Permit N. , NI
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00505
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/14/2007
PARCEL: 2S112DA -00300
SITE ADDRESS: 15230 SW SEQUOIA PKWY 100 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: A COMMON THREAD
Project Description: Replace existing sink. No increase in dwelling unit count.
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: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [PLUMB] Permit Fee 11/14/2007 $72.50
[TAX] 8% State Surcha 11/14/2007 $5.80
Phone : Total $78.30
Contractor:
ADDISON PLUMBING
1407 HOMESTEAD PLACE
MOLALLA, OR 97038 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -785 -1840
FAX 503- 829 -9701
Reg #: LIC 151754
PLM 3 -449PB
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 or 1.800.332.2344.
Issued By: Permittee Signature: A 1 ,A:do-
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.
•
Plumbing Permit Applic , ri,„ CE WE FOR OFFICE USE ONLY
City of Tigard p 1/ Received Permit No.:'
a 13125 SW Hall Blvd., Tigard, OR 47223 1 4 /1--11-!/ Date/By: 1 I t , a j 14 „. , YO /'J
Other Permit No.:
M
Plan Review
Phone: 503.639.4171 Fax: 503 tt. wimp Received
Inspection Line: 503.639.4175 Date Read B Ju;S El See Page 2 for
TIGARD Internet: www.tigard- or.gov ������� ®���'Onl Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. Total
V Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- family dwelling 73 CommerciaUindustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additionalbath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 1 SZ3 C. 5u3 56 Cil u-o " p KAF4‘"? Catch basin or area drain 16.60
City/State /ZIP: Tz . ta „.3). to Drywell, leach line, or trench drain 16.60
�. ldg. /apt. no.:`P' 10d I Project name: Footing drain (no. linear ft.: ) Page 2
R Cou+•+.�6�
Manufactured home utilities 110.00
Cross street/directions to job site:
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 Backflow preventer Page 2
R-e S eat I bre o�C.Nrcre4-. ...At - S� (I 4C L . 0.1 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: C �cf■C-.• . 4 1` • Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City/State /ZIP: Floor drain/floor sink/hub 16.60
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: : ( ) in asin/lavatory i 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: t od,.��,,, QhOA); (%) (L.C. Water heater 16.60
Address: zi s S,4, eo- r�
..o.,-e,c� Other:
City/State /ZIP: A �„ Ca_ Q1042- Subtotal
�� �
Minimum permit fee: $72.50
Phone: (Sa 3 ) 6 s Z. - 16s7 Fax: (Sb3 ) ,s Z - f 1 b1 Residential backflow minimum permit fee: $36.25 73..
CCB Lic.: (511 1- Plumbing Lic. no.: 3 -t Q Q Plan review (25% of permit fee) v
( State surcharge (8% of permit fee) . OU
Authorized signature: d"Yt� TOTAL PERMIT FEE if
Print name: J CC 'e Date: it - Iq- o'i 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.
1:\ Building \Pemtits\PLM- PcnnitApp.doc 06 /26/06 440.4616T(10/02/COM/WEB)
iSb.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PI,M2007 -00505
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11i 14 /2Qtl7
Phone: (503) 639 -4171 fiz �I I Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 12/11/200 TIME: 7 :00AM PAGE: 7
SITE ADDRESS: 15230 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: A COMMON THREAD
DESCRIPTION: Replace existing sink No increase in dwelling unit count.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #:
CONTRACTOR: ADDISON PLUMBING PHONE #: 503-785-1640
Inspection Request Scheduled For: Date: 12/11/2007 Pour Time:
Code # • Inspection Description Confirm # Contact # Message
399 Plumbing final 001293-01 503,320-860i Y
Corrections /Comments /Instructions:
('ogre ; k'.- 01 Pt'
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (TD 14 - 4 -4-/ t t ` /1 Date: (2{ (I (3') Phone #: (503) 718-