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Permit 7/g/.0, > C I OF TI A R D PLUMBING PERMIT A ' r k DEVELOPMENT SERVICES PERMIT #: PLM2005 -00268 _ - A � 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 6/16/2005 PARCEL: 2S101 DC -03800 SITE ADDRESS: 07190 SW SANDBURG ST 10 ZONING: I -P SUBDIVISION: LOT: JURISDICTION: TIG Project Description: New: (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. Moved: (1) lay. 7/13/05, add 80' of footing drain, 80' of storm drain and (3) rain drain connectors. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; 2 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: 1 GREASE TRAPS: LAVATORIES: 3 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: 80 ft Owner: FEES MCCORMACK PROPERTIES LIMITED PARTNE Description Date Amount 7190 SW SANDBURG ST. TIGARD, OR 97223 [PLUMB] Permit Fee 7/13/2005 $159.80 [TAX] 8% State Surcharl 7/13/2005 $12.78 Phone : 503 - 624 -2090 [PLUMB] Permit Fee 6/16/2005 $199.20 [TAX] 8% State Surcharl 6/16/2005 $15.94 Contractor: Total $387.72 DEAN WARREN PLUMBING & REMODEL PO BOX 14701 REQUIRED ITEMS AND REPORTS PORTLAND, OR 97293 Phone : 503 - 492 -9514 Reg #: LIC 154919 PLM 26 -736PB Th is 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 -0 -00 rough OAR 952 - 0001 -0100. You may obtain copies of these rules • irect questions to OUNC by calli n 503 - 246- 9 1- 0- 332 -23 44. Issue B y: 624 1 Permittee Signature: A Call 503 -639 -4175 by 7:00 a.m. for an inspection th. • usiness 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. 1 • w' [[ 11II gi'VED Plumbing Permit AS FoR UI FicL usl on.) • City of Ti and �� 6 15 Received Peron No.: V...�,0 5 \ � 131 SW Hall Blvd., Tigard, OR 97223 P, �CV l3 2� Date/By K /� a� Pe 1 GUzi y Phone: 503.639.4171 Fax: 503.598.1968 OF TIGARI,�,, .. , Plan Review ITY Other Permit No �. 1 � /9 24 -Hour Inspection Line: 503.639.4175 � tt ` rJ � i pus: / Su Internet: w Notified/Metww.ci.tigard.or.us BUILDIN ®IV! Date ed/Met y. hod: -1'�( ® See Page 2 for Supplemental information TYPE OF WORK FEE* SCHEDULE • ❑ 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 (1) bath 249.20 ❑ 1- and 2 -family dwelling Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 13 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: 7 / 9 C) S 5- j cg /O Catch basin or area drain 16.60 City/State/ZIP: 7 ' , ,J c 2 • Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: 4/c eorxtQa6 d o rest Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: '7 y `.4 s n w sal d Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backtlow preventer Page 2 - g 4 57'0 Backwater valve 16.60 • Clothes washer 16.60 Dishwasher 16.60 PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 + J _ I 1 7� Ejectors/sump 16.60 Name: Co tck 'propor 0 Lt r'eJ rait C Expansion tank 16.60 Address: 1 ig 0 , , 5 1 ,t3 190,ra S'1' • Fixture/sewer cap 16.60 City / State/ZIP: l `c e,1trj / 0 ?22 Floor drain/floor sink/hub `a- 16.60 Phone: (Sb 6 2.4 vjogv Fax: (503)G - 2.314(7 Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 ,,// ,, Ice maker 16.60 D e name: e 2, / W r ifroly LtM 3 /'45 PL 4oa Interceptor /grease trap 16.60 ' Contact name: To AcDf. Medical gas (value: $ ) Page 2 Address: P 0 a 0. 9s p(701 Primer / 16.60 City /State/ZIP: pc,-0 of - CJ 72 5'7 Roof drain (commercial) / 16.60 Sink/basin/lavatory 3 16.60 Phone: (SO ) y S 2 - 9Sly I Fax: : () 2 94-..2.-v 8 Tub /shower/shower pan 16.60 E -mail: Urinal / 16.60 CONTRACTOR Water closet 3 16.60 Business name: ,-a (A/4)4/1 ANS A 4emoqi../ Water heater / 16.60 Address: P -O_ 6GX Other: City / State/ZIP: Pv/-Ltt CrL. S 7Z S3 Subtotal Minimum permit fee: $72.50 Phone: ($ ) y5,2 . 937y Fax: (0'73 ),5'� 2y!$ Residential backflow minimum permit fee: $36.25 �� CCB Lic.: /51/ 9/ 3. Plumbing Lic. no.:2 6 - 7 3693 Plan review (25% of permit fee) 0 Authorized signature: / i Z¢-- -1 _ I - ° b State surcharge (8% of permit fee) / 9Y � TOTAL PERMIT FEE .a-F„ Print name: /. oe R a Date: 6 -/6_ 6 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \Permits\PLM- PenniiApp.doc 06105 410- 4616T(10/02/COM/WFB) 47 ✓ ti 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 - l 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 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 55.00 $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 Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof to and 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 Backfow 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 specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 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 Complex Structures Are you capping, moving or replacing existing fixtures? If A "complex structure" is defined as an installation of a plumbing "yes ", please indicate work performed by fixture. Failure to system that meets any of the following criteria. accurately report fixtures could result in increased sewer fees*. Please check all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site utilities. New Moved Existing Capped ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi/Whirlpool providing services to human beings. Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service - Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ My new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ My NFPA 13 - D multipurpose fire sprinkler system. Eye Wash Floor Drain /sink - 2" . Submit 2 sets of plans with any of the above. -3" -4" Car Wash Drain Isometric or Riser Diagram Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal -Commercial three (3) or more stories in height. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor Water Closet - Toilet 3 increase of sewer EDUs, a sewer permit will be issued and Urinal / fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. is\ Building \Penniu\PLM- PeimitApp.doc 3/03 CITY OF TIGARD - - .. BUILDING DIVISION PERMIT #: PLM2005.00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2005 Phone: (503) 639 -4171 i o��, ; Ij Inspection Requests (24 Hrs.): (503) 639 -4175 _�' a, "' INSPECTION WORKSHEET FOR DATE: 6/17 /2005 TIME: 7:11AM PAGE: 14 SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MCCORMACK BUILDING DESCRIPTION: New: (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. Moved: (1) lay. OWNER: MCCORMACK PROPERTIES LIMITED PARTNE, PHONE #: 503-624 -2090 CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503492 -9514 Inspection Request Scheduled For: Date: 6/17 /2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain drain 009594 -01 503780 -9486 Y Corrections /Comments /Instructions: ,A :1, _ ,/ 416 ,_ _ ,IL PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: t r / Date: / /' l lY Phone #: (503) 718 - 7 CITY OF TIGARC BUILDING DIVISION r ' ! . 4 PERMIT #: pLM2005 00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1E42005 Phone: (503) 639 -4171 � �. Mil Inspection Requests (24 Hrs.): (503) 639 -4175 ' LL. INSPECTION WORKSHEET FOR DATE: 7/1W2005 TIME: 7 :11AM PAGE: 74 SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MCCORMACK BUILDING DESCRIPTION: New (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. Moved: (1) lay. 7/13/05, add 80' of footing drain, 80' of storm drain and (3) rain drain connectors. OWNER: MCCORMACK PROPERTIES LIMITED PARTNE, PHONE #: 503 - 624 -2090 CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503 -492 -9514 Inspection Request Scheduled For: Date: 7/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 340 Storm drain 011454 -01 503-236-4152 N Corrections/Comments/Instructions: .11/4 ".7 A . .,* / /I. . . ,.../ !' _.. Ale■l ■ , _ A ...d..._....de .-10 I �/ / . . t r" Aliddr-!-- - ►'� -' SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: '7/ J Phone #: (503) 718- • 1 CITY OF TIGARD . -, ' I 1 BUILDING DIVISION PERMIT #: PLM2005-00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2005 Phone: (503) 639 -4171 i�Az Inspection Requests (24 Hrs.): (503) 639 -4175 W I_.. INSPECTION WORKSHEET FOR DATE: 7/22/2005 TIME: 7 :09AM PAGE: 10 SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MCCORMACK BUILDING DESCRIPTION: New: (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. Moved: (1) lay. 7/13/05, add 80' of footing drain, 80' of storm drain and (3) rain drain connectors. OWNER: MCCORMACK PROPERTIES LIMITED PARTNE, PHONE #: 503- 6242090 CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503- 492 -9514 ' Inspection Request Scheduled For: Date: 7/22/2005 Pour Time: Code # Inspection Description Confirm # C t # Message 335 Rain drain 011983 -01 503-236 -4152 Y Corrections /Comments /Instructions: ..�i _�� a I' //. ■ Iv 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED )/}� am Inspector: '/' ' 2∎d Date: � /-7 Phone #: (503) 718 - CITY OF TIGARD - BUILDING DIVISION ~ , PERMIT #: pLM2005 -00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1612005 Phone: (503) 639 -4171 I N I Nktit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/21/2005 TIME: 7:03AM PAGE: 86 SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MCCORMACK BUILDING DESCRIPTION: New: (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. I OWNER: Moved: (1) lay. 7/13/05, add 80' of footing drain 80' of storm drain and pi rain_ drain connectors. MCCORMACK PROPERTIES LIMITED PARTNE, 503 - 624 -2090 CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503 - 492 -9514 Inspection Request Scheduled For: Date: 9/21 /2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 016228 -01 503-236-4152 N • Corrections /Comments/ Instructions: .PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 9 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005-00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2005 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 .. �:.. INSPECTION WORKSHEET FOR DATE: 10/7/2005 TIME: 7:05AM PAGE: 5 SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: , SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MCCORMACK BUILDING DESCRIPTION: New: (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. Moved: (1) lay. 7/13/05, add 80' of footing drain, 80' of storm drain and (3) rain drain connectors. OWNER: MCCORMACK PROPERTIES LIMITED PARTNE, PHONE #: 503 - 624 -2090 CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503 - 492 - 9514 Inspection Request Scheduled For: Date: 10/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 017761 -01 503 - 236 -4152 N Corrections /Comments /Instructions: , /AA/ZIP /ir L ti 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED kr4 Inspector: Date: 0 /VP Phone #: (503) 718- CITY OF TIGARD - BUILDING DIVISION PERMIT #: PLM2005 -00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2005 Phone: (503) 639 -4171 4 41411 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 109 SITE ADDRESS: 07190 SW SANDBURG ST 10 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: MCCORMACK BUILDING DESCRIPTION: New: (2) 2" drains, (2) lays, (3) water closets, (1) urinal, (1) water heater& (1) primer (1) roof drain. Moved: (1) lay. 7/13/05, add 80' of footing drain, 80' of storm drain and (3) rain drain connectors. OWNER: MCCORMACK PROPERTIES LIMITED PARTNE, PHONE #: 503- 6242090 CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503492 -9514 Inspection Request Scheduled For: Date: 10/27/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 019454-01 503-236 -4152 N Corrections /Comments /Instructions: AIINAIMPr • • • s C a PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: bY7/ Date: D /J Phone #: 503 P ( ) 718 -