Permit CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00439
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/26/2008
PARCEL: 2S 101 BB -01400
SITE ADDRESS: 12176 SW GARDEN PL BLDG 3 ZONING: C -G
SUBDIVISION: PARK 217 LOT: 002 JURISDICTION: TIG
PROJECT: COLOSSAE CHURCH
Project Description: TI - rough -in and install additional fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: 1 GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SPIEKER PROPERTIES LP
4380 SW MACADAM AVE STE 100 Description Date Amount
PORTLAND, OR 97201 [PLUMB] Permit Fcc 11/25/200€ $132.80
[TAX] 12% State Surch 11/25/200€ $15.94
Phone : Total $148.74
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP #3
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 289 -7095
FAX 503- 283 -9514
Reg #: LIC 120893
PLM 34 -412PB
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: , Q A Q i U Permittee Signature: Q °I(1 U ry
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.
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Plumbin. Permit A 1 ) licati An '11''...)' - .. I Uk c.irricr USE
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City of Tigaxd - „ r ic ( ...) -6 Received „ _.
, Datejliy: /I wq 6g Permit No.: "Ltikog-cliq&?
11.-- • 13125 SW Hall Blvd., Tigard, OR 97223 0 t r. ika, Plan Review :.
' Phone: 503.639.4171 Fax: 503.598.19.ii ‘n ili:WVI` ,..i).. ty: ■1111 - Other Permit No_6/03eNcerg r5:
ric,A 13 Inspection Line: 503.639.4175
I ‘10-% VOSV".witeady/By /a. r 0' 0 0 See Page 2 for
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Internet: www.tigard .. \ ..,_ m ,,,, • NotitiedRv1 tidier!' " ,, , _ _ _ _ Sup. lemental Information
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ih"-e.;% , ; .!'7. 'fralail -- 0, -...- - ..ner .14' . . -.4 0,A. '. AM ,,,,' ... %,- A• , ..-AtesAiatirtiat "-•-• - , It t ' ,'"tt ‘-tt ,'' ,' -
D 1 Far special information use checklist.
0 New construction 0 Di" edition
Deleri ition 0 . La. Total
cklition/alteration/replacement 1:IE! er: New 1- 2-family dwellings (includes 100 ft, for each utility connection)
? ig,ifiliftWORiViaRWVOtt l it , roi7fi ': 00 '"1:1, . t- t4 0 .7,X.r.si i . , TIVA - .A. :,, l:: Ski. (1) bath 249.20
tIV.1.1.137.0.-MtiglititgitliritsinSiSiEi!!iiii.liii:iiitot,-.1-..o.i-A*.isio.Artilve.e.'sici.g4,4,7•,..■-.1,--; • t`..":k rs, --,2-_, - , . 1
o 1 - and 2-family dwelling re.kmmercial/industrial SFR (2) bath 350.00
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0 Accessory building I ti-family Si* (3) bath 399.00
Each additional bath/kitchen 45.00
El Master builder •
Iii er: Fire sprinkler ( sq. ft.) Page 2
lifro•qZ,tigtilitWM3T,Ingtilfr=-111X4i,rIMITSZT.PI‘I'A-r.4,- ' . .
kt.o14, ' : :iiitail . ---,:,•_:•, f ,•:••.• .,-. . Site utilities
11, 0
Job site address: , 1 . • 1 _.....
... L ' ...IIIIIII Catch basin or area drain 16.60
or
City/State/ZIP: --lifai et 0 De,ywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: I Project name: 4, 2:1 -9. Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: e-040649fri, elf-494)f
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no, linear It.: , ) Page 2
Storm sewer (no. linear It: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 ....
Fixture or item
Tax map/parcel no.: 5 to i 64 - C I'/"d
Absorption valve 16.60
itt4R,WXWAllata.RaFrfdefik).V1474MTN.I.,'.='-11,' Ti ---J
preventer Page 2 1
zwii - Backwater valve 16.60
(.4 9.411 "--4-1>047.4.A.L-48--" Clothes washer 16,60
Dishwasher 16.60
guitaiLimoen-zr,T:ii:,:mreerfFi:itymisstm2= zwi lmwiginkmi:.. & , ,•,..=,: . -.7 4 ,::, ) A, n)-inking fountain 16.60
Name: Expansion tank 16.60
Address: . Fixture/sewer cap 16 60
City/State/ZIP: Floor drain/floor sink/hub 1 16,60 / 4. t
Phone: ( ) F: • i ( l di
b
; darage disposal 16.60
1 ( .9 -d.,r•Ti,-,Vk„.1. 4 `.'47. 7 •Ff1 . -:1>Wi'-i ,,, 'FiL'Ii - W.:;• , ," 7 ••, , .,, ,,, , tii ah, _ :', 11°se bib 16.60
i -
ce maker 16.60
1=W . “_-.-_iffgifrj2EMIR211M1111. -
Interceptor/grease trap 16.60
Contact name: CIA- (-er) ci Medical gas (value: $ ) Page 2
Address: 3Q A) . kitty . li 025 . r , 3 P 16.60
City/State/ZIP: P014 i II CI 7 Roof drain (commercial) 16.60
--i r pan r Sink/basin/lavatory 4 16.60 (ob .. yo _
Fhme: ( 3) e-9.5$ C 7 - 70 C /5 I F' I : (5e)a)c:2 -c: 1 /
vb shower/showe 16.60
E-mail: l Urinal i 16.60 / 4.. 6,0
1.6.60 - '.2..C.
. :
Business name; iimiswinL.., - Water heater 16.60
Address: ca, ,,, A p A V
Vi i .4 -5' -Other.
-
4
city/statenp ) Ad ct G .' 110■1;-/ -7 . it Subtotal
Minimum perm fee: S72.50
Phone: (‘293) 94-q 70.95. F' I h. ( ) .9 i4/ - Residential hackflow minimum permit
CCB Lic.: AO 8' PI ri bing L.c. no.: L/ ..4 i 24 . : Plan review (25% of permit fee)
is
Authorized State surcharge (12% of permit fee) , Or/
signature: 0 490 P •
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..., - i :Ad --' TOTAL PERMIT FEE pi ,y
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Print name: x4.54 c , 0 rkeS I ll Date: I This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
Pi eRS t F - Pe-NM:F '44-°14" k*Fee methodology set by Tri-County Building Industry Service Board.
INBuildiaa1Permits\PLM-PennitApp.cloc
06/26106 440-4616T (IOW/COM/WEB)
„, .,.t.• . Nmv 24 2008 5: 14PM CASCADE PLUMBING 5032839514 p.2
Plumbing Permit Application - 4 ity of Tigard
Page 2 - Supplemental Information .
Fee Schedule: Residential Fire Su ression S stems
v t- I i `1;mii„ : ` fRP's � yr ,.,, v c er ` 6 WW .
IC3 ':t � s .- 44iW:.1.�l „'uL L :.,wH J.il,,� :„..i! F k lr ',, 3
Footing drai 1' 100' I 2,001 to 3,600: $16a.00
i 5.00 0 to 2,000 , $115,00
Footing drain - each additional 100' I. 6.40 1 3,601 to 7,200: $220.00
Sewer - 1st 100' Pr 5 7,201 and greater $309.0)
Sewer - each additional 100' 11 6.40
Water Service- 1st 100' 55.00 Medical Gas S stems:
Water Service - each additional 100' 146.40 ti;? c s T - ;�; ^ '�''.
55,(10 o.:,- .t, , ..n-- ak..,,,. �4i
Storm & Rain Drain - 1st 100' 51,00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 55,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1,52 for each
rx� - 3 �v *, additional $100.00 or fraction thereof, to and
l . �.. s .. . pi-f..1.74141_ • including $10,000.00.
Commercial Back Flow Prevention Device 146.40 510,00].00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device - each -addit tonal _$100.00_or_fractionthereof, to
(minimum permit fee $36.25) 27.55 and including 525,000.00. _
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
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first 550,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
"4 -0 5 ,wm `1 .nun 3 ,; ! nY.+ ` .
Fixture Work: ; t, : , � ,..% :, Y ti .:_. , : v x . - ; -
Are you capping, adding or replacing fixtu • s? If "yes " Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply,
accuratel re. 'rt fixtures could result in i reased sewer fees. ❑ �Y new commercial building with water service 2" and
n � E ' a3 yr? ` e i 7 ; �', ?e' greater, except systems designed and stamped by licensed
,z �. ,- s ,,� �� �t �r s � , P Y !� pe Y
Y °`' �! � � + �. 1 - .� '� , "'`: 1 to �y �,d� t �,y , ; CngIQCer. •
, r t . ; r VAR NA - _ . t, r, a r : ❑ Any new exterior plumbing site utilities.
Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub/Shower ❑ Anymultipurpose fire sprinkler system.
- Jacuzzi/Whirlpool 1 ❑ Any :complex structure as defined in OAR918- 780 -0040.
Car Wash -Each Stall
- Drive 'mN I - Submit a sets of plans with any of the above.
Cuspidor/Water Aspirator
Dishwasher - Commercial
- Domestic ❑ Isometric or riser diagram is required for new buildings
Eye Wash Fountain that/ meet the . ualifications above.
