8775 SW MCDONALD STREET aIVNOaOW MS 5118
Q
z
O
0
v
t
ti
ti
co
8775 SW MDDONALD ST
CITY OF TIGARD 24-Hour
BUIILDING Inspection Line: (503)639-4175 ® - �MST
—�--
INSPECTION DIVISION Business Line: (503)639-4171 _
BUP
Received —Date Requested_.__—�U ��-5 AM PM�dk SUP
Location 7 7 `�_ 1�' a t,4, Suite— MEC _--
Conta,J Person _ —__. __ Ph(—) _�� �r PLM� L�
Contractor_ — Ph( ) SWR
BUILDING Tenant/Owner -- _— ELC
1 Footing ELC
i-:ou,,+ation Access:
Ftg Dain ELR
Crawl Drain SIT
Slab Inspection Notes: --- ---
Post&Beam - ----- _ _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing — -- - - —
Insulation
Drywall Nailing Of
Firewall _
Fire Sprinkler
Fire Alarm _
Susp'd Ceiling
Root
Other:
Final ----_-- /
PANS PART FAIL
PLUMBING_ _ --
Post&Beam
Under — --—
Rough-In-In
Water Service —
Vr3r
am airs
Catch Basin/Manhole
Storm Drain
Shower Pan _
i
_AR FAIL
_ L _—
(ZZ
Post&Beam
Rough-In -- —--
d Gas Line
Ix Smoke Dampers ---- - -
U) Final
r PASS PART- FAP-
ELECTRICAL——
AI! �— --- ---
J ELECTRICAL —_.—
m Service
j Rough-In
W UG/Slab
'r Low Voltage
Fire Alarm
Final F-1 Reinspection fee of$ required before next irspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - ❑ Please call for reinspection RE:�_— �_.e— __ Unable to inspect--no access
Fir( Suppiy i ne
ADA
Approach/Sidewalk Dot*-�-=-- ` Ins�ftr
Other: _
Final DO NOT REMOVE this Inspeelon record ftem the job site.
PASS PART FAIL
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2004-00475
13125 SW Hall Blvd , Tigard,OR 97223 (503)839-4171 DATE ISSUED: 10/14/2004
SITE ADDRESS: 08775 SW MCDONALD ST
PARCEL: 2S102DD-b2°05
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: TIG
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: r URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: 45 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of sanitary sewer line. Septic tank is to be pumped, filled and inspected.
FEES
Owner: — ----
Description Date Amount
SNOW, GEORGE T AND
DOROTHY JEAN (PLUMB]Perniit Fee 10/1412004 $72.50
8775 SW MCDONALD [TAX] $ State Surcharl 0/14/2004 $5.80
T; +ARD, OR 97224 Total $78.30
Phone:
Contractor:
THEODORE D. MCBEE
13691 SE WILIINGHAM CT
CLACKAMAS,OR 97015-7253 REQUIRED INSPECTIONS
Phone: 503-239-2707 Sewer Inspection
Insp existing/capped fixtures
Reg#: LIC 75513 Final Inspection
IL
rn
-' This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR.
ao
CD Specialty Codes and all other applicable laws. All work will be done in accordance with approved
W plans. This permit will expire if work is riot s!arted 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
952-0001-0-10 ou may obtain copies of these rules or direct questions to OUNC by calling (503)
246- 9.
Iss d By: Permittee Signature:1(
all (503) 39-4175 by 7:00 P.M.for an Inspection needed the next business day
Building Fixtures R¢l,►-Y,GwZIYU.Mf - � ` � O'Y14-c� ` J�-
Ntfmbina Permit AR"i"V E U
Cit of Tigard Receives Permit No.�,O��
�' i DateBy � A _ � 7
13125 SW Ifall Blvd,Tigard,OR 97223 1004 Plan Review ^
Phone: 503.639 4171 Fax: 503.598 1960 Date/ByOther Permit No���j/ �1yZ��
24-Your Inspection Line: 503.639.4173,1 y j r 1 I Ulf' Date Ready/By )uns ® See Page 2 for
Internet: www'.ci.tigard.or.us l �.i I'll\f I' Nutifred/Method. ! Supplemental Information
w.F 4
❑ w construction ❑Demolition For special Information use checklist.
Description St . Fa _Total
Addition/alteratiolt/replacement ❑Other: New 1-2-family dwellings(includes 100 fl.for each utility connection)
CATEGORY pltP. 91tt +,> SFR(1)bath 249.20
9?111-and 2-,family dwelling---
_ C]Commercial/industrial SFR(2)beth _ 350.00
- -� SFR(3)bath 399.00
❑Accessory building ❑Multi-family
------- ------- --- - Each additional bath/kitchen 45.00
❑Master builder ❑Other Fire sprinkler( _sq.ft.) Page 2
INFORMATION AND LOCiAT1ON Site utilities _
n Job site address: Catch basin or area drain 16.60
City/State/ZIP: Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.: Project name: Footing dtain(no.linear R.:_) _ Page 2
— — Manufactured home utilities 11000g16.60
Cross street/directions to job site: Manholes
_ Rain drain connector Sanitary sewer(no.linear ft:
Storm sewer(no linear fl.: ) Page 2
Lot no.: Water service(no linear ft:_) Page 2
Subdivision: -
- Fixture or Item
Tax map/parcel no.: Absorption varve 1660
ritsGRIPTIOI�°d„.
_ x ;bpi ;'`'` Backflow preventer Page 2
Backwater valve 1660
Clothes washer 1660
-- -- Dishwasher 16 60
4 Drinking fountain 16.60
Ejectors/Sump 16.60
Name: —_ Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/ZIP: i
'� '-? i Floor drain/floor sink/hub 16.60 T
Fax: Garbage disposal 16.60
Phone:(lj-0 '� 5 ( )
f 5 Hose bib 16.60
A + Ice maker 16.60
Business name: O Interceptor/grease trap 16.60
Contact name: — D'2 � ��k 1X15 D P? Medical gas(value:S ) Page 2
CL Address: ;Z/)—+ Primer 16.60
City/State/ZIP: vwL Roof drain(commercial) 16.60
N Lrt Sink/basin/lavatory i&60
( 3) 23 7
Phone: � � 9 Fax: ( � Tub/shower/shower pan 16.60
_J E-mail: Urinal 16.60
m , , Water closet -- 16.60
t
�r --'fie: - ',
J Business name: Water heater 16.60
Other:
Address:
--""-- Subtotal
City/State/ZIP: Minimum permit fee $72 50
Phone:( ) Fax:( ) _ Residential backflow minimum permit fee: $36 25
CCB -Lic.: e7 % .Plumbing Lic.no.: Plan review (25%of permit fee)
J P.�..�-�� — State surcharge(8%of permit fee)
Authorized signature: tJ
TOTAL PERMIT FEE � r
Print name: Date: Q l�1 This permit applicatlon 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.
i tBuildingTerrnitatPLMF-PemtitApp doc 12/03 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilitles �, ".nt4afbl t - 4j?en itIF'ee: --
Footing dram- 1"100' 55.00 0 to 2,000 $115.00
Footing drain-each additional 100' 46.40 2,001 to 3,600 _ St60.00
Sewer-1st 100' 55.00 3,601 to 7,100 $220.00
7,201 and greater $309.00
Sewer-each additional 100' 46.40
Water Service-Ist 100' 55.00 Medical Lias S stems'
Water Service-each additional 100' 46.40
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
FixiauXe fsr eta' r , * <. TAtz additional$100 90 or fraction thereof,to and
including$10,000 00.
Commercial Back Flow prevention Device 46.40 . 510,001.00 to$25,000.00 $148 50 for the first$10,000 00 and$1 54 for
Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to
minimumermit fee$36.25) 27.55 and including S25,000.00.
Rain Drain,single family dwelling 65.25 5::5,001 00 to$50,000.00 $379.50 for the first$25,000.00 and S1 45 for
each additional S 100.00 or fraction thereof,to
hlspection of existing plumbing or
and includinR$50,000.00.
iall requested inspections-per hour 72.50 _
s ec
$50,001 00 and up $742.00 for the first 550,000.00 and$1.7.0 for
Subtotal_ each additional$100.00 or fraction thereof.
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"Yes",please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
uaotl Istn ',' '
Fixture Type 4i
Neto iv Comments regarding fixture work:
Baptistry/Font
Bath -Tub/Shower ---
-Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru --
Cuspidor/Water Aspirator
Dishwasher -Commercial _
-Domestic
Drinking Fountain — — —Eye Wash
Floor Drain/sink 2"
Y - ---
.4" _
d Car Wash Drain
Garbage -Domestic
F, Disposal Commercial *Note: If the fixture work under this permit results in an
n -industrial increase of sewer EDUs,a sewer permit will be issued and
r Ice Mach./Refri .Drains
t oil Separator Gas Station) fees assessed for the sewer increase must be paid before the
J Rec.Vehicle Dump Station plumbing permit can be issued.
m Shower -Gang
-Stall
JSink -Bar/"vatory Quantity Total
-Bradley
-Commercial Isometric or riser diagram is required if fixture quantity
-Service t(ital is>9.
Swimming Pool Filter
Washer-Clothes
Water ExtractorPlan Review
Water Closet-Toilet _ Plan review is required if fixture quantity total is>9.
Urinal
Other Fixtures:
i'.Huildine\Pm i,f\PLM-Pemw APP dnc 1103
CITY OF TIG.'& RD PLUMBING PERMIT
DEVELOPMENT SL-RVIL,&-Z" PERMIT#: PLM2004 00476
13125 SW Hall Blvd., Tigard, OR 97223 (56. 1639-4171 DATE ISSUED: 10!15/2004
SITE ADDRESS: 08775 SW MGDONALD ST PARCEL: 2S102DD-00805
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSAL: 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Reversal.
FEES _
Owner: _
Description Date Amount
SNOW, GEORGE T AND II'LUMBI Permii Fee 10/15/2004 $72.50
DOROTHY JEAN ITAXI 9%.State Surchan 10/15/2004 $5.80
8775 SW MCDONALD _
TIGARD, OR 97224 Total $78.30
Phone:
Contractor:
MCROOTER DRAIN SEWER & PLBG SVC
11428 NE SCHUYLER
PORTLAND, OR 97220 REQUIRED INSPECTIONS
Phone: 503-251-9678 Final Inspectio i
Reg#: LIC 103682
PLM 26-724PB
a
oc
r�
J
0o 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 ^ecordance with approved
plans. This permit wi!I 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.
r�
Issued By: � ��r,, � , Permittee Signature(:
Call (503)639-4175 by 7:00 P.M.for an Inspection needed the nex uslness day
Building Fixtures e
Ptumbing_Permit ApRjRQ
City of Tigard Received _ [
r, Permit No�LN�� -0q
6
13125 SW Hall Blvd,Tigard,OR 97223 Date B : `1 —� i' I
Plan Review
Phone_ 503.639.4171 Fax: 503.598 1960 �' (UP� Date/B Other Perim No
24-Hour Inspection Line: 503.639.4175 J `1 t„r,r --
`v Date Ready/By: ® See Page 2 for
Internet. www ci tigard.or.us ,�>�] Notified/Method: Supplemental Information
1 r• � r ti . ,. -to
•
❑New construction ❑Demolition For special information use checklist. __
Description Ea Total
Q Addition/alteration./replacement ❑Other: New 1-2-farfliy dwellings(includes 100 R.for each utility connection)
SFR(1)bath 249.20
[] I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00
❑Accessory building ❑Multi-family SFR(3)bath 399.00
El Master builder ❑Other: Each additional bath/kitchen 45.00
t,.i. � Fire sprinkler( sq.fl.) Page 2
4 "3�f� r 'f Site utilities
Job site address: C 7 S e�Gy /y r 12,044,9-4—D Catch basin or area drain 1660
City/St9te/ZIP: Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.: Project name: Footing drain(no.linear fl: ) Page 2
Manufactured home utilities 11000
Cross street/directions to job site: —
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no.linear fl.:_) Page 2
Storm sewer(no.linear ft.: Page 2
Subdivision: Lot no.: Water service(no.linear ft.: ) Page 2
—��--
Tax map/parcel no.: Fixture or Item
Absorption valve 1660
—�_ _ Backflow preventer Page 2
_ �m a J't �' r---L&os �Y Backwater valve 16,60 �—
Clothes washer 1660
Dishwasher 16.60
Drinking fountain 1660
, •t`,
Ejectors/samp 16.60
Name: C
Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone:( ) Fax:( ) Garbage disposal 16_60
( r � v M It°.1 rr.. �^ t• Hose bib 16.60
�.= iaa., e.L 'moi k•. s :+ � a
Ice maker 16.60
Business name:
._ Interceptor/grease trap 16.60
Contact name: _ Medical gas(value:3 ) Page 2
Address: Primer 16.60
City/State/ZIP: _ Roof drain(commercial) 16.60
Phone:( ) Fax: :( ) Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail: Urinal 1660
Water closet 16.60
Business name: <•'� (� Water heater 16.60
Address: ;�; /(, _ Other_
Subtotal
City/State „ ?99c� �4 �� Minimum permit fee: $72 50
Phone: 7 Fax:(�5�p75' Residential backflow minimum permit Cee: 536,25 'D
-�
CCB Lic.: � �, , - Z Plumbing Lic.no.: ,_ �?zyPlc,review (25%of permit fee)�.
Authorized signature: - —_ State surcharge(8%of permit fee)
u C TOTAL PERMIT FEE
Print name: /5/d+!r� �' �4'�`ra Date: 1 rf This permit application expires If a permit Is not obtained within
180 days after It has beer.accepted as compltte.
*Fee methodology set by Tri-C-unty Building Industry Service Board.
i\Building\Permiu\PLMF-Permit App doc 12/03 440.4616T(1o/02/C0M/WFR)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule Residential Fire Su recsion Systems:
Site u�tiliq :;i, ,��:.: ', W: r� e e , atinilt dee:
Footing dram-1"100' 55.00 0 to.,000 $115.00
Footing drain-cacti additional 100' 46.40 2,001 to 3,600 5160.00
3,601 to 7,100 _ $220.00
Sewer-1 st 100' 5500 7,201 and greater $309.00
Sewer-each additional 100' 46.40
Water Service-Ist 100' 55.00 Medical Gas S stems'
Water Service-each additional 100' 46.40 Zr
Storm&Rain Drain-I st 100' 5500
$100 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
(u' to N` Qfy $ 4�ii) Total additional 5100 00 or fraction thereof,to and
including 10,000.00. _
Commercial Back Flow Prevention Device 4040 510,001.00 to$25,000 00 $148 50 for the first$10,000.00 and$1 `4 for
Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to
minimum permit fee$16.25 27.55 and includin $25,000.00.
Rain Chain,single family dwelling 65 25 $25,001.00 to S50,000.00 $379.50 for the first 525,000.00 and$1.45 for
each additional$100.00 or fraction thereof,to
Inspection of existing plumhing or and including$50,000.00.
s e ially requested ins ections per hour 72.50 $50,001.00 end up $742.00 for the first$50,000.00 and$1.20 for
Subtotal: --leach additional 0.00 or fraction thereof.
Fixture Work:
Are you capping,moving or replacing existing fixtures? If
"yes",please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
i�03
'`- Comments regarding fixture work:
Dia tistry/Font
Bath -Tub/Shower _
-Jacuzzi/Whirlpool --
Car Wash -F.acb Stall
_ -Drive Thru _
Cuspidor/Water Aspirator '—
Dishwasher -Commercial _—
_ -Domestic _
Drinking Fountain
Eye Wash
Floor Drain/sink 7" _
-3" --
4" —
Car Wash Drain
Garbage -Domestic
Disposal -Commercial *Note: If the fixture work under this permit results in an
t -Industrial increase of%ewer EDUs,a sewer permit will be issued and
Ice Mach./Refri .Drains
Oil Separator Gas Station fees assessed for the sewer increase must he paid before the
Rec.Vehicle Dump Station plumbing permit can he issued.
Shower -Gang
-Stall _
Sink -Bar/lavatory _ Quantity Total
Bradley Isometric or riser diagram is required if fixture quantity
-Commercial total is>9.
-Service _
Swimming Pool Filter
Washer-Clothes
Water Extractor Plan Review
Water Closet-Toilet Plan review is required if fixture quantity total is>9.
Uncal
Othcr Fixtures:
i\Buddma\Pandb\Pt.M.PemtitApp doc 3103
CITY OF TIGARD 24-Hour
BUILDING ® Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received ___. _—Date Reques d AM — IP
Location __ � � O ��� _Suite
Contact Person Ph( ) _ PLM 4- 54
Contractor-_ _ Ph( ) — SWR �
BUILDING T nVOwwr —_ — _ ELC
Footing ELC
Foundation ACCe --
Ftg Drain ELR
Crawl Drain w
Slab Infection No % SIT
Post&Beam
Shear Anchors — - -- - -- --
Ext Sheath/Shear
Int Sheath/Shear --'—
Framing f _ —
Insulation
D
Drywall Nailing --
Firewall �—
Fire Sprinkler
Fire Alarm e
Susp'd Ceiling
Roof
Other:
Final
FAIL /
PLUMBING _ ._T�/1r� E1� —7r-) X 47F fZ,4
Under Slab
Rough In /7r*_
Water Service
Sanitary Se () —
Rain Drai t 'i�cy�r1
Catch Bas
Storm DraOIV ,�/ 6,` e/�"
,,s�, 4_ 448-
4 Rik
�jA �C �
i �/ -- „� � C►�
Shower Pan
final
ART FAIL
Post h Beam _ /1_ / O _j
Rough-In —_ [�s� fill
Gas Line
0. Smoke Dampers --
� Final
N PASS PART FAIL
ELECTRICAL L ZDO •f/
Service —
m Rough-In _
(g UG/Slab --
W Low Voltage
Fire Alarm
Final on fee of$----required before next
PASS_ PART FAIL Reins� P� pection. .,Hal 13125S HallBlvd.
SITE _ Please call fo rens tion RE:. __ a to ins no ess
Fire Supply Line �+
ADA
Approach/Sidewalk Daft
Other:
Final DO NOT REMOVE this Inspection record from the Job oft.
PASS PART FAIL
- " INVOICE
N1° 4839
P.O.Box 2349
Oregon City, OR
97045
New Installations CompleteE*tft*M 1
Repair S stems �wwwww.ww.wwwwwwwwwwwww■
Industrial
p g y ww mow r ww w ■_■ Waste
Sewer Connections .w no ::"on .0:0.0 i i w w a Removal
Dmintields w w w w w w w w www :w www i w w Septic Tank Cleaning
Cesspools Sump
Excavating Line Cleaning
Richmond Constniction Ent.,Inc.
(503) 253-7587
Customer P.O.# � Date/0-
Billing Name int C�3eE 46:,yeay17,
Address ff i 7MC PavwCO, f7—
Job
TJob Site#_ _
City ,�� D State ert - Zip Code
Ordered By WC��G _ Phone# _ _ Date A/ O
Job Location ,C-
Service Call
Labor- 00.
-_ -- - --- $
Ili
Pumping S � gallons/ _ $ 0 G
a00 t
Misc
a
Conditions of tank/Distribution Box
�- k_ _.�� s P!QyM/S/dam_ TOTAL CHARGES� -!__
Ernirnclear Is in no way responsible/or damage to the septk:tank or skis on the system.
ur TERMS:Net 10 days.1-1/2%per month will be charged on past due ac punts.(18%per annum). (�
J I ��
i�/'/ �,/��� -099 --S/G 9S= o oo�tl/ �')/ eq�7
Customers Signature:
Service Driver's Signatur Time Dat911V=11 O1e/
TERMS AND CONDITIONS ON REVERSE SIDE REnEEMABI_E IN ALL COUNTIES
'�.,—�A ",�"'_"s® 7�A "ems• '��'7