Permit I
1
' CITY OF TIGARD PLUMBING PERMIT
' ;,1 DEVELOPMENT SERVICES PERMIT #: PLM2003 -00614
J�I DATE ISSUED: 2/10/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07555 SW HERMOSO WAY PARCEL: 2S101AB 01501
SUBDIVISION: HERMOSO PARK ZONING: MUE
BLOCK: LOT: 021 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: •
SINKS: 0 URINALS: GREASE TRAPS:
LAVATORIES: 7 OTHER FIXTURES: 5
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: 100 ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Plumbing fixtures for new 7,250 sq. ft. office building. Other fixtures: 1 expansion tank, 4 hose bibbs. 100ft.
water service.
FEES
Owner:
Description Date Amount
LIONEL LLC
BRAD DAVIDSON [PLUMB] Permit Fee 2/10/04 $400.20
14285 SW PACIFIC HWY [PLMPLN] Plan Review 2/10/04 $100.05
TIGARD, OR 97224 [TAX] 8% State Surcharl 2/10/04 $32.02
Phone : 503 - 620 -5203
Total $532.27
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD, OR 97223 REQUIRED INSPECTIONS
Sewer Inspection Rain Drain Insp
Phone : 503 - 639 - 5296 Sewer Inspection RP /Backflow Preventer
Reg #: LIC 2439 Water Line lnsp Final Inspection
PLM 34 - 29PB Water Service lnsp
Rough -in Insp
Underfloor /U nderslab
Underfloor /Underslab
Top -out lnsp
Storm Drain Insp
Storm Drain Insp
Storm Drain Insp
Crawl Drain
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
Iss ed B y: � � /� ;��' Permittee Signature: - e 1,2Q
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
_ I
,
I
I WESTERN PLUMBING 6036849015 1 2101/03 04:38pm P. 002
r I'
Bull i-ng FiXtur s � E l .� db R..0 }lilt :OFFICE, USE 16 \'CY ;
Plumbin_ g P �A,ppl><catl�on Received / Plumbing
DEC (t 2003 Date /fay: /•�%I /C Pertntt No/ Zoo3 '��4 /y
J Date / i y Approval Sewer SLUR •2Q �� t
City of Tigard a.
g Date/By: Permit No.: �'
13125 SW Hail Blvd. CITY OFTIGRRD Man Review Other --- --
Tigard, Oregon 97223 BUILDING DIVl8loia Date /By: Permit N - U �,dd3 D0�,�/
Phone: 503- 639 -4171 Fax: 503 - 598 -1960 vt Post- Review Land Use sN
1 + Date/By: Case No,:
Internet: ww.ci.tigard.or.us �.' I! Contact luris.:.� El See Page 2 for
24 -hour Inspection Request: 503 - 639 -4175 Name /Method: ( ~ 776 - , Supplemental Information.
TYPE OF WORK ' • FEE* SCHEDULE jfor special information,use checklist) -..: ,
_
n New construction [] Demolition _ Description Qty. I Fee(ca.) I Total
2 Addition/alteration /replacement ❑ Other: New I- & 2- family dwellings
CA TEGORY OF CONSTRUCTION • (includes 100 ft. for each utility connection) •' :. '. •
❑ 1 & 2- Family dwellin: WI Commercial /Industrial SFR (I) bath 249.20
SFR (2) bath 350.00
Accessor Buildin ❑ Multi - Family _ SFR (3) bath 399.00
❑ Master Builder ❑ Other: Each additional bath /kitchen 45.00
JOB SITE 'INFORMATION and LOCATION Fire sprinkler - sq. ft.: Page 2
Job site address; �,l/ d'47I�.,cf 1 . Site Utilities : -- ..
Suite #: Bldg./Apt.#: Catch basin/area drain 16.60
Project Name : /1 r ; .i. ;;',,c.I. ' pt ywell /leach Line /trench drain 16.60
Footing drain (no- linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities _ 110.00 _
Manholes 16.60'
Rain drain connector , 6.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: Lot #: Storm sewer (no. linear ft.) / Page 2
Tax ma. /varcel #: — Water service (no. linear ft.) /DO 1 Page 2 ,5+, ; 0�
DESCRIPTION OF WORK Fixture or'I em
t, .^ no Absorption valve 16.60
/ i ,... -_4�•� . � : '„ Backflow preventer ..� Page 2 -I .
