Permit CITY TIGARD PLUMBING PERMIT
., DEVELOPMENT SERVICES PERMIT #: PLM2004 - 00181
Aril/ I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/22/2004
SITE ADDRESS: 07125 SW HAMPTON ST PARCEL: 2S101AC 01400
SUBDIVISION: BEVELAND NO. 2 ZONING: MUE
BLOCK: LOT: 020 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Building plumbing. Other fixture: primer. Cap (2) drains.
FEES
Owner:
Description Date Amount
SPECIAL DISTRICTS ASSOCIATION OF OR
727 CENTER STREET, NE #208 20 [PLUMB] Permit Fee 4/22/2004 $182.60
SALEM, OR 97301 [TAX] 8% State Surcharl 4/22/2004 $14.61
Total $197.21
Phone : 503 371 - 8667
Contractor:
EAGLE PLUMBING
13801 S FORSYTHE RD
OREGON CITY, OR 97008 REQUIRED INSPECTIONS
Rough -in Insp
Phone : 503- 650 -8703 Final Inspection
Reg #: LIC 47914
PLM 3 -154PB
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: Permittee Signature: - ac)
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Apr^ 21 04 08:49a Eagle Plumbing 503-650-8720 p . 1
,.. _ _ ■
•I'l, b.,/ •■••■•/ ■V• •••■ 111.1.111 ,
• .. ..
• Building Fixtures
Plumbing Permit Application" "OR OFFICE, USE (1%1_1'
City of Tigard
DateHy: fr 1 ov 46 re.nit No-RI...141 ,9420t/ -0 0 N
13125 SW liall Hlvd. Tispiad, OR 97223 ki 21 7 *
Plas Role
1
Phone: 503,639,4171 Fax: 503.5911.1960 Ustelly: Cher Pernik:448W 1 0k:419)/ -
2d- Hour kispectioo Line; 503439.4175 rif 4 :- P
a rty -. ....!_. . Due Andy/By:
Jinn: HI Sit Patel far
Inierna; www.ci,tigaid.or,ua bletifitiVMetbed: Supplersaata/ Liam...Hawn
' 0.‘1 .7,;* , ..,.•:.,...t;.' r.. '.''..-.: .,.... : l '.10..' 1: . ....."40 4 :01*- 1 0LE - ' ..1": • '. . ': . .
El Now commotion 0 Demolition far spacial informadiaa us. chacklisi.
,- Descri0604 I qty. I Ca. 1 Toul
.( 73 .. Aciditiordoltorariontreplseetnent . . ... . 9 0111er.. NLW I - 1.11.mily thinning. (includes 100 fl. 1 CitC11 141111y C0i1r1eC(i00)
• l ! • ....;. t0 ':':.:: :' !.:'' '. .''''' : : '; i.'' SFR ( blth 249,20
El I - and 2-family dwelling VCommenialtindustri al SFR (2) bath 350.00 I
-_, SFR (3) bath 309 00
U Accessory building CI hinIti-fimily
Eseli uklitiOnal badAitelion 45.00
CI Mastor builder 11 Other:
The sprinIder ( so. ft.) EZI3
-.1771 4 K ; 0/" ' ''....: '.." vr ' 51W uWItIu
Sob site address: ' _ • 4. •
h.. • ta ' ' b 1-1 catch trasin or area drain 16.60
City/S tate/ZIP: - ^040T,..1) Aired!, teach line, or crench drain 10.60
, FOOTi111dfain (no, linear ft.: _____) Page 2
SMIC/bIdgiapt. sio_: 1 Project name:
Manoracturod hoar utiliticy 110.00
Cross strccOdiroctionr to job sitc; - 7 2 ,) x 14.km,fi-tm
Manholes 16 60
Rain drain connector 16.60
Sanitary sewer (no. linear ft: _____) Page 2
Storm sewer (no, Ferrer ft.; „..... ) Page 2
Water servion (no. knew 64 ) l 2
Subdivision: Lot no.:
Flamm or Kern
Tax map/parcel no.: 01 -
Absorption valve • .
16.60
ii: jiii,g':■': r , .
