Permit C ITY OF TIGARD PLUMBING PERMIT
.74 COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00423
TIGARD • 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2008
PARCEL: 1 S136CD -00500
SITE ADDRESS: 08050 SW PFAFFLE ST 100 ZONING: C -
SUBDIVISION: PACIFIC CROSSROADS CORP LOT: JURISDICTION: TIG
PROJECT: FBR
Project Description: Interior plumbing for break room and restrooms. Other fixture: primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: 1 WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft --
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
FBR
10300 SW GREENBURG RD Description Date Amount
SUITE 375 [PLUMB] Permit Fee 11/4/2008 $149.40
TIGARD, OR 97223 [TAX] 12% State Surch 11/4/2008 $17.93
Phone : 503- 647 -5416 Total $167.33
Contractor:
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 643 -7619
FAX 503- 643 -7620
Reg #: LIC 12889
PLM 34 -4PB
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 da s of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you t• :lbw rules ado • ed by t. - Ore.. on
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952-01i I I I. You may •bt yin c• •ies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: � %L -- et' Permittee Signatu =:
Call 503.639.4175 by 7:00 a.m. for an inspection th <t busin ss day.
This permit card shall be kept in a conspicuous place on the job sit - until c s mpletion of the project.
Approved plans are required on the job site at the time o - ac, inspection.
.,) -'c�.. S,
Nov 06:33p Bea verton P mbi g Inc 5036437620 p. 4
Plumbing Permit Applieatio I , c ■ — ii; its-0 .i ' Buildin Fixtures ECEI V FOR OFFICE USE ONLY
g
I Lc xncd :
City u1 'Tigard NO V 0 3 r ('� i � g - ti Permit No.. v , �. k
i'lan I Ity: may/•/
...• 4 13 125 SW I Iia Blvd.. Tigard, i IR 4722? rl:au u cvicw (/"
Phone: 50.1.634.'1171 I'9 \: 50.1.59 O ther Permit No.'�•. 6� 1•, 3 4160
luspcxtiuu Line: 5036394175
� 3�f Y OF T IGAR i t ii e I Io GJ Dys
TIGARD .. 1.,,,. ® see Pilo: for
Pilo: 6IJILDIN min
Da1c Rcadr/ny:
Intcrncl: www.t nr.gev ' . _ . sIO N uairied /Nally„,• 4 s.opi....ul lnformution
TYPE OF WORK NHJ FEE` SCHEDULE
❑ New construction ❑ Demolition Fors rria!in armaliunrrehetVlu.
Ocreription OI v. I .. I'. :� fugal
eilI Addition/alteration/replacement ❑ Other: New I- 2- Family dwellings (includes 100 II. l it each utility connection)
y
CATEGORY OH' C :ONsI'IL11('r1ON S R (I) bull 24020
O I - and 2- family dwelling g Commercial/industrial $I:K (2) bath 350.00
C1 Accessory building; ❑ Multi - family til'R (3) lath 3'>7.00
Each additional bath/kitchen 45.1)0
❑ Master builder ❑ Other: ..._
Fire sprinkler (_ sq. Il.) - 1':n.
)OH SITE I\h'OKMATION AND (,()CATION Site utilities
Job site address: 8051) SW Mlle Cinch basin or arcu drain 16.60
City /State /ZIP: Tigard, Oregon 97223 Drywcll. leach line. or trench dr_un 16.60
Sidle/MO./apt. nu.; 100 Pnileul name:
Ewing (nn. linear II.: _) _ Page 2
Manufactured home ulititi,:s 110.0
Cross slreel /dir7etiuns to joh _ site: .. ..
Manholes 16.60
Rain drain connector 16.611
Sanitary sewer (no. linear R.: _ ) 'a 2
—
Storm sewer (no, linear R.: _r ('age 2
Water service (nu. Iineal 0.: _) Page 2
Subdivision: Lot nu.: --
F'istitre Or item
Tax map /parcel use.: -•- -- -- •
Ahserplion valve 16,611
DESCRIPTION OF WORK Backllow prcventcr Pap 2
Add Restrornns and Rreul: Itnom Fixtures Iiaekwiner valve 16.(dl
('Ionics washer I6.60
I)ishw;i +her .. I 16.40 - 16.611
❑ PROPERTY OWNER .. TENANT
Drinking liwntain - - 16.60
— -�.. �.. _ Cjca:tors/surnp I6.60
Name: -
_ I:spans lank l6.60
Address; Fixture/semi cap , 16.60
C ilv /Sluts( /.IP: Floor drain /Iluur.sink /hub ✓ I 16.40 16.60
Phone: ( ) Fax: ( ) Garbage disposal _ 16,6(1
0 APPLICANT ❑ CONTACT PERSON Hos bib Iti.60 -,
- — - - - - -- - Ice maker 16.1.0
— ......... _
Died nos name Inlcrccplor /Cleric trap 16.611
Contact n; Medic:II as (value: $ ) I'tagC 7.
