Permit •
C ITY OF TIGARD PLUMBING PERMIT
r4, DEVELOPMENT SERVICES PERMIT #: PLM2004 -00398
s� ..� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 D ATE ISSUED: 9/3/2004
SITE ADDRESS: 15575 SW SEQUOIA PKWY 100 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: 0 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: T.I. plumbing: (1) new tub /shower, (1) new 2" floor drain, (1) new water closet, (2) moved commercial
sinks, (1) replaced existing sink.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI [PLUMB] Permit Fee 9/2/2004 $83.00
PORTLAND, OR 97224 [TAX] 8% State Surchari 9/2/2004 $6.64
Total $89.64
Phone:
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP#3
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 -544 -7464 T o Insp
Top --out out Insp
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.
Issued By: / / � • A Permittee Signature: d Ql2f:22
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
10 0
t
Pinmbinf Permit Application I P FR i, F f r- t t r 0 • t. \
Cily l s .r+�ae+a.ox 97213 P �y � p
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es www.eitigatior.us g ---- - - tOstifirdidestak 1 S.ppe ae.m rarm+nattoe
ose the 4 Wl I 0 Dame ~
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0 01hcr Deswietlon I Qh I Ea. I Tort
alAddideclaketatiotriseplaccman Near 1.24.3a1b dwelling (includes 100 R for each utility co mccdon )
- :. .,, ,=1- = 249.20
0 1 -sod Meanly dwelling 1- SFR (2) bath • 750.00
0 Accessory indiding 0 MU]d- randly SFR(3) bath 399.00
Bach additional badmlioiarhm 45.00
0 Mazer binder 0 01hca:
4 .440,• m'f :'+= t= =r=o===t r== -= ' _. ►` f 'F1 I Siteaildldea
lob aa�ea i .�S r Su n u 1
) SE n i a_ .-lC u 1 4 Ducts begin or area dram 16.60
a 1°O21P' - 11 f - v t rT 0 z e l Oradell, leach sae, or trench drain 16.60
IIO` ji
/ P tojeatame Cove S • n Footing drain (1n0. linear 0.:____) Page 2
J � v ` J iH®,6mad hmno utilities 110.00
CROSS atcotxJlfiremom to job sure s 16.60
- Rain drain connector 16.60
Sanitary seam (no• linear ft.: _J Pagc2 -
Saone sewer (no. linear p.:. J Pete 2
Sub ivi de:1s 1 f at oar.: Water service (no. liner 0a _ .) , Page 2
Fatare Or item
Tess maptpaoeel no.: gbsotptiou valve - 16.60
i f - yy� ;Ir`677 .; a; y J Badlodow preverner Page 2
is ► 1\ 1� Backwater valve 16.60
Clothes member 16.60
. Dishwasher 16.60
. }� :. ilS fountain 16.60
_ � _. H :`1 16.60
Nem Expeusiort twit 16.60
Addis's: F ypy , ver ca p _ 16.60 Y/��`
Ptoor etrsal0oar sinkibub J 16.60 f (� .F V
tear disposal 16.60
Pbro+O�fa ( ) EC F � () Haacbib 1660'
Beat: 4,,,,,, ' b E. ! - Ih 1 h.cpwa reaac onip 16.60
Contact can= ( ki L_C) N ( " Medical gas (vale: s ) Page 2
Add'ss: 2 la 36 Jar . 14 a (ki-, -Is V.t.n d Dr- • 3 Petrner 16.60
_ Roof drabs (wrtQ
aaetai) 16140
t• >irtt 6 .1 y . ` ► C � in�b ata7 I 1640 qq -
Pb () � 7 mot- - �{ F....:( t .z0 � 4 co C Tab/dtowwa►c Older pen 1650
16.r„a Urinal 1640
F -1 tict�c'y�
:
�l�� j r T •'c :k _: = -r'1', ,� z a Wafer closet / 16.60 f te • Le �
biirii�i i . it1 W - ul fa R M.. � - ~ Water Ironer 16.60
11111.11TallmTh Subtotal
Ci SI* lit ' 6 r• d. sill ,, v • .. _ _ Minima permit fee: t12.50
` Fwc ( ) _ • - Residential backtlaw o®satmtpinlnt fee: 53625 ,5 , ( i
Pla review MK of permit fee)
� : , gg 3 Ploaabing I era : 311 -y ►A PA,
State =charge QM ofparaitfee) it 6 i f 1
Azahorlsod s ue ° ' l,(ii'j 6 (1 >rvi O Tam. PERMXT FEE 4;q . t Li
Tltis Pant 0, + a , d ilk V ". i permit ) application has been as =opiate.
within portal ig not obtained
•Fee aeethodology set by Tri -Canty Building Industry Service Baud.
atteatERReneSsiOUSOCOSSPOSdac 12m. e40•e6167(IWOR/COSO SIO
2. d 66996132E0S •00 2uigwnid apeose0 eE2 :80 b0 IC 2 n171
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ib - I ') AM PM BUP
Location /.‹.S �S •�-� � + /0( , I MEC
Contact Person di Ph ( ) PLM Do '-ad 3 28
4
Contractor Ph ( ) SWR
BUILDING Tenant/Owner � ELC
Footing
ELC
Foundation
Access:
Ftg Drain 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 -
A• ��
Sanitary Sewer 4.111111
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
411111145 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 D Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date /Pe( O Inspector . Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL