Permit ... ,, ,.,
Ei_ � CITY OF TIGARD PLUMBING PERMIT
V COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00072
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/20/2007
PARCEL: 1S136DD-00900
SITE ADDRESS: 06830 SW ATLANTA ST 200 ZONING: MUE
SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG
PROJECT: COLUMBIA MORTGAGE
Project Description: Install (1) breakroom sink and (1) dishwasher.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
MALCOLM ESLINGER
11575 SW PACIFIC HWY. Description Date Amount
PMB0160 [PLUMB] Permit Fee 2/20/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 2/20/2007 $5.80
Phone : 503- 620 -9515 Total $78.30
Contractor:
UNIVERSAL PLUMBING
(DAVID RAY OAKLEY)
8811 SW SPRUCE STREET REQUIRED ITEMS AND REPORTS
TIGARD, OR 97223
Contact # : PRI 503- 452 -7480
FAX 503- 844 -9961
Reg #: LIC 111472
PLM 26 -589PB
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 rule ' ect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss d By: / ( /,l l Permittee Sign: ure: _y� . -'0 t
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.
P1itm Permit Application FOR OFFICE USE ONLY ,r
City of Tigard Received n A � D Permit No.: , i7� �U 7p2--
' I 13125 SW Hall Blvd., Tigard, OR 97223 Date By: f O'er
Plan Review n ^ - _� r�
1 ' - -- Phone: 503.639.4171 Fax: 503.598.1960
Date /By • Other Permit No ACS
TIGARD Inspection Line: 503.639.4175 Date Ready /By: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method' ) i C., Supplemental Information
q ... _ ,, Y ...'..,, , F . „ : . s s ,c,,
_ f6 x, x ";TYP` OF -, ) ' FEE S CH E DULE
•. .::. _P.,... ..� 3 t.,k.i'�. n a ,, si *..��Ez �� t � . _ . _ . e � -z_ - _ _ _ . . _ .. : ,. � ._.k , e,€ , .,� ,. te' , 4 . .
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. I Ea. Total
❑ Addition /alteration /replacement ® Other: Tennant Improvements New 1- 2- family dwellings (includes 100 ft. for each utility connection)
t..
" "' CATEGORY - =OF „CONSTRUCTION'" :' SFR (1) bath 249.20
❑ I- 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:
:, ._ ,
k .'; JO .. Fire sprinkler ( Q ) g 2
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F s . ft.) Page
.. -, ' B'SITE INFORMATIO AND. - - :: „TION
��:? ,.,.,,, _ :.. ra�. rn�,... _ _ . _ � , .... Site utilities
Job site address: 6830 SW Atlanta St. Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97223 (,,sq.., a N/7 //9- Hai -41944 Drywell, leach line, or trench drain 16.60
Suite /bldg. /apt. no.: Suite 200 1 Project name: stn - tit mg 2 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Intersection of SW Atlanta St. and 68 Pkwy
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
Tax map /parcel no.: . ' i 3 D IX L
tx ure or item
„.: x:.,•;,. " ". ! �<� Absorption valve 16.60
�,.� Ab orpt' v t
' .«- DESCRIPTION 'O F'-_WORK. . • ,, ; : 7 --,,.., :x
�, . , „:=Ve..,��:�.< �, ,, .. �, a .., .....x.� .,...•,� _._ Baekflow preventer Page 2
Tennant Improvements Backwater valve 16.60
Clothes washer 16.60
Dishwasher 1 16.60
,,,. ®" �:E,, ;.,. �.,; 41 , Drinking fountain 16.60
PROPERTY OW ® TENANT'
..: ; . Ejectors /sump 16.60
Name: Malcolm & Sharon Eslinger LLC & GSP LLC Expansion tank 16.60
Address: 11575 SW Pacific Hwy. Fixture /sewer cap 16.60
City /State /ZIP: Tigard, OR 97223 Floor drain /floor sink/hub 16.60
Phone: (503) 620 -9515 Fax: (503) 620 -9475 Garbage disposal 16.60
6 12I APPLICANT Hose bib 16.60
® CONTACT�PER$ON
. , Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Malcolm Eslinger Medical gas (value: $ ) Page 2
Address: 11575 SW Pacific Hwy, PMB 160 Primer 16.60
City /State /ZIP: Tigard, OR 97223 f drain (commercial) 16.60
Phone: (503) 997 -8478 Fax: : (503) 620 -9475 Sin asin/lavatory O 16.60
Tub /shower /shower pan 16.60
E -mail: malcolm @eslingerbuilders.com Urinal 16.60
CONTRACTOR
" Water closet 16.60
Business name: Universal Plumbing Company Water heater 16.60
Address: 8811 SW Spruce St Other:
City /State /ZIP: Tigard, OR 97223 Subtotal
Minimum permit fee: $72.50 50
Phone: (503) 452 -7480 Fax: (503) 244 -9961 Residential backflow minimum permit fee: $36.25 7OS"
CCB Lie.: 111472 Plumbing Lic. no.: 26 -589PB
Plan review (25% of permit fee)
/ �f ., J. State surcharge (8% of permit fee) '5-i- $0
Authorized signature: c<i_;;...,1 �_ !; ; ,rte ; 7t ` 30
TOTAL PERMIT FEE
Print name: David Oakley Date: 11/14/2006 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
T \Building\Permits\PLM- PermitApp.doc 06/26/06 440- 4616T(10/02/COM/WEB)
f
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00072
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2007
Phone: (503) 639 -4171 v i �'4i01i
Inspection Requests (24 Hrs.): (503) 639-4175 _AI. 611
INSPECTION WORKSHEET FOR DATE: 3/27/2007 TIME: 7:02AM PAGE: 19
SITE ADDRESS: 06830 SW ATLANTA ST 200 CLASS OF WORK: 1
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: COLUMBIA MORTGAGE
DESCRIPTION: Install (1) breakroom sink and (1) dishwasher.
OWNER: E (LINGER, MALCOLM PHONE #: 503. 620.9515
CONTRACTOR: UNIVERSAL PLUMBING PHONE #: 503.452 -7480
Inspection Request Scheduled For: Date: 3/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 045493 -01 503- 997 -8478 N
Corrections /Comments/ Instructions:
ill, 1
•
i
`PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
7 Inspector: , i Date: , . Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: PLM 2007 - 00072
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/20/2007
Phone: (503) 639 -4171 / / 4
Inspection Requests (24 Hrs.): (503) 639 -4175 ^'I Y.
INSPECTION WORKSHEET FOR DATE: 3/21/2007 TIME: 7 :00AM PAGE: 5
SITE ADDRESS: 05830 SW ATLANTA ST 200 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING H LOT #: TYPE OF USE:
PROJECT NAME: COLUMBIA MORTGAGE
DESCRIPTION: Install (1) brealroom sink and (1) dishwasher.
OWNER: ESLINGER, MALCOLM - PHONE #: 503- 620 -9515
CONTRACTOR: UNIVERSAL PLUMBING PHONE #: 503452 -7480
Inspection Request Scheduled For: Date: 2{21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 043688-01 503 -997 -8478 N
Corrections/Comments/Instructions:
L 40/ /
F
Ei--PASS ❑ PARTIAL APPROVAL ❑ CANCEL I j NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I KA" Date: d ,l/ ® ? Phone #: (503) 718 - 2-/-1