Address: Primer - -/ I 14.4( 16.60
City /Slate /LIP: Roof drain (commercial) 16.60 -
Sinldhasin /lavatory ✓ .._ 3 16,61) 49.511
I'hurn:: ( ) Pax:: ( )
'tub /:hewer /:lower pan I 6.('II
F-mail: _
- --
__ Urinal 1 6.6(1
CONTRACTOR TOR Water clOcct // 2 16.60 --. .
Rosiness name: Beaverton Plumbing,. Inc Wager heater ✓ ✓ I 16.60 16.60
' - --
ddn:ss: 13981) SW Tualatin Valley Ilwy Other:
,
Subtotal 149.40
City/State/ZIP: Beaverton Oregon 97005 -
- - -- Minimum permit Ii:e; $72.50
Phone: (503) 673 -7619 Fax: (403) 643 -7620 Residential hackilnw minimum pennit fee: $36.25
— T
CCD I.ic.: 012889 'Iumhing I.ie. no.: 34-4ph Plan review (2S % ofpumil fcc) e
Slaw sOreharFe(12 "4, of per ' 771 e f ., 9
AutlOritcd signatw /� °
l ok.. (J(J TOTAL, I'L ICMI'I 16 kga.
Print lime: '1 - inn Quells Dale: November 3 1'his permit application expires if a permit is not obtained within
' ' ' ---- 180 dap after it has been accepted an complete.
"Fee i m1iicdoloc,y set by •I•ri- Cntgnty Building industry Service Board.
Ld) uildinutl 'crinils'l'LMF- 1'ennhApp.dix 12(275)6 •14IW61(i111W112(TIM/ws11)
Nov 04 08 10:29a Beaverton Plumbing Inc 5036437620 p.2
Plumbing Permit Applic:rti, 4: - City offt rd
Page 2 - Supplemental Information
COVE �
Fee Schedule: NOV 0 4 L ential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
CP rJF T1 t._ , _...,.._..... --
Foidiu ;diaiu • l" IUU' 55.00 t., �. 0 51 I:;.(0
Footing drain - each additional I0(f 46.40 Diyr D n, 6UU 51( +0.(1(1
"1 ' 200 S220.00
Sewer - 1st 1011' 55.00 7,201 and greater 1i1P1.110
Newer - each additional IOU' 46.40
Water Service - Is) 104.1' 55.1111 Medical Gas Systems:
Water Service - each additional 11111 46.4U Valuation: Permit Fee:
mom, ,' Rain Drain - 1st 1011' 55.110 - '- " " - " ""
S1.00 to $5,000.011 Miuituunl fee $12. > 0
- Storm & Rain Diaiu - each additional I1)11' 46,411 $5,001.00) to $10,110.011 -- $72.511 Mr Ilie first 10,1100.00 and S I.52 for each
Fixture or Item Qty. Fee (en) Total additional $100.10 or rracti,m thereof to and
,ncludin•' $ I0.11110.01).
Commercial flack I Ii w Prevention Device 4(x.•III � - " — "
$ Itl,lllll.011 In 525,1)111 $1 tiff the lint S10,1100.00 and $1.34 for
Residential liaekllow Prevention I)eviee each additional 5100.00 or fraction thereof, to
(minimum permit fee S (5.251 7.7.55 nod inClu(Onit$2.511(0,00.
Rain Drum, single family dwelling 65.25 $Zj 0111.(4) to 550.000.510 517').50 1pr the first $25.000.00 and $1.45 Ii)r ...
Inspect ofcxistinp, plumbing or each additional 51(10.00 or fraction thereof. Iv
specially rc ucslcd ius cclions - per hour 72.50 $ 7 42. inchuhn)' 550.00(1(10,
9 p pyublolal SM,001.011 and up 57011 for the tint Sti0.000.(0 and $ 1.20 for
each addiiian ;d $1(10.01) or fraction thereof
Commercial Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replaeitrg fixtures? If "yes ", flan review is required for any attic Iblluwing.
