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Permit 4 CITY OF TIGARD PLUMBING PERMIT v t DEVELOPMENT SERVICES PERMIT #: PLM2001 -00529 • - „�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/22/01 SITE ADDRESS: 12220 SW SCHOLLS FERRY RD PARCEL: 1 S1346C -00300 SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: M FLOOR DRAINS; . TRAPS: STORIES: WATER HEATERS 1 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 Remarks: Move (3) floor drains and add (1) new drain. Relocate existing electric water heater. FEES Owner: Type By Date Amount Receipt BPP RETAIL LLC PRMT CTR 10/22/01 $83.00 27200100000 BY BURNHAM PACIFIC PROPERTIES 5PCT CTR 10/22/01 $6.64 27200100000 ATTN: JOHN WATERS SAN DIEGO, CA 92101 Total $89.64 Phone 1: Contractor: GRIDLINE PLUMBING + HEATING 4343 SE 37TH AVE PORTLAND, OR 97202 REQUIRED INSPECTIONS Phone 1: 771 -8790 Rough -in Insp Reg #: LIC 00074105 Top -out Insp g PLM 26 -449PB Top -out 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 Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By AO � Ala.& , 41/ Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for an inspection nee he next business day > ' PlumbingPermit Applica 'on Datereceived: /04, 0 I Permit no.:'? /005 """'#• ;1 Cit of Tigard � � 4J,l .'4 1 ! Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, O 97 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: Byeqb I Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory Gommercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction w Addition/alteration /replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist) Job address: / 5-it„, Gi4s(I.z ft/ / Description Qty. Fee(ea.) Total Bldg. no.: Su no.: // New 1- and 2- family dwellings only: Tax map /tax lot account no.: (includes 100 ft. for each utility connection) SFR (1) bath Lot: I Block: I Subdivision: SFR (2) bath Project name: 14/A45'5" 744/' 7wAy SYi SFR (3) bath • City /county: I IP: Each additional bath/kitchen Description and location of work on premises: ,P.POI7!/Ge %Jr, V Site utilities: f 12A Li' i -- Catch basin/area drain Est. date of completion/inspection: Drywells/leach line/trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: G,, I . J J4/(B 7 lvNtBiii, f f Manholes Address: l i . , , S J 7 Rain drain connector City: lg/ pSta te,7� I ZIP: 9' '7�p Z Sanitary sewer (no. lin. ft.) Phone: 1 _ 47' I Fax: I E -mail: Storm sewer (no. lin. ft.) CCB no.: 7 0 . 5 I Plumb. bus. reg. no: Z.- 0 Water service (no. lin. ft.) City/metro ric. no.: / 72 !vol Fixture or item: Contractors representative signature: , Absorption valve P' Back flow preventer • Print name: . /t/ 4/ • r ki Date: �Zj� Backwater valve CONTACT PERSON Basins/lavatory Name: 0,41jl/ 7)U/V4f40/ Clothes washer Dishwasher • Address: /, f Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: `J /- 17 d Fax: E -mail: Expansion tank Fixture/sewer cap Name (print): Floor drains/floor sinks/hub "y Mailing address: Garbage disposal Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENGINEER Tubs/shower /shower pan Name: Urinal Address: Water closet Water.heater. p , City: I State: I ZIP: Other: • Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee information. Notice: This permit application 1:3 Visa ❑ MasterCard Plan review (at _ %) $ expires if a permit is not obtained Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ 8 • to Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440-4616 (6/00/COM) PLUMBING PERMIT FEES: v • • PRICE TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection) One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 3" 16.60 4,6e/./0 PLEASE COMPLETE: 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 I Quantity by Work Performed Gas piping requires a separate mecll�nic I , / / - Fixture T New Moved Replaced Removed/ permit. tzph:ig1� , , I b•Iw i l0 • IPo Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory Hose Bibs 16.60 Tub or Tub /Shower Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Other Fixtures (Specify) 16.60 Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Sewer- 1st 100' 55.00 Floor Drain /Sink: 2" I 3 3" Sewer - each additional 100' 46.40 4" Water Service - 1st 100' 55.00 Water Heater Water Service - each additional 200' 46.40 Other Fixtures (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device" .27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 AD! ! .4 Diii, perk' /11.e me I ICA: Grease Traps 16.60 /- 4 " pit, n v fv QUANTITY TOTAL � Mew rk1 Aiii Isometric or riser diagram Is required if /��r /� �, l C 4 �P Quantity Total is > 9 1 �' Z *SUBTOTAL ' 3 Dv 8% STATE SURCHARGE . & le. q "*PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is > 9 TOTAL $ 14C1 * Minimum permit fee Is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which Is $36.25 + 8% state surcharge. ** All New Commercial Buildings require 2 sets of plans with Isometric or riser diagram for plan review. i:\dsts\forms\plm- fees.doc 08/29/01 CITY C•IGARD 24 -Hour ,+. • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST 3-40 BUP Received Date R nested AM PM BUP Location Z 22 � fd/m Suite MEC Contact Person Ph ( ) '� 5;:)- Contractor X Ph ( ) BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam • Shear Anchors Ext Sheath/Shear Ina Framing � 7 � y /' ' ' b s eeh Framin � l 2v;d<_ � I�i/'P C.9Nl 7 1' Insulation / 4,052 6 Feed° /r0- Q1 S c7Aa 14e. Drywall Nailing -e Firewall Fire Sprinkler �' `� �" 1 ff � Fire Alarm Susp'd Ceiling Roof Other: Anal PASS PART FAIL PLUMBING „" Post & Beam -,- -Under Slab e Rough-In Water er Service Sanitary Sewer Rain Drains Catch Basin / Manhol - Storm I • • er Pan Other: ma SS •AR ME 'NICA 41/ V f2 S ost•& Beam Rough -In Gas Line Smoke Dampers L f^ r �9�OV �,•r• Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final PASS PART AIL Reinspection fee • requ' - • before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE mg • lease • • - .• _ : [] Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date ~ � Inspector £ t44j/e ' Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL ■ i OF TIGARD BUILDING INSPECTION DIVISION MST i lk 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested l� °� AM L PM BLD Location / Z 4( &— ueA1 Suite MEC Contact Person Ph 7/ -ern o PLM c,D6l O a, -� aq Contractor Ph SWR BUILDING Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain irk Lg hib C Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains 41S0 PART FAIL ANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk / D/Z , 6 ` a '/ Inspector /"� � `'�D `�`6� Q- Ext Other Date p Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITI - 'IGARD 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST 22 BUP J Received Date Requested / AM PM BUP Location v = i�i.•%,� - - MEC ■ Contact Person Ph ( ) PLM 2 a / 0 0-5;3`, Contractor Ph ( ) 7 ? SWR BUILDING Tenant/Owner ELC Footing Foundation . ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear � / 27 . fht/ �_ /,e h �q ram •� tie �rn-- Framing ��`` / 07tH Insulation l Drywall Nailing `� 'e �. ) Q$ , e`Z r' 4fr Firewall s Fire Sprinkler (r�Gt7..z,.� 4 / 6ti d. Fire Alarm 7 ��--e 6 N- -7 G11 7d1/-e- car 'S�oY --� rG� Susp'd Ceiling Roof '4- 56' r/, Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In J L Water Service /49' r7 Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: SS PART FAIL MECHANICAL Post & Beam 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 ADA Approach/Sidewalk Date — �- Inspector � � �� r Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL