Permit plpi CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/11/2008
PARCEL: 2S 110DC -02300
SITE ADDRESS: 11535 SW DURHAM RD C -4 ZONING: C -G
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT: JURISDICTION: TIG
PROJECT: GENTOG
Project Description: TI
CLASS OF WORK: ALT GARBAGE DISPOSALS: 2 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 4 URINALS: GREASE TRAPS:
LAVATORIES: 11 OTHER FIXTURES:
TUB /SHOWERS: 3 SEWER LINE: ft
WATER CLOSETS: 12 WATER LINE: ft
DISHWASHERS: 3 RAIN DRAIN: ft
Owner: FEES
HIP WILLOWBROOK LLC
PO BOX 2708 Description Date Amount
PORTLAND, OR 97208 [PLUMB] Permit Fee 1/11/2008 $630.80
[TAX] 12% State Surch 1/11/2008 $75.70
Phone : Total $706.50
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 642 -7323
FAX 503 -642 -7755
Reg #: LIC 24184
PLM 26 -162PB
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.
Issued By:• L .. Permittee Signature:
r 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.
Building Fixtures
�� Wl-f H 07. -o903
Plumbing Permit AggC0 FOR OFFICE USE ONLY '
City of Tigard V R eceived � , Permit I(�n/�``__ 7
13125 SW Hall Blvd., Tigard, OR 97223 8 DatDate/By: g I�f i p{GClgj /
Phone: 503.639.4171 Fax: 503.598.19C�AN 0 8 L00 /� ; ft i Date/By
�n � �
' Plan I�'\ Other Permit No.A.0 -, tp
Lur
24- Hour Inspection Line: 503.639.4175^ T �! W Date Ready/By:
0 See Page 2 for
Internet: www.ci.tigard.or.us ® � Noti '/ ((j! mental fnforma on
1 � fied/Method� Supple n Ci s 1:0,- it v b +. 11 z * M a ` ' « r < 0 5 O , , ,, I SG`IIED7. , = , ' ' <: : s
r4 .��. �...a a� � . ..,.- � ,"�:." :;.!�r r?i �wa a�s"'� u..«'f,,Z � .11 , ;'„:::„ . ::-: � �,.'� v Hsu . . �, F. �2�. . ^rs s�.a_ - ., :.
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. 1 Total
ddthon/alterarion / replacement ❑ Other: New SFR (1) 1- 2- fa mily dwellings (includes 100 ft. for each utility connection)
ii<t� _ �. CAI EGORYtOF CO�ST-RUCFIOIV,r� b 249.20
n. �.� � .:,�. aca.�. .�<,��.'�aes�.�?'�cMw >cr -.aS+s �s. w;fi.. .. "Y�='a a, :.
❑ 1- and 2- family dwelling ormnercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
• Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
r s 1 y ' 0& glib 1FORMA66 ' D a IO W t • Site utilities
Job site address: ' 5 3 5 SLA) 'D(/K m TO Catch basin or area drain 16.60
City/State /ZIP: Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ( Project name: C r �.-� �7 Footing drain (no. linear ft.: ) Page 2
J Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
6 1ait & e 4 G "L - 5 (p Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2
a s f/ b� v Fixture or item
Tax map/parcel no.:
.s.. y ;•t:sr i .,; r p .r ; € ; Absorption valve 16.60
• . , � ., ,F� ION OF VY OR K , � r Y , 4 , , . � , , B ac k fl ow preventer Page 2
i j I s**-- lM (kb V(\ "� Backwater valve 16.60
'' f Clothes washer j 16.60
Dishwasher 16.60
F .. • ' ' t Drinking :mss � � g fountain 16.60
1 ..0X..„.1.--.. �JP t @ ,, ti. .. I 1 R . . .Fb s A
3;.�. .. e,.�,z -�" s . �,. � :�x�..,� ,��r- .�,��wa Q4ii Ejectors /sump 16.60
Name: Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City/State /ZIP: Floor drain/floor sink/hub I 16.60
Phone: ( ) Fax: ( ) Garbage disposal a 16.60
,.
Vim '' il C i d0 a? 1 A s N Hose bib 16.60
Vr'' d '. ' n � CO -- . :. , M NT T PE SO
` Ice maker 16.60
Business name: //// t/i 461 COPS ( /• (J C 1 by0 Interceptor /grease trap 16.60
Contact name: c 3 ,,,)67-;(1_, /....) cC . 0 � ) Medical gas (value: $ ) Page 2
Address: l� Primer 16.60
City/State /ZIP: Roof drain (commercial) • 16.60 •
Phone: ( ) Fax: : ( ) Sink/basin /lavatory ) 5 16.60
Tub /shower /shower pan I 16.60
E - mail:
Urinal 16.60
. ... � � ; � , C RA OR S "A a fi -. t Water closet I . 16.60
r
Business name: e ) .L / 1 / V i ' ` Water heater 3 16.60
Address: 1 (c 0 CA c t „, ) rn 6-,-1.0 g €2 Other:
City/State/ZLP: �j cc C t '],�" 0 b I xi, Subtotal
. 1 7 Minimum permit fee: $72.50 / . s
Phone: ( ) (, 2 1 2.-- ax: ( ) (42r-11 Residential backflow minimum permit fee: $36.25 lD
CCB Lic.: Z Gil s L: Plumbing Lic. ' ('Z 96 Plan review (25% of permit fee) -�-
{{ bState surcharge % of permit fee) 745:70
Authorized signature:
TOTAL PERMIT FEE 70
Print name: ;IA, / VU V"1 1 L Date: I._ S -b U This permit application expires if a permit is not obtained within
t� 6 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\Buitding\Pernits\PL.MF- PermitApp.doc 12/03 440- 4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard '
•
Page 2 - Supplemental Information �> , ,
•
Fee Schedule: Residential,Fire Suppression Systems:
1 s , Qty 0 .b & i: Totat e. ` "
s t_.. 1 e S..... ,,..: `: .' P (11 I agreoot a ge ix _ ,; :? P e,mlt.;..a
Footing drain - 1 100' 55.00 0 to 2,000 ,. „ q $1,15.00
Footing drain - each additional 100' 46.40 2,001 to 3,600' $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
- Water Service - each additional 100' 46.40 4. -1:.,04".;. ,,- : " . =r :� iu �i =; .- 3,# r "'.;,<
: ::Vai atian� 44: „ P e rm it lFe :;,,,' .,.:._ .
Storm & Rain Drain - 1st 100' 55.00
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 • $72.50 for the first $5,000.00 and $1.52 for each
rt°e , �:. rit - 1 ,5 WW1 ee
, a; ": °To al additional $100.00 or fraction thereof, to and
::, 1X UTre;O1', - l t ', ; , t ., 'g k ..:... .7� including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $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) 27.55 and including $25,000.00. .
Rain Drain, single family dwelling 65.25 $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 - _ 72.50. - -
Subtotal: $50,001:00 and up $742.00 for the first $50,000.00 and $1.20 for
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 * .
1 t
� 4 4 hQuanttty by cEixture) "GWorkiiPerfo ntd��
xtureffte a .- i � 4.ii k 4 V!Ite rieei a •
k 4. 21,0*- r g ea 6 i ; n, " c Comments regarding fixture work:
Baptistry/Font
Bath - Tub /Shower ] 1
- Jacuzzi /Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor /Water Aspirator
Dishwasher - Commercial f
- Domestic a
Drinking Fountain
Eye Wash
Floor Drain /sink - 2" 1 .
3 „
-4 "
Car Wash Drain •
Garbage - Domestic I I
Disposal - Commercial *Note: If the fixture work under this permit results in an
- Industrial
Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall I •
Sink - Bar /Lavatory 1 6 a 8' Quantity Total
Bradley Isometric or riser diagram is required if fixture quantity
- Commercial ' Q `,
total is >9
- Service
Swimming Pool Filter _
Washer - Clothes I
Water Extractor " I Plan Review
Water Closet - Toilet 6 6 Plan review is required if fixture quantity total is >9.
Urinal
Other Fixtures: •
is\ Building \Permits\PLM- PermitApp.doc 3/03
CITY OF TIGARD
, .
BUILDING DIVISION PERMIT #: PLM2008-00007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1t11i2CIOB
Phone: (503) 639-4171 1
:
Inspection Requests (24 Hrs.): (503) 639-4175 ,,,J411- • IL
INSPECTION WORKSHEET FOR DATE: 418/2008 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 11536 SW DURHAM RD C CLASS OF WORK:
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: GENTOG
DESCRIPTION: TI
OWNER: HIP WILLOWBROOK LLC, PHONE #:
CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503
Inspection Request Scheduled For: Date: 418i2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3,99 Plumbing final 068052-01 603-642-7323 Y
Corrections/Comments/Instructions:
C1tI-4.
CA- PASS fl PARTIAL APPROVAL El CANCEL I I NO ACCESS
FAIL 1 CALL FOR INSPECTION 1111 ADDITIONAL FEES ASSESSED
Inspector: cr Date: Lili Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: '1/11/2008
Phone: (503) 639- 4171uq��jlll�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/4/2008 TIME: 7:02AM PAGE: 10
SITE ADDRESS: 11535 SW DURHAM RD 4 CLASS OF WORK:
SUBDIVISION: WILLO1ROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: GENTOG
DESCRIPTION: TI
OWNER: HIP WILLOWI3ROOK LLC, PHONE #:
CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 503-642,-7323
Inspection Request Scheduled For: Date: 4/4/2008 Pour Time:
Code #' Inspection Description Confirm # Contact # Message
399' • Plumbing final 067927 -01 503 -&12 -7323 Y
Corrections /Comments/ Instructions:
. ZN ( -46 s , tf t • • o%,c C o t.J P.(i) c4 8 , '� � rin 6 C LA
e p 1. l e-,
C I tc Ar \,\ T - - .ci A-( C o w+t (,) Lc�r a✓
avq,i �. ,r�,.. T 1 `e-A-4 1- t L I L 2,o °
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 - Vti A\Az t..ti._" Date: Li:I'tf/1 0 7) Phone #: (503) 718-
CITY ��N�~�� �~�����N��������
OF uu���mnm��
BUILDING DIVISION PERMIT #: PLM3008.00007
13125 SW Hall Blvd., Tigar , OR 97223 DATE ISSUED: 1/11/2(MD
Phone: (503) 639-4171
Inspection Reque�o(24Hm.):(503)63Q-4175 v�
INSPECTION WORKSHEET FOR DATE: 3/26/2008 TIME: 7:01AK8 PAGE: 24
SITE ADDRESS: 11835SW DURHAM RDC CLASS OF WORK:
SUBDIVISION: WILLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: GENTOG
DESCRIPTION: TI
OWNER: HIP VNLL0VVBR00KLLC. PHONE #:
CONTRACTOR: ANTIL PLUMBING INC PHONE #: 503-54
Inspection Request Scheduled For: Date: 312512008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 007281'01 503.642'7323 �
Corrections/Comments/Instructions:
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E../—T�u� ��� .� r��
— n '
PASS U PARTIAL El NO ACCESS
u u
| | FAIL CALL INSPECTION ADDITIONAL FEES ASSESSED
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Inspector: ~r��~_�V �~~~~-- Date: ij/'/A 7) Phone #: (503) 718-
CITY OF TIGARD „ .
BUILDING DIVISION PERMIT #: PLM200B -00007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/11/2008
Phone: (503) 639 -4171 /vuidlnW1"
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3//9/2008 TIME: 7:01AM • PAGE: 16
SITE ADDRESS: 11535 SW DURHAM RD C -4 CLASS OF WORK:
SUBDIVISION: W1LLOWBROOK BUSINESS PARK LOT #: TYPE OF USE:
PROJECT NAME: GENTOG
DESCRIPTION: T1
OWNER: HIP WILLOWi3ROOK LLC, PHONE #:
CONTRACTOR: ANCTIL PLUMBING INC PHONE #: 603 - 642 - 732.3
Inspection Request Scheduled For: Date: 3/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 066962 -01 503-642-7323 Y
Corrections /Comments/ Instructions:
t c-0 CA-y) ke,ctiQ-bbitA,
Ov--) L.A./LA
( A ok VtA.A 5 3'7 /• r 2 44, S..e,Lt o✓ S'-41„. -4 I unp ,r,
I PASS KPARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \--.-' Date: Si \ t O41 Phone #: (503) 718
CITY OF TIGARD - .. , : , /9Z- /17
BUILDING DIVISION PERMIT #:aoo -D k 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 7,10 'III
Inspection Requests (24 Hrs.): (503) 639 -4175 , J"
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / / �3�� c - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 2 - " — D 6 Pour Time:
Code # Inspection Description Confirm # Contact # Message
32o 0 0 , 9 L , oG y 45-6, of (p(p 4 {- &066
Corrections /Comments /Instructions:
Co ( (0 ) Ro\i Po\-/Me\A A-
-6-01., k— I '& 1 Shp I .. Uw lre, (,�- d m l �J 4 _ VI?.
(At 1 cwt CA ..A 1Q- e/ ('vvc,A^,,f -r-v47
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utp - yon ✓r v pVr tJu./ 4--4 c,c,,1 e PR
M Owl", ` i vir S
An aKI �- �� �.- c/d -� { -.1 l it � �, L 1,) C.a, 1 - `i 2A v y
A ✓ t c% C(.n J v.,c O ✓ v p P6s i d 17 ] -- Co
11 PASS PARTIAL APPROVAL K ❑CE �� NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C An.ft-->-A Date: 2-V9 1,0T7 Phone #: (503) 718-