Permit CITY TIGARD PLUMBING PERMIT
,I,I =`, DEVELOPMENT SERVICES PERMIT #: PLM2005 -00461
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/14/2005 PARCEL: 1S135BB-00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I -P
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Restroom remodel & shower addition. Capped: (1) lay, Added: (2) showers (1) urinal, Moved: (1)
drinking fountain, (2) lays, (3) water closets.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: F2 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: 1 GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
AMB PROPERTY L P Description Date Amount
BY TRAMELL CROW NW INC
8930 SW GEMINI DR [PLUMB] Permit Fee 9/14/2005 $166.00
BEAVERTON, OR 97008 [TAX] 8% State Surcharl 9/14/2005 $13.28
Phone : Total $179.28
Contractor:
CASCADE MECHANICAL SYSTEMS INC
PO BOX 399 REQUIRED ITEMS AND REPORTS
ESTACADA, OR 97023
Phone : 630 - 4492
Reg #: LIC 127012
PLM 3 -324PB
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 . ir_ct questio s t• OUNC by
calling 503 -246 -6 9 or 1- 800 - 332 -2344. �' L
Issued By: Permittee Signature: 1
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.
, . Building Fixtures
Plumbing Permit Ap lication ((�� FOR O FFICI U OiNL �-
City of Tigard IREC�9VL��� Receives �, _
13125 SW Hall Blvd, Tigard, OR 97223 Date/By j ��/ V i ermrt
Permit ���� � f
Plan Review Other Permit No.°
Phone: 503 639.4171 Fax: 503 598 196 [® i 4 2UU /uer 40 Iiaa Date/By J ' ,_4
24- Hour Inspection Line: 503 639 4175 10 J J I Date Ready/By ®See Page 2 for
/
....
Internet: www.ci.tigard.or.us Notified/Method. -'I(r Supplemental Information
TYP OW Wil FEE* SCHEDULE
IGW D ��,CION
El New construction Demolit For special information use checklist.
Description I Qty. I Ea. ( Total
] Addition /alteration/replacement ❑ Other New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
1:1 I - and 2- family dwelling Commercial /industrial SFR (2) bath 350.00
El Accessory building CI Multi-family SFR (3) bath 399 00
ID 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 ` es-4c 5 t Cs ICS CX,-t-k, Catch basin or area drain 16.60
City /State /ZIP 7; s C ick �� `21.--4-� Z Drywall, leach line, or trench drain 16.60
-
Suite/bldg /apt. no: M I Project name 4_1i c_ eM1 5� tt-�Qf� Footing drain (no. linear ft. ) Page 2
Manufactured home utilities 110.00
Cross street /directions 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
Fixture or item
Tax map /parcel no. 1 S 1 .75-•01-1--,2a5-0) J Absorption valve 16.60
DESCRIPTION O W RK Back flow preventer Page 2
C ce C`n p \ el..-- Backwater valve 16.60
� O %fr � `- -. � � Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 1 16 60 \lv
❑ PROPERTY OWNER N g TENANT
Ejectors/sump 16.60
Name. Aern (..-O r" �` C. Expansion tank 16.60
Address: ot5 - 4 . S C - . . . 3 t , ) C cz s C_` k `` Q Fixture /sewer cap 16.60
City /State /ZIP: f-\ -, s e _ f C 1 Q' _ 1 > Floor drain/floor sink/hub 16.60
Phone: ( c) 3) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT Pg CONTACT PERSON Hose bib 16 60
Ice maker 16 60
Business name. )--it_0-� ��� � Interceptor /grease trap 16.60
J
Contact name' `~ S ••%. c Medical gas (value: $ ) Page 2
Address 2i` 2� Ot._.. Ccc \ • Q Primer 16.60
�'
City /State /ZIP: , \\ S \ o Cg `2L\ Roof drain (commercial) 16.60
Sink/basin/lavatory 3- 16.60 `3 ,-1-52),4', Phone e�
(� =-0.=\ =-0.=\ �� Q ® Fax: : ( S.,3) L‘' � . Tub /shower /shower pan 7, 16.60 ' � Zc
E -mail Urinal 1 16.60 ‘ °
CONTRACTOR. Water closet `b 16.60 \ g'":'
Business name C� S ( Q c� qti C `\ S Water heater 1 6.60
Address: //Q /i/".. iO4-t‘ ` f iaox 31`1 31`1 S Other:
City /State /ZIP: esf-ACp CRC . 9-702-3 Subtotal
Minimum permit fee $72.50
Phone (5o3 ) 1,3o - 44 ° )2 Fax (5a) ) fo30 - 5510 Residential backfow minimum permit fee $36 25 / 4 6,V'
CCB Lie. - /27 Q i Plumbing Lic. no.: 3 -32 Pi5 Plan review (25 %ofpermit fee)
Stale surcharge (8% of permit fee) ,' Z
Authorized signature: j -7 G x
TOTAL PERMIT FEE
Print name: 3HS 3N W 532% J t �p Date' 9 -pi y - 05 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 \ Budding \Per mis\PLMF- PcrmitApp doe 06/05 4404616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard ,
Page 2 - Supplemental Information
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 - each additional 100' 46 40 2,001 to 3,600 $160 00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46 40
Water Service - 1st 100' 55 00 Medical Gas Systems:
Water Service - each additional 100' 46 40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000 00 $72.50 for the first $5,000 00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100 00 or fraction thereof, to and
including $10,000.00
Commercial Back Flow Prevention Device 46 40 $10,001 00 to $25,000 00 $148.50 for the first $10,000.00 and $1.54 for
Residential Back flow Prevention Device each 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 $50,000.00 $379.50 for the first $25,000.00 and $1 45 for
each additional $100 00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 " $50,001 00 and up $742 00 for the first $50,000 00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? 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 increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial buildin
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower 2- ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool 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 I ❑ Any NFPA I3 -D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4
Car Wash Drain Isometric 'or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial . three (3) or more stories in height.
- Industrial
Ice Mach. /Refrig Drains _ - .
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall .
Sink -Bar/Lavatory I. Z
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor p
Water Closet - Toilet . increase of sewer EDUs, a sewer permit will be issued and
Urinal k I fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
1 \Budding\Permits\PLM- PermitApp doc 07/06/05
OF TIGARD _ A
1LD DIVISION PERMIT #: PLM2005 -00461
Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2006
P
hone: (5.03) 639 -4171
Inspectio (24 Hrs.): (503) 639 -4175 s_' d L
INSPECTION WORT HEET FOR DATE: 10/17/2005 TIME: 7:04AM PAGE: 35
SITE ADDRESS: 1057 CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCA BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: Restroom rem' *el & shower addition. Capped: (1) lay, Added: (2) showers (1) urinal, Moved: (1)
drinking fountain, lays, (3) water closets.
OWNER: AMB PROPERTY L , PHONE #:
CONTRACTOR: CASCADE MECHAN ' L SYSTEMS INC PHONE #: 630 -4492
Inspection Request Scheduled For: Date: 10/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 85-01 503 -407 -4755 Y
Corrections /Comments /Instructions:
pi
------- -E■1,,,PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector Date: I 0 I 7 /o6 Phone #: (503) 718- 2 4 i
_ 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005.00461
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2005
Phone: (503) 639 -4171 • Ariii
Inspection Requests (24 Hrs.): (503) 639 -4175 s ^__..
INSPECTION WORKSHEET FOR DATE: 9/15/2005 TIME: 7:03AM PAGE: 41
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
1 PROJECT NAME: HEMCON
DESCRIPTION: Restroom remodel & shower addition. Capped: (1) lay, Added: (2) showers (1) urinal, Moved: (1)
drinking fountain, (2) lays, (3) water closets.
OWNER: AMB PROPERTY L p, PHONE #:
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 630 -4492
Inspection Request Scheduled For: Date: 9/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 01577801 503- 407 -4755 Y
Corrections /Comments /Instructions:
/ _
6) or , z?,---( )i71/
-PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
e
Inspector: 11 WW Date: . . Phone #: (503) 718-