Permit A rr CITY OF TIGARD PLUMBING PERMIT
*/#.0 4. DEVELOPMENT SERVICES PE
DEVELOPMENT PLM2003 -00351
A I l 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 DATE ISSUED: 1/7/04
SITE ADDRESS: 4.35635W PACIFIC HWY PARCEL: 2S102CC -00600
SUBDIVISION: /3,5 1L9 ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 2
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 174 ft
WATER CLOSETS: WATER LINE: 33 ft
DISHWASHERS: RAIN DRAIN: 230 ft
Remarks: Site Utilities.
FEES
Owner:
Description Date Amount
DDHK VENTURES, LLC
12604 SW 60TH CT [PLUMB] Permit Fee 1/7/04 $337.40
PORTLAND, OR 97219 [PLMPLN] Plan Review 1/7/04 $84.35
[TAX] 8% State Tax 1/7/04 $27.00
Phone : 503 977 - 0589 Total $448.75
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone : 503 Sewer Inspection
Water Service Insp
Reg #: LIC 2439 Storm Drain Insp
PLM 34 - 29PB Storm Drain Insp
Storm Drain Insp
Final Inspection
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
Issued By: Permittee Signature: i //‘
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I 1 773//6?
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..:00..; 16.37 FAX 5035981960 CITY OF TIGARD
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c e ctilities
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) T:11133.bill? Perni..,21----- ion I Received ..., PI umbing fi .
I
Da/ay: / -1'8' -o3 P. rmi t No. YUV1 On))
I Planning S.
: In of Tigard RECEINIED 1 Date/By: Approval wcr
? =it No.: _ et,...4 •-....,
.:
• 2: SW Hall B ;vizi. I Plan Review C cher
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• • _L.:. r•regon 9.7223 11114 . Dat,..9 9 :rrnit No.:
• • -. • 1 ti" F iX: 563_501,91JB ...., ,
.,..:. ..,.._._......:... , Post-Review f. ind Use
-ockhin,, 1 - 61. i Date/Bv: I C ise No.: N
:: !:71:a.-: •‘-wcii.ci.ti2ard.or.us 1 "
-Tv nV "T. .....,..T.4.- -1-. f Contact 1; ris.: I CO See Page 2 fcr
-o..: P.equest: 503-ai-a I Name/Method: ' I Supplemental Information ■•
BUIDING • ' ______________,
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• •----- --- - 7- 1 : i"Yr g C;tiir. --77 . 7.-----7 7 •-! -7 7 . • •. 71.7Er..SCHI'D.TAIr(ior -i^e_al ? .."._
• • ----; • ...):•.-..:::::..;'...ur,. I '...e.::t.../117.1. 0 es,:ritvior, I pr I - .:',-Llea.1 / re..al t / - )
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.-:...: 7• a i T...rar.i c■c:/rs_alc , i_j ..._ - ._,. , :.. ..- . :- - • -•:.: .....:Tg4.4a..1.4:.itiV. : '-;: -: - : :-. .. -....: .. ,
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F rior.).. • . . . , • • " : io na ilia:NOR':Uri aehturilir .tEdnisecil oia I :.. ,. :•• • : . -•
-..........._.,....
-.3FR •"1! bath I 7, 9.20
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-!- J,- , 1 1 Ct 7 "7".` . ---
- -. • ' - I zFR. (2) bath I i 30.00
' - • • -, ' 1.1 ! : ) tlt-Farnily • ...
1 SFR (31 bath I L 3 00
. ' '. ...1 ... 4?.... Builder . 41....:4;_-.-:: F Each additional bathildtchen
1 iL5.00 I
.. r• ...- .---L--
TOBr.SY3XLN
.FORIVEITION• and *CAM go '...!•' '.:.'. Fire sprinkler - sq. ft: j P Ice 2 .._
. ? ..c •,:acii%tss: Alardrealli MOE ::" •::.". ''..1:c.::::' r •i!: f- *.•'_':. ------
•.: : --' - 13 .r :r
! B • pt • SI Catch basin/area drain - • ;. 6.60 ! -3 3 .4.0 I
- --- 1!‘
07/well/leach line/trench drain 6.60
- 024.
• •- • - I ...._.„_________,
FloCng drain (no. linear ft..1
:n tc lob sit.t.
Manufactured home utilincs ' I i , :0..30 7
Manhoics 1 15.60
Rain drain connector i 6.60 ‘.......\-
Sanitary sewer (no. linear ft.) c5 rta Flee 2 /0/, '-/0 -.
, . . .. . .
