Permit CITY TIGARD PLUMBING PERMIT
, 11' DEVELOPMENT SERVICES PERMIT #: PLM2004 -00267
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/15/2004
SITE ADDRESS: 07035 SW HAMPTON ST PARCEL: 2S101AC -01100
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 017 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 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: 4 URINALS: 1 GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Interior fixtures: Relocate 1 garbage disposer and 2 sinks, 2 sinks replace existing, 1 sink cap. 1 toilet
relocate, 2 replace existing. Add 1 urinal and cap 1 shower,.
FEES
Owner:
Description Date Amount
AFT - OREGON
10725 SW BARBUR BLVD STE 50 [PLUMB] Permit Fee 6/15/2004 $149.40
PORTLAND, OR 97219 [TAX] 8% State Surchari 6/15/2004 $11.96
Total $161.36
Phone : 503 245 - 9815
Contractor:
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280 REQUIRED INSPECTIONS
Phone : 503 - 244 - 1900 Rough -in Insp
Top -out lnsp
Reg #: LIC 52378 Final Inspection
PLM 34 -150PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued By: �� 1,411P Permittee Signature: (777
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Jun 11 2004 6:33RM HP LASERJET 3200 p.1
06/10/2004 18:50 FAX 5035881980 CITY OF TIGARD 21002
lU'n' 10 2004 1 52P HP LASERJET 3 2131.k p. s
iv
• Pl b ne Permit Applica� W 2n ` � ' ' J O4 I t I: t:1 Hi r r I i r s i
City of Tigard - p -
17125SW Nall Blvd., Timid, OR 9712 U4 R t � . :� �_
MIMIC 503.639 4171 Fate 503,69$.1960 ' as 1st
r p pm/ft OIfi Ptrrit Tla.:
2d- Hour 6apnacion Lim: 603.439.x[75 ,✓�; ";Y 05 . . .'. 'i ° . t7r�k . 3.r
lesenne www.ci.iisrd.orne si a .e 1 P ' - - Nodied eel I � , Srpelwesai[rrtMa INN
*I:17,12:1 I 4 , -, •1 ?''," rte �∎�I_ - i " 71 t t. _ + 'l 1. r l - a E7_� s r- )ik _iv t
❑ New eosetr I] Demolition ArrspndaI kale vlmr see c[ .
- Dined • on .,, L Tod
AddItics/ake rrlronheylacessea[ ❑ Outer: • New 1 - 24 rrity dwellings Co fled= 100 (116r omit utliey eomeesion)
t T - n - V it s"' r i :,1 ~ ,. , , ' ... .�I ' I. , si (1) bat X9,'1[ • si • T�
Q 1• rlfd 2- family doodling XI Ctonmc[tagt/MOdnitiisl SFR (1) bath 330,00 •
D Met ertsy h iilesng D Matti. fatuity' silt P7 bath III 399.00
❑ Paster tnt¢]dtt D ether; Each additions! bath/etches 45.00
¢ 1 �, 1 _ Pi naprinklor�_sts R.) Pogo 2
iv'714- � �. .. -. - 'i erE- ' 1,0 .1 �I�F' . _ �',, , :iP< its 2.: d i PA 611ftUtilities •
Jab alit address: ]'4 J bit lI _ CAA basin wawa drab 16.60 1
City/Stetcf2IP: 'r A RD n0 k c_. ek y y VS Dimon, WWI line. of bench drtein 16.60
9vti P IdgIept, sot: I Prof sot seine; A Footing flrelt►(tia liserir Q: Pegs 2 j
laimetionarcd homy utilities I MIN
- Cross etsectldirectionStojob AMC Maabolee . i 16.60
Rein ants mama= 16.60
Sanitary iswcr (as, tines L: ___,) Page 2
Stara acwa (no. Mass ft.: ) Pap 2
Subdivision; I (, m•; Water Jervis% (no. knew R: , Pape 2 ��
pasture or Iles
Tut tttap/pareel no Absorption valvi
,.' : ,;,�r ,. yG- , ..., Inf,. `, , - - = }10JJ 1, I II a ddl o � p1�6.60
• . •YY, IiM. l[l • 4, .. .2,..2...,x' __S _ »Y •--, J'�'�__' " .1._._ .: ,T + S �.>L.,{7f. Fanciest c
- ' - ! i l._ �: BecIcwaservalve 16.60
Clothes washer 16.60
. Dhliveeter
/ 16.60
�p +rrn{F„ c -.:IV • . L °�.r r �,eva Dri.kbi fo�taln 16.60
..•
' :s r. n;4 tt a _ ; x i ar. Lz .1- v- Ejatori(itntrp 16.60
Name: ft CT Or ' • t?xperuimDank 16.60
Address: . 1�iw ,�i r y f Finawdaswer cm W 16.60
City/5tatrfZlP: / 01 ..1-- • b.ii Floordnirtaloor 16.60
haw: (56) -' 0 r 11 e ( ) a g e d i s p o s a l i 16.60 / . C J
lion bib
16.60
Bwineas maw ' ors C iRr / PL v w[ Q I al err in e[ roe d
Coate tx there%:% 16.60
,p fi .� PIll ,s,,, J (� matel (value: $ . ) Psis 2
Andreas: V �' 7 ` 14 O Mats 1640_
City/StottJZIP: pd�Tum? 0 / . 472 Roof drain (commercial) 16.60
,
Pho»e ( ) .. fit' Slitk/baiin/lavetoiy , 5/ 16.60 (6,
� y 1 �� I Fax: • ) 7 �j' - Tublskovictiiho pus 16,69
E -rnsil thins! IL ,,,L,
p��yr ,7 l i U -" .:' e - 'P • ., i . .,.- ... -� i 16.60 ,1x"V 0 I E(1;.fil - 1 - --' 131 RIJG 2 ' !∎I'L'e t ,..,. CS .U. '" •∎•- •' -- , %tor abut• 2 "66 49.10
Buenesa name: ; ..0 s se a A l ` . pi_ IJiitt a i m.' 4- Weser hooter 16.60
Aadreis: L (1 S(.J uJ� AW J ether: .
