Permit r ,
u CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00300
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/13/2007
PARCEL: 2S 112DA -00800
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: PAC STAR
Project Description: Cap (1) sink & (1) toilet and replace (1) sink.
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: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PACIFIC REALTY ASSOCIATES •
15350 SW SEQUOIA PKWY #300 -WMI Description Date Amount
PORTLAND, OR 97224 [PLUMB] Permit Fee 7/13/2007 $72.50
[TAX] 8% State Surcharl 7/13/2007 $5.80
Phone : Total $78.30
Contractor:
JAMES ROOD PLUMBING
2459 SE TV HWY PMB #168
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 648 -3907
FAX 503- 681 -2196
Reg #: LIC 57355
PLM 34 -199PB
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 worts 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 ailing 503.' 6.6699 or 1.800.332.2344.
Issue B �(� Permittee S ature: , ��j /
By: — maw �._
Call 503.639.4175 by 7:00 a.m. for an inspection that • usiness 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.
o ,rf ROM : JAMES ROOD PLUMBING FAX NO. : 503 6483907 Jul. 12 2007 12:21PM P1
• • -• • • V1J L Vr a. L Vly.y
t 1 �wvvy
- Plumbing Permit A iica>mou
of Tigard b .•4t C 6.� ts
City ''"
13126 SW H a l l Tigard, DR 97223 Nay: • Per'4124. ace*" - eel 360
. Phom: 503.639.4171 Fax: 503 59 40 1 2 2001 tawdry: Omer Permit No,: 1 -' • )
T 1 i ; in Lhte: 503 639.4175 - ,
Warm:: wwatignrdet.go �. a N � l
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Q i.tw construction HT J � i i v 131 �� POP _ on�,7Y.a gat alu
JZ AddlCOalal credoal'epiacoa:ctl ❑ether. 1[0111 Es. Tots
,Wow 1- Emily dwell= C•whrdee 100 ft for earl, Airy eoaaectina)
'4LT G R T C AF c 0O14#1 . 404131* 8FA (1) b ads_ 249?0
0 1- and mm
2- family dwelling 0 Coarcialadtistrial 8FR (2) bath _ 3S0.00
❑ Romano blinding ❑ Multi family SF1t (3) bath 399.00
❑ Master builder ❑Other: Leh additional bathAdteime 45.00
` • <i , J� 11C<'L� . >? •. • Fire.prl:Wet ( s4 ft) Page 2
�O>►4fl1OlY A1�1D' LOiA1TQQr1 Site Kinks Job airs address: 1 SO s SW SC 4oie.. P ctaehbosto or asendrain 16.60
CSty/51.re/2fg: A6..tlt�..d / 0 Y ten, Iowa line, or wax* dish I 16.60
, �Sa ld itrt eo.: 16 0 1 gmj oaotc �• y FootluQ tare (ao.1b rte: ,..J
Page • i ZOss to job Fite: 110 Op
Manbdes 16.60
Pain drain =motor 16.60
Sanitary nue (no. Fear R: _) zniimmil
Storm saws' nowt: ,....) PA 2
SuDdivisioro I Lot ear Were 'entice (ao. Omar fl.: _J Pose 2
Tax asapiparoal no.: A5) (T) �' 00800 °`
;`( OF`'03tR' Absorption valve' 16.60
C e, /0.1./ "� K 7b (,t,.f•: C. �`t7 kk Bonbon= yobs Pest
60
���i e} S i �.0 C» 1 7a 11;.rt �'
it C1otboc washer
.. MN 1660
pishwacl,e: ` 16.60
: ET PLO ?Pffi+p'QyV : In DrtNdag famahii s 1660 Mil
Notuz 16.60
Address: > ion leak 1660
Fl cap - 1660 33. 2
GYty/StuzeMP: Floor dra e/floor obibibub 16.60
Mar ( ) Fax: ( ) Garbage disposal 16.60
- : <- °' • : 1.=a thoppudi2,47. • - _ :,.-.p . • . Q •C_OZrrisc It'> 3;$0pr _ Hoce bib ■ 16.60
austaass mom
1016¢1 1660
Catsact nom
P 16.60
aedregc: Modica/ sa. (value: s Pap _
Prather 16.60
C am' Roof drala (commmoinl) 16.60
n o = ( ) Fax:: ( ) Sinklaaabtllavatoey ,all 16.60 g .. (
F•mail: 7ub/ctiowe>ysboas or Pdrrt 16.60
C•4bx:. . . , ( . utlt r 1660
Warm dot 16.60
Siam Dearer
• I _ 16.60 1
City/State/IIP: r % , , M 0 `, _ / / Subtvrrrr 30
Pte ( ) - re) Pa ' (54) 68/- u e
e r Ro ai dmi.l 6addlow sa ni minimum is 536,25 - .
COB l..te.: - i r+�a t«: ss6.0 7oZ
3 SS / P lumbing lie. no.: -/ � p Pf i review (2514 of peanle tree) i
Audyasized.i :.. jr State sercherpe (8% of permit rte ) 5. $0
PmIt,uor,e, arl gr" A flats: ATM" ra
Pita. Farr aplaulllon sages To-That..
s L o U ed', j
180 days 4tar it 4ag Iwo aetsepntd of
1•dbhYOemift neese�.mo la:rae .a.sianotweatwato rFestaatbsdoloa�aet tnao lac Hoard.
t Accumulative Sewer Tally Parcel # 2S112DA -00800
Tenant Name: Pac `itar This SWR# 2007 -00176
Site Address: 15055 SW Sequoia Pkwy# 100 This PLM# 2007 -00300
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off # s count # value # s values
Baptisery/Font 4 0 0 0 0 0
Bath - Tub /Shower 4 0 0 0 0 0
- Jacuzzi /Whirlpool 4 0 0 0 0 0
Car Wash - Each Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor /Water Aspirator 1 0 0 0 0 0
Dishwasher - Commercial 4 0 0 0 0 0
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain /Sink - 2 inch 2 0 0 0 0 0
- 3inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash Drn 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 0 0 0
- Industrial (over 5 HP) 42 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar /Lavatory 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 0 0 0
- Service 3 0 1 3 0 -1 -3
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 2 9 0 0 -2 -9
Current Fixture Value -9 divided by 16 = -0.6 Current EDU 1 EDU = $ 2,800
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
(lunge -9 divided by 16 = -0.6 over (under) $ (1,680.00)
Enter EDU Change Here -0.6
Notes: * **CREDITS * **
I
Authorized Name /Signature: Debbie Adams 0 II• Date: 7/13/2007
Bu u' g Division
'Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\ Building \Fomu \SewerTallySheet.xls 02/02/07
Accumulative Sewer Tally Parcel # 2S112DA -00800
Tenant Name: Pac Star _ This SWR# 2007 -00176
Site Address: 15055 SW Sequoia Pkwy# 100 This PLM# 2007 -00300
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value capped off value added added total total
count off # s count # value # s values
Baptisery/Font 4 0 0 0 0 0
Bath - Tub /Shower 4 0 0 0 0 0
- Jacu zi /Whirlpool 4 0 0 0 0 0
Car Wash - Each Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor /Water Aspirator 1 0 0 0 0 0
Dishwasher - Commercial 4 0 0 0 0 0
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink - 2 inch 2 0 0 0 0 0
- 3inch 5 0 0 0 0 0
- 4inch 6 0 0 0 0 0
- Car Wash Dm 6 0 0 0 0 0
Garbage Disposal
- Domestic (to 3/4 HP) 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 0 0 0
- Industrial (over 5 HP) 42 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink - Bar /Lavatory 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Commercial 3 0 0 0 0 0
- Service 3 0 1 3 0 -1 -3
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 -1 6 0 -1 -6
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 2 9 0 0 -2 -9
Current Fixture Value -9 divided by 16 = -0.6 Current EDU 1 EDU = $ 2,800
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -9 divided by 16 = -0.6 over (under) $ (1,680.00)
Enteer_�E Change Here -0.6
Notes: ** *CREDITS *** 474/ C �L,P.,elf_ aligt;z. ro I'i-M0m0// / .oIl? az,..„.,..A.,i
Authorized Name /Signature:; Debbie Mains i Date:' 7/13/2007
B 1. g Division
'Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I: \Building \Forms \SewerTallySheet.xls 02/02/07
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00300
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/13/2007
Phone: (503) 639 -4171 t
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 7/31/2007 TIME: 7:07AM PAGE: 41
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: PAC STAR
DESCRIPTION: Cap (1) sink & (1) toilet and replace (1) sink.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: JAMES ROOD PLUMBING PHONE #: 503-648-3907
Inspection Request Scheduled For: Date: 7/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 053073 -01 503 - 939.4632 Y
Corrections /Comments /Instructions:
Cety -e, c--1L.4.1.‘,.:4 fr
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: rn 141^ -' \'L-'--- Date: — 4 31 / 6 7 Phone #: (503) 718-