Permit ... • •
'r ~ • CITY OF TIGARD
PLUMBING PERMIT
ri I l� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00670
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/13/2005
PARCEL: 2S112DD -00701
SITE ADDRESS: 15800 SW UPPER BOONES FERRY RD A -300 ZONING: I -P
SUBDIVISION: 'OREGON BUSINESS PARK II LOT: JURISDICTION: TIG
Project Description: • TI
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CLASS OF WORK: ALT 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
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Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 • [PLUMB] Permit Fee 12/13/200E ' $116.20
[TAX] 8% Statc Surcharl 12/13/200E $9.30
Phone : 503 624 - 6300 - Total $125.50
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Contractor:
ADDISON PLUMBING
1407 HOMESTEAD PLACE REQUIRED ITEMS AND REPORTS
MOLALLA, OR 97038
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Contact # : PRI 503- 785 -1840
FAX 503- 829 -9701 •
Reg #: LIC 151754
PLM 3 -449PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if Work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center.' Those rules are set forth in OAR
952 - 0001 -s.o • 'ugh OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 5 0 3- 246 -669 • o - 0 32 -2344.
Issued B .: ( Permittee Signature: y
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Building Fixtures
Plumlbin " "' tt
e g0 UIG lit n FOR OFFICE USE ONLY
Received I ►
City of Tigard Mr... ' nn, Date/By 1 0 ' f Permit No (ga 04,70
13125 SW Hall Blvd., i :i ., OR 9722 Plan Review i
Phone: 503.639.4171 Fax: 503.598 1960 S / /sr, 4,, Y Other Permit No.�'�.OWJ '�D 4.
■ Date/B .
24- Hour Inspection LiQJTS� r"•�p-► � LARD �0' ' _ '''I I,. Date Ready/By J El See Page 2 for
Internet: www.ci.tigs� ?LD�NG Ilf1hl$(O ' J Notified/Method. //Z ,J d ' ' Supplemental Information
TYPE OF WORK ///���� ( ti FEE* SCHEDULE
❑ New construction ❑Demolition For special information use checklist.
DeXPIO n I Qty. I Ea. I Total
Is Addition /alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 249.20
❑ I- and 2- family dwelling gl Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ 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. t site, Sw w >ioo s 2b 13-3 Catch basin or area drain 16 60
City /State/ZIP 1-_0. . oc, ,., 0 . op_ 910 ?S Drywell, leach line, or trench drain 16.60
Suite. /apt. no.. Q, Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /d to job site: 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
Tax map /parcel no 0/5 /I a 7) a - Q07v/ Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Back flow preventer Page 2
Backwater valve 16 60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain
16.60
Name: P,s._ Ty Expansion tank 16.60
Address: is-38- Su. rje,q_o∎ w ['Kw-5 `tk 3 c0 • Fixture /sewer cap 16.60
City /State /ZIP: 'b, 09-- et 7Zz4 loordra floorsink /hub I 16.60 /t.. t„o
Phone ( 503 ) bZ4- fe ;o-c Fax" (SO-• ) (,-Z�.I. -1755 Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address Primer 16.60
City /State /ZIP Roof drain (commercial) 16.60
Phone: ( ) Fax: : ( ) in asi avato ; S`^'4 3 16.60 '4 t-`ar
Tub /sh s ower pan / 16.60 /6.60
E -mail:
Urin 16.60
CONTRACTOR Water closet Z 16.60 51 .'LO
Business name p\kq;Se,,,, Q v cs Water heater 16.60
Address: iyol Ko•a.,,.cSi1e P\o-x -e Other:
City /State /ZIP.,M of?-... cj•7 Subtotal //40,..
Minimum permit fee: $72.50
Phone: (sz3 ) 7SfS -1S`4 f5c;- 7vo- -criib Fax: (Se 3 )g i' i Residential backflow minimum permit fee: $36.25
CCB Lie.: (s Ste- Plumbing Lic. no.. 3- 4449'
Plan review (25% of permit fee)
State surcharge (8% of permit fee) !' ,/V
`
Authorized signature: ei p s> TOTAL PERMIT FEE ia•SQ
Print name. 30..y tM•pov a Date 1 2 - S -- or 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.
1\ Budding \Permis\PLMF- PermitAppdoc 06/05 440- 46t6T(IO/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information sr ` N
'Fee Schedule: Residential Fire Suppression Systems:
. Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I 100' 55 00 0 to 2,000 $115 00
Footing drain - ea additional 100' 46.40 2,001 to 3,600 $160 00
3,601 to 7,200 $220 00
Sewer - I st 100' 55.00 7,201 and greater $309 00
Sewer - each addition. 100' 46.40
Water Service - Ist 100 55.00 Medical Gas Systems: /
Water Service - each add Tonal 100' 4640 Valuation: Permit F,ie:
Storm & Rain Drain - 1st 00' 55.00 $1.00 to $5,000.00 Minimum $72.50
Storm & Rain Drain - each ...ditional 100' 46.40 $5,001.00 to $10,000 00 $72.50 f. the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additi, -al $100.00 or fraction thereof, to and
met • mg $10,000.00.
Commercial Back Flow Prey - ion Device 46.40 $10,001.00 to $25,000.00 $ 8.50 for the first $10,000 00 and $1 54 for
Residential Back flow Preventio Device -. ch additional $100.00 or fraction thereof, to
(minimum permit fee $36 25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.0t $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per h , ur 72.50 and including $50,000.00.
Subt tai: $50 00 and $742.00 for the first $50,000.00 and $1 20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fix res? If "yes ", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria
accurately report fixtures could result in inc • ased sewer 'ees *. Please check all that apply.
Quantity by (Fixture) Wt k Perfor ed ❑ Any new commercial building.
Fixture Type: place ❑ Any new exterior plumbing site utilities.
Previous Capped Added Listing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tu.117 I $ ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi irlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain Any NFPA 13 -D multipurpose fire sprinkler system.
Eye Wash
floor Dralasink U t
Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain � I oometric or Riser Diagram
Garbage - Domestic ❑ Isometric orl•ise�er diagram is required for new buildings
Disposal -Commercial three (3) or morestories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Statio Comments regarding fixtu a work:
Rec. Vehicle Dump S • ion
Shower -Gang
Stal
Sink ' avatoj, J I
radley
• ommerci
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this ermit results in an
Water Extractor p
Water Closet - Toilet I I increase of sewer EDUs, a sewer permit will be issued and
. Urinal fees assessed for the sewer increase must be paid before the
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Other Fixtures: plumbing permit can be issued.
i. \Building\Per mtts\PLM- PermitApp doc 07/06/05
CITY OF TIGARD
‘ A
BUILDING DIVISION PERMIT #: PI-M2006.00$70
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/130006
. tais6
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' 'll..
INSPECTION WORKSHEET FOR DATE: 1/20/2006 TIME: 7:00AM PAGE: i00
SITE ADDRESS: 16800 SW UPPER BOONES FERRY RC) A -300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME. MATTHEWS GALLERY
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -524- 6300
CONTRACTOR: ADDISON PLUMBING PHONE #: 503 7135 - 11340
Inspection Request Scheduled For: Date: 1/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 025314 -01 603-740-8116 N
Corrections /Comments / Instructions:
( I
r/ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: // ?/( l/ i Phone #: (503) 718-
CITY OF TI 1 C O GARD
BUILDING DIVISION ` PERMIT #: PLM2005-00670
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/l31).005
Phone: (503) 639 - 4171 .. 11
Inspection Requests (24 Hrs.): (503) 639 -4175 s'!+� ° I..
INSPECTION WORKSHEET FOR DATE: 1/3/2006 TIME: 7:01AM PAGE: 7
SITE ADDRESS: 1800 SW UPPER BOONES FERRY RD A - 300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK Ii LOT #: TYPE OF USE:
PROJECT NAME: MA1THE_WS GALLERY
DESCRIPTION: Ti
OWNER: PACIFIC REALLY ASSOCIATES, PHONE #: 503 - 624 - 0300
CONTRACTOR: ADDISON PLUMBING PHONE #: 503 785 - 1110
Inspection Request Scheduled For: Date: 1/3/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 024298 -02 03 740.8116 N
Corrections /Comments /Instructions:
6_
PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: I / Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM200 00670
13125 SW Hall Blvd., Tigard, OR 97223 ! DATE ISSUED: 12113/2005
Phone: (503) 639 -4171 / ' r
Inspection Requests (24 Hrs.): (503) 639 -4175 °'IL.
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 8
SITE ADDRESS: 15800 SW UPPER BOONES FERRY RD A -300 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME: MATTHEWS GALLERY
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-624 -6300
CONTRACTOR: ADDISON PLUMBING PHONE #: 503- 785 -1840
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 023633 -01 503-740-8116 N
Corrections /Comments/ Instructions:
i ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
W I -.
Inspector: V Date: ,)- 6 61 Phone #: (503) 718-