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Permit I' CITY TIGARD , f PLUMBING PERMIT A & DEVELOPMENT SERVICES PERMIT #: PLM2001 -00610 '�'I 13125 SW Hall Blvd., Tigard, O R 97223 (50 639 -4171 DATE ISSUED: 12/6/01 SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100 SUBDIVISION: OREGON BUS. PARK III ZONING: I -L BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS: STORIES: 1 WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS: SINKS: 2 URINALS: 2 GREASE TRAPS: LAVATORIES: 4 OTHER FIXTURES: 2 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 5 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Plumbing tenant improvement. Other fixtures are (1) eye wash and (1) primer. FEES Owner: Type By Date Amount Receipt PACIFIC REALTY ASSOCIATES PRMT CTR 12/5/01 $282.20 27200100000 15350 SW SEQUOIA PKWY #300 -WMI PLCK CTR 12/5/01 $70.55 27200100000 PORTLAND, OR 97224 5PCT CTR 12/5/01 $22.58 27200100000 Phone 1: Total $375.33 Contractor: POWER PLUMBING CO P 0 BOX 23144 TIGARD, OR 97281 REQUIRED INSPECTIONS Phone 1: 244 -1900 Rough -in lnsp Reg #: LIC 52378 Final Inspection 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 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. • Issue y: / _ i .. 4 _ <Li //��: . 1 P erm it tee • S i / /, _ /,. „ i �! A . i -- CaII (503) 639 .175 by 7:00 P.M. for an inspection needed the next bus ness day - 26 / Z • 3t! Plumbing Permit Application .......:.,1 Date received: 1/ /(p /e �/ Permit no.: L i`/ o vrG/ -pt /.. :�,; City of Tigard )13 4 ; � 1 � Sewer permit no.: Building permit no.: Address: 13125 SW Hall BI , City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 NOV 16 2001 Date issued: By: Receipt no.: Land use approval: Cl (IF 'i'1GARD Case file no Payment type: 0.i .r. r .k1SIOO TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement 0 New construction 0 Addition/alteration /replacement 0 Food service 0 Other: JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist) Job address: / c7 6 5- S ^1 Z t,' et V . Description Qty. Fee (ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: Tax map /tax lot/account no.: (includes 1 for each tnilityrnasection) Lot: Block: I Subdivision: _ SFR (2) bath Project name: A, pO�5 * ,v*--(ooh NA�tJa SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premises: Site utilities: Catch basin/area drain Est. date of completion/inspection: Drywells/leach line/trench drain Q. PLUMBING CONTRACTOR Footing drain (no. lin. ft.) `. 1 Manufactured home utilities ' Business name: - 1 -4 O4„/\ 7 .(w„i5, Manholes , '+ Address: , f 1� �otl St..J utT► ��'� Rain dr con nector - City: ?, 1 State: oit I ZIP: 91 ZZ_ Sanitary sewer (no. lin. ft.) Phone: 1 -h•/ -I C (4 p I Fax:t* ii-REez g -mail: Storm sewer (no. lin. ft.) j CCB no.: ,S 2 j 7Fs I Plumb. bus. reg. no: 3 y�S W service (no. lin. ft.) o City /metro lie. no.: ) 4 1 (0 2 Fixture or item: representative signature: Absorption valve Contractor's re p g� � +"�` Back flow preventer Print name: l Z: Gk. .% _ Date: ) /--1 -0/ Backwater valve CONTACT PERSON Basins/lavatory W 9 Name: 1 CS C r: ryv...� Clothes washer Dishwasher Address: Drinking fountain(s) • City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank OWNER Fixture/sewer cap Floor drains/floor sinks/hub ii 1 Nawe (print): " �1 q r g 1 ,3 •d Garbage disposal Mailing address: J Hose bibb City: I State: I ZIP: Ice maker Phone: 1 Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) - l will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) ' 3 Owner's signature: Date: Sump IIIIIIMIMIIIIWarWMIT Tubs/shower /shower pan Urinal L Name: Water closet de 5 Address: Water heater City: 1 State: 1 ZIP: Other. I - aye west. l Phone: 'Fax: 1E-mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $ 1 visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number. 1 / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440-4616 (6V00/COM) PLUMBING PERMIT FEES: -+. PRICE TOTAL • New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink / ► 16.60 it (10 the dwelling and the first100 ft. QTY (ea) AMOUNT for each utility connection) Lavato ry ✓ L 16.60 (O i "1O One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet / 16.60 t3 SUBTOTAL Urinal V Z 16.60 33 -zed 8% STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray ✓ / 16.60 Ito ,k 0 Washing Machine 16.60 K Floor Drain/Floor Sink 2" ,i I 1.0 /6 . 6° PLEASE COMPLETE: 3" 166.660 • 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory '4 • 16.60 Tub or Tub /Shower Hose Bibs Combination r Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet 5 f Urinal Z • Other Fixtures (Specify) 16.60 Dishwasher El Q. .'.j sL r/ % no. 6,0 Garbage Disposal 14 SF or- d ' Al . t O Laundry Room Tray 11 1 Washing Machine P (2,t N i_Q-. / , 11 „.1.0 Floor Drain /Sink: 2" 1. Sewer - 1st 100' 55.00 3" Sewer - each additional 100' 46.40 4° Water Service - 1st 100' 55.00 Water Heater Water Service - each additional 200' 46.40 Other Fixtures (Specify) Storm & Rain Drain - 1st 100' 55.00 E tweSk Storm & Rain Drain - each additional 100' 46.40 r Sdkk-• /. Commercial Back Flow Prevention Device 46.40 II %KS." Residential Backflow Prevention Device* 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 . QUANTITY TOTAL ,./ Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL a$,,,p 7 8% STATE SURCHARGE a2 59 el **PLAN REVIEW 25% OF SUBTOTAL 7$5 , P, r /�✓ i • Required only if fixture qty. total is > 9 TOTAL �l�f', 33 $ 3199:17 * Minimum permit fee is $72.50.8% state surcharge. except • Residential Backflow Prevention Device, which is $36.25 • 8% state surcharge. ** All New Commercial Buildings require plans with isometric or riser diagram and plan review. i:\dsts\forms\plm- fees.doc 10/10/00 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested / 7 AM PM l BLD • Location A-u- Suite MEC Contact Person I : S Ph PLM ao j 0 Contractor Ph a- —1 g 4d SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer c /� Rain Drains PASS P - T FAIL - •L Post & Beam • Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE BackfillGrading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA - Approach /Sidewalk Other Date 7 � — Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24rHour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP Date Requested Z AM PM BLD Location r/ S . oS - - 7 a /711 Suite MEC r Contact Person Ph 2' L i -( PLM ov ( &a WO Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing CCeSS Foundation FPS Ftg Drain SGN Crawl Drain Inspect! n- Notes: Slab ` SIT Post & Beam J Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service • Sanitary Sewer Rain Drains -SS FAIL MECHA Post & Beam Rough In Gas Line Smoke Dampers . ✓ -C-c; &I/CI fr Final - PASS PART FAIL t I uw .eT 1 N A �t /'j y , Os � ELECTRICAL 1 Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ 1 Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date f /2 re/B/ Inspector 7i'(/ L d "e, Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. - CITY OF TIGARD BUILDING INSPECTION DIVISION MST a ` 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP Date Requested / � ,, ' ,, � ,/ � 7 AM PM BLD I Location I ,c 7 7d ��c� a /t-Q__ Suite L MEC Contact Person Ph �' 4 7 19e76 PLM ON 00 6 (0 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 11' Fire Alarm (- Iga "- Susp'd Ceiling , /o Q Gf Roof Misc: Final PASS PART FAIL \ ?' ' L PLUMBING 1 J dG €1/ hied 5 `"."J - �" ., 4 Post & Beam / Under Slab q i rt • Top Out __ Water Service 2) 7� 1/t�l•t /dam ` fit, R A...- Sanitar Sewer Rain Drains r) ' / / `i Sees SS PART i / A ! v/•fr R ✓' A s - do-es f g 4 w MECHANICAL Vr d K a/o ( Post & Beam . // �V Rough In 4) i .c.. wa 4 Na p ( - Gas Line Smoke Dampers 7 , 4 ) / rP4 d It Tri co--c 4dir► Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA ���/ Approach /Sidewalk Date /1 — 2 7 / Ins / I q e`e r Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. - • CITY OF TIGARD BUILDING INSPECTION DIVISION f a 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP • Date Requested AM PM BLD Location / S 7 .-7?, ' A-0 Suite MEC Contact Person L ,l )cam Ph 7 7,S SL PLM girl CSC /6 Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN • Crawl Drain Inspection Notes: Slab SIT. Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling r Roof /, (QL I,R, ) ffS • Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab op u ater Service Sanitary Sewer Rain Drains Final PASS ART FAIL MECHA Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA to-0 Approach /Sidewalk Date /2 ! Inspector Prif / ! e7�/�F . Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. Ipr, CITY OF TIGARD BUILDING INSPECTION DIVISION • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST BUP • Date Requested / ( / — � AM PM BLD [ Location J / 7 0 5 7 Z 7k1' /1 MEC Contact Person Ph , j 7 7 SL. S CG PLM eie &/ Z> Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam • Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 06 � J � r1 5��c�'� - Fire Alarm Susp'd Ceiling . O L /'4 /.-% Jam✓ �N v4 r � j /'-e. �—.�� Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Stab% Top Out Water Service Sanitary Sewer Rain Drains 4 ,Q...__PART FAIL MECHANICAL Post & Beam Rough In ,1 / yi Gas Line /� Smoke Dampers 0 •-• ://4,17 .e c-9 7 Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE BackfilUGrading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date ///2 7 /01 Inspector � J� ector 7/ Z / e . Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.