Permit CITY TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 - 00554
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/14/2006
PARCEL: 1 S136DD -00900
SITE ADDRESS: 06830 SW ATLANTA ST 100 ZONING: MUE
SUBDIVISION: HAINES CROSSING II LOT: JURISDICTION: TIG
Project Description: (1) breakroom sink.
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: RAIN DRAIN: ft
Owner: FEES
MALCOM ESLINGER
11575 SW PACIFIC HWY Description Date Amount
PMB 160 [PLUMB] Permit Fee 11/14/200€ $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 11/14/200€ $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 rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
it � f
ok. ,
Issued By: � jeJ Permittee Signature: . A l � i
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.
. . / ��� ( •
" ► ^ i
Plumbing Permit Applic o �8�E . FOR OFFICE USE ONLY
City of Tigard Received
111 g N n v 2006 Date/By: I /� �� Permit No. l ;00 ,,..-o0 .5-5-11 � 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review -22t7 Phone: 503.639.4171 Fax: 50b5 60 Other Permit N
er erm�,,/ g_.,1_,01.71:%'
Inspection Line: 503.639.4175 I �' �IG�B® Date/By: �"
TIGAR[i BUILDING DIVISION Date Ready/13y: luris� Ed See Pag[ 2 for 0
Internet: www.tgard- or.gov Notified/Method: Supplemental Information
TYPE,.: OI, . y ORI : : ; r . ; ; <. •:.
..<:: ... : ; ,; ."; - .. <.,..- .:: ^::
:'EEE *`SGHEDUI�Fl -:
New construction ❑ Demolition For special information use checklist
Description I Qty. Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
E" '
ORY "OF ',CO QTR
':[CAT G S . UGTION : Z;..:.
i„ 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
❑ Master builder Each additional bath/kitchen 45.00
::.......... . ....., :.....,...,.,,., ,...._.,.,, ire sprinkler ( sq. ft.) g
F' spr' kl r s . ft. Page 2
x;= 4S;:r°: S
,a JOB ITE, INFORNfAT1ON ;p t1N LOCA` LION.', :x i� ? ;,'
Site utilities
Job F site Yx l'Aaddress: ii) 11410.44,,�'Q , . � � � Catch basin or area drain 16.60
City /State /ZIP: l f O,(7 ( 1 012_ Ci, - 7 3 Drywell, leach line, or trench drain 16.60
no.: /nj Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt.
r!� Project name: ,$,t DIGS ( v6si Ai 2,
Cross street/directions to job site: -{- Manufactured home utilities 110.00
�..t� coi f' A ° ti l ' f " Manholes 16.60
r'te' Vi2A Rain drain connector 16.60
I 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.:
Fixture or item
.:: c ,.- ....r.. ;.,,:,.x :......_,:•; : t :.. valve o t
_ _. - -- Absorption al 16.60
;.DESCRIPTION OF WORK, .•.-,.; ., >_ ". u,..;
, ,
:::, ;r :... .
-, ac preventer . ...... -, .. „ <." B k flow
, pr even er Page 2
T jf' / . reodA/t S & 5 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Ol' >E 'Y`; O NE
-;� „. ..�. Drinking fountain 16.60
"L'�PTA
x�.t ;�. ;; in,
� it Ejectors /sump 16.60
Name:1 4 kA al.. (� j G
R' ��� Expansion tank 16.60
Address: L s5 7S — C, 60 Fixture /sewer cap 16.60
Cit /State /ZIP: ''� = y I Iefjl_ fL?...4.4_,A;
97017' Floor drain/floor sink /hub 16.60
Phone: ( -' 'Z . Fax: 6- _ ar p sal .
_x,
.:.:, .APP,LICA ; ,,:.; :.. §E '.:.
..,., ,: -.. .,..... :.❑ . , . 1� i � TtAGT,. PR
age is o
H bb 1660
`� ' Ice maker 16.60
Business name: j � 06 C g e► Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
C
Phone: ( ) Fax::( )
Sin basin/lavatory i 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
_
:CONTRA CTOR::
C O
�." ..:. .::....:: <_....���,:......, ater c set
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
Phone: (503) 452 -7480 Fax: (503) 244 -9961 Residential backflow minimum permit fee: $36.25 7„2,_ sz
CCB Lic.: 111472 Plumbing Lic. no.: 26 -589PB Plan review (25% of permit fee)
Authorized signature: ,, � ;,.., .. �y r , `� State surcharge (8% of permit fee) 5-F00 f` - . TOTAL PERMIT FEE [ X.
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)
- . .
CITY OF TIGARD .
BUILDING DIVISION
A PERMIT #: PLM2006-00554
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639-4171 4 4:4400_10 . 1 I 1 r
Inspection Requests (24 Hrs.): (503) 639-4175 ...,_14- 11..
INSPECTION WORKSHEET FOR DATE: 2/1/2007 TIME: 7:01AM PAGE: 13
SITE ADDRESS: 06830 SW ATLANTA ST 100 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: (1) bieakroom sink.
OWNER: ESLINGER, MALCOM PHONE #: 503-620-9515
CONTRACTOR: UNIVERSAL PLUMBING PHONE #: 503-452-74130
Inspection Request Scheduled For: Date: 2/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
0 V399 Plumbing final 042846-01 503-997-84713 - N
Corrections/Comments/Instructions:
Aia›,
PASS I I PARTIAL APPROVAL n CANCEL I I NO ACCESS
I FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: . Date: /
\ 0
Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200& -00554
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639 -4171 /0 miai�W41 l
Inspection Requests (24 Hrs.): (503) 639 - 4175'1:.
INSPECTION WORKSHEET FOR DATE: 11/15/2C)06 TIME: 7 :0710M PAGE: 25
SITE ADDRESS: 06830 SW ATLANTA ST 100 CLASS OF WORK:
SUBDIVISION: HAINES CROSSING II LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: (1) breakroOrn sink. •
OWNER: ESUNGER, MALCOM PHONE #: 503-620-9515
CONTRACTOR: UNIVERSAL PLUMBING PHONE #: 503- 452 -7480
Inspection Request Scheduled For: Date: 11/15,2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 039801 -01 503-997-8478 N
Corrections /Comments/ Instructions:
PASS I I PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: M, , Date :`l ( Phone #: (503) 718 -