Permit s a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00296
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/11/2007
PARCEL: 2 S 113AB -01201
SITE ADDRESS: 16290 SW UPPER BOONES FERRY RD BLDG E ZONING: I -L
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: CALYPTE
Project Description: TI -
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: 1 GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 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 7/11/2007 $215.80
[TAX] 8% State Surcha 7/11/2007 $17.26
Phone : Total $233.06
Contractor:
ADDISON PLUMBING
1407 HOMESTEAD PLACE
MOLALLA, OR 97038 REQUIRED ITEMS AND REPORTS
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 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these es or dir questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
A
Iss d By: / �/4l 4 / Permittee Signature: ` % ∎ k ! 1 L� / jam /; 4
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.
1
i
Pl Permit Application .. U . FOR OFFICE USE ONLY . '
Received No /n� ^�
II � City of Tigard Date /By 1 11 07 Li wag
v 1 3125 SW Hall Blvd , Tigard, OR 97223 Plan Review
= , r .. Phone 503 639.4171 Fax: 503 598.1960 Date/By. Other Permit No.: 5.1011-,9407- vb l 7,
Inspection Line: 503 639.4175
TIGAR - ' Date Ready/By I nteme t: www ti and -or. ov t;
ry' - �*_, ', g g Notified/Method � s ®See Page 2 for
1 (�( Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑ Demolition For special information use checklist.
Description I Qty Ea. I Total
K Additionlalterationlreplacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
❑ 1- and 2- family dwelling Commercial /industrial SFR (2) bath 350.00
El Accessory building CI Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45 00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft ) Page 2
• JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: l6, a 4 t% � �� es 77 'Ed Catch basin or area drain 16.60
�r y,
City/State /ZIP: T.e.ar► DK g 9,2 Z 4 Drywell, leach line, or trench drain 16.60
Swte/bldg /apt. no I Project name : / � Footing drain (no linear ft : _) Page 2
[ Manufactured home utilities 110.00
Cross street/directions to job site: 72 e 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
.A5 // 3 9 6 /2-0/ Fixture or item
Tax map/parcel no.• A .r
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
/', a�� j r,1,/1 N A li e .iA� Backwater valve 16.60
-1 �l Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16 60
Ejectors/sump 16 60
Name Expansion tank 16.60
Address Fixture /sewer cap 16.60
City /State /ZIP: lour drai Floor sink /hub 2 16.60 j 3, oTD
Phone. ( ) Fax ( ) Garbage disposal 16.60
1:1 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 /4s too
City/State /ZIP Roof drain (commercial) 16 60
Phone ( ) Fax:. ( ) Sink/basin /lavatory lig 16 60 g
Tub /shower /shower pan 16 60
E -mail:
Urinal 16 60 idOO
9
CONTRACTOR Water closet 3 16 60 ty c. qt)
Business name. ptdd Q lv,s4.1o', ,, LL c Water heater 1 . 16 60 1 6, (Oa
Address 2142.5 f $egvsi ce.ct-t- Q. D Other.
City/State/ZIP Z Subtotal
Cit
Y 1N.wL%v.a0 r Oe. q' � t Minimum permit fee $72.50 f?G
Phone: (5a3 ) (4 L — i%or' Fax: (so; ) 632. - Met et Residential backflow minimum permit fee $36.25 OV3t
CCB Lie.: I S t 1 S Plumbing Lic. no.: 3 - pi.9 p Plan review (25% of permit fee)
State surcharge (8% of permit fee) / `J ,;?
Authorized signature TOTAL PERMIT FEE Z3 ,e)
Print name: 3- po MOO Date h —It —eel This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Trt- County Building Industry Service Board
i \ Bin ddtng\Pemuts\PLM- PcmnApp doc 06/26/06 440- 4616T(1 0 /02 /COM /WEB)
CITY OF TIGARD
BUILDING DIVISION � PERMIT #:
PLM2007- 002E16
13125 SW Hall Blvd., Tigard, OR 97223 / %\ DATE ISSUED: 7/11/2007
Phone (503) 639 -4171 _
Inspection Requests (24 Hrs.): (503) 639 -4175 s ' F BI I :.
INSPECTION WORKSHEET FOR DATE: 9/612001 TIME: 7 :00AM PAGE: 68
SITE ADDRESS: 16290 SW UPPER BOONES FERRY RD BLDG E CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CALYPTE
DESCRIPTION: TI -
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADDISON PLUMBING PHONE #: 503 - -1t3A0
` lam""
Inspection Request Scheduled For: Date: ` 2007 1/ ` I ; Pour Time: `�
Code # Inspection Description Confirm # Contact # M- s-ge
3 99 Plumbing final 056199 -01 503-319-7343 Y
Corrections /Comments /I uctions:
(
e
Xj 4/.../7 A/_ f ,...--
,,Q 1-
- 4 1 3--S s /
.,
-, 77/.*"------'-
SS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� : A.(P/ _ - � z- Inspector: 1 ` Date. Phone #: (503) 718
CITY OF TIGARD _
BUILDING DIVISION
A -
j PERMIT #: PLM2007 -00296
13125 SW Hall Blvd., Tigard, OR 97223 .r./. DATE ISSUED: 7/11/2007
Phone: (503) 639 -4171 ✓
Inspection Requests (24 Hrs.): (503) 639-4175 o L ''
INSPECTION WORKSHEET FOR DATE: 7/27/2007 TIME: 7:03AM PAGE: 11
SITE ADDRESS: 16290 SW UPPER BOONES FERRY RD BLDG E CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CALYPTE
DESCRIPTION: TI -
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADDISON PLUMBING PHONE #: 503.785 -1640
Inspection Request Scheduled For: Date: 7/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 052912 -01 503 -740 -8116 N
Corrections /Comments/ Instructions:
tii--PASS H PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `�:I Date: 2 � / Phone #: (503) 718- il A
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLM2007 -00296
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/11/2007
Phone: (503) 639 -4171 j � l �►
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/19/2007 TIME: 7:03AM PAGE: 56
SITE ADDRESS: 16290 SW UPPER BOONES FERRY RD BLDG E CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: CALYPTE
DESCRIPTION: TI -
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: ADDISON PLUMBING PHONE #: 5033-785 -1640
Inspection Request Scheduled For: Date: 7/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 052327 -01 503 - 320.8601 Y
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6?) h ��ti Date: ✓, ` 47 \ (t)/ Phone #: (503) 718-