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Permit j - 1 a CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00482 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/8/2006 PARCEL: 1 S136DD -03400 SITE ADDRESS: 11740 SW 68TH PKWY 250 ZONING: MUE SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG Project Description: Interior fixtures. All new 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 Description Date Amount 6600 SW 105TH AVE. STE.175 BEAVERTON, OR 97005 [PLUMB] Permit Fee 10/17/200E $72.50 [TAX] 8% State Surcha 10/17/200E $5.80 Phone : 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: �p ,/ 7 Permittee Signature: 4` 2 e , c)q 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 /5/ 34 -03/00 Qd -et9..13V Plumbine Permit Application rUR OFrlcl: 1,si: ()\1.V OCT ' City of Tigard _ �'�' � `'� q 13125 SW Hall Blvd, Tigard, OR 97223 -: ! ! t r. 10//10/010, Permit N•. 2. _� e ?/ 1111 • Phone: 503.639.4171 Fax: 503.598.1960 �, Plan Review other ifs t�t4 ,Aatel9y. T 1 G A R [� Inspection Line: 503.639 �. , ", ./ " WBT , : ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: ,_J Supplemental Information TYPE :OF WORK NEE* SCHEDULE .. ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition /alteration/replacement 9'Other: 9o- �� 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 *ommercitl /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: // gyp S 6g-7 7 X Catch basin or area drain 16.60 City /State/ZIP: 17644, 4,--,,, Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: A5) I Project name: yL/9 Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 P l� ' 1 V Rain drain connector 16.60 - Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: 1 Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item .. Absorption valve 16.60 • _ • ' ' DESCRIPTION OF WORK Backflow preventer Page 2 1-i(/i� ,z.i.,/ Backwater valve 16.60 Clothes washer 16.60 Dishwasher • / 16.60 1 l t Drinking fountain 16.60 'CI PROPERTY OWNER ' I , 0 TENANT 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 a 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: R.. f drain (commercial) 16.60 te • in/lavatory 7 I 16.60 I % ? Phone: ( ) Fax: ( ) ¢ 1 . shower /shower pan 16.60 E-mail: PAii(M Urinal 16.60 ' " CONTRACTOR ' Water closet 16.60 Business name:14/ 57 / ,„„,,, //t/G Water heater 16.60 Address:6796,0 776,49 Y/ 4i ,,o/ Other: 1 City / State/ZIP: ,4,Q 0 4 g 23 Min imum Subtotal ,�n �* permit fee: $72.50 Phone: ( ) 639 - Fax: (-CO) G-90/S Residential backflow minimum permit fee: $36.25 .7 (50.3 - 1� - 8i' , Plan review (25% of permit fee) CCB Lic.: 0 2v . 19 Plumbing Lic. no.:i%2 4J State surcharge (8% of permit fee) $p Authorized signature: , /� , e /� e /J C/ -r 4...: TOTAL PERMIT FEE :.-0 Print name: Too l/pp ' 1 Date:/j?/>/ a This permit application expires if a permit is not obtained within '�'J 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. L\B uildingTermibIPIMF- PmnitApp.doc 04/05/06 4404616T(10/02/COM/WFB) CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2000.00482 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1•18/2006 Phone: (503) 639 -4171 • At Inspection Requests (24 Hrs.): (503) 639 -4175 i ... INSPECTION WORKSHEET FOR DATE: 3/9/2007 TIME: 7:01AM PAGE: 75 SITE ADDRESS: 11740 SW 68TH PKWY 250 CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 008 TYPE OF USE: PROJECT NAME: OHCA DESCRIPTION: Interior fixtures. All new fixtures. OWNER: PNWP LLC, PHONE #: CONTRACTOR: WESTERN PLUMBING PHONE #: 503-639-5296 Inspection Request Scheduled For: Date: 3/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 04454003 503 - 639-5296 N Corrections /Comments /Instructions: / / il PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 11/ r i Date: p) Phone #: (503) 718- . VA