Permit •
b
r •
CITY TiGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PLUMBING
PLM2005 -00438
�,� DATE ISSUED: 9/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135AB 04500
SITE ADDRESS: 10250 SW GREENBURG RD 212 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN BLDG LOT: 001 JURISDICTION: TIG
Project Description: Cut and cap line.
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CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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
EQUITY OFFICE PROPERTIES TRUST
ONE SW COLUMBIA ST #300 Description Date ' Amount
PORTLAND, OR 97258 [PLUMB] Permit Fee 9/6/2005 $72.50
[TAX] 8% State Surcha 9/6/2005 $5.80
Phone : 503 -412 -4800 Total $78.30
Contractor:
MP (MILWAUKIE) PLUMBING CO
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P.O. BOX 393
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Phone : 503- 655 -9161
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Reg #: LIC 5002
PLM 3 -17PB
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: `%7:7 ' "4 „ ,,M t 5 Permittee Signature:
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.
SEP -06 -05 10:01 FROM -MP Plumbing 5036551726 T -506 P.002/003 F -682
";uiwding Fixtures
Plumbing Permit Application.Z.0 FOR OFFICE USE ONLY
City f Tigard � w
SW Ha Receiver, ( 0
131 Blvd., Tigard, OR 97 � v DacrJBy (p , Permit No.: ZQr _�
Phone_ 503.639 -4171 Pax: 503.598.1960 O A Plan Review
6 .LO l Te t.,,, Dal rJl3y; Other Permit No.:
24- Hour Inspection Line: 503- 639.4175C ? � j J. ._ 1 ' '
Internet: www.ci.tigdrd.or.us - .. Date lie e rho . 1 Supplemental Information
See Page 2 for •
}} +.- _ ....,r_MAD /MtchoEd:::
4 � �4z`ti'' ; " ' $a'� q -.'� 3A w rt'i ' - C'j 1 " - �7 1 i . ;, S. 4 . c j 4 Noti6ed
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M ZEfi.R...,1.WI LiL .. - ' . S ±2.4. 1 :71&L ,tc g „w.V.rI'e ll'it=":; .1:62ePe � �' n'�-f ' .^ y ' .� A'7 r' i " . 2 . G•1 �. 1 .. ,, • .. f$ :„"`
_ � '' •t'1 .r M fit' - :,
0 New construction • . DU'tL U t� ❑ Demolition . For special information use C/teeklise
y 2 Other:
Addition /alteration/replacement 0 _ Description Qty. E T otal
�., �. ,,,��� c �.. A . TMf New 1 -2 -Wally dwellings (includes 1001t. for each utility connection)
-t�T ` . r ^ i t .,,- r :''" ' 1 � "�� = ., �U to : ., a'- : 1'1 „r� .. •
mir ,;:[iysliylf: �ti � �e i;J..t� 't' '�--- . - .� �.'', �?;S�'�,.,.. _..z�_ �4..d $FR b
rr'.f 1 () d� _ 24920
01- and 2-family dwelling' : 1i Couuncrcial / industrial SFR'(2)bath • 350 -00
❑ Accessory building 0 Multi- family SF11.(3) bath ' 399.00 •
❑ Maste builder ❑Di Each additional bath/idtchen 45.00
i
Fires rnkler s ft
c�'i 7• y = 1.2 : : = G
.,. � „_ 7` r •.V R €` ° . Ffigi.- ;-r�., . 1 ::.-r�,.. V`-.; ;�&70•1�{ri•'1C.
i P ( 4• ft.) L I Page 2
E � 'S- ill.. y��,,� i.Z±i`k'sL2= [-.W'llh c IW e� vl 1' t IT ' 4 l J
�Sv_��..� �I. � r � � � .r�... ... a ,�, :I Site utilities • Job site address: N 7( Q ��.�." �1 v`C� 1 Catch basin or area drain 16.60
City/StatctZ]P: �'' . Drywell, leach line, or trench drain - 16.60
. ' '.Idg. /apt uo_ Projectnatue• Q IL Forting drain (no. linear ) Page 2
�.�'� 1Ca ��' 4. of g
Cross street/directions to job site: q Manufactured home utilities 110.00
`� �� Manholes 16.60 •
Rain drain connector _ 16.60
Sanitary sewer (no. linear R,: _ ) Page 2
- Storm sewer (no. linear ft.: - ) Page 2 r
Subdivision 1 Lot no.: water service (no. linear R.: ) Page 2
Fixture or item
Tax map/parcel no.: _
a }r :�: •y "�`,, ."•rg^•.�.. - . ,,• w;l . i �,.�� Absotptionvalve • 16.60
r r a7 �- i+ '7'.n to` !... ,aer.:a � Z +,• t'�" { a 1 , 1.'�tfl j
• is�. }'��,,::!!17 ±�.tJ�... _ r' S� tr' ��h' i��'.'r'� -'T�' �'r'�SAC�� aC
B1CflOW llreVC71 ter •.�;;. '3 �•5 r Page 2
C l t" . A c ir ' \ -_ ("NO Backwater valve : - 16.60 ▪ '
Clothes washer 16.60
Dishwasher • • 16.60 .
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:t..'.:� 17:4 y � . . r�:w4r.";�..!'4` «'MM, .r• . .��� 4'AkY� Ir'....,�,
x'� 'ti;f ii'u (�;w �x , ! �r,W�.�' - r;.;..��,"�f �; `5 k z ,c; � Drinking fountain 16.60
tl '_2 % tIkt ",:'�14 --]- k��.= R :!t� rk-7,:.,,: iAX..:.:. .X;:F�llC�'7�AC l>, , i• , . ;,:;i • + .,rsy ,i1.• •,.A!:1�t
Name: Ej ectt r /suanp 16.60
. c \Im t E ' " 4. *> C" • " 0 E - -'C• • Expansion tank • 16.60
Address: \ t- p : Za..3.3 ,L'%) re - wrr , tk Y^f•\ 1V2__ Fixture/sewer cap \ 16.60 \ L D • 14u
City/State/ZIP: -----\ � 0 9 Floor drain/floor sink/hub 16.60 '
Phone: ( . ) p ( ) . Garbage disposal 16.60
; I. S`;. _ .: �: ; ,07:,5. -:, "' ' .F:':Z . :3" ":;w- _1 ; i no r;i,.., .,•ltT:i -rk - :�•, -'^.- � -` '. , 5
.7? 1$0C bib
t e 3tr t k w 16.60
.�lO:ai.a �^t ; P c 1,'� � A",J ,� f',Y, ' �?: � x ��. ��:a � �: �t���n -h D t F) h'•r o. ,
"..J_., s.r.t -�, •," _ le.t '�'i;!F'i�y�rt_., 1CC tlralC
��- 16.60
Business name: .�� � Interceptor/grease tar .
_ eP / grease �p • 16.60
Contact name- T `h = �`f'�� C"e_cr Medical gas (value: $ ) Page 2
Address: Th�c 39'2.) `. Primer 16.60
City/State/ZIP: --A . -(--- C \ Roof drain (commercial) 16,60
• •
Fax : (5b3 ) . rS ~` ' Sinklbasin/lavarory_ 16.60
Tub /shower /shower pan 16.60
E -mail: • . - _ ,
i, trI'Fr� ":jiT�l N� -' -�P� i:!,?!": -•.� "s, ��:" ?.�r. - - a;r.';1}��e"'. •:,.. • Urinal • 16.60
-, t ys 1,5 lcr, . ?x. _q'x' c, c; ii w may= of % ,!....<, r �' rs: c �..1 ' e w
- ^''''� -.• � . -
. � � -.s�c �� .may- .:,:�.' - .i��:� -,. �.r ���6�� or Water closet 16.60
Business name: `` r-r-. . `e. Water heater 16.60
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City/State/214: QX - �..t -r
C.,�5 ar gi p15 Subtotal ,��
T
Phone Minimum permit fee: $72.50
( 3) �.D - - . . Fax: ( - - 2C0 Residential minimum permit fee: $36-25 - 1 2 '
CCB Lic.i AP OD. Plumbing Lie_ no.: \^1 ),y PIan review (25% of permit fee)
Authorized Signature: State surcharge (8% of permit fee) ��" 6
TOTAL PERMIT FEE .,.._.----ice
Pi'int name: t--- 4/., Date: C k / L 5 This permit application expires permit P pplication ex ires Ifs ermit is not obtained with;n
180 days after it has been accepted as complete.
"Fee methodology set by Tri -County Building Industry Service Board.
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;:us.atainakPe.,,,; Tun.ncF -r rmiwpp.d 12 440.4616T()d02/COM/WEB) -7g . 30
SEP -06-05 10:01 FROM -MP Plumbing 5036551726 T -506 P.003/003 F -682
Plumbing Permit Application r City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su I • ression S stems:
r-F4 :i i-_n+.7"`^ ,..•,-75: ;',0 i>iSS: "-43, � -+;,0 "i' i77:4-71:,5-TI-A, 7 , ,K w *; l ira arAi:21 7 ,.. w ` ,a,- ,;:774: .f -:- ; ,:,
r : ,tlr 11 ..4 4 -• t r F - �-•r h,. } ,,�� ty ,-.2-9 , � 0 ➢ 7 r' ; ,'i1 4 3 II i i. ,, t;r: ...
x�l�l -. � •.. - �. ��.uc K .. - r:�Lua;LcSr�.JO1� ' �'S'r �I��.. EL'x•:�Y�r;,�� � :.. -v.�- .� - _. �dr� .. -
Foodas drain - l 100' 55.00 0 to 2,000 $115 -00
Footing drain each additional 100' 46•40 Mil 2,001 .m 3,600 $160.00 ,
3,601 m 7,200 $220.00
Saver - 1st 100'- 55 - 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service- 1st 100' - 55.00 i Medical Gas S stems:.. ,
Water Service - each additional 100' — 46.40 M . - '''.. _, ' w . _ ,_
i i [� , � i f-. J ! 1 Vzt ..
LJ ^. = ; lr Y ` %ttI'P• -, '�R
Storm & Rain Drain - 1st 100' 55.00 $1.00 °.5 -
— .00 to $5,000.00 Minimum fee 572.50
Storm & Rain Drain - each additional 100' 46.40 NM $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
;.z. ..1 c s:� � illi T c�, 1 additional $100 -00 or fraction thereof m and
r ' "' 1; .i :,y L F „ ? v ',,0 ty „'iF . r „t9i g ri r..., g
��!i1 P�u P I -i k: i ft kin 1 �.k u� „ ` N 4 c ' � � - �u�� �, :. . �s;. i , �' . : �, i�: .g.c., i' . �,' including $10.000.00. -
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $J4$,50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device - - -. --- . -- -•- •- eachadditional- SI00.00or fraction thereof, to -
miniaurm • cnnit fee $362 27.55 __ and including 525,000.00. _
Drain, single family dwelling . 6525 525,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 51.45 for
Inspection of existing plumbing or • t each additional $100.00 or fraction thereof, to
g P g and including $50,000.00.
, :. eciail . uested i - • - tions - • er hour 72.50 $50,001.00 and up $742.00 for the fast $50,000.00 and $1.20 for
Subtotal: 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 re a ort fixtures could result in increased sewer fees *.
-,J,-; ; kl �, j J ' ; y ,, '"`'Q '. ? . :.w F,a'z , 17 Comments regarding fixture work:
. a t.,. IM--.^.. »Z�._.1T...r......fi*��.._. � +'��9b .S - 9.7.. � �' 1L.�'.r. wl
,ptistry/Font - .
Bath -Tub /Shower .
Jacuz/Whirol - -
Car Wash -Each Stall _
-Drive Thru
Cuspidor/Water Aspirator -
Dishwasher - Commercial _
- Domestic
Drinking Fountain - - - - - -
Eye Wash . - -
Floor Drain/sink - 2"
- 4 " .
Car Wash Drain
Garbage Domestic '
Disposal - Commercial *Note: If the fixture work under this permit results in an
- Industrial increase of sewer EDUs, a sewer permit will be issued and
Ice MachJRefrig
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle • • • • Station plumbing permit can be issued.
Shower -Gang .
-Stall •
Sink Baro aysiory — entlititf - TOtal —'------
- Bradley Isometric or riser diagram is required if fixture quantity
-commercial �" total is >9.
- service
Swin]tnin_ Pool Fitter
Washer - Clothes
Water Extractor Plan Review
Water Closet - Toilet _ Plan review is required if fixture quantity total is >9.
Urinal _ - •
Other Fixtures: _ -
haunekocim+uoPLM•p =rmih^PP. a a'W
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CITY OF TIGARD ,, .
BUILDING DIVISION PERMIT #: PLM2005 -00438
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/6/2005
Phone: (503) 639 -4171 / A , y� igi •
Inspection Requests (24 Hrs.): (503) 639 -4175 , I1„ _
INSPECTION WORKSHEET FOR DATE: 9/7/2005 • TIME: 7 :08AM PAGE: 91
SITE ADDRESS: 10250 SW GREENBURG RD 212 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER /LINCOLN BLDG LOT #: 009 TYPE OF USE:
PROJECT NAME: SPEC SPACE •
DESCRIPTION: Cut and cap line.
OWNER: EQUITY OFFICE PROPERTIES TRUST, . PHONE #: 503-412-4800
CONTRACTOR: MP (MILWAUKIE) PLUMBING\CO PHONE #: 503 -655 -9151
Inspection Request Scheduled For: Date: 9/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 015054 -02 503 - 655.9161 N
Corrections /Comments /Instructions:
or, '" - •!► - sr -,fir
F SS • ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
7?
Inspector: Date: q 9 , 0 Phone #: (503) 718-
\