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 nv (Fixture) work Performed greater, except systems designed and slumped by licensed
Fixture Type: Itetnu. e eat iTtcer,
'h
PreviuuF _ (7iggwd Added X I.linl; ❑ New exterior plumbing site utilities for any complex structure
ItupIistry /runt as defined in OAR 918-780
I lath - luh/Shower ❑ Medical gas and vacuum systems lilr health care facilities.
•.lace /'.i'Whirlpuul ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall _ ❑ Any complex slruclure as defined in OAR9I5- 750.01)40.
-r)r i v TIl i u
('nspidux /Ve Ik. Aspirulur _ �, Submit 2 sets of plans with any of the above.
Dish wash I:
er -Commercial -
Drinking Fountain - Isometric or Riser Diagram
I.:yc Wash ❑ Isometric or riser diagram is required for new buildings
Ilt><',r Drain /sink - 2'" _- 1/V that meet the qualifications above.
_J"
car Wash Drain
(iarba1.e -Demotic Comments regarding fixture work:
Disposal -Commercial
- Industrial
Ice Mud,. /I(etim. Drains
Oil Separator (leas station)
Ito:. Vehicle Damp Sia
Shower -G ang
-Stall
Sink - liar /I.avatory / •
- Bradley VVV 777 *Note: Kate fixture work under this permit results in an
- commercial increase of sewer F1)Us, a sewer permit will be issued and
- Serv 1 ce r otetc/N fees assessed for the sewer increase must be paid before the
Swimna1.•. P„t 1 ihC -
Vdu x511 plumbing permit can he issued.
:hci - ( lothta
Water Fsir ;netor I r
Water Closes - Toilet w l
Urinal � /I y wa xy cl4 5 15
Other I:isuires: a l - )(Afl�/r✓�
3 )4) p- Ti
rut, Pevn as',I'LM.PernurAnn rime 12 ^..7rrr, II /L/
•
• • ' • City of Tigard
13125 SW Hall Blvd. � 1
Tigard, OR 97223 • •
Phone: 503 - 639 -4171
T I GAR]D
FAX TRANSMITTAL
Date ///9fr
Number of pages including cover sheet 3
To: 71h afel /q From: ��//// /
Co: /41 1..g � ��./ �!/ /, Co: City of Tigard
Fax #: c5U G L'j ^7ro?0 . Fax #: 503.598.1960
Ph #: 5 598'
SUBJECT: ` A( ,57 '7'S /a) / /6
MESSAGE:
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I: \ Building \ Forms \FaxTransmittal -P.doc 1/18/07
'e TRANSMISSION VERIFICATION REPORT
TIME : 11/04/2008 09:59
NAME
FAX
TEL
SER.# : BROH7J690762
DATE,TIME 11/04 09:58
FAX NO. /NAME 5036437620
DURATION 00:00:39
PAGE(S) 03
RESULT OK
MODE STANDARD
ECM
•
•
•
City of Tigard
13125 SW Hall Blvd. !I
Tigard, OR 97223
Phone.- 503-639-4171
TI GA RD
FAx TRANSMITTAL •
Date JJ 9
Number of pages including covcr sheet 3
To: -zTdazeefezzq___
From: Al.tree40 /� r
Co: 1 ,ra Co: .<a/ r A. City of Titer l
Fax #: CJ ~ `D 7 Fax #: 503.598.1960
Ph #: J_Ca — 59 --/q 66 -
SUBJECT: f /C'Q v //
MESSAGE:
I T,
CITY OF TIGARD - . - . • i
BUILDING DIVISION PERMIT #: PLM2008.00423
13125 SW Hall Blvd., Tigard, OR 97223 / 7 DATE ISSUED: 11/7/2U01'5
Phone: (503) 639 -4171 11 l
Inspection Requests (24 Hrs.): (503) 639 -4175 F ..
INSPECTION WORKSHEET FOR DATE: 1/8/2009 TIME: 7:00AM PAGE: 16
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
DESCRIPTION: Interior plumbing for break room and restrooms. Other fixture: primer.
OWNER: FBf2 PHONE #: 503 -647 -5416
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: a03- 643.7619
Inspection Request Scheduled For: Date: 1/8/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 079507 -01 503- 201 -5089 N
Corrections /Comments /Instructions:
e 5 /de /7 a )
( / / - ' • r- - r S" y'1 G4
/ /_
b) ' / )- b y Aro r
p
,e.i/e_, .0 _„( i ( 9_0 4
t iA A 1/4.,
_,
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \� / t c Date: 1� 1 Phone #: (503) 718 - T "I (,/
P ( )
CITY OF TIGARD
•. '"
BUILDING DIVISION PERMIT #: PLM2008.00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/712009
Phone: (503) 639 -4171 I nl
Inspection Requests (24 Hrs.): (503) 639 -4175 ; ,,-4.91- t e L..
INSPECTION WORKSHEET FOR DATE: 11/26/2008 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
DESCRIPTION: Interior plumbing for break room and restrooms. Other fixture: primer.
OWNER: FOR, PHONE #: 503 -&17 -5416
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 503 -543 -7619
ff./
Inspection Request Scheduled For: Date: 11/26/2008 Pour Time:
• Code # Inspection Description Confirm # Contact # Me •. - • -
320 Plumbing rough -in 078550-02 971- 645-1266
Corrections /Corn is /Instruct ons: T
•
❑ PASS ❑ PARTIAL APPROVAL • CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES AS ESSED
Vv • I OW a z
Inspector: Date: / Phone #: (503) 718-
CITY OF TIGARD `
r- } ,' .
BUILDING DIVISION PERMIT #:
f PI_M70()8- OOd;t3
13125 SW Hall Blvd., Tigard, OR 97223 II DATE ISSUED: 11/7/20013
Phone: (503) 639 -4171 kritit filI i b
Inspection Requests (24 Hrs.): (503) 639 -4175 °__.. 1
INSPECTION WORKSHEET FOR DATE: 11/21/2008 TIME: 7:()OAM PAGE: 15
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
DESCRIPTION: Interior plumbing for break room and restrooms. Other fixture: primer.
OWNER: FBR, PHONE #: 503 -647 -6416
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 503 -543 -7619
Inspection Request Scheduled For: Date: 11/21/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 078381 -01 503-643-7619 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FA . ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
a 1 % ili '_ v .' Phone #: (503) 718 - f -w
CITY OF TIGARD T . -
BUILDING DIVISION PERMIT #: PLM200f- 00423
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/7/7_ooti
Phone: (503) 639-4171 ��
Inspection Requests (24 Hrs.): (503) 639 -4175 ° 'I I..
INSPECTION WORKSHEET FOR DATE: 1/19/2008 TIME: 7:02AM PAGE: 15
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
DESCRIPTION: Interior plumbing for break room and restrooms. Other fixture: primer.
OWNER: FBR, PHONE #: 503-647 -6416
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 503 - 643-7619
Inspection Request Scheduled For: Date: 11119/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 078261 -01 503 -643 -7619 N
Corrections /Comments /Instructions:
/
J
9
}
❑ PASS ❑ PARTIAL APPROVAL ,CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES A SESSED
r�j b
Inspector: Vb " ` Date: U/ Phone #: (503) 71 S- /
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200P 004?3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/71200t3
Phone: (503) 639 -4171 ��. , I�Ih
Inspection Requests (24 Hrs.): (503) 639 -4175 _ F ' _..
INSPECTION WORKSHEET FOR DATE: 11/12/2008 TIME: 7 :00AM PAGE: 47
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
DESCRIPTION: Interior plumbing for break room and restrooms. Other fixture: primer.
OWNER: FBR PHONE #: 603- 647 -6416
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 503.643 -7619
Inspection Request Scheduled For: Date: 11/1212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 077922 -01 503-201-5718 N
Corrections /Comments /Instructions:
•
•
\ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
✓ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CI LVi.AJS Date: 1 1 1 1 2, i1 Q) Phone #: (503) 718-
CITY OF TIGARD ` , _ ,
BUILDING DIVISION r PERMIT #: PLM2008 -00423
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/712009
Phone: (503) 639 -4171 I�lt
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' '1i F`'_-
INSPECTION WORKSHEET FOR DATE: 11/10/2008 TIME: 7 :02AM PAGE: 11
SITE ADDRESS: 08050 SW PFAFFLE ST 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CROSSROADS CORP LOT #: TYPE OF USE:
PROJECT NAME: FBR
DESCRIPTION: Interior plumbing for break room and restrooms. Other fixture: primer. •
OWNER: FBR PHONE #: 503 - 647 - 5416
CONTRACTOR: BEAVERTON PLUMBING INC PHONE #: 503643 -7619
Inspection Request Scheduled For: Date: 11/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 077890 -01 503-643-7619 N
Corrections /Comments/ Instructions:
Acc 2 ? 0() 42y LJ ;11 6e. Cr,A Li ,.
J ' k \ .4 f Looms Ova) ,..).
/06'61 ❑ PARTIAL APPROVAL ❑ CANCEL
❑ NO ACCESS
't FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gb .k_Jc\/"- Date: 1 i 10\ NT Phone #: (503) 718-