Permit lb 0? to
C ITY F TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00454
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/30/2008
PARCEL: 1S135CA-00600
SITE ADDRESS: 11200 SW GREENBURG RD OFC ZONING: R -12
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT: 001 JURISDICTION: TIG
PROJECT: AUTUMN OAKS PROPERTIES LLC
Project Description: Community /Laundry Room 1/13/08, adding (1) additional lay, water closet & washing machine,
capping (1) floor drain.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 8 BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 4 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
AUTUMN OAKS PROPERTIES LLC
6036 SW MADISON ST Description Date Amount
PORTLAND, OR 97201 [PLUMB] Permit Fee 12/30/200E $232.40
[TAX] 12% State Surch 12/30/200E $27.89
Phone : [PLUMB] Add] Permit 1/13/2009 $33.20
[TAX] 12% State Surch 1/13/2009 $3.98
Contractor: Total $297.47
SHANNON CONTRACTING
2065 NW MILLER RD #415
PORTLAND, OR 97229 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -913 -1339
Reg #: LIC 159498
PLM PB619
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 r- • ab copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued :y: /41, , . I Permittee Signature: A. A
OP
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.
:, r•
CITY TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00454
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/30/2008
PARCEL: 1 S 135CA -00600
SITE ADDRESS: 11200 SW GREENBURG RD OFC ZONING: R - 12
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT: 001 JURISDICTION: TIG
PROJECT: AUTUMN OAKS PROPERTIES LLC
Project Description: TI.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 7 BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 5 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
AUTUMN OAKS PROPERTIES LLC
6036 SW MADISON ST Description Date Amount
PORTLAND, OR 97201 [PLUMB] Permit Fee 12/30/200€ $232.40
[TAX] 12% State Surch 12/30/200€ $27.89
Phone : Total $260.29
Contractor:
SHANNON CONTRACTING
2065 NW MILLER RD #415
PORTLAND, OR 97229 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -913 -1339
Reg #: LIC 159498
PLM PB619
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 f. •w rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -1 .0. Y.. y obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
eir
Issued By: aaAi e 1-d6/v - Permittee Signature: -�
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.
n
• :P1uthbing Permit Application
Building Fixtures RECE .11.
FOR OFFIC USE ONLY -
City of Tigard DEC 3 0 20 Jeeei, -ed t Permit No.: Oa yS(f
U 13125 SW Hall Blvd., Tigard, OR 97223 atelB l2 30 o g I t112 1
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Pe rmit N o.: /� 0 q � O
CITY OFTI G A1 e B e ad /B t ris ®S �I` 70 f�6 6 48 "
Inspection Line: 503.639.4175
TLGARD y y' g
Internet: www.tigard- or.gov BUILD DNIS t e d /M etho d: - � ci Supplemental Information
TYPE OF WORK . FEE* SCHEDULE .
❑ Ne construction 111 Demolition For special information use checklist
Description Qty. 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- and 2- family dwelling ❑ Com rcial /industrial SFR (2) bath 350.00
❑ Accessory building ulti- 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: / . 2 06) ;_� -' (Y.://6..'1J (n ‘,0.-_(:)( Catch basin or area drain 16.60
City /State /ZIP: � f l �.. 2' Drywell, leach line, or trench drain 16.60
11 tt Al , 0I/ v l a ,,. I .. z,
Suite/bldg. /apt. no.: 4 J ProJec9ttj'name: 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: Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 7 16.60
Dishwasher 16.60
.. _ ,- ❑PROPERTY OWNER . ( ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 5 16.60
Phone: ( )
Fax: ( ) Garbage disposal 16.60
' • ,❑ APPLICANT` ' ,. . ❑ CONTACT PERSON. Hose bib 16.60
' Ice maker 16 60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Sink/basi avato ., 16.60
Phone: ( ) I Fax:: ( )
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
_ CONTRACTOR, Water closet 1 16.60
Business name: S%Ir-l:vi,):�=i a. ae i,� (. C Water heater 16.60
Address: . r - ) p ,� CJ y , N , ' p Other:
: 1 l ( 7 Subtotal
City /State /ZIP: e
u : -,vCt 6)( `/ `i Minimum permit fee: $72.50 2 ))I
Phone: ( ) C i 3 , - (a, 9 .-- Fax: ( ) C Residential backflow minimum permit fee: $36.25 2 32 • `-(G
p Plan review (25% of permit fee)
CCB Lic.: 1 1t Plumbing Lic. no.: ....2, 9 State surcharge (12% of permit fee) 2 7 • $9
Z.la•Ip se_,_-
� •1• I \ , Aut ortzed signature: - TOTAL PERMIT FEE 26,6.2.9
Print name:
�1 J Date: 'V This permit application expires if a permit is not obtained within
�' ' ✓ ��'� /w ' �� 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1:\ Building \Permts\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard , . e -
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities," Qty . Fee(ea) Totals kSquare'Footage' Permit.Fee , .
Footing drain - I' 100' 55.00 0 to 2,000 , $115.00
Footing drain - each additional 100' 46.40 2 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
Q Fe ( ea ) Total additional $100.00 or fraction thereof, to and
F1Xtlid'e.OI"ItClll . r,: Qty.- 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 Backflow 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
specially requested inspections - per hour 72.50
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work: . Plan Review Installations ,.w
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and
Qua by!(Fixture)'WorkPerformed "' greater, except systems designed and stamped by licensed
x `
• engineer.
Fixtiire,Typg: Replace
- . Previous Capped Added„ Existing ' ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918 780 - 0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall ❑ Any complex structure as defined in OAR918 780 - 0040.
- Drive Thru
Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
-Domestic
� r_
Drinking Fountain ISOmetric Or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
-3"
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec.. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory •
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
1 :\Building \Permns\PLM - PermitApp doc 12/27/06
MY OF MA RI 1-4. , ) I
Et tin- DING DIVISION ,74 PERMIT #: !DI j 0,41A
13125 SW Hall Blvd., Tigard, OR 97223 , ., / 7 , DATE ISSUED: ty rAli :,t-
Phone: (503) 639 -4171 l "� 74 iPlI��Ik 1/
Inspection Requests (24 Hrs.): (503) 639 -4175 .1 ,,
INSPECTION WORKSHEET FOR DATE: iiimon9 TIME: : j 3A , ; PAGE: f;
SITE ADDRESS: - 11,0) ; W GRFBIBURG RD OFC CL OF WO K: I
SUBDIVISION: + `iE_9 "C'1„ mN iJ Aker f {pA 1`ialk �r LOT #: ow YP U
PROJECT NAME: AUTUMN OAKS S PROPER ICE: !.1..0 1
DESCRIPTION: - 11 \
OWNER: F;,I "1111;,,r�g OAKS PPC, 'E' 111 - .. i ?..( ,r; PHO #:
CONTRACTOR: sl CmivoC'1 c;x:)r.lCi.A;.'Cii:t;; PHONE #: 503..913_1339
Inspection Request Scheduled For Bate: /12/20 0.)t Pour Time: A'C 4( .1
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Code # Inspection De ription Cc , u; # Contact # essab - i W■
::c.?;) Plum n _ugh•iii 0 'O. -01 f,03- 913 -1339 \ 2;.-S .6
Cor -ct •n / om ent- /Instructions: f , -
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PASS IRTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
3 �1.�
Inspector:
‘,/ Date: V li�i�G Phone #: (503) 718 - Y
p /
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Pi M200t1 -00 A
13125 SW Hall Blvd., Tigard, OR 97223 0,-- DATE ISSUED: 12/30000B
Phone: (503) 639 -4171 ii,
. ,/
Inspection Requests (24 Hrs.): (503) 639 -4175 ° :_..
INSPECTION WORKSHEET FOR DATE: 1/12/2009 TIME: 7:00AM PAGE: 5
SITE ADDRESS: 11200 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT #: 001 TYPE OF USE:
PROJECT NAME: AUTUMN OAKS PROPERTIES LLC
DESCRIPTION: - 1 . 1
OWNER: AUTUMN OAKS PROPERTIES LLC, PHONE #:
CONTRACTOR: SHANNON CONTRACTING PHONE #: 503.913 - 1339
Ins Inspection Request Scheduled For: Date: i11� Pour Time: lA
p Q 1/12/2009 �"
Code # Inspection Description Confirm # Contact # essab - k _
320 Plumbing rough-in 079603 -01 603-913-1339 Y -
Corrections /Comb ents /Instructions:
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PASS F.4 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: .
ns ector: . C/ Date: I I"2 o ! Phone #: (503) 718 - °`g 'Z
CITY OF TIGARD
..., A4, BUILDING DIVISION PERMIT #: a e
I I..M. 008 -0044
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12130/70()8
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ''I -iL
INSPECTION WORKSHEET FOR DATE: 1//212009 TIME: 7:00AM PAGE: 4
SITE ADDRESS: 11200 SW GREENBURG RD to=t.`,'. CLASS OF WORK:
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT #: 001 TYPE OF USE:
PROJECT NAME: AUTUMN OAKS PROPERTIES LLC
DESCRIPTION: - n. AUTUMN OAKS PROPERTIES LLC, PHONE #:
CONTRACTOR: SHANNON CONTRACTING PHONE #: 503. 913.1339
Inspection Request Scheduled For: Date: 1/12P009 Pour Time: 6vct
Code # Inspection Description Confirm # Contact # Mes a e
17i'. 2::"“
315 Pool/beam plumbing 079605 -01 503 -913 -1339 Y
Corrections /Comments /Instructions:
.
/ I CA/W��'
/ ` 1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
()-1 I A 710 ±_04
Inspector: Date: / Phone #: (503) 718-