Permit 69 /SW06 .44. ,4D7/ . 4.aea.41— (0 8 7•
C ITY OF TIGARD PLUMBING PERMIT
�� DEVELOPMENT SERVICES PERMIT #: PLM2006 -00435
! , L :.� I I 13125 SW Hall Blvd., Tigard, O R 97223 503 - 639 -4171 DATE ISSUED: 9/28/2006
PARCEL: 1 S134BC -00200
SITE ADDRESS: 12162 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: TI Other,1 capped sink. 10/31/06, installing 1 less sink, for a total of (7) sinks.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
• FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 7 - . . URINALS: GREASE TRAPS:
•
LAVATORIES: 0 OTHER FIXTURES: 1 .
TUB /SHOWERS: SEWER LINE: ft -
•
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SAUNDERS, WILLIAM W TRUSTEE Description Date Amount
2155 KALAKAUA AVE STE 500
HONOLULU, HI 96815 [PLUMB] Permit Fee 9/28/2006 $182.60
[PLMPLN] Plan Review 9/28/2006 $46.65
Phone : [TAX] 8% State Surchari 9/28/2006 $14.61
Total $243.86
Contractor:
CH KRUSE PLUMBING
5802 SE 88TH REQUIRED ITEMS AND REPORTS
VANCOUVER, WA 98665
Contact # : PRI 360 - 573 - 4337
FAX 360 -573 -5303
Reg #: LIC 111654
PLM 37 -296PB
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 -00 U through OAR 952 - 0001 -0100. You may obtain copies of these rubs -er direct questions to OUNC by
calling 503 -246 99 00- 332 -2344. -
Issued y _: p14 Permittee SignatL e: ` - jr 0
•
V
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.
/
y BoalAng Fixtures
Plumbing Permit Application FOR OFFICE LSE ONLY
City of Tigard Date/By. Received lo of Permit No.: 1(,��06,- 00935
v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
IN III Phone: Ot her Permit No.: .SL
Phone: 503.639.4171 Fax: 5 03 . 598 . 1960 ate � � �' AioO up • 0022.4 T I G A It D Inspection Line: 503.639.4175 Date Ready/By. ru"s' Ed See Page 2 for
Internet: www.tigard - or.gov Notified/Method: // I Q. Supplemental Informat
TYPE OF WORK 1 1 FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
0Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath r 249.20
m
❑ 1- and 2 -family dwelling Womercial /industrial SFR (2) bath
C- 249.20
350.00
❑ Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: i x1 u 2 . s w S clh.r 1 s .�r�y � , Catch basin or area drain 16.60
City /State/ZIP: T Ci. r 01 (� e, g 7 2-2-3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ' Project name: T I„ B ' b "cc Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: (4 n w f CA r..44.n
Manholes 16.60
n Rain drain connector 16.60
1 r� 1 54- 4 S c.,h_o I 1 S F-e tr Y y IG.-N 1 Sanitary sewer (no. linear ft.: _J Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear it: ) Page 2
Fixture or item
Tax map/ arcel o.: 1 5 13 Q G - 00.10
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
▪ S ._ l I • • a1 . W �,k( I...tA ,1 G �
. P c t C. Backwater valve 16.60
• Mrs 5 -} -cat. pr P r\ ■'- �'1 d - '�'U(e..0 Avi I�I,W �ICJSk bO.tC , Clothes washer 16.60 /4, 4,
bre041- s ; rN IL. 4" J S ko k
p 6D Si rr S , Dishwasher 16.60
❑ PROPERTY OWNER X TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: T he . RaA beJ(S Expansion tank 16.60
Address: 1.7 1 (n 2 S L3 Sri-km i Ls 1ti(y T2.-•1 Fixture /sewer cap 16.60
City /State/ZIP: T t 3� (ct 0 IZ C 7 2.2-3 Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
J:IAPPLICANT --a PERSON Hose bib 16.60
Ice maker 16.60
Business name: Sp i ! gr, Baw berry L i... 4 a b ILL � ar b e(-S Interceptor /grease trap 16.60
Contact name: re S p @� A , l 1 A L Medical gas (value: $ ) Page 2
Address: . 1 : 11 : 01;.. • 1 Ion U 1 N 1✓ 31 Primer 16.60
City /State/ZIP: \ 1 co .. fn )mil p MI 9 14 2- Roof drain (commercial) / , .0 16.60
e .asin/avatory =7 ' f • 16.60 ,.:`7b
Phone: (3(p 0) 7 7 L ( 1 to c I Fax:: (562) (9 el $ - (p 1 )
Tub /shower/shower pan 16.60
E-mail: S p i E. S }Jut' b.erS P I - Cc, -,..-. Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: C - H H. cruse_. P I u n-' bin J l ,1 0 � Water heater j 16.60 //0,(961
Address: 02 S E :•: `4-` 1 1 op Other:
1. City /State/ZIP: \I 0.n Co J J eA 14A 91 t 6 S � � subtotal
Minimum permit fee: $72.50 / 8a k6
Phone: ( 4 D) 57 3 4 3 3 '7 Fax. (3 i'70) 1 5 - 7 3 - S 3 0 3 Residential backflow minimum permit fee: $36.25 D
CCB Lic.: 5 1 3 - 7 Plumbing Lic. no.: I I i sy Plan review (25% of permit fee) L/ • GS
• State surcharge (8% of permit fee) ( i/- le (
Authorized signature: ` J ./2') ,i;;,.. , _, TOTAL PRMIT FEE alga. a
Print name: ''// Da e: This permit application expires if a permit is not obtained within
{..1 �) P. Ot • P . % b eTG / I L � Jo (' 180 days after it has been accepted as complete.
