - 00600
SITE ADDRESS: 12045 SW HALL BLVD ZONING: CBD
SUBDIVISION: TIGARD HIGHWAY TRACTS LOT: 012 JURISDICTION: TIG
PROJECT: 7 ELEVEN
Project Description: Bring existing handsink up to code.
CLASS OF WORK: ALT 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
Owner: FEES
ALPROP CO
6149 SW SHATTUCK RD Description Date Amount
PORTLAND, OR 97221 [PLUMB] Permit Fee 10/24/200E $72.50
[TAX] 12% State Surcha 10/24/200f $8.70
Phone : Total $81.20
Contractor:
APOLLO DRAIN & ROOTER SERVICE
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 239 -8801
FAX 503- 669 -9568
Reg #: LIC 49418
PLM 26 -533PB
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 OU NC by ca ling 503.246.6699 or 1.800.332.2344.
•
Issu d By: • V Permittee Signa e: i ,i ror ��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.
N Oct. 23. 2008 2 : 30PM No. 5234 P. 1
Plumbing Perdit Application
RECEIVI
Buildi>Il<g Fixtures .• : r OTE[CE °USE 'ONLY • , ; '
Rc ccivy : d ... /a a, o p , y lA O --- ......
' City of TigardTigard ppT 2 3 2008 r ,,,, n , t'em,u t.,, -. G//OgC/�QD�{ /�
At 13125 SW hull lilvd., Tigard, OR 91 223 Plan Review
21 .:. Phone: 503.639.4171 Fax: 503.598.196 TIGARD Other Permit No.:
DatcBy:
TIGARD Inspection Line: 503.639:1175 C11 �r VISIT ) to iteadynay; r,� i : I 171 :see Poo 2 fir
Internet: www.tigard-or,gav BUB.DING DI NblifitdiMrtJu.I', Snpptt•mcntul Inrurm:Moo
TYPE OP WORK FEE* SCHEDULE
El New cunslnteIiun El Demolition
For spLClrrllajornudla2n use checklist.
- Description Q. Ha. �ztul
Addition/alteration/replacement 11 Other: New I- 2- family dwellings (includes I00 for each utility
' CATEGORY OT CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- family dwelling , 0)ounercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- f,rrnil SFR (3) bath 399.00
Each additional bath/kitchen 15.00
Master builder ❑ Other: •
Fire sprinkler ( sq. It) Page 2
JOB SITE INFORMATION AND LOCATION ( Site utilities
Job site address: It j 2-0 C.) C 1 ) f ,t � ' v
� -� IN (,{/A ' Caleb basin or area drain 16.60
v
City/State/ZIP: )� d (06L_ C / 1. , Drytiuell, leach line, or trench drain 16.60
Suite/bldg./apt. nu.' Project name: Fooling drain (no. linear II! ) 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 Water service (no, linear ft.: ) Page 2
_ --.. lot no.: Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
• DESCRIPTION OF WORK - - ...
Dackllow pm /enter Page 2.
_ r I in 0 ( r lrll DA Y v 1l ,7+ f Up Backwater valve 16.60
f ly C on Y , Clothes washer 16.60
Dishwasher 16.60
....... . ........__ Drinking fountain
...... Nf
❑ k'HUI F;It't 7' Ul N:jcctarslsump 16,60
Name: 1 '� �: tt TENANT
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
TOPPLICAN'1_....., } . .......
CONTACT PERSON
Ice maker bib 16.60
, (/I b .........
er 16.60
Business name: �(i��� r� p t ...... p ............ .
��, � Cr � _.. . ............. incrcc torlgrcasc 1 6.60
Contuet name: Medical gas (value: S ) Page 2
Address: Primer 16.60
City /Blanc /7TP: Roof drain (commercial) 1 6.60
Phone: (0.- t o Ug • I 100 I ( ) Sink/busin /lavtdory 16,60
I _...-- -- - --- ......_...,... 'rub /Shower /shower pan 16.60
T moil: urinal 16.60
(:C)N'I'RAC:'I'012 Water closet 16.60
Business name: i
ice/
Add .; / �u ft YV1iL Water heater 16.60
_; �i �, �/ ._... c �
ress: r ' �j 'n ((A•
City/State/ZIP: r t Subtotal
� _ ..........._.... -- -
�` vvr) «� I - - - - -- .." Minimum penult fee: $722.50
Phone: ( L� Z�, C /) •W ? ...__._.__. Fax: (e ,: a) �apQ , (�G a s) Residential hackllow minimum permit lee: $36.25 _
CCU Lie,: J G L��, Plumbing Tic, nu„ ;). J Plan review (25% of permit fee)
?CP J?� _�
C` - State surcharge (12% of permit tee)
ri,ed signalo - �-, A-i`')(.0
PERMIT ( TOTAL PERMIT ECG
1 i- runt t ...._ ..... � -r _.. ����� -.
name: � ,� I Dale: /�/ /� This permit application expires If a permit is not obtained within
f "� � ` �l ('� L �� I 180 days after it has been accepted as complete,
*Feu methodology set' by rrt- County Building Industry Service hoard.
I■Huildi4Pcrmit.9 \If- Permit APP.dnc 1 •1.10.1016T( 1 0102 /CoM,wJ/Ft)
CITY OF TIGARD ,.
, .,..,
BUILDING DIVISION . PERMIT #:
PLM2008-00413
13125 SW Hall Blvd., Tigard, OR 97223
A DATE ISSUED: 10124/2008
Phone: (503) 639-4171 41 / I BIllitit Iiii`
Inspection Requests (24 Hrs.): (503) 639-4175 T .,-Igni■ IL
INSPECTION WORKSHEET FOR DATE: 10/27/2008 TIME: 7:00AM PAGE: 0
SITE ADDRESS: 12045 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: TIGARD HIGHWAY TRACTS LOT #: 012 TYPE OF USE:
PROJECT NAME: 7 ELEVEN
DESCRIPTION: Bring existing handsink up to code.
OWNER: ALPROP CO, PHONE #:
CONTRACTOR: APOLLO DRAIN & ROOTER SERVICE PHONE #: 503.23E0801
Inspection Request Scheduled For: Date: 10/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077209-01 503-239-8801 N
Corrections/Comments/Instructions:
C C .k L \ t ''' ) ' - '"
,_.... -
&PASS I I PARTIAL APPROVAL 0 CANCEL 7 NO ACCESS
I I FAIL 7 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector:OM Vlik-A--.A Date: 3 \2. 1/- Phone #: (503) 718-
, .