Permit (/ /v /1,f : CA, - 6)r -Aire civ -'nY e--_S
a I TY OF T I G A R PLUMBING PERMIT
1 COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00427
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/12/2008
PARCEL: 2S 113AA -00400
SITE ADDRESS: 16260 SW 72ND AVE B2 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 018 JURISDICTION: TIG
PROJECT: AMSOIL
Project Description: Interior plumbing. Relocating (2) water closets and (2) floor drains and adding (1) sink. Other
fixture: primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 4 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 4 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [PLUMB] Permit Fee 11/12/2008 $199.20
[TAX] 12% State Surch 11/12/200E $23.90
Phone : Total $223.10
Contractor:
DEAN WARREN PLUMBING & REMODEL
PO BOX 14701
PORTLAND, OR 97293 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -236 -4152
FAX 503- 296 -2218
Reg #: LIC 154919
PLM 26 -736PB
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 B - Permittee Signature: �� , Vc-f/
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.
Plumbing Permit Application ��� o y J ,
Building Fixtures FOR OFFICE USE ONLY
City of Tigard �® DateBed Permit No.:
q 13125 SW Hall Blvd., Tigard, OR 97 . Pl an R y -co
ev iew
11 111 • Phone: 503.639.4171 Fax: 50 =''t' Date/By: AIME Other Permit No.: - p/� _ 6 _
Inspection Line: 503.639.4175
T I G n R D 1 i I' Date Ready /By: ® See Page 2 for
Internet: www.tigard or.gov Nov A Notified/Method: Supplemental Information
TYPE OF WORK G'�` FEE* SCHEDULE
❑ New construction ❑ L '�i• " s® ` ` S �V '� For special information use checklist
�� Description Qty. � Ea. I Total
Q�9#0..\) Addition /alteration/replacement ❑ Q 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 Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - 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: / 6., 6 tj 5 0.1 7 A ''" 1- Catch basin or area drain 16.60
City/State /ZIP: J r,&L .1 t9 , ,' 7yZ y Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ) I Project name: -Fn So,' 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: I 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
---t-r Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: pd._ y'r,., s /--
P 424 Expansion tank 16.60
Address: /,S3,�U S S e 5oo, +) P24 64i Fixture /sewer cap 16.60 c i: City /State /ZIP: Por A - v 9// . S' ))- u/ Floor drain/floor sink/hub 16.60
(5 3 ) 6 - Lf _ 6
Phone: a o e Fax: ( ) Garbage disposal 16.60
❑ APPLICANT. ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: na.6 - (,(',,,, '' ,,,, D�esirool{o
� Interceptor /grease trap 16.60
Contact name: Z1Q A. , ) Medical gas (value: $ ) Page 2
Address: P. O. "3 c if. / y >o/ Primer r 16.60
City/State /ZIP: Por+ M • 9 71 S 3 Roof drain (commercial) 16.60
Phone: (yt:N ) 7a c 9 4' 8 6 F a x : : ( ) ) 3 �'G -- 13/ Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 2 16.60
Business name: Water heater ' 0
Address: Other:
City /State /ZIP: Subtotal
Minimum e! fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 119 .
CCB Lic.: / Sy' 9/ t Plumbing Lic. no.:) 6 3 6 t -V Plan review (25% of permit fee)
State surcharge (12% of permit fee) 9 0
Authorized signal
TOTAL PERMIT FEE
Print name: A. a Date: /( -t) -cog This permit application expires if a permit is not obtained withi l
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
l:\ Building \Permits\PLMF- PermitApp.doc 12 /27/06 440- 46I6T(10 /02/COM/WEB) =
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage:. Permit Fee:
Footing drain - 1' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 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
Storm &Rain Drain - 1st 100' 55.00 Valuation: Permit Fee:
$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
-
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
• 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
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
and including $50,000.00.
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 for Plumbing Installations
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
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
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
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" r2 a - � 2. that meet the qualifications above.
-3 „
- 4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
Industrial l r -
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 Z
Urinal
Other Fixtures: Fp Z _ 2. -e-
i:\ Building \Permits\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200a- 00427
13125 SW Hall Blvd., Tigard, OR 97223 / ‘ DATE ISSUED: 1 . If1 `s20
Phone: (503) 639 -4171 n 4p��u &
Inspection Requests (24 Hrs.): (503) 639 -4175 $ '' :_..
INSPECTION WORKSHEET FOR DATE: 1114 /2009 TIME: 7:01Am PAGE: 35
SITE ADDRESS: 16260 SW 72ND AVE 82 CLASS OF WORK:
SUBDIVISION: O E:r ow BUSINESS PARK I LOT #: 016 TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Interior plumbing. Relocating (2) water closets and (2) floor drains and adding (1) sink. Other fixture:
primer.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503-236-4152
Inspection Request Scheduled For: Date: 1/14/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 079668 -01 50:3- 236.4152 N
Corrections /Comments /Instructions:
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1 PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
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Inspector: Date: ( A / Phone #: (503) 718 - 3- -1)
CITY OF TIGARD 4
BUILDING DIVISION .PERMIT #: PLM2008-00427
13125 SW Hall Blvd., Tigard, OR 97223 Ce ...,,, A v ) ..... „..--1<TE ISSUED: -11/ty2008
Phone: (503) 639-4171 .- imaitio0i,',
Inspection Requests (24 Hrs.): (503) 639-4175 .4147 -IL
INSPECTION WORKSHEET FOR DATE: 119/2009 TIME: 7•01AM PAGE: 8
SITE ADDRESS: 16260 SW 72ND AVE B2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: oie TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Interior plumbing. Relocating (2) water closets and (2) floor drains and adding (1) sink. Other fixture:
primer.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503-236
Inspection Request Scheduled For: Date: 102008 Pour Time: wp
Code # /Inspection Description Confirm # Contact # Mes%ag:.
+
399 Plumbing final 07955401 503-236-4152 Y
Corrections /Comments/ Instructions:
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Inspector: Date: 1M ( 11 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00427
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/12/2008
Phone: (503) 639-4171 "IV
Inspection Requests (24 Hrs.): (503) 639-4175 .-414, '-'....
INSPECTION WORKSHEET FOR DATE: 1/7/2009 TIME: 7•01A16,A PAGE: 7
SITE ADDRESS: 16260 SW 72ND AVE B2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 010 TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Interior plumbing. Relocating (2) water closets and (2) floor drains and adding (1) sink. Other Fixture:
primer
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503-236•1152
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
‘/
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Code # Inspection Description Confirm # Contact # Mes e
399 Plumbing final 079475-01 503-780-9486 Y i&Kelc,
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Corrections/Comments/Instructions:
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Inspector: ,____ Date: 1 / 7 7 d 1, Phone #: (503) 71718-
CITY OF TIGARD
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BUILDING DIVISION ,, PERMIT #: PLM2008-00427
13125 SW Hall Blvd., Tigard, OR 97223 A , A bATE ISSUED: 11/12/2008
Phone: (503) 639-417 itli VN / i (..)
,-/-
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/812008 TIME. .isAiryi PAGE: 6
SITE ADDRESS: 16260 SW 72ND AVE B2 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK 1 LOT #: 018 TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Interior plumbing. Relocating (2) water closets and (2) floor drains and adding (1) sink Other fixture:
primer.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503-236-4152
1"
Inspection Request Scheduled For: Date: 12/8/2008 Pour Time: •rib
Code # Inspection Description Confirm # Contact # Me-:.agz A 414
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Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00427
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13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 - 020008
Phone: (503) 639-4171 knoolimpAill '
Inspection Requests (24 Hrs.): (503) 639-4175 , 1J— I
INSPECTION WORKSHEET FOR DATE: 11/13/2008 TIME: 7 PAGE: 9
SITE ADDRESS: 16260 SW 72ND AVE 132 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I . LOT #: oi9 TYPE OF USE:
PROJECT NAME: AMSOIL
DESCRIPTION: Interior plumbing. Other fixture: prima.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DEAN WARREN PLUMBING & REMODEL PHONE #: 503-236-4152
Inspection Request Scheduled For: Date: 11/13/2008 Pour Time: fiS1 vo k
Code # Inspection Description pi ps &onfirm # Contact # Mec‘a A
305 Plumbing underslab V 078042-01 503-780-9486
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Corrections/Comments/Instructions:
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Inspector: ,..A CiVir-'-' i I
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Date: 0 1 3 / 6 Phone #: (503) 7