J 1
*Fee methodology set by Tri-County Building Industry Service Board.
!A Building \Pamils\PLMF- PamitApp.doc 07/06 410.4616T(10/02/COM/WEB)
I / - (( ' Le 0
Plumbing Permit Application - City of Tigard
rf % .
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 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 Backfiow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 1 i 7 0 0 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, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following'critena
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.
Previous Capped Added Existing ❑ 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 ❑ Any new residential building containing three (3) or more
.- Domestic dwelling units.
Drinking Fountain
❑ Any 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 t *Note If the fixture work under this p results in an
Water Extractor
Water Closet - Toilet 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 \Permits\PLM- PennitApp.doc 01 /06/05
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2006 -00435
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9120/2006
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 - I �..
INSPECTION WORKSHEET FOR DATE: 11/9/2006 TIME: 7:02AM PAGE: 54
SITE ADDRESS: 12162 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: THE BARBERS
DESCRIPTION: TI Other,1 capped sink. 10/31/06, installing 1 less sink, for a total of (7) sinks,
OWNER: SAUNDERS, WILLIAM W TRUSTEE, PHONE #:
CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360 - 573.4337
Inspection Request Scheduled For: Date: 11/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 039523 -01 360 - 772 -1165 N
Corrections /Comments /Instructions:
7" xi _
1
`PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A / -- Date: I L' i
� Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 00436
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/213/2006
Phone: (503) 639 -4171 A I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/8/200 TIME: 7 :03AM PAGE: 30
SITE ADDRESS: 12162 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: THE BARBERS
DESCRIPTION: TI Other,1 capped sink. 10/31/06, installing 1 less sink, for a total of (7) sinks.
OWNER: SAUNDERS, WILLIAM W TRUSTEE, PHONE #:
CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360-573-4337
• Inspection Request Scheduled For: Date: 11/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 039433.01 360-772-1165 Y
Corrections /Comments /Instructions:
wt 41) 3 go , 9iv D 0 @ter
11 t i 4 . 45
•
❑ PASS [ RQRTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 1 V Date: t \\I% v Phone #: (503) 718- 1'iJ
CITY OF TIGARD -
- BUILDING DIVISION i PERMIT #: PLM2006- 00435
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/26/2006
Phone: (503) 639 -4171 Alke
,_a_tsel nspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: •I0 /12/2086 TIME: 7 :01AM PAGE: 40
SITE ADDRESS: i2162 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: THE BARBERS
DESCRIPTION: TI Other,1 capped sink
OWNER: SAUNDERS, WILLIAM W TRUSTEE, PHONE #:
CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360-573-4337
Inspection Request Scheduled For: Date: 10/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 038087 -01 360- 772 -1165 Y
Corrections /Comments /Instructions:
•
4 ...eAss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 Date: tb/01 Phone #: (503) 718 - �� w
t
CITY OF TIGARD • •
BUILDING DIVISION PERMIT #: PLM2006.00435
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/28/2006
Phone: (503) 639-4171 �4�g il
Inspection Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: 7 PAGE: 26
SITE ADDRESS: 12162 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: THE BARBERS
DESCRIPTION: TI Other,1 capped sink
OWNER: SAUNDERS, WLLIAM W TRUSTEE, PHONE #:
CONTRACTOR: CH KRUSE PLUMBING PHONE #: 360 - 573 -4337
Inspection Request Scheduled For: Date: 10/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing undersiab 037559.01 360 - 518-1375 Y
Corrections /Comments/ Instructions: fln P - M M ILt■41110 d ;
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,p
Inspector: / v Date: / - 51/ � � Phone #: (503) 718- gv
2,