as Th � lrfr • cr • ei'7 T � s vaeaa 1449,40 � minimum pettatt be: 572.50
nom; (Sx } ) .2.10-/ . / 9 . 6 o . . Fait:' (04 3,) I' , 4 4 4 4 ' - N A s C tteeiden1lat baok6ow real awm email 11e: $76.25
CCB Lie: s,2 3 7 r . • Plumb Lie, na : 34,4 5e PU ' pun oniony Q %otF..eb
Audwcitsd tlgaettce: S epitomic. 1 q
rt r TOTAL t?'ER IR PEE / 1.
I mot muse --� s r iAif., 8. i� Date: C . d p • d et 1 Ta la permitsppltaulot+ expires K • petatle In set obtained witbli
160 flea ell r it has bets accepted as complete.
• Pas mbthodakey set by Tri• County &Slaina Itdusvy 5pvioe 0 Dud.
iMpta.,rte.,ak,JMACPsrw,ltA s.db. 1? Y1411 Fr(16110r01WWWE711
Accumulative Sewer Tally_ , ,,,, , Parcel # � ti : °+` �' �,� ��
�� T� d � � � A � This SWR ' d c-
odo4.4A . , o'tP,c.... �, , 41- � . ,a This PLM #r a si l i. • 1
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 F Z 0 %# 0 u ax 0 0 0
Bath - Tub /Shower 4 �, s 0 0 0 0 0
Jacuzzi/Whirlpool 4 �s • 0 � '°a 0 -.� b 0 0 0
Car Wash - Each Stall 6 e'l 0 , <;: Y 0 . 0 0 0
- Drive through 16 * �O* 0 � � 0 � `P' 0 0 0
Cuspidor/Water Aspirator 1 4 ' 0 "'� 0 0 0
Dishwasher - Commercial 4 ,, 0 � '� , 0 t 0 0 0
- Domestic 2 s 0 �v 0 j 0 0 0
Drinking Fountain 1 , t ▪ 0 m . 0 5� 0 0 0
Eye Wash 1 t " : • 0 :, l' i • 0 4*
A 0 0 0
`
Floor Drain /Sink - 2 inch 2 I" ,
9
- 3 inch 5 ala 0 R :::<;,,f ' r . 0 .�'; 0 0 0
4 inch 6 �. 0 �� 0 0 0 0
Car Wash Drn 6 • 0 � z 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 • 0 1;: 0 0 0
h
- Commercial (to 5 HP) 32 0 0 ree::k:0 s 0 0 0
- Industrial (over 5 HP) 48 0 ;.�: 0 „4 „ 0 0 0
i
Ice Machine /Refrigerator Drain 1 { Q 0 0 :- 0 0 0
Oil Sep (Gas Station) 6 - 0 ' ° 0 0 0 0
Rec. Vehicle Dump station 1 '' 4 k
p . , � x 0 , ' 0 0 0 0
Shower - Gang (per head) 1 0 � k 0 , 0 0 0 itsi
A At - Stall 2 0 ` �` 2 0 -1 -2
t
Sink - Bar /Lavatory 2 a.; { ' 0 2 0 -1 -2
- Bradley 5 c 0 0 0 0 0
Y n,: %s,
Commercial 3 v< 0 .� 0 0 0 0
- Service 3 0 sue 0 5 0 0 0
Swimming Pool Filter 1 �`� 0 � e
Washer Clothes 6 0 0 0 0 0
Water Extractor 6 0 k 0 0 0 0
Water Closet Toilet 6 :` a. 0 J/ 0 0 0 0
Urinal 6 , . • 0 ��.. 0 • � 0 0 0
Previous EDU Count `X: 0 0
Capped EDU Credit 0
TOTALS 0 0 2 4 0 0 -2 -4
Current Fixture Value -4 divided by 16 = -0.3 Current EDU 1 EDU = $ 2,400
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -4 divided by 16 = -0.3 over (under) $ (720.00)
Enter EDU Change Here `y.
Notes:
Name: Date: / // // 5"7", / , 4 !7‘i
Building Division
Note: The property owner shall retain this record for sewer credit purposes. In the event of a credit, this
document stamped "ORIGINAL" shall serve as a credit voucher and must be submitted to the City of
Tigard Building Division to redeem credit towards future system development charges.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION' Business Line: (503) 639 -4171 MST
/ BUP
Received Date R ested A �°�� AM Y PM BUP
Location ! 6 35 — J Suite MEC
Contact Person Ph ( ) PLM ' 4/'' Od a(07
Contractor Ph ( ) 7 r' ! ' C2C) SWR
BUILDING Tenant/Owner firr ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
4/
PLUMBING
Post & Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
• ' S PART FAIL
HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dat Y� � Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL