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Permit CITY TIGARD PLUMBING PERMIT l; DEVELOPMENT SERVICES PERMIT #: PLM2005 -00140 Ail All 13125 SW Hall Blv Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/12/2005 PARCEL: 1S134BC-00300 SITE ADDRESS: 12272 SW SCHOLLS FERRY RD ZONING: C -G SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG Project Description: Bathroom addition only, DOES NOT INCLUDE KITCHEN. New: (1) fl.drain, (1) sink, (1) water closet. Moved: (1) sink. Replaced (1) water Closet. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: A2 FLOOR DRAINS: 1 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 0 URINALS: GREASE TRAPS: LAVATORIES: 2 OTHER FIXTURES: 0 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: 0 RAIN DRAIN: ft Owner: FEES BPP RETAIL LLC Description Date Amount BY BURNHAM PACIFIC PROPERTIES ATTN: JOHN WATERS [PLUMB] Permit Fee 4/12/2005 $83.00 SAN DIEGO, CA 92101 [TAX] 8% State Surcharl 4/12/2005 $6.64 Phone : Total $89.64 Contractor: F & F PLUMBING & HEATING INC 6810 SE 45TH AVE REQUIRED ITEMS AND REPORTS PORTLAND, OR 97206 -7787 Phone : 503- 774 -5140 Reg #: LIC 101473 PLM 26 -526PB 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 -246 699 or 1- 800 -3F-2344. Issued By: Permittee Signature: � _ -- . � 1ii► 4_:.. .� 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. IN`s oZ- Peril- . "Plumbing Permit Application FOR OFFICE USE ONLY City Tigard Received /_ / Z. ^ �jQ j `(� �,�� ./ 1�� Cit of 7 J �/C/J_� Pem,;tNo.: `�„`1 U�V Dat e 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review , p ,/p A p\ Other Permit No.: Phone: 503.639.4171 Fax: 503.598.1960 rah;, Date/By: ��� 0� 24- Hour Inspection Line: 503.639.4175 E`' I Date Ready/By: - Jun El Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total TS-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 (B.Commercial/industrial SFR (2) bath 350.00 • ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/lcitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: , 2. 2'7 2 S`' Sc tiooLs CEQ,g-f (,j' Catch basin or area drain 16.60 City/State /ZIP: 11 Qitbr(L20 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: a N wikY Pv Footing drain (no. linear ft.: _ ) Page 2 Manufactured home utilities I 110.00 Cross street/directions to job site: V..,✓A\p.:e- \-m,,\ 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 ag DESCRIPTION OF WORK Backflow preventer Page 2 fo 1 1-4 9- M S H o D v T" t o t Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: Fixture/sewer cap 16.60 City/State/ZIP: Floor drain/floor sink/hub 5 16.60 ) ( 60 Phone: ( ) Fax: ( ) Garbage disposal . 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin/lavatory 2. 16.60 33, 2-b Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet Z 16.60 33 , L! Business name: F't : c MP-i1 .t' 4 %4 Ic t 0 & Water heater 16.60 Address: (0 8 1 4 52 4% _Other: City/State /ZIP: PoP -�H /...,) '0 ©YZ-� 5 7 2X3( Subtotal Minimum permit fee: $72.50 ' Phone: ( 50'3) 774. 5( A O Fax: 6'03 774 5 j 5 Residential backflow minimum permit fee: $36.25 3 CCB Lic.: [ d A 4, J Plumbing Lic. no.:2( - 524p p 5 Plan review (25% of permit fee) State surcharge (8% of permit fee) 6' ( Y' Authorized signature. TOTAL PERMIT FEE k 9. c V Print name: & ,`t iZ gr>l� Date: 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- PemiitApp.doc 12/03 440- 4616f(10 /02/COM/WEB) 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 - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 S 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 Backflow 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or 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: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by (Fixture) Work Performed Fixture Type: Replace New Moved Existing Capped Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator - Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" -3 „ -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an Separator (Gas - Industrial increase of sewer EDUs, a sewer permit will be issued and Oil Separator ( Ice G . Drains Station) 1 f assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory i 1 Quantity Total - Bradley • Isometric or riser diagram is required if fixture quantity - Commercial total is >9. - Service - Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:\ Building 'Pemtits\PLM- PemmitApp.doc 3/03 1 CITY OF TIGARD BUILDING DIVISION e PERMIT #: PLM200 0014Q 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/12/2005 Phone: (503) 639 -4171 U u 4 p � i ;� 41 �[�' l Inspection Requests (24 Hrs.): (503) 639 -4175 ...7,m/pl INSPECTION WORKSHEET FOR DATE: 5/16/2005 TIME: 7 :09AM PAGE: 17 SITE ADDRESS: 12272 SW SCHOLLS FERRY RD CLASS OF WORK: SUBDIVISION: GREENWAY TOWN CENTER . - LOT #: TYPE OF USE: PROJECT NAME: MCMENAMINS DESCRIPTION: Bathroom addition only, DOES NOT INCLUDE KITCHEN. New: (1) fl.drain, (1) sink, (1) water closet. Moved: (1) sink. Replaced (1) water Closet. OWNER: BPP RETAIL LLC, PHONE #: CONTRACTOR: F & F PLUMBING & HEATING INC PHONE #: 503.774 -5140 Inspection Request Scheduled For: Date: 5/16/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 006946-01 503- 774 -5140 Y Corrections /Comments/ Instructions: /ii 7 9 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED qn/ Inspector: Date I Phone #: 503 P ( ) 718 -