Permit Ir
A ITY OF TIGARD PLUMBING PERMIT
r DEVELOPMENT SERVICES PERMIT #: PLM2005 -00248
..� II DATE ISSUED: 6/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 DC -01100
SITE ADDRESS: 07298 SW TECH CENTER DR ZONING: I -
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Backflow device.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CIRCLE A W PRODUCTS COMPANY Description PHIL PINGSTERHAUS escription Date Amount
BY B -LINE SYSTEMS, INC [PLUMB] Permit Fee 6/6/2005 $72.50
HIGHLAND, IL 62249 [TAX] 8% State Surcha 6/6/2005 $5.80
Phone : Total $78.30
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Phone : 503- 771 -9449
Reg #: LIC 42671
PLM 34 -70PB
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: ,1 Permittee Signature: Ste., qi∎
'lJ
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.
06/06/2005 15:51 503 - 771 -9454 CROWN PLUMBING PAGE 02
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Plaint ire Permit A II ill n ^ 1,01i orrlu I.. t r. 0.1 .
City f' Ii i,ard i DR 97223 \` \� 1 O 6 L4o� A0= h 71)- I CJ Permit No�� 1 C-0 5.---40
13125 5 al Blvd„ T gard ./ ei, Plan Review Other PermitNo.; rffn Phone: 502 .63 P.4171 Fax: 503.598.1960 • M1r p, , mate/0 .
24- k In J,pC coon Lute: 503 639 4175 � O� 1 vase Ready/By: RI See P �2 for
I 1Information
n ernet: w :v .ci.ti ardor.us 1 Mcthod suppleme°
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34 ,��_ a�:r.l �i___r.�l�_ }.:} - .i'�:i.._C3 de'f.r.1.., -_.�l 1..1 _•,?,'_e.. e,,Y. ... � 1 5 .. � s.r l Y .1, 71; .,.Y.�. _ I.Ir
� _ For special ktforrn�on use Meagre.
❑ New cot sir rctioa ❑ Dem. lition Description ( Qty. 1 Ea. I Total ,
Additiof'al eration/rcplaeement ❑ Other _New 1- 2- family dwellings (includes 100 ft. for each utility connection)
� ;F 1 ri , , 4iL? ` r Y4 { �;?.,',}, I iy{ 1"�..1t � i'[i ' $ if i� } SFR(1)bath
', i ?, r � ,A - r P(Ip y , r r I v i- 1 1 t' , J Jr t J k c :,,,,,:i.,„,,5-7..,4 7 , 249.20 :��r as },,1, Sr _c:.s r _.4,,.i 1, t ', �,� .� }t. nv S r..dL.-_:i ;t 1aK: � ti --- �--�u . }. f r .. . . ..0 _z_ _
❑ 1- and 2 Fm oily dwelling Egl Comr terdalrrndustrial SFIt (2) bath 350.00
SFR (3) bath 399.00
❑ Accesso y I milling El Mull:lh 45.00
- mily Each additional bath/kitchen
[l Master 1 rail ler ❑ Otbe Fire sprinkler ( sq. ft-) Page 2
vfl /yt 4 di }F,f I + IN Srr t't rZ•L x Ft �y j t 1. 0,1 7 ��•t�r J iI t . ,ark ;i�', ,{k4- _ i 1 `i -i ,'
}�' i hi t 'J ' i y r .. J r � u ! , • h J , l - ,..., y ,. : 4 70 1, i n b'`y.l � 7 n� 7 � 91 I L t.m. f v g C - a r' I r v 'ii -
..fi.I,t.�i..l• e .1 a..:.�>�._ X13 ti,r -.r.._ .�,t .n11 }....a.r ,L:.,l.].�.r> =,3,.. Site Politics
Job site add :%s;: 7298 Tech Center Drive Catch basin or area dram 16.60
Ciry /Stater .IP Tigard, OR 97223 _ Oryweli, leach line, or uench drain 16.60
; Footing drain (no. linear R,: Page 2
dg Ipt . no.: Project name: Mtt1t era. 3 Plastit� Manufactured home utilities 110.00
Cross stree 'di'ections to job site: Manholes 16.60
• Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _ ) Page 2
"" Storm sewer (no. linear ft.: • 1 Page 2
Subdivisioi ^ I Lot no.: Water service (no. linear ft.: Page 2
Fixture or item
Tax map /p{ roll no
p� t r „ c r , ' r r i r c ' s � t � ; mv Absorption valve 16.60
n37,0 il- iliV.i li' n i.7., 3 ? + ,17Il,! i 7 -3 �d,: rl ? , . 1'Fy. PS�'J�t� y r r: zS i4� M 'W� ,, k ]'/
s t 1 N Z 1 .4 ) tit t r + t t } t 1 '.k L . 1 h ' ,, 1 ' Baclflow proventer / Page 2 1 4‘. 4o
,t }.m.v c. !� u9 ;,.. u.L rr.9- .._.L. "., ro_Crl4ur2. ..c�.�� Vl�7� Y t(c. ,_., ,k.v. stu_.t L , I.o �,f
Change or it o Id DOUBLE CHECK Valve with new 11! / inch Valve. Backwater valve 16.60
Clothes washer 16.60
• Dishwasher 16.60
n r c ,, ' . ' . r � j 7.: i 4 "P- 4i! r y l r'1 jZP itl ar�c r �. L,'i el 7c +i a . Drinkin fountain 16.60
.or • { irit i Qry -. f j','` : r 1 . : :_ trc, r . :4 I , .k r r t ' f :``ry'I
'.d1. :.�. ;w ��_ . t ilt ,i..,.,t�A.�I.h.l..t. 'r.'.r�.� r, .:.{ ,N� ,�.A� A._ .�>_,l�•rd,..., .r�;u3 Ejectors/ S LLIrt Q 16.60
Name: Mu di Craft Plastics expansion tank 16.60 .
Address: 7 !9! Tech Center drive Fixture /sewer cap 16.60
City /State/ !If : Tigard, OR 97223 Floor drain /floor sink/hub 16.60
• Phone: (50 !i)3 520970 Fa x: ( ) y _ Garbage disposal 16.60
iC?� }q r r ,i v t G 1 Iii r , t
1+;.7 rF.." } J'! - i; , ,1 ri W y t�� f-y, i r ,3 1 rt �C r ,ryi - Hose bib 16.60
8 1:.r,.i:11�'�, 1_ I i∎ :.,, i ' Ii.tl „s.- - ,,, - � r r is t. a?1ids i ,,.1 „ii� _ ;; T ri 1 . •∎ ∎;= C_._iv.7,e..,L.ic: %R2Li 'l!
ice maker 16.60
Business n sm:: Interceptor /grease trap 16.60
Contact ns .ne: _ Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State, .!D'• Roof drain (commercial) 16.60
Phone: ( ) Fax ( ) Sink/basinflavatory 16.60
Tub /shower /shower pan 16.60
E-mail: �, r vxr) 1 y a r 't' 7.., r cr �.(( 1Jrinal 16.60
('gi : tit r SC rOir,I Lalv 111101. 7 fi ;."e J rl�.� 1 'r' ,?f PV ,W iI,I 'e ttt: '1 NF.1.�
.L,.. :.•,r, r I :a." d uiL.4.f E3 /1:;', ;�. :4, F z: �.L affil ' x'sh ' . t t ; ,.il i 11l ,il Water closet 16.60
Business r !un e: CROWN PLUMBING Water beater 16.60
- -
Address: 5429 SE FRANCIS STREET Other:
City /State i!1]': PORTLAND, OR 97206 Subtotal
Minimum permit tee: $72.50
Phone: (5(: 771-3443 Fax (51,3)771-9454 Residential backfl minimum permit fee: 536.25 7 _.,, ow
Lie.: 42 i71 / Plumbic Oie_ no.: 34 - 70PB Plan review (25% of permit fix)
Authorizer i si rnahue: / � I State surcharge (8% of permit fee) .5' &O
■ _ TOTAL PERMIT FEE 17 ' ?O •
Print name )C ennis Underwood I Date: •C� This permit application expires ifa permit is not obtained within
180 days alter it bas been accepted as complete.
' *Fee methodology set by Tai- Cosmty Building Industry Service Board.
I; i3WldIng1Per :rit'PLM- PermitApp.doc 12/03 4404616T(10/02/OOMWEB)
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM200S -0024B
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/16/2005 TIME: 7:10AM PAGE: 101
SITE ADDRESS: 07298 SW TECH CENTER DR CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MULT CRAFT PLASTICS
DESCRIPTION: Backflow device.
OWNER: CIRCLE A W PRODUCTS COMPANY, PHONE #:
CONTRACTOR: CROWN PLUMBING PHONE #: 503-771 -9449
Inspection Request Scheduled For: Date: 6/1612005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 009373 -01 503 -771 -9449 N
Corrections/Comments/Instructions:
," e gy p. ✓'t Q- cwL --s/� - f Xi,e7 � 4 -d0 ✓ lT.
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C arte F�',�al� �t-✓
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (TO t-%.v ; `\ rte-- Date: G, i / 6 /oS °. Phone #: (503) 718-