Permit ! � .. u `- 1+ • � •
,. il a I CITY OF TIGARD PLUMBING PERMIT
i ° ` COMMUNITY DEVELOPMENT- PERMIT #: PLM2007 -00246
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- TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/14/2007
PARCEL: 2 S 10 3 D D -01201
SITE ADDRESS: 13920 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT: JURISDICTION: TIG
PROJECT: GOODWILL INDUSTRIES
Project Description: (2) new backflow preventers.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2
OCCUPANCY GRP: M 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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: • ,
FEES
GOODWILL INDUSTRIES Description Date Amount
1943 SE 6TH AVE
PORTLAND, OR 97221 [PLUMB] Permit Fee 6/14/2007 $92.80
[TAX] 8% State Surcha 6/14/2007 $7.42 ,
Phone : 503- 238 -6190 Total $100.22
Contractor:
WILLAMETTE PLUMBING & MECHANICAL
PO BOX 5805
SALEM, OR 97304 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -585 -4682' .
FAX 503 -585 -0013 '
Reg #: LIC 159315
PLM 27 -70PB
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.
•
Issu - :: y: M � A l Permittee Signature: Sje / ' t //4 f {%r*f
i, Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
t• 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.
Jun 14 07.03:29p - p.1
Plumbing Permit Appficati III ECBVED FOR OFFICE LSE ON L1
City of Tigard JUN 1 4 2007 Received / } V �/ LE Pan,nNo.: 6
i
NE 13125 SW Hall Blvd., Tigard, OR 97223 P` y R e �� I V �� w ..21-1
C Phone: 503.639.4171 Fax: 503.598.
o Pj OF TIED P y. "" Other No.: eupado_ 31
Inspection
110 A R ►, Line 503.639.4175 BUILDING DIVISION DaLe ReadyiBy: 1 ' ' El See Page 2 for
Internet www.tigard- or.gov Ni ethock
L Supptemental Iahormation
TYPE OF WORK . FEE` SCHEDULE
❑ New construction 0 Demolition For spacial information rue checklist
Description I Qtv I Ea- I Total
❑ Addition /altcratioa'replacement 'Willer New 1-2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- family dwelling }I Commercial/ndustrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Master builder Q Other Each additional bath/kitchen 45.00
Fire sprinkler ( _ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION
Site utilities
Job site address: 13C1 ZO Sw F . 14ig(�/c.../ Catch basin or area drain 16.60
T� a,, .tt / Cl �� �'
City:State/ZIP: Drywell, leach line, or trench drain 16.60
SuitelbldgJapt. no.: I Project name: 6. , t' z 65 Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
FF
Manholes 16.60
S c' � l�t7c�+K l«fi S-lite�'' Raindrainconnector 16.60
Sanitary sewer (no. linear IL: ) Page 2
• Storrn sewer (rw. linear ft.: ) Page 2
Subdivision: Lot no.: I Z...p'
Water service (no. linear Q: ) Page 2
Fixture or item
Tax map /parcel no.: Xs i..0 3 1) Absorption valve �j 16.60
DESCRIPTION OF WORK Backflow prevents G' Page 2 CI 2.80
I/V . e.:u is 1i ka»r, r> S // Jry v1 C t3 Backwater valve 16.60
Clothes washer 1660
• Dishwasher 16.60
lif PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
_ it Ejecxors�sutap
16.60
Name:
la1g .6 ill 'ys Expansiontarrk 16.60
Address: jII. 3 517; S,x ,4j. Fixture/sewerrap 16.60
City/State/ZIP: Floor drain /floor sink/hub • 16.60
o:al�tf 0MZ ° � ' 1��
Phone: ( ,sag) o? '2 - 6 1 4.0 Fax: (SD) A 31- 1705- Garbage disposal 16.60
APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Business name: t . ' ( pl jjll lee maker 16.60
W t G�p fA?t1 7 �util�t 'g / [ or ( tt Interceptor/grease trap 16.60
Contact name: Periail civiii'lk Medical gas (value: S ) Page 2
Address: rep �CJrc
+- SVrjS- Primer 16.60
City/State/ZIP c441,- . (fig q( Fax:(S)) 3 o t f Roof drain (commercial) 16.60
, Sink/basm7avatory 16.60
Phone: ('rp7 I - cgs `A - co , 5
Tub/shower/shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
1 TOR A
Business name ( 4J f�RMC � � 40.1167 i. I'G�1sr►• i''d44 ; • Water heater 16.60
Address: F'D Q S VO7 -- Other
City. /State/ZIP: Sa3 4.r, e5R 9730'; Minirmrmpermitfee :$72.50 iZAD
Phone: (cC13) f V Z I.
TZ. Fa'c ( C3) S - - 0013, Residential backflow minimum permit fee: $36.25
CCB Lie.: 1 5---q ? I s Plumbing Lie. no.: d-7 ? pp. Plan review (25% of permit fee)
Stale surcharge (8% of permit fee) l 4 Z
Authorized signet
/)7 TOTAL PERMIT FEE Print name: 1 Dae: i L I This permit application expires If a permit is riot obtained within
J 180 days after it has been accepted as complete.
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00246
13125 SW Hall Blvd., Tigard, OR 97223 404 DATE ISSUED: 6/14/2007
Phone: (503) 639 -4171 ksw
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 6/19/2007 TIME: 7:01AM PAGE: 64
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: (2) new bacldlow preventers.
OWNER: GOODWILL INDUSTRIES, PHONE #: 503 -238 -6190
CONTRACTOR: WILLAMETTE PLUMBING & MECHANICAL PHONE #: 503-585-4682
Inspection Request Scheduled For: Date: 6/19 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 050426 -01 503- 209 -3586 N
Corrections /Comments /Instructions:
-i •g/ j/ ,
•
ES 7' SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: c° i Phone #: (503) 718 -