Backwater_valve - - L i) 16.60
Clothes washer ' i ny , 16.60
Dishwasher / 1 P , ,i,/ 16.60 J. G'•'-
Drinking fountain � ,1 - 16.60
0 PROPERTY OWNER' ❑TENANT / Ejectors /sump 1 ` 'f•' / 16.60
j._., Name: ., a,tJ i-L 44-e....... — (,4:j.S� / _ Expansion tank 4 , ✓ 16.60 /69: (=-
Address: Fixture /sewer cap 1 .16.60
City /State /Zip: Floor drain /floor sink/hub • " , - 16.60
— Garbage disposal - , I6.60
Phone: Fax: Hose bib /' y 16.60 l2/,' \ll
• ® APPLICANT 'CONTACT PERSON ice maker -, ' - 16.60
Name: °;,-._5 �°�� *"7r- i Interceptor /grease trap 16.60
a" r '/ M ed ical gas - value: S Page 2
Address: , , ;4:,F .tee „” - % (% t ",,• , 4; ,. , " , 4: . g'
City/State/Zip: ' Primer 16.60
�
„ ,.`lam - a , �� , ' .� Roof drain commercial) 16.60
�•
Phone: , ,. ?',3 -- �
,., : ,e:, Fax : t•��, x , •.,:;. /;; Sink/basi /I a or g gifT 16.60 111°,'0
E -mail: Tub /showers ower pan 16.60
CONTRACTOR Urinal . . 16.60
S f .� O t y 16.60 0` °" '1.f ' ,
Business Name: �, f, �5�.��,�"�t�'+r,�'��:��,,�::��' Water closet
9,4 ,...C.6 --.• '�' -�' ,.F�;7;c ' . ,'.t= • d":=%.!r
Water heater 0 f A.- 16.60 le f„, 'y
Address: 9
� ` _ Other _
_Cit /State /Zip : -7 ,� "a ,: -,. .:f;•TM`' ° °.:"'F; Other:
Phone: °` -rrrt Ft•' Fax • ..;* ^'-- ;;., Plumbing Permit Fees* 0
subtotal $ �28i ..f`_ °=c' GOD
CCB Lic. #: :-' Plumb. Lic. # :.., .., . f
Minimum Permit Fee $72.50 S
Authorized �.._° o
(� i� / �';^�.�''�•,_ .,,.. �.�... F 4 r - - •° ,
; Residential Backflow Minimum Fee $36._5
Signature: . _6 - Date:jq F«•' i Plan Review (25% of Permit Fee) $ { /00.0.5
- /�''�' r ..-6,7-7 State Surcharge, (8% of Permit Fee) $ v://: 3 z. o z
-' �- (Please print name) - - - TOTAL PERMIT FEE s { � f
Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or 5 y7
ISO days after it has been accepted as complete. . riser diagram for plan review.
*Fee methodology set by Tri- County Building Industry Service Board.
i \Dsts \Permit Fomis \PlmPermitApp.doc 01/03
&MO bn/ SE1. - /116 E41-C (, 67 )/7
CITY OF TIGARD 24 -Hour
BUILDING Inspection Like: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested '�a AM PM /� UP
Location 7 S S.� APA Suite @0 3-0, 6 / 3
Contact Person r B- --- Ph ( ) Sc 03 PLM Odd 3-'DO /
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ��►� � �,�� 1 PLM 2003- OCR (/3 '%I- � I 1 �/16�9Y/6/04/ AVM J°
Insulation c..14, Act �cec k W l �w Pie. X44. -- b— a," 7 cam.
Drywall Nailing
Firewall K � � i_ 0 03 c fo / t-/. �i tiw I c q / / S O S/
Fire Sprinkler I t ��'" '" M O
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING R or✓kL P Lk—Jo �.c �lt �.A I /o ✓ova I r.
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PAS PART FAIL
MECHANICAL
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: Li Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 9 123 ) c - Inspector 0 11 Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
BUP
Received Date Requested < / AM PM BUP
7,5
Location Suite MEC
Contact Person K Ph ( ) S 7 7 — —C EoZS PL c Oo3 ° 00 13
Contractor stn Ph ( ) 64 NR . %3 - G p / T
BUILDING Tenant/Owner ► �-�V I cut, 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 / a/
Fire Sprinkler l �� /.><
Fire Alarm
Susp'd Ceiling
Roof
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 reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
A
DA
Approach /Sidewalk Date C Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL