Permit C ITY OF TIGARD PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT PERMIT #: PLM2006 - 00483
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/8/2006
PARCEL: 1S136DD-03400
SITE ADDRESS: 11740 SW 68TH PKWY 200 ZONING: MUE
SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG
Project Description: Interior fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
PNWP LLC
6600 SW 105TH STE.175 Description Date Amount
BEAVERTON, OR 97005 [PLUMB] Permit Fee 10/17/200E $72.50
[TAX] 8% State Surcha 10/17/200E $5.80
Phone : 503- 636 -2500 Total $78.30
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 639 -5296
FAX 503- 684 -9015
Reg #: LIC 2439
PLM 34 -29PB
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.
Issued By: Permittee Signature: Jj
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.
'Building Fixtures 1 5134 Dip -3q Do
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Plumbing Permit Application FOR (,IFFICF. I,1/4;I1 ()NI.)
City of Tigard ( ? r" ryry Received Permit No. .
a 131 25 SW Hall Blvd, Ti '° Y l. 00� Date/By. !O / 1V ( aid& ctA( -poy8g r
Tigard, OR 9722`3 Plan Review
Phone: 503.639.4171 Fax: 503.598.196 Day Other Fermium -tX 4 /45 °
r 1G A It D Inspection Line: 503.639.4175 , - Date Ready/By IT" ® Seep e 2 for
Internet: www.tigard- or.gov - Notified/Method: Supplemental Information
TYPE OF WORK , FEE* SCHEDULE : ' ' '
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement Other: �Jr New 1- 2-family dwellings ¢s (includes 100 ft. for each utility connection)
' ' . CATEGORY OF CONSTRUCTION ' . SFR (1) bath 249.20
❑ 1- and 2 -family dwelling commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
, „ . ,- JOB SITE INFORMATION AND LOCATION • : Site utilities
Job site address: ii S 4r Catch basin or area drain 16.60
City/State/ZIP: ' O4,4io .,,,3 Drywell, (each line, or trench drain 16.60
Suite/bldg. /apt. no.:a9) Project name: A' ,,9s l��-' .� 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: l Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
' 4- .' - - DESCRIPTION OF WORK Back flow preventer Page 2
_ , . . . . - " P i c . " •4 / '3 Backwater valve 16.60
Clothes washer 16.60
- Dishwasher 1 16.60 1 (p lob
- ; PR OWNER ; I , ._ ❑ TENANT Drinking fountain 4/4 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 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
' , Q. APPLICANT • - ' ' n 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
Phone: ( ) I Fax: : ( ) in/lavatory 6.0 16.60 33 , Q (0
uwer/shower pan 16.60
E-mail Urinal 16.60
. ... .. ' CONTRACTOR Water closet 16.60
Business name: W57 J ,Lfni e /jt/C, Water heater 16.60 _
Address:9960 4611 �G4/2 ,� j /o/ Other:
city / State/ZIP: Subtotal 4y, (_)
�(� 4�� o4 ! ��3 Minimum permit fee: $72.50
Phone: (SJ )103 ►- G Fax: (. ) lji $y -9diS Residential backflow minimum permit fee: $36.25 `. ,9,
CCB Lic.: 021/,/9 Plumbing Lic. no.:3 , 4j' _ Plan review (25 %ofpermit fee)
�-✓ State surcharge (8% of permit fee) j,
Authorized signature: ,,,, d�-z " ! TOTAL PERMIT FEE ` 50
Print name: -7 dn„.... f �" 1 Date /0 , This permit application expires if a permit is not obtained within
/ l 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
l:\ Building \Pamib\PLMF•PmnitApp.doc 04/06/06 440.4616T(1W02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006- 00483
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2006
Phone: (503) 639 -4171 (+�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 319/2007 TIME: 7:01AM PAGE: 76
SITE ADDRESS: 11740 SW 68TH PKWY 200 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 008 TYPE OF USE:
PROJECT NAME: PARTNERS GROUP
DESCRIPTION: Interior fixtures.
OWNER: PNWP LLC, PHONE #: 503 - 636.2500
CONTRACTOR: WESTERN PLUMBING PHONE #: 503. 633.5296
Inspection Request Scheduled For: Date: 3/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 044E40-02 503 -639 -5296 N
Corrections /Comments/ Instructions:
/
►� - ASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V Date: , Phone #: (503) 718 -
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