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Permit CITY OF TIGARD PLUMBING PERMIT i DEVELOPMENT SERVICES PERMIT #: PLM2002 -00091 ..� - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/20/02 SITE ADDRESS: 06650 SW REDWOOD LN 235 • PARCEL: 2S112DA -01400 SUBDIVISION: PP1996 -048 ZONING: I -P BLOCK: LOT: 002 JURISDICTION: TIG 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: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Adding (1) breakroom sink, (1) dishwasher, (1) water heater, (1) 2" floor drain and (1) primer to new tenant space. FEES Owner: Type By Date Amount Receipt PACIFIC REALTY ASSOCIATES PRMT CTR 3/20/02 $83.00 27200200000 15350 SW SEQUOIA PKWY #300 -WMI 5PCT CTR 3/20/02 $6.64 27200200000 PORTLAND, OR 97224 Total $89.64 Phone 1: Contractor: DEAN WARREN PLUMBING 3111 SE 13TH PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone 1: 236 -4152 Rough -in Insp #: L IC 172 Top -out Insp Reg Final Inspection PLM 26 -83PB • 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: If, I Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day gcoA-0 gas - Plumbing Permit Application Date received: 03 / f o a, Permit no.: aN 2,-qzt5 9, - ,: ,_. ;, City of Tigard ' . `•� I City b Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: E 'r date: op Fax: (503) 598 -1960 " 2jgoo D.,_ 0 0d9 a., Date issued: By1 Receipt no.: Land use approval: Case me no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist) Description Qty. Fee(ea.) Total Job address: 6 5 0 S (,J R •Q ' 'a New 1- and 2- family dwellings only: Bldg. no.: Suite no.: 3 .s- ■■ ` Tax map /tax lot/account no.: (includes )1 0 ( 1 batit ft.foreac6 utility connection) Lot: I Block: I Subdivision: SFR (2) bath Project name: 5 TD /Q A Sf-7 77 h c i7 eV SFR (3) bath City /county: T 6-4 ZIP: 9 -7 a y Each additional bath/l itchen 'I De s cription and location of work on p emises: ,4 I!) d / Na Site utilities: i e- -L' 9Qb)M Si.../K. Catch basin/area drain Est. date of completion/inspection: Drywells/leach line/trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) n ' Manufactured home utilities ` ^ Business name: ) -_-_, ` • ` i _ j✓ RTAM Manholes t . Addres (L . S i 1 t � Rain drain connector City: i 0 I RT -1_, ..,,, J I StateQ/e1 ZIP: C37a Sanitary sewer (no. lin. ft.) Phone Fax E -mail: Storm sewer (no. lin. ft.) 0�3 (0 —�-1 15� _ 6-1/1/1E-mail: Water service (no. lin. ft.) , CCB no.: © _ Plumb. bus. reg. no: _ b a c p City/metro lie. no.: ; MINIMPEPPIEMIL Fixture or item: Contractor's representative signature: Absorption valve � - , - i . • I s rreventer Print name: M Date: 02 p ._ Backwater valve CONTACT PERSON Basins/lavatory f r , u Name: ��r ` r Clothes washer Dishwasher / /6.4 Address: Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank OWNER Fixture/sewer cap $ Name (print): / 772 t t ST- ST- 4.1.. Floor drains/floor sinks/hub /6. ', Mailing address: / S SO S (,.) SPA L k Azo Hose bibb City: (-, & ( I Stateeve ZIP:9 Y Ice maker Phone t-.(__ ., 001 Fax: I E-mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) / , /t Ao will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) / /6. 6 Owner's signature: Date: Sump ENGINEER Tubs/shower /shower pan Name: Urinal Water closet Address: Water heater / 76.6 City: St ate : ZIP: Other: Phone: I Fax: I E -mail: Total O Not all jurisdictions accept credit cards, please call jurisdiction for mote information. Minimum fee $ . 3 en Notice: This permit application Plan review (at _ %) $ ❑ Visa ❑MasterCard expires if a permit is not obtained Credit card number: / / State surcharge (8%) $ MPS Expires within 180 days after it has been TOTAL $ SIIMff Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440-4616 (6m00✓COM) / . PLUMBING PERMIT FEES: ' • PRICE , TOTAL New 1 and 2- family dwellings only: `. FIXTURES (Individual) - . QTY ' (ea) . AMOUNT (includes all plumbing fixtures in PRICE . •TOTAL. Sink / 16.60 the dwelling and the flrst100 ft. QTY (ea) AMOUN' Lavatory 16.60 for each utility connection) One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE , Dishwasher / 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 • Floor Drain/Floor Sink 2" `. 16.60 PLEASE COMPLETE: 16 3" 16.60 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a separate mechanical Fixture_ Type: New • Moved Replaced Removed/ permit. Capped MFG Home New Water Service 4 • 46.40 ' Sink / MFG Home New San/Storm Sewer 46.40 Lavatory .. • - Tub or Tub /Shower . Hose Bibs 16.60 _ Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal - Other Fixtures (Specify) 16.60 Dishwasher 1 i e l >,,,,Eo_ (_F 0) I Garbage Disposal f v Laundry Room Tray - Washing Machine Floor Drain /Sink: 2" Sewer - 1st 100' 55.00 3" ' Sewer - each additional 100' 46.40 4" Water Service - 1st 100' 55.00 Water Heater Other Fixtures Water Service - each additional 200' 46.40 • (Specify) Storm & Rain Drain - 1st 100' 55.00 li4.t Hii-- / Storm & Rain Drain - each additional 100' 46.40 V • • Commercial Back Flow Prevention Device 46.40 . Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 ' QUANTITY TOTAL Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL . . 8% STATE SURCHARGE *`PLAN REVIEW 25% OF SUBTOTAL ■ Required only if fixture qty. total is > 9 TOTAL $ * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. ** All New Commercial Buildings require plans with Isometric or riser diagram and plan review. • I:\dsts\forms\plm- fees.dOC 10/10/00 • - 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 Location Co Suite_ J MEC Contact Person Ph ( ) 2 3(0 q /SZ PLM � d e f Contractor Ph ( ) 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 Fire wall Fire Sprinkler Cf 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 Ot == • - " PART FAIL CHANICAL 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: El Unable to inspect — no access Fire Supply Line ADA �� C I/ ., Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL