Permit ., rti „ CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: PLM2008 -00116
TIGARD ' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/19/2008
PARCEL: 1S135CA-02600
SITE ADDRESS: 11130 SW GREENBURG RD ZONING: R -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: GOOD NEIGHBOR CENTER
Project Description: Replacing water service piping.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 200 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
GOOD NEIGHBOR CENTER
11130 SW GREENBURG RD Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/19/2008 $101.40
[TAX] 12% State Surch 3/19/2008 $12.17
Phone : 503 -443 -6084 Total $113.57
Contractor:
MP PLUMBING CO
P.O. BOX 393
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 655 -9161
FAX 503- 650 -7050
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 B • ` - - Permittee Signature: .. ...___e"' Permittee
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.
ij n: 03/18/2008 14:56 11347 P.002/003
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Plumbing Permit App on �
Building Fixtures 5 �� k,, c'� rgiz 01 i I(i liS O:N •
City of Tigard MAR 1 r LUIUd Received ? / - 47 , 7.
DateB J D
PennitNo.: /_ /� f/ � ui ...- U/ tJ l
13125 SW Hall Blvd., TigEOr 23 Plan Review
I, 6 Phone: 503.639.4171 .5 '9 Date/By. Other Permit No.: /314/ R - 6 - 0
T I G A 1: CJ Inspection Line: 503.63 0 DING D I VISION Date Ready /By: Jugs: ® See Page 2 for
Internet: www.tigard- or,gov Notified/Metod: Supplemental Information
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❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total '
if Addition /alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
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... �. �::,;:t,., r�:�'I �. „':.,,n,..,,,.,- s,,._. ,,.,,-w ................ ... 1,. SFR ( bath 249.
❑ 1- and 2- family dwelling Irt Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
SFR (3) bath 399.00 .
Each additional bath/kitchen 45.00
❑ Master builder
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Other: Fire sprinkler ( s . ft.) Page
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Job site address: /,i At� lrumditr ,eGI' Catch basin or area drain 16.60
City /State /ZIP: t ,�� p �,- ,( GI, J "/ Dtywell, leach line, or trench drain _ 16.60
Suite/bldg. /apt. no.: 71" -- Project name: j4J �� /fir Manufactured home utilities • 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _J Page 2
Storm sewer (no. linear ft.: ) Page 2
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Subdivision: I Lot no.: Water service (no. linear ft.: ) ; ' Page 2 /DI 0j .--
Tax map /parcel no.: Fixture or item
„rr;. ::c;c « 7: ? <4i'itvgNl' , • , ¢ , ;n��'r'" -' °;F,,,, „, ,,,,, „,:„.n)'ltvi:?!:.;1i Absorption valve 16.60
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` Page 2
yL ��' 4 #1 f G/6' . �r� Backwater valve 16.60
Clothes washer 16.60
• Dishwasher 16.60
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,,,ppp �/�/ Ejectoislsump 16.60
Name: 9l 1 d194i pj 6.e Expansion tank 16.60
Address: Fixture/sewer cap 16.60
• City/State/ZIP: Floor drain/floor sink/hub 16.60 • Phone: ( ) Fax: ( ) Garbage disposal 16.60
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r �r .� ?l,; eq..4 • u f � r - � - h� , Hose bib 16.60
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: 53i?. r. 3.' Y:+�y,r,t2- ,i+ns.. _:�:.r.,:::, wed; ce.' r ',Li?�;f;'ig4cu:,:<s,�mEixr.'r, ian: ..1'r..._.:.r;..nc::.�.,:e:,:�: noii !i�<arum:.,m:n,YaS.,L?t:�.diii Ce] maker 16.60
Business name: MP PLUMBING CO., INC. • Inters tar/ trap Interceptor/grease tra 16.60 .
Contact name: TAMI Medical gas (value: $ �) Page 2 _
Address: PO BOX 393 Primer 16.60
City/State/ZIP: CLACKAMAS OR 97015 Roof drain (commercial) 16.60
Phone: (503) 655 -9161 Fax: : (503) 650 -7050
Sink/basin/lavatory 16.60
E -mail: TAMIG@MPPLUMBING.COM
Tub/shower/shower pan 16.60
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Business name: MP PLUMBING CO., INC. Water heater 16.60
Address: PO BOX 393 Other 'h
City/State/ZIP: CLACKAMAS OR 97015 Subtotal 14//. Y-
- Minimum permit fee: $72.50
Phone: (503) 655 -9161 Fax: (503) 650 -7050 Residential backflow minimum permit fee: $36.25
CCB Lic.: 5002 n � Plumbing Lic. no.: 3 -17PB Plan review (25% of permit fee)
Authorized signature: , J fl% , / i1 , - State surcharge (12% of permit fee) �� f�i
at �l L ! J /zj TOTAL PERMIT FEE j13, 4
Print name: TAM1 RILEY I Date: J. // A/ This permit application expires if a permit is not obtained titer
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
r:\ Building \Fermis\PLMF- PermitApp.doc 12/27/06 440 -4616T(10 /02/COM/WEB)
•
. .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008-00116
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/19/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ,s,a0- IL
INSPECTION WORKSHEET FOR DATE: 4/17/2008 TIME: 7:02AM PAGE: 28
SITE ADDRESS: 11130 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GOOD NEIGHBOR CENTER
DESCRIPTION: Replacing water service piping.
OWNER: GOOD NEIGHBOR CENTER, PHONE #: I:M-443-6084
CONTRACTOR: MP PLUMBING CO PHONE #: 603-685-9'161
Inspection Request Scheduled For: Date: 4117/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 068623-01 603-666-9'161
Corrections /Comments/ Instructions:
e a.4--S'e•A Adstitteitw-cA:7 CNC Wark/
cok ft 5)4,./
*PASS PARTIAL APPROVAL CANCEL Li NO ACCESS
n FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 01\r‘i■A- Date: 1 --) j ITI , P 07) Phone #: (503) 718-
. ,
• CITY OF TIGARD •
BUILDING DIVISION
PERMIT #: PLM2008-00116
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/•1912008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/2812008 TIME: 7:01AM PAGE: 20
SITE ADDRESS: 11130 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GOOD NEIGHBOR CENTER
DESCRIPTION: Replacing water service piping.
OWNER: GOOD NEIGHBOR CENTER, PHONE #: 503-443-6084
CONTRACTOR: MP PLUMBING CO PHONE #: G03
Inspection Request Scheduled For: • Date: 3/28/2008 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
395 Misc. inspection 067486-01 503-655-9161
006k".-1
Corrections/Comments/Instructions:
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F A; ■ 44(
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ST;‘, L oLit•
yj PASS AWAL/AP.-laINDVAL fl CANCEL fl NO ACCESS
FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
—
Inspector: (To kg/NA...A Date: 3 V25:CA 67\ Phone #: (503) 718-