Eye was
Floor Drain/sink • 2” II
-3 ” Comments regarding fixture work:
Car wash Drain I :
Garbage - Domestic I
Disposal -Commercial -
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) '''
Rec. Vehicle Dump Station I.
Shower -Gang Ii *Note: If the fixture work under this permit results in an
- Stall ' increase'of sewer EDUs, a sewer permit will be Issued and
Sink - BarlLavatory y fees assessed for the sewer increase must be paid before the
- Bradley plumbing permit can be issued.
- Commercial
- Service
Swimming Pool Filter
Washer -Clothes
Water Extractor
Water Closet - Toilet 2..
Urinal i
Other Fixtures:
I •.1aUIldineenn<tdPLM•PamMPp.doe 09n110a .
CITY OF TIGARD ,
BUILDING DIVISION
A °12 PERMIT #: PLM2008-00439
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/2612008
Phone: (503) 639-4171 theil0\
Inspection Requests (24 Hrs.): (503) 639-4175 „,-,411 .,... 6
INSPECTION WORKSHEET FOR DATE: 1/2112009 TIME: 7 PAGE: 8
SITE ADDRESS: 1)1 /6 SW GARDEN PL BLDG 3 CLASS OF WORK:
SUBDIVISION: PARK 217 LOT #: 002 TYPE OF USE:
PROJECT NAME: COLOSSAE CHURCH
DESCRIPTION: TI - rough-in and install additional fixtures.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE #: 603-289-7095
Inspection Request Scheduled For: Date: 1/2112009 Pour Time: 1 ,2---4
1
Code # / Inspection Description Confirm # Contact # Me sage
399 Plumbing final 079888-01 603-289-7095 Y
Corrections/CommentOtructi
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iK PASS F PARTIAL APPROVAL CANCEL fl NO ACCESS
FAIL 7 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
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Inspector: Date: Phone #: (503) 718-
CITY ������8�������� ' ' ` _ y�
��mm w ��m� mm����nm�� = ~~ BU��UN��� DIVISION / ~ PERMIT #: pL�����0�
39
1312GSVVHaUB|vd,Tigand.ORA7223 E ISSUED: 12/2612008 .
Phone: (503) 639-4171 .�/7 7t
Inspection Requests Hnn�:�Q3)G30��175 °1. - 1 � � \ ��
INSPECTION WORKSHEET FOR DATE: 1/20t2009 / TIME 7 PAGE: 8
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SITE ADDRESS: 1217GEW GARDEN pL BLDG 3 CLASS OF WORK:
SUBDIVISION: PARK /17 LOT #: 002 TYPE OF USE:
PROJECT NAME: COLOSSAE CHURCH .
DESCRIPTION: T| - rough-in and install additional fixtures.
OWNER: SP|FKER PROPERTIES UP. PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE #: 503-269-7O95
��
Inspection Request Scheduled For: Date: 1/20/2009 Pour Time: V~ ~
Code # Inspection Description Confirm # Contact # K8ee
399 Plumbing final 079848-01 503^2897096
Corrections/Comments/Instructions:
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| PAS �� PARTIAL APPROVAL 0CANCEL | 1 NO ACCESS
L n CALL FOR INSPECTION D ADDITIONAL FEES ASSESSED
I n s p e c t o r : = - ° � Date: �i' Phone #: (603) 718' ) - ~ ~ / ~~ 4
CITY OF TIGARD .
........ jill
BUILDING DIVISION 01 - 2 3 (.,... E "y ED: PLM2008-00439
13125 SW Hall Blvd., Tigard, OR 97223 DAT, D. _12/26/2008
Phone: (503) 639-4171 Awlli li ll illeili 1- /
Inspection Requests (24 Hrs.): (503) 639-4175 r-LIIL f '" () 0 ■
INSPECTION WORKSHEET FOR DATE: 12/29/2008 TIME: 7 PAGE: 11
SITE ADDRESS: 12176 SW GARDEN PL BLDG 3 CLASS OF WORK:
SUBDIVISION: PARK 217 LOT #: 002 TYPE OF USE:
PROJECT NAME: COLOSSAE CHURCH
DESCRIPTION: TI - rough-in and install additional fixtures.
OWNER: SPIEKER PROPERTIES LP, PHONE #:
CONTRACTOR: CASCADE PLUMBING CO. PHONE #: 603-289-7095
Inspection Request Scheduled For: Date: 12/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 079229-01 503-289-7095 N 0
orrectio
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1 PASS )12, PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL El CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: iZi' . Date: L2- 1------ Phorie #: (503) 718- 2-4-24