Permit Er CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00527
DATE ISSUED: 11/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S113BA - 00400
SITE ADDRESS: 07632 SW DURHAM RD 130 ZONING: I -
SUBDIVISION: SW CENTER SDR1999 - 00020 LOT: JURISDICTION: TIG
PROJECT: UNITED HEALTHCARE
Project Description: Install water supply line for new refrigerator, no drain. No change in EDU's.
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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
OPUS REAL ESTATE OREGON IV LLC
1000 SW BROADWAY Description Date Amount
1130 [PLUMB] Permit Fee 11/29/2007 $72.50
PORTLAND, OR 97205 [TAX] 8% State Surcharl 11/29/2007 $5.80
Phone : Total $78.30
Contractor:
POWER PLUMBING CO
P 0 BOX 19418
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34 -150PB
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 .. 6699 or 1.800.332.2344.
Issue• By: (11 .l iLj _ , � Permittee Signa re: - / ir ( • -�
Call 503.639.4175 by 7:00 a.m. for an inspection that busirfess 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.
Fr 1
FROM POWER PLUMBING (THU)NOV 29 2007 13 :34/ST.13 :34/N0.6860422214 P 1
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I' eiumbin Permit A licati
City of Tigard C 1V E Recei. -d it 24 DI amt No.: Z-d0 TA
13125 SW Hall Blvd., Tigard, OR 97223 O
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Phone 503.639,a 171 Fax; 503.598,19bg0V 2 200 Plan ll y : , �/o ig
Ins CtiOn Line: 503.639.4175 � tvtl 11 AY'" other Permit Na ": S U r � 7 "L'4
r I `. 't . t > Internet: www,tigard- or.gov w Dore Ready/By: i s la See Page 3 for
a , 0 Notttie method: L! [44 S • . -. • tin information
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i❑ New construction d Demolition For special information use checklist,
Description I Qty, 1 Ea j Total
[rAdditioa /aitera tionhe;p{aoement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
.hx.
∎w ,W 4 ,,,. - , ,r'n:i.:, ; - ' SFR (t) bath III 24920 --
_
❑ I- and 2- family dwelling 0 Commercial/industrial SFR (2) bath 350,00
(o Accessory building 1:) Multi-family SFR (3} bath 399.00
❑ Master builder -. - Each additional bath/kitchen 4i.00
❑ Unc�r: Fire sprinkler (_ sq. ft.) Pasc 2 _
. ' ' l SITE INFORMATION AND.' LOCAYltION Site utilities __
F ob site address; I Z Do (1n n (A• ..W .. ti Catch basin or area drain r 16 60
City/State/ZIP: f(� �j, ., O -7,a I Drywcll, leach line, or trench drain T 16.60
Suitrlbldglapt no.: Pfoj«:t name: U L -' L / Os ! A1144
"� "" Foetin$ dram (no, linear fL: _ ) Page
.
Manufactured home utilities 110.00
Crass sbeet/directions ro job site: - _ ,
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ti: I Page 2
o sewer (no. (meet ft.: _) I Page 2
•
Subdivision: Lot no,; Water service (no. linear ft.. ( i Page'
- - " ' - Fixture or item
Tax map /parcel no.: •
Absorption valve ? I 16.60
A DESCRIPTION OF WORK Backflow preventer ) I Page 2
p r7 v16 I �� - S l r, P _ `� Backwater valve " 16.60
p _IP
_ _ A Ed • - . 1 :/\ At i Clothes washer 16.60
' /4 .0 /.A., t M Dishwasher 1 6.60
V � Drinking fountain 1660
a', '/'l a) aRRtt$R Q reraNP J
Name: Q I _ c Ejcctorslsump _( 6.60 1
r ''� Expansion tank 16.60
Address_ 1CCO 6 th t��G t��{� -1 1 1 Fixturdsewer 16.60
City /StaterZTP: Pp2-r' L►c) 01-- O c7 ?S Floor drairvfoorsirtk/hub - _16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
• '9 ' a • . !...ri3 C OiYir ACT Hose bib 16.60
,% ,': - !cc maker 16,60
Business name: - Val 1 W Interceptor /grease trap 16.60
Contact name:
__ k-i N - o 1 ' �/ 1 /�l Medical gas (value: $ ) Page
ACl�d p� x '" / 'f 1 j Pruner
i 16.60
City/State/ZIP: ty /State/ZIP; P + ` � � `� Roof drain (commercial) .. 16 60
1 , Sink/basirVfavator2 16 "60
Phone: ( ) A4k..{ - [a Fax; : ( ) va`t� - i-2,5
TuNShower /shower part 16.60
E -mail:
-. - .. -� - Urinal , 16.60
•. : �' ;� : - : Water closet
16.60
Business name: irV p � �. -t�j, Water heater 16.60
Address: r r . . u _ l , • .A ' J . v> Other: / ' I1a�
City/State/ZIP: L ,+�,` - M permit fee; $72,50 50 ;
Phone: ( ) L,.1,} 4_. 1 V V Fax: ( ) ' W _(-3 Residential backflow minimum permit fee $36,25 �2 I
I CCB Lie.: 5,), Plumbing Lie. no.: A . • % Plan review (25% of permit fee)
Authorized signature: . . Stansturtrargc ofpesma S Lr
f �1 TOTAL AL PERMIT FEE E '-•l i. 6 D
Print llama: f •(/ e i S .�.? S - P.>i'� J 1 1 I bet / f o / f Tf° "relt application expires IT a pert its not t bddued *Orin
�j 180 days OW it Itas been accepted ea o apletc.
"Ftsr*ftrodtfbogy set* TrvComfty Building Industry Service Board.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007-00527
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2007
Phone: (503) 639-4171 ,_. Argralt
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/27/2007 TIME: 7:00AM PAGE: 28
SITE ADDRESS: 07637 SW DURHAM RD 130 CLASS OF WORK:
SUBDIVISION: SW CENTER SDR1999-00020 LOT #: TYPE OF USE:
PROJECT NAME: UNITED HEALTHCARE
DESCRIPTION: Install water supply line for new refrigerator, no drain. No change in Mrs.
OWNER: OPUS REAL ESTATE OREGON IV LLC, PHONE #:
CONTRACTOR: POWER PLUMBING CO PHONE #: 503-2441900
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 062193-01 503-244-1900
Corrections/Comments/Instructions:
Care
•
IA PARTIAL APPROVAL fl CANCEL NO ACCESS
FAIL fl CALL FOR INSPECTION Li ADDITIONAL FEES ASSESSED
02/11,A_A
Inspector: Date: ( \ lion Phone #: (503) 718-
.. _ •