Permit -
C ITY OF TIGARD PLUMBING PERMIT
rl� DEVELOPMENT SERVICES PERMIT #: PLM2004 -00401
' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/3/2004
SITE ADDRESS: 15575 SW SEQUOIA PKWY 140 PARCEL: 2S112DD -01600
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: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: 1 bar sink 1 water heater.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES [PLUMB] Permit Fee 9/2/2004 $72.50
15350 SW SEQUOIA PKWY #300 - WMI
PORTLAND, OR 97224 [TAX] 8% State Surcharl 9/2/2004 $5.80
Total $78.30
Phone:
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP#3
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 - 544 - 7464 Rough -in Insp
Top -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: _ Permittee Signature: DYf cry j ai a
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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Plumbine Permit Applicatio - pciR ( i s F_ ()NIA
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0 PttunING.: 44,14 00 yo/
13125 SW MR Blvd., Tigazd, OR 97223 0 - S Castor 950 ea
Phone: $0.1539.4171 Fax: 503_598.1960 0310.0 ... , , : Flati •
Taracilly: oram remit sitea) R dho 1
24- Hour lespeesion line: 503.639.4175 „AL.:-41' ow. p...deBy: -
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Interact www.ti.titausLor.us - tvuttaegusteuust -7-pc Sappleracasal tetterenatiors
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El New commentkin 0 Demolition Fs,- specie fracas's:deo &ae dame! Ia.
Deseripdon 1 Qty. 1 Ea_ I Thud
atAdditionfalecanionimplaceman 0 Other New 1-24armly dwelling' (Mendes WO tt. for each utility connection)
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0 t- and 2-6ani1y dwelling 1 . Coonnercialrandusrial SFR (2) bath - 350.00
0 As:armory building 0 biotti-fitanly SFR(3) bath 399.00
Each additional baduleitehen 45.00
0 Master Wilder [3 O ther:
Fixes sprinkler (____ sg. 0.) Page 2
;-_.11/3 ,; t ;".;:, .."':-., ,-... ..... :'''' LR:::-.: *: r1 • -
,... -. ...-4. - -,..7".:Z.nil el F. . ia;.&_,'. ...:.4, - .: -: . - 'i .1. .L_•?,1 .. ..t., t. :- 012 sae a lma
Catch basin erases drain 6.60
..--....7.-Tr di itita I_ MIIIIIIII , Drysta, leach line. or treacle drain 16.60
Footing drain (no. linear 0.:______) Page 2
Stdtealdespl. uo.: 140 C2=1=0 li
- 11.11oatiscoacd hen= utilities 110.110 .
Cross strcd/dirediam: to job site
Manholes 16.60
- Rain drain connector 16.60
. -
Page 2 . •
Sloan sewer (no. linear ft.: _.) Page 2
I Subdivision: I Lot no.: Water aervics (tia. linear ft.: ____) --- Page 2
nature Or item
I Tax soap/parcel no.:
Absorption valve 16.60
• - - .4 ' - .....-2. • d. :-.F.9;47:
r::1:* ` 0. . .... ,.....• !-It: 1- :1:•-•. 4 cF.,V,...4.,M■:::.:: - .:.- 1 4.5 thddlow prcrater Pa,ge 2
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- • ab . ,e___ A- ; ,, ...... valve 16.60
Ctothts washer 16.60
Disavosher 16.60
I/sicking fountain 16.60 ,
• i -3.4i ar .1 wgi#4C-q -1 ::.9.f-
• • - - - -, Ejectors/nom 16.60
Mon= Expansion tank • 16.60
Address: name/sewer cap 16.60 '
CityrSoneZIP: Plow drainifiaor sioldhub 16.60
Phone ( ) Fax ( ) Garbage disposal 16.60 . ■
16.60
.• ' ..: - _- '", '77: ' ••-• - -414.' - i.'i 1:-j-11, i;• 11;` '! '7 --..7. -. -- .: .4.R Husctft
4 . .. - '6ar. • ...'a:' - .' t'A 11 = : ,.... • . I.M. - 1 1 °?.^.7 .....e.; ice figker
16.60
Blida= BaIZZC C rl a P i v 1 fn\- (25 Cr) . • W° °1' 16.60
Comae sante GI- t
• •) .. I... Merkel gas (valac 5 _ ) • Page 2
• 16.60
Addiess: •2( '"; ' • t i .... .,. ,..-- • .., ,,,, ii,..... . - Primer .
Roof drain (commercial) 16.60
aty/Stater2IP: d -- ik' . r C 2_
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sinumerisrbwatoty i 16 la -(6 0
Pbu= ( ..,5 ) 15/44. -"--) 4 S . Fax' ' 1 ) /sq- ( et0 411 Tubfshowerfshower pan 16.60
E-mail: Urinal 16.60
:-Ik: DVAX" - -- -edi x .1;pw.r. i t. -...:. i-IiiElizsc water cios, 16.60
'1'...kRE:.:•••• - .1 - r.S - Z- - - , :-I:v.1:47.1.1:0 , • ...- -- ,-.1.4.-..:.....•*-: - -: - ....-- -. .. • . . -
Business man= C RS 0 A E.-,.. fp( lArY1‘ ikliC 0) • Water bentor I 1 I
16-60 110,46
Address: 2(130 k • b. . ' _ a II • 0 - 3 Other.
Subtotal
City/State/ZIP: ^ • ,- •
• .. Minimum permit fcc: $72.50
none ( ) 1 31.../ 1-1 - I I 1 -1 / f t-) Fax: ( ii <Q -6 log q Residential backflow minimum permit fee: 536.25 '72 56
Plan review (25% of permit fee)
0:33 Lie.: ' - , C Plumbing Lie. nem' • -L i?
State surchotge orh of pomit ree) . ■C
'
Autborized sigeantre:-. -i -f-lani r ib , a-xi? -05 TarAL.pgamn-FEE . . , AA
Print accum r ) ( 1 r‘; e Lk') ik) 6 - Date n permit applicadan maims if a permit is nor obru'ineil within
100 days after it has been accepted as complete.
*Fee methodology set by Tri-Cetutty Building Latium Service Boarc.
asuairsniumazara4-retratarnee 1 dahli6161(10,00VCOrdrviEin •
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a - d 6899882E0S -o3 2usciwnid apeose3 2T:80 t.0 TO deS
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received c— z� – Date Requested / / iT AM PM BUP
Location J . Z! .� r Suite MEC
Contact Person Ph ( ) � / '7f � PLM o70Q Y —DO '{d
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _d 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
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Oro
•A PART FAIL
ANICAL
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA Date l� C �k Inspector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL