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Permit A , • CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: P 10/200 -00638 '�' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/10/2004 SITE ADDRESS: 14650 SW 97TH AVE PARCEL: 2S111AC -02700 SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5 BLOCK: LOT: 037 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: 10 FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 330 ft DISHWASHERS: RAIN DRAIN: 725 ft Remarks: Site utilities for new addition, reconfiguring of existing parking, add new parking & water treatment. Other work: 236' of footing drain, (2) manholes, (10) rain drain connectors & (2) backwater valves. FEES Owner: Description Date Amount TIGARD TUALATIN SCHOOL DISTRICT 6960 SW SANDBURG ST [PLUMB] Permit Fee 6/10/2004 $1,027.40 TIGARD, OR 97223 [PLMPLN] Plan Review 6/10/2004 $256.85 [TAX] 8% State Surcharl 6/10/2004 $82.20 Phone : Total $1,366.45 Contractor: PARFITT PLUMBING 12172 SE 222ND DR BORING, OR 97009 REQUIRED INSPECTIONS Water Line Insp Phone : 658 - 5068 Water Service Insp Reg #: LIC 85121 Storm Drain Insp PLM 3 - 274PB Storm Drain Insp Storm Drain Insp Storm Drain Insp Rain Drain Insp Rain Drain Insp RP /Backflow Preventer 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246- 99. ' - b( T75,0 Issu d By: • _CA_ - �, /, / i• 1 Permittee Signatur G r • -- Call (503) 63• -4175 by 7:00 P.M. for an inspection needed the next business d y .,. Sa 4 Utili >< 3e7 a .. FOR OFFICE, USE ONLY ' iiimbrng Pemitalp it t Received ` � p,, Plumbing h . 1i 5 1 imgA4' ' . s� Date/By: / 3 /Lb Permit No.: . e 1. Approval Sewer City of Tigard DEC 2 4 Planning y: Permit No.: 13125 SW Hall Blvd. qt NO3 s+ P lanning Plan Review Other L, Tigard, Oregon 97223 CITY OF TIiaA�� Date /By: Permit No.: d 1r,9oo3- 'o 4037 Post - Review Land Use F .., Phone: 503-639-4171 �� L• } �� /p, p � yi � u , I t Date/By: Case No.: HP D 9co.5 - vb ©/ Internet: www.ci.tigard.or.us a &A I Contact y •s ® See Page 2 for 24 -hour Inspection Request: 503- 639- 4175 '" - Name /Method: j/&' Supplemental Information. C . , ).'ff ttri ei =TYPEOFIWORK ' ' 510H , €'.. .. '`4` FLEE 'SCHED nformattonuse,chW00;6 n : ❑ New construction ❑ Demolition Description Qty. Fee(ea) Total ® Addition /alteration/replacement El Other: ,'' ": New l & '�; "' 1 1 "1 . : a 41 -ic a s ;too ct'.`tfo each ai A 1e 1o'n)1 f _ :: ',_ ` ;.. '�' a Ce'ATEGORY OF CONSTRUCTIONS ; ," , ` , - ""�°'�'° � SFR (1) bath 249.20 -, ❑ 1 & 2- Family dwelling [ Commercial/Industrial SFR (2) bath 350.00 ❑Accessory Building ❑ Multi- Family SFR (3) bath 399.00 ❑ Master Builder ill TPORMATIO Other: Each additional bath/kitchen LOCATION4a itchen ' 45.00 ?.; ;«f�,,;�'�,�`- . N�'� � ` _�' Fir sprinkler - sq. ft.: Page 2 ° I !i �� in: s.,., Tr ' tU ", iSlte Utilitlw... S � r,„3 ��`..r,_ , C . - { . osite addressS��✓IJjIG1���� Suite # JJA Bldg. /Apt. #: iUlS1- Catch basin/area drain 1 0 16.60 14 Project Name: ' - N', Y - 2(nottJ {RGkDDIE Dr /leach line /trench drain 16.60 b �. Foot dra (no. l ft.) 23 Page 2 /01 . 9D Cross street/Directions to job site: �Q / Manufactured home utilities 0 110.00 0 I i M i rPJW� To 5w Me roa��t.�o i Manholes _ 16.60 , 3•% Me. Y3 D IJ/4LXj 'To SW gild-k- AO E. Rain drain connector 1 0 16.60 /“.0u Sanitary sewer (no. linear ft.) 0 Page 2 a Subdivision: Lot #: 2 70b Storm sewer (no linear ft.) 72S Page 2 '333.9 v III L Water service (no linear ft) 3'30 Page 2 /97. �r Z . Tax map /parcel #: , 7• =: 9 a x , DESCRhPTION OF WORK`S �, t� � �"'� �� �. .� s .. . �, _. . g ... _ _. a. � �� � FIXtUCC�01'�e121 - � = r,,�'_ ^� t° `Z Absorption valve 16.60 itrYit/ Mop 0 PEW P'{ UC.Tt - V SC Backflow preventer Page 2 9,41/0 S�(�YJlc1�T GOMMDJU4 ' R MDOG, .TC. ) Backwater valve ( a 16.60 3,ad Clothes w.. her 16.60 Dishwasher 16,60 Drinking fountain /16.60 : PROPERTYxOW.NERk, v, 1 TENWNit ' ii W :,r Ejectors /sump / 16.60 Name: Tt( Agn- -TIAL AIIK) shpt Pttai(1 Expansion tank / 16.60 Address: GI ( 4L 4,froo yt Q .G. ttv, Fixture /sewer cap / 16.60 City /State /Zip: - &/ .'O ell ZZ3 Floor drain /floor sinlc/hub / 16.60 Garbage disposal / 16.60 Phone: Sb3 - 43 l -4DD0 Fax: 95 L - 4 091 Hose bib 16.60 AP.PLICAN ``. ' * , N ISOONTACT PERSON*-- Ice maker 16.60 Name: f tt1 r f D 1 - 1 - NSo 1 -0v1.1, D(sSON WEE KeS Interceptor /grease trap 16.60 Address: 'S l9 %) t. A6141NCsCo J 4. 3 Zoo Medical gas - value: $ Page 2 Primer 16.60 City /State /Zip: (Dr-'Tt.p /..)0 '7 2D 4 Roof drain (commerci 16.60 Phone: 226 - 6 cco Fax: 211 - 5 1 i 2 Sink/basin/lavatory 16.60 E -mail (,i V, 3 c. Sty co co IAA Tub /shower /sho r pan 6.60 ` of " a _ OO TR.A'O _ q ' ga .. l :�, .. . Urinal •1 .60 Business Name: r >� i I water clo 16. o Water eater 16. Address: Other: City /State /Zip: Other: Phone: Fax: YAM:. I 1'°.,'PlumtiingPermit Fees a.: Subtotal $ CCB Llc. #: Plumb. Lic.#: Minimum Permit Fee $72.50 $ a7 y0 Authorized i . l /�� Resid Minimum Fee $36.25 1/ O • Signature: �4, .• / LW /� / Date: a Plan Review (25% of Permit Fee $ - i, g i � :. `�',.. s. Wale. - A r( 4 State Surcharge (8% of Permit Fee $ $, , ,go (Please p t name) / I TOTAL PERMIT FEE $ / .. ,, 5 Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri- County Building Industry Service Board. is \Dsts\Permit Forms\P1mPermitApp.doc 01/03 C § .4t. / Plumbing Permit Appli - City of Tigard Page 2 - Supplemental Information . - • r- • Fee Schedule: Residential Fire Suppression Systems: ignfRi4!;1.$1*PIAIMg.:;AfiE;%.,3 Qty Fee(ea) t'r01l1 : - .i1�PermitFee :;> Footing drain - 1' 100' 1 55.00 CS 0 to 2,000 ; • $1.15.00' Footing drain - each additional 100' I 46.40 2,001 to 3,600 : ', $160.00 (.•4 0 3,601 to 7,200 $220.00 • Sewer - 1st 100' b 55.00 0 7,201 and greater $309.00 Sewer - each additional 100' 0 46.40 0 Water Service - 1st 100' I 55.00 Brno Medical Gas Systems: Water Service - each additional 100' Z 46.40 I Z ;''Val'Uatio l - ,_„ , _ `-- re.ili FCC ;' :, - , - . = _ . Storm & Rain Drain - 1st 100' I 55.00 5 , $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' (, 46.40 ZZBHb $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and . x: ;: , Fixtiiirii Item & , '` Qt 'E ee (e1C ,. TP[ilitr including $10,000.00. Commercial Back Flow Prevention Device 1 46.40 416.9 $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) 0 27.55 0 and including $25,000.00. Rain Drain, single family dwelling 0 65.25 t) $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 0 72.50 0 $50,001.00 and up • $742.00 for the first $50,000.00.and $1.20 for • Subtotal: each additional $100.00 or fraction thereof. • Fixture Work: Are. you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to , accurately report fixtures could result in increased sewer fees *. p uant►tyjli {Ftxfurej W erfo Ciiik r med ' Comments regarding fixture work: . /F zture Type " � °Q . , h ; A t Repl r , Wi g ,,. r ,s „•,, ; :a,„. i id '.,Mov , "°:Existing , tapped;; . Baptistry/Font Bath - Tub /Shower - Jacuzzi /Whirlpool Car Wash - Each`S. 11 -Drive T Cuspidor /Water Aspirator Dishwasher - Commercial - X -Domestic , • • Drinking Fountain - - - - Eye Wash Floor Drain/sink - 2" • 4„ - Car Wash Drain *Note: If the fixture wor under this permit results in an - Garbage - Domestic increase of sewer EDUs, a sewer permit will be issued and Disposal - Commercial - Industrial fees assessed for the sewer increase must be paid before the Ice Mach. /Refrig. Drains plumbing permit can be issued. Oil Separator (Gas Station Rec. Vehicle Dump S • on Shower -Gang -Sta Sink -:.r /Lavatory :radley - Commercial - Service Swimmin4Pool Filter Washer - Olothes i - - Water Extractor Water Closet - Toilet __ - - I - Urinal Other Fixtures: is \Dsts\Permit Forms\PlmPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested /2 — 4-5 - AM PM BUP Location Suite MEC Contact Person Ph ( ) 4 0 337 PLM 4 63 - 6 , 63 Contractor Ph ( ) SWR 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 Susp'd Ceiling /13 Roof 4/1/ 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 Oth • ri • - S PART FAIL HANICAL 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 fl Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA - Approach /Sidewalk Date / L�1 6 Inspector ��� Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL