Permit •
C ITY OF TIGARD PLUMBING PERMIT
l� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00429
c�J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/7/2005
PARCEL: 2S112DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
Project Description: TI, other fixtures are (1) expansion tank and (2) primers.
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: 2 URINALS: 1 GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES: 3
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 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 9/7/2005 $265.60
[TAX] 8% State Surcharl 9/7/2005 $21.25
Phone : 503 624 - 6300 Total $286.85
Contractor:
PMSI LLC
21195 NW EVERGREEN PKWY #204 REQUIRED ITEMS AND REPORTS
HILLSBORO, OR 97124
Phone : 503- 466 -2222
Reg #: LIC 158286
PLM 34 -434PB
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 • • low rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 :101-0010 thro OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
c. ing 503 - 246 -6699 o : a 332 -2344.
Is ued By: L I ad VA Permittee Signature:
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.
'" w
Pktmbi t? Permit Application FOR OFFICE USE ONLY
City of Tigard VA) 1P ,� ' j` Received _ � /
� �A ? %R j `' [ Date /By: � �n QS Permit Nol1M � f
13125 SW Hall Blvd., Tigard, OR 97223 . . -- "- Plan Review 1 , `•
Phone: 503.639.4171 Fax: 503.598.1960 c 444.100A1# Date/By: Other Permit No. $ -*VI
24- Hour Inspection Line: 503.639.4175 "J' l : -� e� l Date Ready /By: tare ® See Page 2 for
Internet: www.ci.ti ard.or.us is ; ')'1� Supplemental
g Notified/Method: lnformation
. TYPE OF nt F `TIGARO FEE* SCHEDULE
❑ New construction Blign IVEnStainSION 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 (I) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
El Accessory building 12 Multi-family SFR (3) bath 399.00
ID 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: I L1.ci '2), s Q OLt,v ` p�', t f q Catch basin or area drain 16.60
C i State /ZIP: T / C� 1 a .j "" " lUt Drywell, leach line, or trench drain 16.60
Al, Footing drain (no. linear ft.: ) Page 2
uit /bldg. /apt. no. Project name: A �--,
Cross street/directions to job site: Manufactured home utilities 110.00
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.: / Apr) "• Q / ( 00
Absorption valve 16.60
DESCRIPTION OF WORK
Backflow preventer Page 2
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 I 16.60 (4, (D0
Address: Fixture/sewer cap 16.60
City/State /ZIP: Floor drain/floor sink/hub )" ,- 16.60 33 .?
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Qmm ut Interceptor /grease trap 16.60
Contact name: .Yl Q. Medical gas (value: $ ) Page 2
Address: IVUV 2 4.1)zA t\ e r p uAkji gi ? Primer X 16.60 ,33 '•b
City/State /ZIP: jtVil y v I1 Qa Roof drain (commercial) 16.60
� 1 JV 17 U ' � � Sink/basin/lavatory j 16.60 ; g 3. 00
Phone: 5)?)) 5)?)) ,, ' Z�Z I Fax: : `,J3 - D.4-1
Tub /shower /shower pan 16.60
E -mail: Urinal i 16.60 1U,(60
CONTRACTOR Water closet V 16.60 LI 1, x 0
Business name: Water heater ' 16.60 1 53.Z+D
Address: Other:
City/State /ZIP:
Subtotal (pc, 4
Minimum permit fee: $72.50 t
1111hone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
I CCB Lic.: i 5 t Plumbing Lic. no.: 34-1-04 tiJ Plan review (25% of permit fee) /4
Authorized signature: ' L ` �l State surcharge (8% of permit fee) 4 9, I . 9.5
A k I' A I _ TOTAL PERMIT FEE Alkil__
Print name: ga IRV u , 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\Pc st•LM- PcrmitApp.doc 12/03 440-4616T(10/02JCOM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639 -4171 I I
Inspection Requests (24 Hrs.): (503) 639 -4175 '"I �..
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 29
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: TI, other fixtures are (1) expansion tank and (2) primers.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-624 -6300
CONTRACTOR: PMSI LLC PHONE #: 503 - 466 -2222
Inspection Request Scheduled For: Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 019010 -02 503-888-0214 N
Corrections /Comments /Instructions:
4cA cc . / �i-
C
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 Date: / 0 /21/ r Phone #: (503) 718-
CITY -OF TIGARD -
-
BUILDING DIVISION - PERMIT #: PLM2006 -00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7 /2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 - 4175 , 11,1- `'I .
INSPECTION WORKSHEET FOR DATE: 10/17/2005 TIME: 7:04AM PAGE: 30
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MG
DESCRIPTION: TI, other fixtures are (1) expansion tank and (2) primers.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 624 -6300
CONTRACTOR: PMSI LLC PHONE #: 503 -466 -2222
Inspection Request Scheduled For: Date: 10/17/2005 Pour Time:
Code # • -; - - • : - I - cription Confirm # Contact # Message
399 Plumbing final 018492 -04 503 - 888 -0214 N
Corrections /Commen uc ions:
K ® oQ w cad - K i I•-k\v'S .
(14 o w L Passva.z)
G) Pckswte kAicr k toLc. v ,,, , , i 2,12_ j _
% \ L V Av c - r6 .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
t FAIL 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�- � A � r�r� .r
Inspector: ° V v4 i Date: r - W Phone #: (503) 718- 2.40 ■
r .
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM2005 -00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639 -4171 r �
Inspection Requests (24 Hrs.): (503) 639 -4175 I..
INSPECTION WORKSHEET FOR DATE: 10/12/2005 TIME: 7:04AM PAGE: 38
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: TI, other fixtures are (1) expansion tank and (2) primers.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 6246300
CONTRACTOR: PMSI LLC PHONE #: 503 - 466 -2222
Inspection Request Scheduled For: Date: 10/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 018092 -01 503519 -0606 N
Corrections /Comments/ Instructions:
(
❑ PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: I ' , Phone #: (503) 718 -
CITY OF TIGARD . .
BUILDING DIVISION PERMIT #: PLM2005-00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2005
Phone: (503) 639 -4171 haw / ovalol
Inspection Requests (24 Hrs.): (503) 639 -4175 A. L.
INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7 :03AM PAGE: 82
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: TI, other fixtures are (1) expansion tank and (2) primers.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503. 6246300
CONTRACTOR: PMSI LLC PHONE #: 503 - 466 -2222
Inspection Request Scheduled For: Date: 9/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 015739-01 503- 519-0606 N
Corrections /Comments /Instructions:
PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / 6s Phone #: (503) 718-
e-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM2005 -00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/712005
Phone: (503) 639 -4171 1v:
Inspection Requests (24 Hrs.): (503) 639 -4175 II
INSPECTION WORKSHEET FOR DATE: 9/0/2005 TIME: 7 :09AM PAGE: 73
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: TI, other fixtures are (1) expansion tank and (2) primers.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 624 -6300
CONTRACTOR: PMSI LLC PHONE #: 503 - 466 - 2222
Inspection Request Scheduled For: Date: 91W2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 015144 -01 503 - 519.2475 Y
Corrections/Comments/Instructions:
b- e
IF • - SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 97. 7 , - , Date: V IP Phone #: (503) 718-