Permit �ITY TIGARD PLUMBING PERMIT
�,� DEVELOPMENT SERVICES PERMIT PLM2002 -00102
R�I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/28/02
SITE ADDRESS: 14160 SW 72ND AVE 150 PARCEL: 2S112AA -00900
SUBDIVISION: NELSON BUSINESS CENTER ZONING: I -H
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: 1 GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing tenant improvement, adding 9 additional fixtures and capping 4 fixtures. Other fixtures are 1 primer
and 1 expansion tank.
FEES
Owner:
Type By Date Amount Receipt
RREEF PROPERTIES PRMT CTR 3/28/02 $199.20 27200200000
720 SW WASHINGTON SUITE 710 PLCK CTR 3/28/02 $49.80 27200200000
PORTLAND, OR 97205 5PCT CTR 3/28/02 $15.94 27200200000
• Phone 1: 503 - 295 -5555 Total $264.94
Contractor:
ASSOCIATED PLUMBING CO
P O BOX 301362
PORTLAND, OR 97230 REQUIRED INSPECTIONS
Phone 1: 331 -0582 Rough -in Insp
Top -out Insp
Reg #: LIC 57890 IC 57 Insp existing /capped fixtures
Final Inspection
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: / If _ _ Permittee Signature q ' ..Z/7
Cali (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Mar AS 02 10:06a ASSOCIATED PLBG 503 331 0581 p.2
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2,boA - GO i 30
A Plumbing Permit Application
't" ' 'r C' of Tigard Date re :tined: / i v7 hermi no.: ibl Ape -00 ti) .
„aJ;L . . . i Address: 13125 SW Hall Blvd. Tigard. OR 97223 Sewer permit on.: Rultdingpermit no.:
Ciro of /lard Phone: (503) 639.4171 ProJeet'appL no.: R dtuc: ^�
Fax: (503) 598-1960 Date ic uen: y Receipt no.: O
Land use approval: Case Re m.: Payment type:
•
0 1 et 2 family dwelling or accessory 0 CometciaUbtdustrial CI Multi- family 0 Tenant improvement W
m
0 New construction 0 Addition/alteration/replacement CI Food service 0 Other:
r 1 - t 1 1 L , t forspecialinfonratinnuserhL. hlisli
lob address: 1 4160 51!! 72 Sail( loo Desctptloo _ Qty. Fee(m) Total C
Bldg. no.: 1 Sate no.: l;ta New l -attf �fartdlydwdlittga only;
Tax mwphax tot /account no.: (mcbodes bath
B for each utility msmectioa)
Lot: Block: t J Subdivision: SFR () bath
{ es U93 I.og;S i[S GrOda S (2) bath
Project name:
SEtt (3) bath
City /caanty: Tit) a d / inhl . 1 ZIP: 4 1722) Each additonal bath/kitchen ,----'
Description and Location of wset on Site oath m
Tt'nkr} =01 prov eon t4 t •- Ens f En/ Catch bash liarea drain
Est. date of completion/inspectfon: • Drywelts/Lacb line/trench drain
'Footing drain (no. Itn. ft.)
Business acme: Manufaetu rod home utilities
/4 5S0(i4 f r At o il Manholes
Address: PO Best jot 36; 1 Rain drain connector • i O.
Gty: Qor}/Qa1 State:6A ZiP
i I 97 ail -43aa Sanitary sewer (no. tin ft.)
Phone: 5 331 o 1 Fa1:: 331 c 6J 1 E -mail: ---". Storrn soma (no. lin. f1.) c�
CC1) no.: 57840 1 Plumb. btu. reg. no: A 6 " 41A PB Water sere ce fno. lin. ft.) -
City/menu lit:. no.: )96/ Fixture or keat: -
Contractor's mpresentative signature: Absorption valve
Print name Back flow xi: venter
L D ate : -i 9 - a t Backwater valve
• - CONTACT I'E1 SON
Basins/law Cory A
Name: e h tre LAC kin Clothes waster
Address: PO 8:4% 30136 wattle
City: Po. 1.-/ State: OR ZIP: e) '1,04 Drinki.: heuttain(s) •
� 5 °3 33) 051}2, Fax: 331 o58i E -mail: — Ejectors/sump n tan
Ex on tank i , (1 / `
. •_ UN•Nf7t Roue/serer cap
Name (print): ' ke EF Floor draint/llc+or sinks/tub l
Mailing address: 72 0 7 Garb ;•. a disposal
5 oil 1NA11 i 19 -a 5 u , a 10 Hose bibb
City: o. }) 44J State: oR ZIP: 371) lee -
Phone: Fax: E-mail: lnter:cpam grease tap
Owner installation/ residential mainmta»oe only: The actual installation Primer(s) 1
will be grade by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property 1 own as per ORS Chapter 447. Sink(s). ba::in(s). lays(s) L
Owner's signature: _ Date: Sum .
F:�r ;1:VCFlt Tubs/show :dthowerpan _ .
Name: IS A Urinal 1
Address:
Cif Water closes
. Water cl _ 1
City: }state: IZ1P: Other.
Phone: j Fax: 'Email: Total ' y
(?ra W in*tsmeoo.■ ,owp sees ogd otore tank aan (or ma= iMonnappd Minimum fee .. S / /' G/ •
I U vise O stesrnCerd Notice: This perms appl cation /
t expires if permit is not obtained Plan review (at %) $
y 9. $O
Credo card amber: • Ll- - • within 180 der) s after it hes been State surcharge (8%) .... Y �
i i
t apnu S
�. M i d ew
:,rds... o cal e.aaar card — aeegnal as compkte. OTA 6
•.4
Mar 49 02 10:06a ASSOCIATED PLBG 503 331 0581 p.
PLUMBING PERMIT FEES:
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_ g . E .. % ( }:,:•r- :I111�lC�lfiT:" • ��oWhh1 • FeeFl�l;�. ,,;,;%
Sink ) 18.80 0114.0614 ' 100,� : „ , Q /:. x - ifaiiiaidi-kimity.Woiiiiiiti36iiE , F;f::: •_:.: Lavatory 16.60 O (1) bath • 8 249.20
Tub or Tub/Shower Comb. 18.60 TWO (2) bath . - 8d5O 00
Shower Only 16.60 Three (3) lath $398.00 , •
Water Closet 3 16.60 SUBTOTAL :..
Urinal j 16.60 SIG STATE SURCHARGE . ;.:;!:= :. ;.•. :,: .
Dishwasher :
" 18.60 PLAN RE VIEW 25/ OF SUBTOTAL :.' ' it : .' . •
TOTAL .: i , ,.• ;
Garbage Oteposel - 18.60 _
Launc by Tray 16.60 '
Washing Machine 1680 •
Floor Drain/Floor Sink a 7H PLEASE COMPLETE:
3. 4 16.80
Water Heater o coomrslon G dice kind 18.80 ;;, ^' °` : • 'L:,
Gas piping requmes a separate mat rya dcal 1 . f � - -i' , - - - °t s I' ` fit -' .:•, pied '
permit ;:r, 1
MFG Homo New Water Service 46.40 xS j
MFG Home New San/Stone Sewer 48.40 Lavatory I
Tub or TufdShower
Hose Bibs 16.60 CombinaUfn •
Roof Drains 16.60 Shower Q try •
Drinking Foui4ain 16.60 Water Closet
Urinal _ ' •
Other FfhdLtes (Specify') i S�
'� cxr � / 1660 Garbage Disposal _ .
i � / Laundry Room Tray
Wasting 1'chlne •
Sewer -1st 100' 55.E Floor DfBI USInIC "
9"
Sewer - each addilonallt)0' 46.40 4' •
Water Senfloe -1st 100' 55.60 Water Herder
Water Service - each additional 100' 46.40 Other FDd MI5 .
Morin & Rain Grain - 1st 100 56.00
1.1.1•1,49t14 A, I
Storm & Rain Drain - each addie:nal 100' 46.40 .
Camnaudel Back Flow Prevention Devka 48.40 4
Residential Backflow Prevention Device' 27.55 '
Catch Basin 16.80 _ - -
Inspection of Edging Plumbing or Specially 72.50
Requested Inspections parfhr COMMENTS REGARDING ABOVE:
Rain Orein, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
borne,* or Azar diagram brequtrod8 ; r' ;} .
QuewSt y Totals a 9
"SUBTOTAL :•'',i. '
=.i, ''. 2 32. yo
8% STATE SURChARGE /f/ -
"PLAN REVIEW 20% OF $UBTOTAL ,.,: ,:r :; ;. ' ., r /
Recurred ohty a Ease qty. told is a 9 - .:.ti. ; •r -
TOTAL • >r.t.a;. ;:,.,
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"Mlnimem ptmdt fie Is 172.50 • 3% state surcharge. except Residential Baddlow
Weran5an Device, which Is $36,25. state surdmrgo.
"All Now Commercial Buvdbtgs resale viols wIth isometle or deer diagram end
plan rwiew.
rWstslforneslpim.fees.Qoc 10/10/00
C0 J QUIV9I1 d0 A.LI0 0961 988 £09 XVd L)Y :ST )I11L TO /£1 /30
MIPILOF TIGARD 24-Hour -
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested � `a AM PM BUP
Location / 1 4( r ./1d �
6 7• -
d - Suite /,_C MEC
Contact Person Ph ( ) PLM C ) O / o
Contractor Ph ( )
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm / r _
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL -
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
al
PART FAIL
• ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line 9 7L �Date /' Z Inspector ector Z' // 2 a�� ' Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
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