Permit (49) CITY OF TIGARD PLUMBING PERMIT
IN COMMUNITY DEVELOPMENT Permit#: PLM2017-00205
Tigard OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 05/24/2017
T t i;A R Dg ,( ! A Parcel: 1 S 136CC00100
Jurisdiction: Tigard
Site address: 8200 SW PFAFFLE ST WiIti
Project: Westside Christian HS Soccer Field - Subdivision: None Lot: None
Project Description: Site utilities for new soccer fields: (3)catch basins,(2)manholes&6,844'of storm sewer lines. 1/18/18:
REPRINTED to add(3)more catch basins and 100 FT of storm sewer.
Contractor: GREGORY PACIFIC CORP Owner:
11650 SW 67TH AVE#130
PORTLAND, OR 97223
PHONE: 503-639-3887 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Catch Basin or Area Drain 05/24/2017 $56.28
Specifics: 2 ea Manholes 05/24/2017 $37.52
6844 If Storm Sewer 05/24/2017 $2,613.90
Type of Use: COM 1 12%State Surcharge- 05/24/2017 $324.92
Class of Work: ALT Plumbing
Type of Const: 3 ea Catch Basin or Area Drain 01/18/2018 $56.28
Occupancy Grp: 100 If Storm Sewer 01/18/2018 $62.54
Stories: 0 12%State Surcharge- 01/18/2018 $14.26
Plumbing
Total $3,165.70
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �• ,/ L%� ature: _ 1`LbG=t��J'
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application r t�'
Site Utilities RECEIVE])] :, i OR 0E1 l( I t •,l: 0\1 '1
City of Tigard !Date/y: ,1 Permit No.: PC ,, 7-DOa20$
Ilig .1 13125 SW Hall Blvd.,Tigard,Olit,�a 23/4 2 017 pan Re Review ay 17 '
I Phone: 503.718.2439 Fax: 50159819 Date/By: Other Permit No.:
T l t,A 1:a Inspection Line: 503.639.417 j / Date Ready/By: Juns: H See Page 2 for
Internet: www.tigard-or.gov 1 I �f r I.v Z AMU Notified/Method: Supplemental Information
F" < ygiti, `..t.t " JVJS z 4 Mfr °W4 �,..6' 4 }} i ,
0 New construction 0 Demolition Forspeclal information use checklist
Description I Qty. [ Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ®Other:School Fire sprinkler( sq.ft.) Page 2
,' JOB SIT$ 1 RMATiOOrl ANIi itus 1a Site utilities:
Job site address:8200 SW Pfaffle Street Catch basin or area drain C. 18.76 Cj 1p•aS
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: l Project name:Westside Christain High Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 2 18.76 37. 59-
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft. `s t Page 2 rel(r,1&ID
Water service(no.linear ft.: ) Page 2
Subdivision: l Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
.. r.�..z+,. 4 ly_ ,, .� .! s !... T. ` S A .n a. x ; Backwater valve 12.51
, �
bar. 5.4-,ar'I".+..g,:' rt� 1 Clothes washeI 25.02
Install new storm drain piping,storm manhole,storm filter manhole Dishwasher 25.02
Install
l -,CG-f,
ll storm filter catch basin,2 ea.std.catch basins and field drainage Drinking fountain 25.02
N t
//IX/4-
1 r ,, ( '9c, A (•l.l(�Ls' 0 fry'.� Ejectors/sump 25.02
1`PROP11'1`ld I ' tw u ti c�' ' r a k Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) I Fax ( ) Ice maker 12.51
? e ' `;A A + E i 1iet(1' itgQ( . r Interceptor/grease trap 25.02
Business name:Gregory Pacific Corp Medical gas(value:$ ) Page
Primer 12.51
Contact name:Peter Hagen
Roof drain(commercial) 12.51
Address:11650 SW 67th Ave,Suite 130 Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97223 Solar units(potable water) 62.54
Phone:(503)639-3887 Fax::(503)296-5928 Tub/shower/shower pan 12.51
E-mail:peter@gregorypacific.com Urinal 25.02
fir/j .�-CIORyy F Water closet 25.02
x.. ., :v_ , Water heater 37.52
Business name:Gregory Pacific Corp Water piping/DWV 56.29
Address:11650 SW 67th Ave,Suite 130 Other: 25.02
City/State/ZIP:Portland,OR 97223 Subtotal al 767,7o
-
Phone:(503)639-3887 Fax:(503)296-5928 Minimum permit fee: $72.50
Plan review (25%of permit fee) ^^
CCB Lic.:66416 Plumbing Lic.no.:34-456PB e
State surcharge(12%of permit fee) 3,Z4,`t 2
-
Authorized signature: / TOTAL PERMIT FEE 3 p?y�,4r 7,
Print name:Peter A.Ha en Date 5-24-2017 This permit application expires if a permit is not obtained within ISO days
g after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
INCITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017 00205
-f-t GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/24/2017
Parcel: 1 S136CC00100
Jurisdiction: Tigard
Site address: 8200 SW PFAFFLE ST
Project: Westside Christian HS Soccer Field Subdivision: None Lot: None
Project Description: Site utilities for new soccer fields: (3)catch basins,(2)manholes&6,844'of storm sewer lines.
Contractor: GREGORY PACIFIC CORP Owner:
11650 SW 67TH AVE#130
PORTLAND, OR 97223
PHONE: 503-639-3887 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Catch Basin or Area Drain 05/24/2017 $56.28
Specifics: 2 ea Manholes 05/24/2017 $37.52
6844 If Storm Sewer 05/24/2017 $2,613.90
Type of Use: COM 1 12%State Surcharge- 05/24/2017 $324.92
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $3,032.62
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Nof - ion - -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire questions to OU\C by calling 503.232.1987 or 1.800.332.2344.
Issu•d By: I / L Permittee Signature: Al
.eik
/4
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Plumbing Permit Application
Site Utilities RECEIVE!)
Received
- City of Tigard Date/By: Permit No.: Pu�ao/7_005
114 ii 13125 SW Hall Blvd.,Tigard,O //�223 4 , Plan
Review �`/ /7
Phone: 503.718.2439 Fax: 50 98"..19 - "+
Date/By: Other Permit No.:
T 1 G A R I7 Inspection Line: 503.639.417 a , ``I� Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov V,1' , t Y I.1, t) Notified/Method: Supplemental Information
' V ' G . . .Fte•-•SE11
0 New construction ❑Demolition For special information use checklist
Description Qty. Ea. ] Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
� ,.. ON RVCUI J` SFR(1)bath 312.70
0 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ®Other:School Fire sprinkler(_sq.ft.) Page 2
JOB SITE;1NEORMATION AND i'ATIO Site utilities:
Job site address:8200 SW Pfaffle Street Catch basin or area drain 3 18.76 5/0,a�
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Westside Christain High Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 2 18.76 37, 59-
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:4Qyy Page 2 A,4,1 .,30
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DE$c i 'TION OF VYO�
Clothes washer 25.02
Install new storm drain piping,storm manhole,storm filter manhole Dishwasher 25.02
Install storm filter catch basin,2 ea.std.catch basins and field drainage Drinking fountain 25.02
Ejectors/sump 25.02
0
PROPERTY I31`1 1J I ,.1r iNT' ,. Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑`APl<' ,ll Cl coIprasoN Interceptor/grease trap 25.02
Business name:Gregory Pacific Corp Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Peter Hagen
Roof drain(commercial) 12.51
Address:11650 SW 67th Ave,Suite 130 Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97223 Solar units(potable water) 62.54
Phone:(503)639-3887 Fax::(503)296-5928 Tub/shower/shower pan 12.51
E-mail:peter@gregorypacific.com Urinal 25.02
COTRACTOR Water closet 25.02
- Water heater 37.52
Business name:Gregory Pacific Corp Water piping/DWV 56.29
Address:11650 SW 67th Ave,Suite 130 Other: 25.02
City/State/ZIP:Portland,OR 97223 Subtotal O2/707.7 0
Phone:(503)639-3887 Fax:(503)296-5928 Minimum permit fee: $72.50
-
CCB Lic.:66416 Plumbing Lic.no.:34-456PB Plan review (25%of permit fee) -�
ai,
,_ State surcharge(12%of permit fee) 3;4.9 2
Authorized signature: h L� TOTAL PERMIT FEE 3 02A, (o 2,
Print name:Peter A.Hagen Date:5-24-2017 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 Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00205
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor