Loading...
Permit s s . CITTGARD PLUMBING PERMIT '' ' I DEVELOPMENT SERVICES PERMIT #: PL 12/20% -00009 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/12/2006 PARCEL: 2S113AD-01700 SITE ADDRESS: 16920 SW 72ND AVE ZONING: C -G SUBDIVISION: ROSEWOOD ACRE TRACTS LOT: 030 JURISDICTION: TIG Project Description: TI, other fixtures: (1) drinking fountain, (1) expansion tank,(1) primer & (1) fixture cap which removes (17) fixtures. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS: 2 TRAPS: STORIES: 1 WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: 1 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: 4 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 4 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES BRIDGEPORT LAND LLC Description Date Amount 3939 NW ST HELENS RD PORTLAND, OR 97210 [PLUMB] Permit Fee 1/12/2006 $298.80 [PLMPLN] Plan Review 1/12/2006 $74.70 Phone : 503-224-2676 [TAX] 8% State Surcharl 1/12/2006 $23.90 Total $397.40 Contractor: POWER PLUMBING CO P O BOX 19418 REQUIRED ITEMS AND REPORTS PORTLAND, OR 97280 Contact # : PRI 503- 244 -1900 FAX 503- 244 -8825 Reg #: LIC 52378 PLM 34 -150PB 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 require :. , ollow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 d001 -0010 thr. •h OA 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by ca ing 503 - 246 -66• ' • -: • 332 -2344. 1 / • • Is ed By: , �!� ��L -1 __n Permittee Sign„ 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. Plumbing Permit Apc"tion r 1 Q� FOR OFFICE USE ONLY City of Tigard „< - * \' : Received ' Permit No.. , C-\� ✓r fOw (r7 � �Qo� 13125 SW Hall Blvd., Tigard, OR 97223 (\ l�,ti DatDate/By: y : � � , � � Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ;.!' � , � /�nr_4I� Date/By: //104, ,�L� Other Permit No.: 24- Hour Ins ection Line: 503.639.4175 \ . ..� P �� ` Date Ready/By: lu ® See Page 2 for Internet: www.ci.tigard.or.us `� Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction 0 Demolition For special information use checklist Description i Qty. 1 Ea. 1 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- and 2- family dwelling igt 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 INFORMATION AND LOCATION Site utilities Job site address: 16 q ; ,2 0 Si.&) 7 n cI / WE . Catch basin or area drain 16.60 City /State /ZIP: l "1. so_ 1` O cc- con �-f 7a q Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: /0 Project name: D50) t) S k Q�, S 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 n� / / hp -• �/ 704, Fixture or item Tax map /parcel no.: pvJ ;J Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 P k ,,,,btu� - A)e /,, ,r S�v6UM S Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER { 0 TENANT Drinking fountain 1 16.60 Ejectors /sump 16.60 Name: Expansion tank ( 16.60 Address: Fixture /sewer cap / 6 pP 16.60 City /State /ZIP: Floor drain /floor s k/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 (�1 i -. /� Ice maker 16.60 Business name: peui�P r 1' ll..IY%b i (C W • Interceptor /grease trap 16.60 Contact name: in • K e_ ( � as r e. Me di cal gas (value: $ / tt 11 ) Page 2 Address: 66 1 l SW rYl j 4 hD m r L f, Yak . Primer 1 16.60 City /State/ZIP: o « Roof drain (commercial) 16.60 � n< C 7 c l Phone: (553)ayy- 9©o Fax ::(563) 3 clay - ggas--- Sink/basin/lavatory 6 16.60 11 Tub /shower /shower pan 16.60 E -mail: R"'1 t KP L.0 a pwrr jA,s ,m 111 /lc� co . C- tvi Uri J 1 16.60 (� CONTRACTOR Water closet 9 16.60 Business name: po,,, e A t x in J. n Water heater 1 1 16.60 Address: 6611 (, rY1 1,,4 n n (n et 10 Other: Subtotal 8 , g0 City /State /ZIP: p c k\ � op. c 7T.. 7 Subtotal ? , 9 permit fee: $72.50 Phone: (5 / _ I4 pp Fax: (503)x'1 - gay S Residential backflow minimum permit fee: $36.25 CCB Lic.: 52 375 Plumbing Lic.no.: -150Pa Plan review (25% of permit fee) 74. 7O - State surcharge (8% of permit fee) R3 Authorized signature: TOTAL PERMIT FEE 39 , '/ Print name: A/c. (mar rcn Date: / -6 ,2 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\PLM- PermitApp.doc 06/05 440 -4616T(10 /02/COM /WEB) • . 1 S '` Accumulative Sewer Tall Par # 251,13 AD 01700 T y nant Name :DSW'Shoes ; <` F This Address: ,.16920 SW .72nd.Ave f; This PLM# PLM2006:400009, Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #s values Baptisery/Font 4 0 , , 0 „ -„ , 0 0 0 Bath - Tub /Shower 4 0 0 0 0 0 - Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash - Each Stall 6 0 0 0 0 0 - Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 ,"' 0 0 0 0 Dishwasher - Commercial 4 0 0 ? 0 0 0 - Domestic 2 , 0 0 0 0 0 Drinking Fountain 1 ' _ 0 1- 11 , - 1 0 0 Eye Wash 1 0 0 " 0 0 0 Floor Drain /Sink - 2 inch 2 - , 0 ,�4 , „ 8 K , 2F`e' 4 -2 -4 - 3 inch 5 .. 0T" 5 _ 0 -1 -5 - 4 inch 6 x, , ', 0 0 5,. 0 0 0 - Car Wash Drr 6 _, 0 �Y- 0 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 ;_ter 0 '.', 0 «60 0 0 0 - Commercial (to 5 HP) 32 0 0 v' 0 0 0 - Industrial (over 5 HP) 42 0 0 , „ 0 0 0 Ice Machine /Refrigerator Drain 1 0 ,� ,> 0 ri w` r ` 0 0 0 Oil Sep (Gas Station) 6 0, ` 0 .��� 0 0 0 , 0 ''',.;*'-0, Rec. Vehicle Dump station 16 0 ! •, . :- 0 0 0 Shower - Gang (per head) 1 0 ' <x 0 r. : 0 0 0 - Stall 2 ,' 0 .7 , r 0 F : >k .,F' 0 0 0 Sink - Bar /Lavatory 2 ,1 ,,, , 0 ', -; 10 ' ,A,h` 8 -1 -2 Bradley 5 ' 0 0 0 0 0 - Commercial 3 , , , 0 1 , ! 3 , , 1,' , 3 0 0 - Service 3 `; 0 ' 3 %fix .1`„ 3 0 0 Swimming Pool Filter 1 0 x -r 0 0 0 0 Washer - Clothes 6 .,` 0 0 0 0 0 Water Extractor 6 0 0 *_;; 0 0 0 Water Closet - Toilet 6 0 X , 3, . 18 4 , ! 24 1 6 Urinal 6 , h . 0 1'" 6 : . 6 0 0 Previous EDU Count , 0 0 Capped EDU Credit 0 TOTALS 0 0 17 54 14 49 -3 -5 Current Fixture Value -5 divided by 16 = -0.3 Current EDU 1 EDU = $ 2,600 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change -5 divided by 16 = -0.3 over (under) $ (780.00) Enter EDU Change Here =03 Notes: * ** *EDU CREDITS * * ** Authorized Name /Signature:'Debbie Adamskl , . ` : - , ; .. • Date: "-:'1/1'2/2006 Building Division f Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher hich must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. i:\Building\Sewer Tally \SewerTallySheet.xls 7/1/05 CITY, OF TIGARD (2L M'! BUILDING DIVISION PERMIT #: 7O , - ad D O i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: ( e,0 9 Z O 7 4 `_ CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: I CONTRACTOR: PHONE #: 1 Inspection Request Scheduled For: Date: 3 = / - 0 (p Pour Time: ,f Code # Inspection Description Confirm # Contact # Message -339 P ( D Z36 - D-7�I Corrections /Comments /Instructions: Ca re. Ji Ua l wL-' V ( i r A-)..`. 1 L te,, PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS H FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: C1_ V Date: 41 Phone #: (503) 718- 'CITY OF TIGARD BUILDING DIVISION PERMIT #: I :I Mi`? M- (.`s(r 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: "1/12/200 Phone: (503) 639 - 4171 " n• Jf .40/040 Inspection Requests (24 Hrs.): (503) 639 -4175 � ±i 11.. INSPECTION WORKSHEET FOR DATE: 2/2/2006 TIME: 7 :02AMMi PAGE: 613 SITE ADDRESS: 1692() SW 72ND AVE CLASS OF WORK: SUBDIVISION: ROS(sWOOD ACRE: TRACTS LOT #: 030 TYPE OF USE: PROJECT NAME: DSW SHOES DESCRIPTION: ] I, other fixture: (1) drinking fountain, (1) exparision tarik,(1) primer t (a) fixture cap which r<°nk:ev (1 7 ) fixtures. OWNER: BRiiJ3L.PORT I..AN[ LLC , PHONE #: 0S() t. 224 ?( ;°/6 CONTRACTOR: POWER PLUMBING CO PHONE #: 5O3- 24..1- 1110() Inspection Request Scheduled For: Date: 2/2/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 3.20 Plrrrthin9 rougl;.in 02615601 0I y03- 96.2721 • '! Corrections /Comments /Instructions: 0' if A //.1. • l r_ PASS • ' TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: /277-4- Date: c Phone #: (503) 718- • ^ �����~W��J����� ��U��� OF mo��m�mum� ' ^ BUILDING DIVISION PERMIT #: [�.M200600809 13125SVV Hall Blvd, Tigard, ORQ7223 DATE ISSUED: 1/12/2K;; Phone: (503) 639-4171 ' |napeo�nRoquoo� �4Hroj:(5O3)63Q'4175 44 INSPECTION WORKSHEET FOR DATE: 1/202006 TIME: 7:00AM PAGE: 91 SITE ADDRESS: 1(92U SW72NDAVE CLASS OF WORK: SUBDIVISION: BQSEN00D ACRE TRACTS LOT #: 030 TYPE OF USE PROJECT NAME: USVVSH0EO DESCRIPTION: T| other fixtures: /1\dhnNng{cwntein,M\*xpmnsionLonk.(1)ph/no/&H>|ixturec»pwhich rm/uves (17) fixtures. OWNER: Bf?./DSEP(RT LAND U'C. PHONE #: 603-2262876 CONTRACTOR: POWER 'LUMF3IN(3 CO PHONE #: 603 Inspection Request Scheduled For: Date: 1/200008 Pour Time: Code # Inspection Description Confirm # C ntac Message 305 F1umhing undo slab 026342-01 Corrections/Comments/Instructions: �^ [ � /// ri PARTIAL APPROVAL CANCEL || NO ACCESS FAIL | CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED .�� Y �Lmy� Inspector: /�� � - `^ Date: / / ~ /\'~ Phone #: (503) 718- CID( OFTIGARD w BUILDING DIVISION ` . ., PERMIT #: i ?L.W.fEi1 -i i x: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/12.11, )6 Phone: (503) 639- 4171 � tk Inspection Requests (24 Hrs.): (503) 639 -4175 4'1,;i I INSPECTION WORKSHEET FOR DATE: 1/113/2006 TIME: 1:0 PAGE: N'l SITE ADDRESS: 1 32O SW 7 2ND AVE CLASS OF WORK: SUBDIVISION: ROSEWOOD ACRE TRACTS LOT #: 030 TYPE OF USE: PROJECT NAME: {)SW sHOES DESCRIPTION: TI, other fixtures: (1) drinking fountain (1) expansion iarak,(1) prime! & (1) fixture cap which IQ :int :) O (17) fixtures:. OWNER: BRIDGEPORT LAND LI..C, PHONE #: 603-2242676 CONTRACTOR: POWER PLUMBING GO PHONE #: 03.244•'1x„10 Inspection Request Scheduled For: Date: 1/1012006 Pour Time: Code # Inspection Description Confirm # ntact # Message 305 f'lu ill bina under i i al) 026135-01 603-936.2721 Y Corrections /Comments /Instructions: I v` s 7/ r L iCit 1 A . 2, - .Y. g5 ( 1/4,t • ( t . PASS YPARTIAL APPROVAL ❑ CANCEL f I NO ACCESS U FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: LA." Date: 1/ alb 6 Phone #: (503) 718 -