Permit CITY T I GA R D PLUMBING PERMIT
A* DEVELOPMENT SERVICES PERMIT #: PLM2005 -00206
AII DATE ISSUED: 5!31/2005
13125 SW Hall Blvd., Tigard, OR 97223 5 - 639 -4171
PARCEL: 1S135BA-03302
SITE ADDRESS: 10520 SW CASCADE AVE ZONING: I -P
SUBDIVISION: OFFICE DEPOT LOT: JURISDICTION: TIG
Project Description: New:(1) drinking fountain,(1) water closet,(1) urinal, 70' water service. Moved: (1) sink, (2) water
closets. Replaced: (2) 3" floor drains, (2) sinks.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS: 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: 1 GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: 70 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MARX, ERNEST L + BARBARA R Description Date Amount
TRUST
2140 VELOZ DR [PLUMB] Permit Fee 5/31/2005 $221.00
SANTA BARBARA, CA 93108 [PLMPLN] Plan Review 5/31/2005 $55.25
Phone : [TAX] 8% State Surcharl 5/31/2005 $17.68
Total $293.93
Contractor:
MIKE PATTERSON PLUMBING
15028 S MITCHELL LANE REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone : 503- 632 -7374
Reg #: LIC 81746
PLM 3 -359PB
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 -0 1 010 thr gh OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calli 503 - 246 -6699 • -8 0 3;2-2344.
Issu d B y: ._ / / j i L. / i P Permittee Signa ure: ,i ',11/ /c:2
Call 503 - 639 -4175 by 7:00 a.m. for an inspection th. • usiness 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.
01/28/2005 12:09 FAX 5035981960 CITY OF TIGARD 4 001
F .
Plumbing Permit WE®rc I i cy i E c»L
of Tigard Received � r.-/- ll 1� _ Pernik No 7 r n
'
131 SW Hall Blvd., Tigard, OR 97223
Date/BY:. ) /
Phone: 503.639.4171 Fax: 503.598.1W 1 6 2005 t1 � Other Pernik N O.
24 - Hour Inspection Iine: 503.639.4175 l ll'1 Plan Review DategBy: �/271 , .J '^' ` p ' " _ed 3 a0/
2
Internet: www.ci.tigarrl.or.us CITY OF TIGAR _ -`y" 1 "Y -- BaseResay /By: , u , �: ® See Page Z rnr
Nolifi 'S ` Supplemental Information
aS , _ : :.� h'ri';j: _ '` ri: i'n` ' �i r,n " �731, lS t : ,..; 1 ; g �•. :a.;• , ro c rN 39; 2.. ,i' u 1 . r•i, i. . . .
' . ; : '.1. :. L:. ...- � 4'!.; . I I ., rllf- . p.�::. �'I` "i ?�..�. : I 7r'. :1%,.5 '�0.4
Q New construction 0 Demolition For special information use checklist
al Descri•tion • , Ea, Total
UUr. ' "r 1 "�� Other:
New 1 - 2- family dwellings (includes 100 ft. for each utility connection)
. 't't;" 'r " ;�
: °.. :
a. :. 14�
� oi� a > '.. ' CiC' N " ':' _ ' SFR 1 bath 249.20
0 1- ' and 2- family dwelling M1 ' ' nmerciallindt>tiatrfal SFR (2) bath ■ 350.00
Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
_ ❑ Other:
- i ! t� :Ild:,t y, •„,-. -- ----�, , Firssprinkler�_sq. it) Paget
-1 :. ::-; : r - .A B.S ' I Y!F'O 71` cre " :iii : :, _.
. ; f: ... . �• 5tte utilities _
Job site address: i d i i s etch basin or area drain 16.60
City /State/ ' Drywell, leach line, or trench drain 16.60
Suite/bldg.apt no.: Project name: Footing drain (no. linear R: ) Page 2
Cross strcct/directions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear it: _1 Page 2
Storm sewer (no. linear ft.: Page 2
-
Water service (no. linear It' Q)' l Page 2 ~5• „,,0 Subdivision
1 Lot no -:
Fixture or item
Tax map/parcel no.: /./35,6,4 0330 2.- .
C'.
. ", .,. „„ ; .- - _ . Absorption valve 16.60
0 :i7 :u.I� Ei:7:'" 1 �{ ' !1)1 b ti: ,. : :•.' .
.41,:: ! < :1,-•.•r , ___ __ _ ;. 1'; A y i; _ .. : VLF "i 0 : : -1. t a''. . 1:4 1• a•i ∎ : :,
. .. _.. }t, _. .. _ ;. Sackflow pm-venter Page 2
am di 1 '! or _ _ - t7," . s Backwater valve 16.60
8 ,�, 4 0 Ai AI Clothes washer 16.60 •
I f,
J s Di hwashcr 16.60
OP " i > uxi el. :.. 1 • ,. ' ` j. t . Na � D rakin fountain 1 16.60 /60 , 6)0 •
alvJ6'i
CIF'.` ?` -. . .1 Il r..li,r. A ' i : : :. :G. � !! 11 :01 ..1 V -,- ,.. i' ' :` - , ••= ;yr •
Name: xc t o rslsum p 16.60
Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sinlcThub • 16.60 0 53 . Par
phone: ( ) Fax: ( ) Garbage disposal 16,60 .
:, {3 f•. V e ••pc �,t. Hose bib 1b.G0
' :F?il' i :�' Ell:::".
! ' .....- �' : ' ` , 1 .... - ii�h G lr re ori : : , < , 16.60
Business name [ce maker
_ interceptor /grease trap 16.60
Contact name. Medical gas (value: $ _ ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (commercial) 16.60 _
Phone: ( ) F ( ) Sink/basin/lavatory 16.60 '/9 ,
E Tub/shower/shower pan 16.60
, : _,v .,. ;a .F� k •• :, ., , Urinal 16.60 / . SOD
:;,s•.tY•`1`cF�. :•i_r.t;`• I :� ,. • •Q� : ?tr;.iiA.'r' � : ; c'E;.•-.'•. : : : :�. 'i l Water closet 1M i6•60 • $0
M vll Al 11, Water healer 16.60
Address: ( ,At. Z _ ' . Ot er:
Subtotal
City/State'/ZIPC3y , ' -1' 4.. a r a Minimum permit fee: 572,50 OO
Phone:
(9_53 kt n i117j a Residential backflow minimum permit fee: 536.25 e
•
•
1 J D .luau; , _ Lie. no 3 . Plan review (25% of permit fee) 55. ■
Authorized sigaa State surcharge (8% of permit fee) (o .
• •
_ �1• a _ • TOTAL PERMIT FEE ��'�
t .
Print name. is_ � - � Date: This permit application expires if a permit is not obtained within
I80 days after It has been accepted as complete,
*Fee rnethodelogy set by Tri- County Building Industry Service Board.
iswuirdingu en iuu tau- emnk•AVC•4oc WO 4 40.461611 roroyc0atrw,;a)
CITY OF TIGARD -'°
BUILDING DIVISION PERMIT #: PLM2005 00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/31/2005
Phone: (503) 639 -4171 Uronir
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/11/2005 TIME: 7 :07AM PAGE: 82
SITE ADDRESS: 10520 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: OFFICE DEPOT LOT #: TYPE OF USE:
PROJECT NAME: OFFICE DEPOT
DESCRIPTION: New:(1) drinking fountain,(1) water closet,(1) urinal, 70' water service. Moved: (1) sink, (2) water
closets. Replaced: (2) 3" floor drains, (2) sinks.
OWNER: MARX, ERNEST L + BARBARA R, PHONE #:
CONTRACTOR: MIKE PATTERSON PLUMBING PHONE #: 503 -632 -7374
Inspection Request Scheduled For: Date: 7/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 011098-01 503 -632 -7374 N
Corrections /Comments / Instructions:
•
ir „, ,i ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9 Art Phone #: (503) 718-
, •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200S -00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/31 /2005
Phone: (503) 639 -4171 A hu , ��ipil t� ���
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/16/2005 TIME: 7:10AM PAGE: 63
SITE ADDRESS: 10520 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: OFFICE DEPOT LOT #: TYPE OF USE:
PROJECT NAME: OFFICE DEPOT
DESCRIPTION: New:(1) drinking fountain,(1) water closet,(1) urinal, 70' water service. Moved: (1) sink, (2) water
closets. Replaced: (2) 3" floor drains, (2) sinks.
OWNER: MARX, ERNEST L + BARBARA R, PHONE #:
CONTRACTOR: MIKE PATTERSON PLUMBING PHONE #: 503 - 6317374
Inspection Request Scheduled For: Date: 6/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 009440 -01 503 -632 -7374 Y
Corrections /Comments/ Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
•
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6Dw3N Date: (l j 4, � Phone #: (503) 718-