Lot #: Storm sewer (rio. linear ft.) 5 tr Ps-e 2 Lql.S
. ..f..larr:S7Cil: I
7 Water service Ct_:mlir__,_ c5 , . z,„ . Pace :.'_ . 55,
. ' . !7...4...7.Da....c.e. ?i:YGIKZII_Ol.f/211E4_00aoli4
1, r
:..
. ... - 7 EstRxerilkiiloi
' ..kbscrction Yakve i•
5 nckflow preveiter : i Page 2, -- -,„
H. _: 4 _H _15 60 • ' -
---,----_.„--
Backwater - tal - e
-- '
--- ---
Clothes washer - ____ -- r - Th
l -
. _
Dishwasher I 16.60 V
------7
r,,--1 Drinking fountain I 16.60
.11. ' CEI.MEDIMITI'lk.:!:"!.1■Zilgi:ia!',::!:: _ .
Ejectors/sump 16.60 -
;.•..i.::• p plir
- _ Expansion tank 16.60
IP kl -
-4 ,/ _, • al ■ Fixture/sewer imc 16.60 , N
-
, -- - - Fluor 6mM/floor sink/hub ' • 16.60 I
. ; • Y.c 4...1.7): e, 4: . _.......,
--- --- --- CI arbaae disposal
Hose bib
- • ,::.;...: -' • :!:!.:..".‘:: IF : El CONTACkiIREIL50311.tlii.:... Ice maker I _ .16.60 I '-
'....--.• 'Fr r • ..i.,,...... F
1 interceptor/grease Zap 16.60 - I ,
• ---
.. AA •.... - - • ''' iras - value: S e 2
s Pa .
.-_,...-....- .' JIM A Medical 1
Amy 4 ,,,„
-... r.
ep Prime
111 "/ ATIMno"mmu"---&-F22. r 16.60
.;.= ___-_-_ Roof drain (conamercial) I 16.60
_7/7 izorricaricm G*, • ; ,77 1-
_ .
storinn 4. .0
....
-*. -- • '-' Tubishower.'shower ma __-1.--- 16.4) .-
".:- 1.'' '. ' '' ' il, "--"" T ---- Ki : , ; . : '.:ClaWrefikTirOgt.`..t:' ::'.' :'!7fi.•.;..! A .. • Iiir-r-i 1/4.51:
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Watt: -closet I
1(S.50_. %
.1..; .:. -::• -■.:.::: £€)7 A/ /
- --- -- f %Vita neater 11:.a !
.-.1..::.: 2 V Set, 774g- 57 .
• Other - ----i----4-- %.,
1 :
. •-•- -----
1 •: ;!S 776
e9L r/ ?7...3 ,a a ; Other: f I -
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E ax: i 17 " ..r SratIVEM ?.1:;: ::',:;•:• ; ' S•4
• - ••• -1.• • ,..... #: ,-, Plu_niti. Lic.#7 J --R9 / / Subtotal I S -
• -- -- e- • Minimum Perm it Fee 572.50 S
I
-
.. _ .. • gl
. ..- ._.._. Alf ..,.:71 tiroS i Rdsldenci:113ackflow Minimu a Fee 536 .23 : 3
Plan levier, ( c fPermit .7 .7 R • 35 .
#r - l ir r . ‘kvi,t/1 trr ,
, j State Surcharal (a% c f Permit Feel I S .Z . oo '
• _ . i
(Please pnnt name) I 'TOTAL P.IRMIT FEE 1 S zitylif. 75
:is permit application expires If a permit is not obtained within All new commercial buildings pew :ire 2 sets of plans with iv:metric or
• •.. • zr q. has been accepted as COMplaC. riser diagram for plan review.
'Fee methodology set by TH-Cout ry Building Industry Sc,.' ice Boaro-
: ::..!•:timit f 01/03
',wii
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received _ — 47 ate Requested . 2 V (f AM PM BUP
Location - w�All�11 ` / G� Suite MEC
r Contact Person /3 S L5 , Ph (. ) PLM 'd 3 — 1)c-3S/
Contractor '' Ph ( 11 ) SWR
,,��11
BUILDING Tenant/Owner /� / / (LeAA ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall 41 i L %� _ /i , / � _ �� /�i
Fire Sprinkler -
Fire Alarm /
Susp'd Ceiling
Roof
Other: `1 � r i :A -
Final
PASS PART FAIL %
PLUMBING I I) /!/ `� %Ir/ �L �� / ' / ���L_
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch B • s•n / Manhole
Storm Drain
Shower - an
Ot . - •
Z t.'77.C47(/'
• PART FAIL
HANICAL �. / I � v
Post & Beam C �T�
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line VI& �,y� ADA A r% , -)_/
Approach/Sidewalk D I nspe�to� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL