Permit I c� . V t •
i CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00170
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/26/2007
PARCEL: 1 S 135BB -00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I - P
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HEMCON
Project Description: 340' of storm sewer work for addition.
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 340 ft
Owner: FEES
HEMCON TECHNOLOGIES
10575 SW CASCADE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/26/2007 $147.80
[TAX] 8% State Surcha 4/26/2007 $11.82
Phone : 503- 245 -0459 Total $159.62
Contractor:
COFFMAN EXCAVATION LLC
PO BOX 687
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 656 -7000
Reg #: LIC 146689
PLM 3 -407PB
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 rul- : • uestions to OUNC by calling 503.246.6699 or 1.800.332.2344. •
* " 1' Iss d By: i ` I ` &.��. Permittee Signature:
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.
4 ,
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Plum P ermit Application FOR OFFICE USE ONLY
City of Tigard Received / w
Date/By. p 07 W/ 70
7 Permit No : t q 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
3
Phone. 503.639.4171 Fax: 503.598.1960 Plan Review
-
Date /By Other Permit No..
Inspection Line. 503.639 4175 Date Ready/By: �� ®See Pa e 2 for
TI G A R D Internet: www.ti and -or. ov S
g g Notified /Method. `� Supplemental Informat
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249 20
❑ 1 - and 2- family dwelling ® 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 spnnkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 10575 SW Cascade Ave. Catch basin or area drain 3 16.60
City /State /ZIP: Tigard / OR / 97226 Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: I Project name: HemCon Facility Expansion Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Approximately 1000 ft. NW of Greenburg
Manholes 16.60
Rd. on Cascade Ave. - Back side of existing building. Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.. 340) Page 2 A/7. &O
Subdivision: I Lot no.: Water service (no. linear ft. _) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Demolish and relocate existing storm line around proposed building expansion. Backwater valve 16.60
Demo 15" concrete line (approx. 210 LF) Install new 15" PVC (approx. 340 LF) Clothes washer 16.60
Install laterals and connect to existing Dishwasher 16.60
® PROPERTY OWNER I ❑ TENANT Dnnking fountain 16 60
Ejectors /sump 16.60
Name: HemCon Medical Technologies Expansion tank 16.60
Address: 10575 SW Cascade Ave. Fixture/sewer cap 16.60
City /State /ZIP: Tigard / OR / 97226 Floor drain/floor sink/hub 16.60
Phone: ( ) I Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Coffman Excavation
Interceptor /grease trap 16.60
Contact name: Chad Sawyer _ Medical gas (value: $ ) Page 2
Address: 13014 Clackamas River Rd. Primer 16.60
City /State /ZIP: Oregon City / OR / 97045 Roof drain (commercial) 16.60
Phone: (503) 656 - 7000 I Fax: : (503) 656 -0686 Sink/basin / lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: csawyer@coffmanteam.com
coffmanteam.com
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Coffman Excavation Water heater 16.60
Address: 13014 Clackamas River Rd. Other:
City/State /ZIP: Oregon City / OR / 97045 Subtotal
Minimum permit fee: $72 50 go
Phone: (503) 656 -7000 Fax: (503) 656 -0686 Residential backflow minimum permit fee: $36 25 1
CCB Lic.: 146689 Plumbing Lie. no.: 3 -407PB
Plan review (25% of permit fee)
State surcharge (8% of pennit fee) / /,j9
Authorized signature. + p ).. ( t
TOTAL PERMIT FEE / • op,
name: I
r -L._ � / I Date: le ��` This p ermit 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.
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I\ Building Permits \PLM- PermitAppdoc 06r26,06 440-4616T(i0r02 /COM /WEB)
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CITY OF TIGARD 4yr
BUILDING ,DIVISION PERMIT #: PLIA200? -00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 40c12^107
Phone: (503) 639- 4171r� 1 '� •
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 4 /3t 20' TIME: 7:OSAM PAGE: 13
SITE ADDRESS: i0S755 SW CASCADE AVE. - 130 CLASS OF WORK:
•
SUBDIVISION: CiA:Y;A0E Eat t; Dl�lE; �,= CENT[ } LOT #: TYPE OF USE
PROJECT NAME: I• iE.hMcON
DESCRIPTION: 340' o; s?o ;In suer a,,r tos a� �'itiort.
OWNER: 1 1 _t:l !I it, - 11.9 �GIES PHONE #: E03-246-0469
CONTRACTOR: COFFMAN EXCAVATION LLC PHONE #: 59,?,
•
•
Inspection Request Scheduled For: Date: 413012008 Pour Time:
Code # Inspection Description Confirm •# Contact # Message
3:9 Piuniii'og . Ota90a98 -O4 503-5M802
0 -5?;; 8
Corrections /Comments /Instructions:
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L°i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: <TOLvN.--Z Date: qi36' Phone It: (503) 718
CITY OF TIGARD -.. 1 BUILDING DIVISION PERMIT #: PLM2007 -O0170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/200
Phone: (503) 639 -4171 6I�
Inspection Requests (24 Hrs.): (503) 639 -4175 "
INSPECTION WORKSHEET FOR DATE: 8/1/2007 TIME: 7:03AM PAGE: 2
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: 340' of storm sewer work for addition.
OWNER: HEMCON TECHNOLOGIES, PHONE #: 5O3 245 -0459
CONTRACTOR. COFFMAN EXCAVATION LLC PHONE #: 503 - 656 - 7000
Inspection Request Scheduled For: Date: 8/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 053209 -01 503-523 -8802 Y
Corrections /Comments /Instructions: l
62-4 IL-y-tv ...14,e4c4-41 AI r 4 ,,,A' k PASS I 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 11 r' Date: C 6001 Phone #: (503) 718-
CITY OF TIGARD `' -
BUILDING DIVISION PERMIT #: PLM2007 -00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2612007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s' 1111
INSPECTION WORKSHEET FOR DATE: 7/18/2007 TIME: 7:01AM PAGE: 58
SITE ADDRESS: 10575 SW CASCADE AVE 130 - CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON -
DESCRIPTION: 340' of storm sewer work for addition.
OWNER: HEMCON TECHNOLOGIES, PHONE #: 503 - 245.0453
CONTRACTOR: COFFMAN EXCAVATION LLC PHONE #: 503.656 -7000
Inspection Request Scheduled For: Date: 7/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 052219 -01 503-710-0938 if
Corrections /Comments /Instructions:
❑ PASS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: -- 71 1� 07 Phone #: (503) 718-
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00170
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/26/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s'.� °7 IL.
INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 60
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: 340' of storm sewer work for addition.
OWNER: HEMCON TECHNOLOGIES, PHONE #: 503 -245 -0459
CONTRACTOR: COFFMAN EXCAVATION LLC PHONE #: 503
Inspection Request Scheduled For: Date: 7/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 052114 -01 503 710 -0938 Y
Corrections /Comments /Instructions:
Tr Iv\ Pai-1-! w 1 S.7NTL, C,., t g ar: ,., L0 Ali i j OvC.K
PA4 (i -'i
EX PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: lli Date: �) J a Phone #: (503) 718-
1
CITY OF TIGARD �; --,
BUILDING DIVISION PERMIT #: PLM2007- 00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED :`' 4/2612007
Phone: (503) 639 -4171 p:n�l�l4
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/9/2007 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: 340' of storm sever work for addition.
OWNER: HEMCON TECHNOLOGIES, PHONE #: 503.245.0459
CONTRACTOR: COFFMAN EXCAVATION LLC PHONE #: 503 - 6°-,6`7000
Inspection Request Scheduled For: Date: 5/912007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 047950 -01 503-710-0938 Y
Corrections/Comments/Instructions:
r a ! 1
- 3 i - 4 / IF'
i
- -- • 1A—PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
fl FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED - )1 Inspector: G 1 Da /? Phone #: (503) 718 - 2 y