Permit 4 a /e 1o7 ,�/ .� �C,
C Y OF T I GA� ..D PLUMBING PERMIT
,�
COMMUNITY DEVELOPMENT
PERMIT #: PLM2007 -00264
TIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/20/2007
PARCEL: 1 S 133RD -02200
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE ZONING: R -7
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: WESTGATE BAPTIST CHURCH
Project Description: TI - Install (1) baptismal sink. 6/26/07, ADDING BACKFLOW PREVENTER AND PRIMER.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: E2 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WESTGATE BAPTIST CHURCH
12930 SW SCHOLLS FERRY RD Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/20/2007 $72.50
[TAX] 8% State Surchart 6/20/2007 $5.80
Phone : [PLUMB] Addl Permit 6/26/2007 $63.00
[TAX] 8% State Surcharl 6/26/2007 $5.04
Contractor: Total $146.34
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 691 -6166
FAX 503- 691 -6771
Reg #: LIC 87906
PLM 34 -250PB
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 c 503.246.6699 or 1.800.332.2344.
Issued
1010 � � k , /L _/ Per m ittee Sig..ture: ' 1' !
Call 503.639.4175 by 7:00 a.m. for an inspection t .t 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.
Jun. 20. 2007 12:29PM Modern Plumbing No, 8046 P. 2
C.
i
Plumbing Permit Applicati FOR OFFICE [: E. ONLY City of Tigard R "` °d i 1 Ptnvrt Na .
11 13125 SW Hall Blvd„ Tigard, OR 97223
Date B ` 1 ) t L� 11 J� 70, S 2 0 200 pl7nlZdtitn
s
Date L'�
Phone: 503.639.4171 Fax: 503.598.19 Other lemur No �/
' m � � n �_
1 1 U A It Lt Inspection Line: 503.639.4175 CITY OF `.IGARD Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov Notifed/Method: I li g tiuppleffiented Informatlon
TYPE OF R:ORh; " PEE' SC D UCE:
❑ New construction ❑ Demolition Far special information use checklist
I)estaiption C2tt'. Eo. I Total • f Addition /alteration/replacement El Other New 1 - 2 dwellings (includes 100 ft, for each utility connection) '
' ' : H , . `' C : :ATEGE)121 ' OF C't3 7S"Piliii:IO1V SFR (1) bath 249.20
-
0 I- and 2- family dwelling %Commercialindustrial SFR (2) bath 350.00
111 Accessory building 111 Multi- family
SFR (3) bath 399.00
❑ Ivlastcr builder Each additional bath/kittchen 45.00
d Fire sprinkler ( sq. ft.) Page 2
` .: JOB :SITE. E FOR1tLtTIcN. M W LOCAT
SEte utltltiee
Job site address: 1 Cj7 3 Sk.,,) I 13( -}-1--, Catch basin or area drain 16.60
City / State/ZIP: ----' a d 0 2Z J ` ,_ Drywell, leach line,
(no_ ne, or trench drain A ) 16.60
� )j Q4 c. I�Qp� ST Footin drain linear = rage 2
Suitc/bldg. /aps name: no.: Project Wae: -
9 Manufactured .home utilities 110.00
Cross stl•eet/directi.onsto job site: - G( -Af ck1 Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2 __T
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
: 1 O Werth
.. ,.. Backtl w pre Page 2
,S .�� 6 N p v C5.1/4-•t S 1. Backwater'valvc 16.60
r . gym t h ' .4 `i Y` DG!- 5 d Clothes washer 16.60
r - r�
� Dishwasher 16.60
R i. 1 UR D fo
`; " S,rfr ,' ". lijectora / sump 16.60
Name: ` _ Expulsion tank 16.60
Address: Fixture /sewer cap 16,60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) t3arbage disposal 16.60
:': ,, : .: Hore b 1
•
Ice m et 16.60
Business name:
Itoerceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address; Primer 16.60
City/ State/ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: ( ) I fiax:: ( ) Tub/shower /shower pan 16.60
E -mail:
Urinal 16.60
,....
cFplvxx*.: ; ; water closet 16.60
Business name; MODERN PLUMBING CO. Water heater 16.60 _
Address: 11120 SW INDUSTRIAL WAY Other: 13 et f ill S a--` ( 6,9,4,0 City /State/ZIP: TUALATIN, OR 97062 ( Subtotal
Minimum permit fee: $72.50 12 .S U
Phone: (503) 691 - 6166 Fax: (503) 6914771 Residential backflow minimum permit fee: $36.25
CCB Lie.: 87906 • mbing Lie, no.: 34 V 1'1 D review (25% of permit fee)
State surcharge (8% of permit fee) 5 . v
Authorized signature:0 / 0 TOTAL PERMIT FEE , -. 1 53, 3 p
Print name: p .e` 1,, ra k e - ,ri Date: r -157 This permit application expires if a permit is not obtained within
180 days after It has bees accepted as complete.
°Fee methodology set by Tri- County Building Industry Service Board.
1:\ Bwldinn∎PeanitsTLM- PemritApp.dee 06J26/o6 44O-46tsr(tcO2/Com/ B)
•
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: P1_1\0007-00264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2012007
Phone: (503) 639-4171 :11
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9m/2007 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 10730 SW 130TH AVE MULTI CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST CHURCH
DESCRIPTION: Sanctuary TI - Install (I) baptismal sink. 6/26/07, ADDING BACKFLOW PREVENTER AND
PRIMER.
OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503-691-5166
- Inspection Request Scheduled For: Date: 9/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 056460-01 503-691-6166
Corrections/Comments/Instructions:
Cpe, `1r R,
Cart,Rvek.,-yt
S s PASS El PARTIAL APPROVAL 0 CANCEL El NO ACCESS
I I FAIL 0 CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
Inspector: CP (/)*,./ ; Date: j. 11-9.1 Phone #: (503) 718-
_ .
' •
.
CITY OF / '
��mm o *�'m TIGARD ~
BUILDING ��U��U��U��0�
DIVISION PERMIT #: PLM200700264
/
13125 SW Hall Blvd., B|vd Tigand , OR 97223 DATE ISSUED: 6/20/2007
| Phone: (503) 639-4171
Inspection Requests (24 �Hraj �
�]3)G3O4�175 0.-"-^- ^ � � �
INSPECTION WORKSHEET FOR DATE: 6/28/2007 _ TIME: 7:01AM PAGE: 69
SITE ADDRESS: 10730 SW 130TH AVE MULTI-PURPOSE -- _ CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST CHURCH - -
DESCRIPTION: TI - Install (1) baptismal sink. 6126/07, ADDING BACKELOW PREVENTER AND PRIMER.
1
OWNER: VVESTGATE BAPTIST CHURCH, � PHONE#:
CONTRACTOR: MODERN PLUMBING PHONE #: 503
' Inspection Request Scheduled For: Date: 6/28K2007 Pour Time: `
Code # Inspection Description Confirm # Contact # Message
320 051106-01 503-631-6166 Y
Corrections/Comments/Instructions:
,
�� ~_
/ ' •
�p � '� f '' / ����-
/
�r -
,
. 4 .- /
�� °^S8 �� PARTIAL |CAN[�EL NO ACCESS
[ I 7 — �� / [ /
|| FAIL I I CALL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
~�_--
Inspector: Aqiizz) Oa�a�/�' �� u1 Phone#� E�O3\ 71O- °" / `�
/ �
s CITY OF TIGARD
BUILDING DIVISION #: PLM2007-00264
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2007
Phone: (503) 639 -4171 _�i
Inspection Requests (24 Hrs.): (503) 639 -4175 !i-
INSPECTION WORKSHEET FOR DATE: 6/25/2007 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 10730 SW 130TH AVE MULTI PURPOSE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST CHURCH
DESCRIPTION: TI - Install (1) baptismal sink.
OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: MODERN PLUMBING PHONE #: 503-691-6166
Inspection Request Scheduled For: Date: 6/25/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
306 Plumbing underslab 050845 -03 503 -691 -6166 Y
Corrections /Comments /Instructions:
0/ f.A. 3 7 :4-
_5 'Y)-- - 17
c ;
'41_ PARTIAL APPROVAL fl CANCEL I NO ACCESS
FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
1
Inspector: /' ( Date: 6 9 Phone #: (503) 718 -2 1-1,,79