Permit 'l . CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00128
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/1/2007
PARCEL: 2S 109DA - 02100
SITE ADDRESS: 12455 SW BEEF BEND RD ZONING: R -
SUBDIVISION: ARLINGTON HEIGHTS NO. 3 LOT: JURISDICTION: TIG
PROJECT: ARLINGTON HEIGHTS NO. 3
Project Description: Private water lines.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 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: 4,400 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
ARLINGTON HEIGHTS OWNERS
ASSOCIATION Description Date Amount
17700 SW UPPER BOONES FY RD [PLUMB] Permit Fee 5/1/2007 $2,050.20
PORTLAND, OR 97224 [TAX] 8% State Surcha 5/1/2007 $164.01
Phone : Total $2,214.21
Contractor:
KEN LEAHY CONSTRUCTION
PO BOX 489
CORNELIUS, OR 97113 -0489 REQUIRED ITEMS AND REPORTS
Contact # : PRI 357 - 219 -2193
Reg #: LIC 44159
PLM 34 -445PB
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 direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue By:
i Permittee Signature:/CA �iti` 71______ 111 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.
. . I W1(1.+1 k OEtVED
i
Plumbing Permit Application .2- I OR oFricF USE ONLY'.. •
City of Tigard MAR �oo Receiver• Permit T.
Y 13125 SW Hall Blvd., Tigard, OR 972 pF TIGARD Date%B,•- "y
07 6 3 2277 of 2
Ty Plan Revi
Phone: 503.639.4171 Fax: 503.598.1 'N G D 1�1 Other Permit 1 �d�f5�
1V1�1 Date B 1t7Doc2
TI G A RD Inspection Line: 503.639.4175 LD Date Readyil3y: Juris: 65 See Page 2 for
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
PE!: i• % ORIC r'°. . `' . FEE* SCHEDULE .
® New construction ❑ Demolition For special information use checklist
Description I Qty. Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
` ;r: :: g • CATEGORY =.OF:CONSTRUCTION + . ` SFR 1 l bath 249.20
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
Each additional bath /kitchen 45.00
❑ Master builder ❑ Other: -
$ . Fire sprinkler ( sq. ft.) Page 2
;;:;.'JOB SITE :•1NF.ORMATIONAND.:LOCATI.ON:
a::r.,y'� �w':'!::,...:,• ,.....:.. � ..:::....- �:��:t:<�.:�::..., ,.:..,:, � .....::..:.. .:.....:.:..::))1!;:.;:;..ir' 4: Site utilities
Job site address: WCTM 25109DA, TL 2100, 2S110CB, TL 600 &700 Catch basin or area drain 16.60
City /State /ZIP: Tigard, Oregon /a y/ 4 4 / Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Arlington Heig is III Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Beef Bend Rd & SW Summit Ridge St
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: 68
Water service (no. linear ft.: 4369) 44 Page 2 2050.20
Fixture or item
I Tax map /parcel no.: 2100, 600, 700 wn valve • . , : : € . D ESCRIPTION OF= • : W ORK ` ,. s , .. Backflow preventer Page 16.60 •
N _ e 1. c( . C_2>
- .J L am_ , f�1L _� _ Backwater valve 16.60
"J Clothes washer 16.60
Dishwasher 16.60 •
.::: .,., - ,. ® v: `.: ❑ . : . ;: ... :: •: Drinking fountain
Q . s :::t ..:.. , .. ..........�,..,..- ' .... " -; " : d a�z _... -w..:. :. :... • • tors sul • Ejec / ttp 16.60
N Name: Tom Weber
Expansion tank 16.60
Address: 12755 SW 69' Ave, Suite 100 Fixture /sewer cap 16.60
City/State /ZIP: Portland, OR 97223 Floor drain/floor sink/hub 16.60
Phone: (503)517 -8284 Fax: (503)601 -3524 Garbage disposal 16.60
;: s: r° ..` °�::: K ::: �.x :.. -..., r Hose bib 16.60
APPLIC ,. : .
:. <:.; ❑`CONT.A►CI'PERSON..:.:
:..: • : . : fir':::::: >:...::
Ice maker 16.60
) Business name: Matrix Development Corp. and Terra - Weber, Inc. Interceptor /grease trap 16.60
Contact name: Tom Weber Medical gas (value: S ) Page 2
Address: 12755 SW 69th Ave, Suite 100 Primer 16.60
City/State /ZIP: Portland, OR 97223 Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (503) 517 -8284 Fax: : (503) 601 -3524
Tub /shower /shower pan 1 6.60
E -mail: Urinal 16.60
: ~n�- • ....;:
. .... ..:.... . . .
. � . „•:;:' : i �. .: :: CO :'
.:: ,•:: • .:..:; . � .. -. ....:.:.;�,... zi<ni: - Water closet 16.60
Business name: p e jyt Water heater 16.60
Address: yv �` U Other:
City /State /ZIP: Subtotal 2050.20
Minimum pennit fee: 572.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: 536.25
CCB Lie.: Plumbing Lic. no.: •`.!
State surcharge (896-efperrtetfee)- .� !a/^
Authorized signature:
TOTAL PERMIT FEE'
Print name: Date: 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 Industt erst{ce 1
le rV
I: ":Building''Permits`•.PLM- PermitApp.doc 0626.06 440- 46I6T(10.02•COM'w'EB) O��
CITY TIGARD -5---- PLUMBING PERMIT
7 COMMUNITY DEVELOPMENT PERMIT #: PLM2007-00128
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 5/1/2007
PARCEL: 2 S 109 DA -02100
SITE ADDRESS: 12455 SW BEEF BEND RD ZONING: R -7
SUBDIVISION: ARLINGTON HEIGHTS NO. 3 LOT: JURISDICTION: TIG
PROJECT: ARLINGTON HEIGHTS NO. 3
Project Description: Private water lines.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 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: 4,400 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ARLINGTON HEIGHTS OWNERS
ASSOCIATION Description Date Amount
17700 SW UPPER BOONES FY RD [PLUMB] Permit Fee 5/1/2007 $2,050.20
PORTLAND, OR 97224 [TAX] 8% State Surcha 5/1/2007 $164.01
Phone : Total $2,214.21
Contractor: �+
KEN LEAHY CONSTRUCTION
PO BOX 489
CORNELIUS, OR 97113 -0489 REQUIRED ITEMS AND REPORTS
v
Contact # : PRI 357- 219 -2193
•
Reg #: LIC 44159 • ; ‘l� �J� I�, v
PLM 34 -445PB I
�
Vii ,.
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 direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue By: ' ��_ I Permittee Signature:/ 1/v%
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for. PLM2007 -00128 REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ Code I Inspection Description PASS Date By I
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in _ 1
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain _ - 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
_ 250 Roof nailing _ ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection: —
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in 1
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 1 625 Duct work _
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown -_
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection: 320 Plumbing rough in
998 Alarm final J
999 Sprinkler final 322 Shower pan
X 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
I 205 Footing X 399 Plumbing final
210 Foundation walls —
215 � Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer _ 1
498 Grading final 595 Mis c. inspection:
499 Final inspection 1 599 Final inspection 1
1: Building \ Forms \InspCard- AOP- Blankdoc 02/02/07
This form is recognized by most Building Departments in the Tri- County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
BUILDING DIVISION
TIGARD TRANSMITTAL LETTER 0
TO: DATE RECEIVED:
DEPT BUI I' ING DIVISION RECEWED
MAY — 1 2007
CITY OF TIGARD
FROM: � , , t l ✓� , B UILDING DIVISION
COMPANY:
PHONE: 6 E....Byi\�-
RE: 1 a Lt S S � ` e< =-a�c� 6--0 Co /
(Site Address) (Permit/Case Number)
00> c ‘ ------ k Li 7 (Project name ubdrvisio
or n name; lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and /or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Oth (e xplain):
____ s Al A A . 1,:_..' ° -z— 2 i
%-.)Lt 0 A ,,i
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑ No Fee Description: Amount Due:
$
$
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I: \Building \Forms \Transmittal Lettcr- Revisions.doc 4/4/07