Permit C ITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00453
1i�� DEVELOPMENT SERVICES DATE ISSUED: 10/5/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102CC -00500
SITE ADDRESS: 13500 SW PACIFIC HWY 86 ZONING: C -G
SUBDIVISION: TIGARD MARKETPLACE LOT: JURISDICTION: TIG
Project Description: GO WIRELESS.
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PACIFIC CORP /ELLIOTT ASSOCIATES Description Date Amount
200 SW PINE ST, SUITE 200
PORTLAND, OR 97204 [PLUMB] Permit Fee 10/5/2006 $83.00
[TAX] 8% State Surcha 10/5/2006 $6.64
Phone : 503- 224 -6791 Total $89.64
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 691 -6166
FAX 503- 691 -6771
Reg #: LIC 87906
PLM 34 -250PB
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: _IR fP,
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.
Oct 04 06 '03:19p MODERN PLUMBING 503 691 6771 p.2
Plumbing Permit Application Fok orricE LSE ONI.1
City of Tigard Das I -6 . f �. .1 t No :' V _. i 4 1 e, 0 i
13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 � D Other Permit No /�Q6 oC, )
24 Hour Inspection Line: 503.639.4175 1 j
Date Ready/By: Q ! a6� J uris I ® See Page for
Internet: www.ci.tigard.or.us NolifedMletio• d 21.52 for each additional
TYPE OF WORK FEE* SCHEDULE •
❑ New construction ❑ Demolition For special information are checklist.
a - ription I Qty. I Ea. I Total
121 Addition/alteration/replacement ❑ Other:
N • I- 2-famlly dwellings (includes 100 ft. for each utility connection)
. CATEGORY OF CONSTRUCTION y ' (I) bath i 249.20
❑ 1- and 2-family dwelling I Commercial /industrial _ ' (2) bath - -- 350.00
❑ Accessory building ❑ Multi - family
S • (3) bath 399.00
Ea... additional bath/Idtchen ' 45.00
❑ Master builder ❑ Other:
Fi : sprinkler ( sq. ft) I Page 2
JOB SITE INFORMATION AND LOCATION Sit utilities
Job site address: 1 6500 5 uu f Q.C.' t {1 t_, 41x.11 �.f C: basin or area dram 16.60
City /State/ZIP 1 , A r a d C> 1 q 1 LL3 I 11, leach line, or trench drain 16.60
Suite/bldg./apt. no.: I Project name: 11, (oc-K- bJ Ste-t' B 14 L} , F.. ;rig drain (no. linear ft.: ) Page 2
ufactured home utilities 110.00
Cross street/directions to job site: 'des 16.60
' • •• dram connector 16.60
S ary sewer (no. linear It: ) Page 2
St. . sewer (no. linear S ) Page 2
Subdivision: I Lot no.: W:•. r service (no. linear It: ) Page 2
Fi . • re or item
Tax map/pareel no.: cZ 5 1 0,,2 C C 0 6_5-4 0 Ab • • .lion valve 16.60
DESCRIPTION OF WORK , ... a ow preventcr Page 2
f). (( lit) O t ti Ba • :ter valve 16.60
Ti \aGt Per(v - 3u4 2061,- 1)37-7 Cl.' swasher 16.60
DisH• - er 16.60
a • fountain 16.60
❑ PROPERTY OWNER ❑ TENANT Ej- ••,rs/sump 16.60
Name: Exp • . sion lank 16.60
Address: Fi . sewer cap 16.60
City/State /ZIP: Fl. • r drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Gar. age disposal 16.60
❑ APPLICANT El CONTACT PERSON H•• bib 16.60
Business name: Ice 16.60
In • .tor /grease trap 16.60
Contact name: M -..cal gas (value: $ .) Page 2
Address: Pri . er 16.60
City /State/ZIP: Roo drain (commercial) 16.60
Si .... a/lavatoey .- 16.60 33. Z•
Phone
( ) +Fax:: ( ) Tub . ower /shower pan 16.60
E -mail: 16.60
CONTRACTOR W.. , closet r c)- 16.60 3 3
Business name: 1" , p O e f- n TA t ..r - c ■ NCI %Vat - heater k 16.60 ( 6 ( (3
Address: 1 `1 2c , S V.7 li r`k. \i S*' li % ei k kfrOol
Subtotal
City/State/ZIP: - r t_Aa k (.111 If. ) d� Minimum permit fee: $72.50
Phone: (5113 ) CDC Co I to (e I Fax: (503) Co c 1 Ca 7 1 Residential bacldiow minimum permit fee: $3625 `6 (S (D
•
CCB Lic.: 81 9 0 (, j umbing Lic. no.: 34_2_56e 3 Plan review (25 %of permit fee)
State surcharge (8% of permit fee) ( (0j Y
Authorized signature: n /,J /,( �� TOTAL PERMIT FEE R4 (i1
I Print name": D el r , fn l-. 6 e o.,r ei . Date:' O l y /0 g, I This within
permit application expires if a permit is not obtained thin
1( 180 days after It has been accepted as complete.
*Fee methodology set by Trt -County Building Industry Service Board.
is EuildinglPermitaU 'mMiPami;App.doe 06r05 440- 4616T(10/02/COMME8)
1
CITY OF TIGARD +
BUILDING DIVISION PERMIT #: PLM2006- 004553
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/512006
Phone: (503) 639 -4171 Ly �
Inspection Requests (24 Hrs.): (503) 639 -4175 _�' �:..
INSPECTION WORKSHEET FOR DATE: 10/17/2006, TIME: 7:04AM PAGE: 47
SITE ADDRESS: 13500 SW PACIFIC HWY 86 CLASS OF WORK:
SUBDIVISION: TIGARD MARKETPLACE LOT #: TYPE OF USE:
PROJECT NAME: GO WIRELESS
DESCRIPTION: GO WIRELESS.
OWNER: PACIFIC CORP /ELLIOTT ASSOCIATES, PHONE #: 503.2246791
CONTRACTOR: MODERN PLUMBING PHONE #: 503 -691 -6166
Inspection Request Scheduled For: Date: 10117/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 038323-01 503 -691 -6166 Y
Corrections /Comments /Instructions:
P i' .
m . i SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 Date: /[ ?/�t Phone #: (503) 718
CITY OF TIGARD
BUILDING DIVISION v PERMIT #: PLM,7.00 : -UCult T'. i
13125 SW Hall Blvd„ Tigard, OR 97223 DATE ISSUED: 106/10
.<<
Phone: (503) 639 -4171 gez r��
Inspection Requests (24 Hrs.): (503) 639 -4175 2 F:
INSPECTION WORKSHEET FOR DATE: 'i'IPO /2OOE; TIME: '0`) AM PAGE: .
SITE ADDRESS: 1.13f;00 SW PAi;1f ft HWY 8€; CLASS OF WORK:
SUBDIVISION: WARD MAPkl Pi ,ACt LOT #: TYPE OF USE
PROJECT NAME: 1O WIRLLESS
DESCRIPTION: (1 WIRELI:.,`
OWNER: PACIFIC. ir,'i'1 7 !Pit_i.t Ko f - 1 tsw;;OC :1A) Lam., PHONE #: 1 :$03 s , , f;; �.i
CONTRACTOR: N!' %I.t. Rlv Pt 'As/ON PHONE #: "Rti'L `, •:It's,
Inspection Request Scheduled For: Date: 11!..10/200t , Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 f'lumknn9 final 04O07er1'33 504 -F -6106 Y
Corrections /Comments /Instructions:
X
„...,,
7----.4 eri6/1"." ., ,
(PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -\ . '�/ I
Inspector: Date: Phone #: (503) 718 -