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Permit . C ITY OF TIGARD PLUMBING PERMIT ' COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00057 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/21/2008 PARCEL: 2S 102AB - 05302 SITE ADDRESS: 12360 SW MAIN ST ZONING: CBD SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: CASCADE ACQUISITIONS Project Description: 225' water line. Connect to existing in basement. CLASS OF WORK: OTR 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: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 225 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES CASCADE ACQUISITIONS 9180 SW BURNHAM Description Date Amount TIGARD, OR 97113 [PLUMB] Permit Fee 2/19/2008 $147.80 [TAX] 8% State Surcha 2/19/2008 $17.74 Phone : 503 -519 -9530 Total $165.54 Contractor: PROGRESSIVE MECHANICAL INC 9123 100 HELENS SUITE 1 TE 100 REQUIRED ITEMS AND REPORTS SUI CLACKAMAS, OR 97015 Contact # : PRI 503- 654 -0303 FAX 503 654 - 4969 Reg #: LIC 140856 PLM 3 -440PB 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: Permittee Signature: An ezia 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. Plumbing Permit Applicatio ° 4. ' ` 1 201 SL4) p1 a 1 & Building Fixtures FOR OFFICE USE ONLY City of Tigard RECEIVED Receive Permit ' 13125 SW Hall Blvd., Tigard, OR 97223 DateB i P /07) , 0 1 ,00� 00,57 E ° 41I Plan Review Phone: 503.639.4171 Fax: 503. EIRq 9 6 Date/By: 2008 Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: inns Ed See Page 2 for TIGARD Internet: www.tigard or.gov Notified/Method: Supplemental Information CITY OF TIGARD FEE* SCHEDULE TYPE B� IG DIVISION ❑ New construction ❑ 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) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ID Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: j 2.3 4'O Sul) MA //V Catch basin or area drain 16.60 City/State/ZIP: 11 bk72.,6 ote-baj 97'123 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 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: Lot no.: Water service (no. linear ftt) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 ' eje � A . S TIN to 1NL�✓L I h Sot-vice /ce Backwater valve 16.60 1 14 K- TO I4°UrC I N;14 U, ,Me• Clothes washer 16.60 2c! ©ice l y4'l/✓ /#V 8u91t yti�)vr/cd ir w exI Sl, Dishwasher 16.60 A PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: 'p L i(// v( C Q q ,O - Expansion tank 16.60 Address: I - (6 'rtA) MA 1 p�1 / Fixture/sewer cap 16.60 City/State /ZIP: `fl bkr210 topterg,clmj q'? -23 p,' l f40 Floor drain/floor sink/hub 16.60 (ce ) Pi- S Q Phone: Fax: ( ) �]M/14,.. Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON-T-1 Hose bib 16.60 AO) Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) I Fax: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: p/2/p (,it1� 'IVE MCC1 /? lap-, INC. Water heater 16.60 Address: 412-3 r sr . r}e"1et f j o i re l b0 Other: City/State /ZIP: (I, - G/LA>nl ,4-s p 110 C.711/ q 7015" Subtotal Minimum permit fee: $72.50 Phone: (4, ) (p 5 y - C3 03 Fax: (90 ) b g - L19b y' Residential backflow minimum permit fee: $36.25 / A $O CCB Li No �S(p O , R � Plumbing Lic. no.: 3- 1 410 p..9 Plan review (25 %ofpermit fee) f � State surcharge (12% of permit fee) / 7. Authorized signature: U a . { V 5 TOTAL PERMIT FEE /6 .� Print name: 1)A/( 0 P. r 2v y I Date: 2 - - O g This permit application expires if a permit is not obtained withi 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:1 Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities - Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 1 3- -6' Medical Gas Systems: Water Service - each additional 100' 46.40 9.A •jf'.' Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Q ty. Fee (ea) Total additional $100.00 or fraction thereof, to and Fixture or Item including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to • (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Replace engineer. Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash - Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" _ that meet the qualifications above. -3" -4" Car Wash Drain Garbage - Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley *Note: lithe fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: is\ Building \Pcrmits\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD di- BUILDING DIVISION PERMIT #: PLM200R -000 57 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/21/2003 Phone: (503) 639- 4171 os4I� l l Inspection Requests (24 Hrs.): (503) 639 -4175 11. INSPECTION WORKSHEET FOR DATE: 2/27/2008 TIME: 7:00AM PAGE: 57 SITE ADDRESS: 12360 SW MAIN ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: CASCADE ACQUISITIONS DESCRIPTION: 225' water line. Connect to existing in basement. OWNER: CASCADE ACQUISITIONS, PHONE #: 503. 519.9530 CONTRACTOR: PROGRESSIVE MECHANICAL INC PHONE #: 603-654 -0303 Inspection Request Scheduled For: Date: ?J27/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 06568G•01 540- 331 -9489 N �•>✓� 1. Corrections /Comments /Instructions: n �� � ! V L 1 V I • y ►... l i 'I t/i ✓i - \ Ot,� R , 1 , A i L0 C Girt 'e1 L.v1• - ite.} • *PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (111w►w�� V Date: 2 \21) ) 07) Phone #: (503) 718-