.. - '', .'. : i, •:', i .,i.t..:f:;•: • .' _'•','F''''.1 • ' : ' '' ... e l. . 1 .. f.:7 :!.i•i• '-'• ' . , • . •:' '• ' 4 ..• V ' Backflow preventer rage 2
- Backwater valve 16,60
Clothes washer 16.60
Diitiwasher 16.60
,•:". • Drinhing fountain 1640
, .•iewriritiV.l.::: .::;....i,i ....,1.....;.:•:..,•::::: ..'ri:.iiii,; :0.:; 0: :::.,. r : .
16.60
NAME!
Evanston oink 16.60
Arklrecc: Fixture/sower eati; $ r I •* 0 *66 - 0 •
- .
city/Slate/ZIP: Floor drain/floor sink/hub 16.60 •
Phone: ( ) rax: ( ) Garbage disposal 1660
"'. 4 it.: I •::•-. se Hobib 16.60 •
'!':■A!.7:',..j.:j.i:;',".:''..r.:40:140, 044.4. ?: .. •t t.t.C4:i'!1$4.44. i *14.‘ : " lee miser 16.60
?Lk) tiktf)j‘3& .... Inteeeentodgyease rap 1640 .111
Contact um= ( ' :i C ' '.' k: • Medical gas (value: $ ) Page 2
Address: La . -_ . , ...) -
1r. PA .0■■ Primer A 16.60 KM
City/Stain/ZIP: 0 _ - . 1 I& P-j C - It : - - Roof drain (commercial) 10.60
• Sinkfbatin/laestory MI 16.60 Kirnia
Pbone: 5 ) ‘.., -10 • 3 .'• P ( 4 .. ... 17 ).46:510 .Z/7.2. - ..--. Tub/shower/show pan IIII 16.60 allill
E-niail:
rinat 16.60
ki
!' 4 4`,1:. • i'.: '::':1 : . ..:1 .•1* 1,J
0)1144 ii. 4000 :':. .• ; ' 1 :•:),!.;;;;:i,; :',.:; : i'pl:;.:::,: li 1:i i i):.; . wain clout in 16.60
.i. iri • , ;.. 4 ■: ..• - . , - .4e. ; . • . ' ..1. - .A., , . .
.....--...-1..,-1-...............z."...,..._,- .----
Business names e .. . -- A C.,. (.....e. Vc0,:t j C'i Weter hinter 16.60
Address: i 3 - e - • ''' •• P--D other
_.... -------- MN
TIMANI iRa too
ci, • e ..A -- t ... 4 a 70
Minimum permit fee: $ 72 .50
Mime: sz5 )44 - - • • - yo.: . 1) , --t■,. •6-7.2 Residential backflow minimum permit ree2 S 36 • 25 MN
Lie 11D.
CC Plan review (25% of perM11B:e) =TWA
EI Lic_: - e . Plumbing A /13, _ _ .
State sareuerge (8% a permit ter)
Authorized si soma= (s
TOTAL PERMIT Fa
Prim mime; C7 04)- <. a ...\- Date: 4 LA -44- 'This permit application utpirtt if a permit is not obtained irith$ 1 91 , 4. I
ISO days after it has ticen accepted SP ailinilele-
*Fee methodology set by Tri-County Building industry SerVice BOMA
...*•104.0 .1.K La003 doll().1611STOt.VJ24CCIP4rWISZ9
Accumulative Sewer Tally Parcel # 22S101AC -01400
Tenant Name: Special Districts Association of Oregon This SWR:
Site Address: 7125 SW Hampton This PLM# 2004 -00181
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 0 0 0 0 0 I
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 2 4 0 - -
- 3 inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash Drr 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 0 0 0
- Industrial (over 5 HP) 48 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 0 0 0 0
- 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 6 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 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 4 3
Notes:
Name: ,., _..,..„_ �_ , �_ .__,4_, .� Date: /a, -�y,V
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 Requested — 4S AM PM BUP
Location • Ark/it/I Suite MEC
Contact Person Ph ( ) PLM e `f' °o / 8 (
Contractor Ph ( ) 7 9 � — /c 3q SWR
BUILDING Tenant/Owner 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 / r Roof J
Other: ,
Final
PASS PART FAIL /
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 reinspecti n RE: Unable to inspect — no access
Fire Supply Line
ADA / ok
Approach/Sidewalk Date I n spector y i � Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL