Permit CITY OF TIGARD
PLUMBING PERMIT
�'\ DEVELOPMENT SERVICES PERMIT #: PLM2004 -00302
. 41 1 '\
.i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/30/2004
SITE ADDRESS: 15055 SW SEQUOIA PKWY 120 PARCEL: 2S112DA 00800
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: 1 GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Capping (8) fixtures and relocating (1) sink.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI [PLUMB] Permit Fee 6/30/2004 $149.40
PORTLAND, OR 97224 [TAX] 8% State Surcharl 6/30/2004 $11.96
Total $161.36
Phone :
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP #3
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 Rough -in Insp
Insp existing /capped fixtures
Reg #: LIC 120893 Final Inspection
PLM 34 -412PB
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 -6699. . Q;
Issued G��'!� Permittee Signature: r d�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next siness day
0 */2/,/x004 11:03 FAX 5091961960 CITY OF TIGARD (1002
•-•'''.. • RECEIVED
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Q wooessrey amue a - 1maR1►
Each a udten 45•4112 Q 7.['m r �F�- z„zo,� . a otim Mb sp`idder (____m, ft) �_ _
16.611 ▪ . _ - -k�..� 1660 . e e.w. r.i. 0 es_ flerpc11, lash Var. co Beach Grain
• r�-� - 1 � 1 axeA( Q>± 4.r ,F�elai6drsM (,,. �+,�. __ _� t1ao0 '
Caw .n:.ier sift 641061ee kW
,
drain vosnor • 16.60
ae
Sa r ;a l , = war WI,. lour B.: ____.) . Past 2 - •
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9rbdi kk,9e I 1AK am
' Manta Loom
zsacris Wpmealrtm _ _.Aueaapda, wire 1160
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V 1 u Nrn1rZ. [13 �-3•. t et#strv* t 16.611• •
• Clotho Ieit� 16.60
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1 Para ;L-.Y. PIA �� �.�„ Wilt 16.(a
AdobsOlt • � A .. A. ..... ( 3 (X1 $ 16.60 1 .11. Sb
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leeelanix fownrsaclel) 1660
G><rrswer� .f ti A S120ibeinflo tier , ` 1660 • 1(6 ,
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Catjal:leajr. V. 6 i taarmaennk Re! 37230 /48 y6.
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E' 669968 - o3 5uTgwnTd ape0se3 eSS :IT 170 EZ unf
Accumulative Sewer Tally Parcel # 'A: J': � .i MMI` `
11:000 :144 Tram Pa Exports This SW RA N/A
+ g _ 0 ." SI S ', ZQ T his PLM # k g014 9, 41Q7, ,f �.,.. ,, .
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off #s count # value #s values
Baptisery/Font 4 0
4 k ��° �� 0 „,�:F 0 0 0
.,
Bath - Tub /Shower 4 0 ; 4 k 0' 0 0 0
Jacuzzi/Whirlpool 4 A ,,, 0 4 �;w" 0 ,, 0 0 0
Car Wash - Each Stall 6 0 0 - 0 0 0
- Drive through 16 0 0 ^`� 0 0 0
Cuspidor/Water Aspirator 1 ;„ 0 . 0 : '',.:1,i.i..e:,,t'AKi::::, 0 0 0
Dishwasher Commercial 4 0 , 0 s 0 0 0
- Domestic 2 ¢ a . 0 ` o o ,. ; c , 0 L. 0 0 0
Drinking Fountain 1ft.' 0 � 2 ,�, 0 -2 -2
x
Eye Wash 1 j 0.4,' 0 �`, 0 ° z K u 0 0 0
Floor Drain /Sink 2 inch 2 s� 0 v4 '� ,x 0 ;X; 0 0 0
- 3 inch 5 0 v� 0 ��` ` 0 0 0
- 4 inch 6 � ip' 0 1, ., 0 �� ; : 4 0 0 0
- Car Wash Drn 6 s 0 � ss 0 ' e '' 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 � :, ,, r',1 ., ;,; 0 : ati 0 0 0
- Commercial (to 5 HP) 32 � � " , 0 A 0 f : 0 0 0
- Industrial (over 5 HP) 48 H y , l 0 kw 0 �1 {� 0 0 0
Ice Machine /Refrigerator Drain 1 4 0 , 0 0 0 0
Oil Sep (Gas Station) 6 „ 0 , r 4 Z ., 0 0 0 0
n d i e � � :T
• Rec. Vehicle Dump station 16 .1.40 i , ; 0 r rY ill ! 0 ? g t: 0 0 0
Shower - Gang (per head) 1 rt : , ' 0 '444115 0 a 0 0 0
-Stall 2 ti�g `
4� 0 0 sh �, 0 0 0
Sink Bar/Lavatory 2 ,57,,:
5 " , 'N < 0 "` 0 Y
- Bradley 5 , ; :� 0 rfusfil 0 . 0 0 0
- Commercial 3 4 ? 0 0 e.. 0 0 0
- Service 3 r 0 6 �: 0 -2 -6
Swimming Pool Filter 1 " °'' 0 F 0 a; ' 0 0 0
Washer - Clothes 6 0 ! i 0 0 0 0
Water Extractor 6 = ,. 0 0 0 0 0
Water Closet - Toilet 6 0 1 8 0 -3 -18
t , N "It �? 6 ., ''� , 0 -1 -6
Urinal 6 .�...v.. 0
Previous EDU Count k 4 x 0 0
Capped EDU Credit _ . 0
TOTALS 0 0 8 32 0 0 -8 -32
Current Fixture Value -32 divided by 16 = -2.0 Current EDU 1 EDU = $ 2,500
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -32 divided by 16 = -2.0 over (under) $ (5,000.00)
Enter EDU Change Here
E.'0 S
Notes:
Signa ure: a ! , .1 ' l! Date: , //e r 3 c
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher
which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
i:\ Building \Sewer Tally \SewerTallySheet.xls 11/19/03
CITY OF TICAARD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Reques ed 8.-- AM L PM BUP
Location / 6 SS .l J Suite l aD MEC
Contact Person Ph ( ) �� '9 � 3 PLM �d — 0 e ) 3 0 . 2 . —
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ' � i 7, f -c - 2 ' r , ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
Other:
CO PART FAIL
HANICAL
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
Approach /Sidewalk Date 1 I 0 4 Inspector ""`" i ( Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL