Permit Y '
CITY OF T PLUMBING PERMIT
e'r' DEVELOPMENT SERVICES PERMIT #: PLUMBING PER 0635
J II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/14/2005
PARCEL: 1S134BC-00300
SITE ADDRESS: 12244 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: Replace existing fixtures. Other fixtures: (1) drinking fountain.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BPP RETAIL LLC Description Date Amount
BY BURNHAM PACIFIC PROPERTIES
ATTN: JOHN WATERS [PLUMB] Permit Fee 11/14/200: $149.40
SAN DIEGO, CA 92101 [TAX] 8% State Surcharl 11/14/200f. $11.95
Phone : Total $161.35
Contractor:
R A WARNER PLUMBING
PO BOX 820785 REQUIRED ITEMS AND REPORTS
VANCOUVER, WA 98682
Phone : 360 - 896 -0370
Reg #: LIC 151329
PLM 37-521PB
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 rule or direct questions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: �� j Permittee Signature:
e
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. -
Building Fixtures
Plumbing Permit ApplI ii E V ) 1:01Z OFFICE 1'sr ONLY
City of Tigard A'" a eI / �c' �� Permit No 1�`,, 7 �/).s� l/ .! �Iv( f5
13125 SW Hall Blvd., Tigard, OR 97223 �' L q �O plan Review r.LV�+
Phone: 503.639.4171 Fax: 503.598.1960 r.:;., ,.. . DAY Other PemotNe.:
24 Hour Inspection Line: 503.639.4175 CITY OF TIGA -""1191" : _ I Date Ready/By. See Pa 2 for
Internet: www.Ci.tigard.or.us Bill nl NC DN(.,( ^ OtV Date � Supplemental Info
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
-, Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: ( 2 'Z L(4 <L.t, S C..(...D((S P i� Catch basin or area drain 16.60
City/State/ZIP: ---1-9 ' .4!� A C us Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: )O`(��-f[ P S � Footing drain (no. linear ft.: ) Page 2
Cross street/directions to job site: S dLAA s n IRA c� ,/ l S ,r Manufactured home utilities 110.00
i
l l L u�-`� 14- ` Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
2 A kLec .... b tAzp S',,,, IL Backwater valve 16.60
'�. R (o bai , ba % / a 8 �1 La-A4 Le,L Ga O (,e a- Clothes washer 16.60
6 /t w�. ket �� Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain ' 16.60
Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub Z 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
❑ APPLICANT ❑ CONTACT PERSON
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer ellt. 16.60
City / State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 3_ 16.60
Tub /shower/shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet Z 16.60
Business name: Ta IPI, W Alt-u.../VC.,. p ,,..,p co. • Water heater i 16.60
Address: )0 ,.1. 82_0 7 & ` Other:
City / State/ZIP: J (�J C -().�l �?f(L. ( Q 8GO 2 Subtotal
Minimum permit fee: $72.50 / y6
Phone: (--jw) 772 - 2 t.(q o Fax: (3 LO £'9(o U 3 7 U Residential backflow minimum permit fee: $36.25 7 ` �
CCB Lic.: ( 5 (3 9 Plumbing Lic. no.: Ac 3 7- S2.( A3 Plan review (25% of permit fee) //t 4
Authorized signature: ,,i- State surcharge (8% of permit fee)
TOTAL PERMIT FEE A/ ifs"'
Print name: /Z(c4..oir_d ta. t✓.yt.,,w_ I Date: /( - /•y/- d( This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
is\ Building \Permits\PLMF.PerrnitApp.doc 06/05 440-4616T(10/02/COM/WEB)
•
Plumbing Permit Application - City of Tigard
'
Page 2 - Supplemental Information 't
Fee Schedule: Residential Fire Suppression Systems
Site Utiliti • Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1 10' 55.00 0 to 2,000 $115.00
Footing drain - each ditional 100' • 46.40 2,001 to 3,600 _ $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional l 0' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additio , 1100' 46.40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72 .0
Storm & Rain Drain - each additi • at 100' 46.40 $5.001.00 to $10,000.00 $72.50 for the fi t $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total • additional $101.00 or fraction thereof to and
including $ I 1 100.00.
Commercial Back Flow Prevention De •ce 46.40 $10,001.00 to $25,000.00 $148.50 for e first $10,000.00 and $1.54 for
Residential Back flow Prevention Device each addi * nal $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 and incl ding $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379. I for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or eac . dditional $100.00 or fraction thereof to
specially requested inspections - per hour 72.50 an including $50,000.00.
Subtotal: $50,001.00 and up 42.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: P • n Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes' A "corn ex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to syste , that meets any of the following criteria
accurately report fixtures could result in increased sewer f.. *. Ple• .e check all that apply.
•
Quanti by (Fixture) Work Performed Any new commercial building.
Fixture Type: Replace A Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower • Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool p ividing services to human beings.
Car Wash - Each Stall ❑ Plu sing installations, alterations or additions to food service
- - -A
- Drive Thru faciliti • where new plumbing fixtures, including interceptors,
� area.
Cus. idor/Water Aspirator �� are being i . led for the food service are
Dishwasher - Commercial - -__
❑ AnY new resi s - tial building containing three (3) or more
- Domestic dwelling units Drinking Fountain
Eye Wash
on ❑ Any NFPA 13 - D mu - surpose fire sprinkler system.
Floor Drain /sink - 2"
- 4" , - Submit 2 sets of plan h any of the above.
Car Wash Drain in= Isometric or Riser . 'agram
Garbage - Domestic [ Isometric or riser diagram is requir: , new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filt.
Washer - Cloth *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet Z increase of sewer EDUs, a sewer permit will be issued and
Urinal . fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
i:\ Building \Pennits \PLIN- PenniIApp.doc 07/06/05
i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005-00635
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1412005
Phone: (503) 639- 4171r1
Inspection Requests (24 Hrs.): (503) 639 -4175 �'!!+� ''L
INSPECTION WORKSHEET FOR DATE: 12/19/2005 TIME: 7:01AM PAGE: 41
SITE ADDRESS: 12244 SW SCROLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: Replace existing fixtures. Other fixtures: (1) drinking fountain.
OWNER: BPP RETAIL LLC, PHONE #:
CONTRACTOR: R A WARNER PLUMBING PHONE #: 360 - 896 - 0370
Inspection Request Scheduled For: Date: 12/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 023662 -01 360-601-7940 N
Corrections /Comments /Instructions:
/ (, ; ( >y
(1
s •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4
a)/ Date: L2 1 . b I Phone #: (503) 718 -
Y
CITY OF TIGARD ''
O
BUILDING DIVISION - PERMIT #: PLM2005 -00635
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005
Phone: (503) 639 -4171 A� e
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I 1 ..
INSPECTION WORKSHEET FOR DATE: 11/29/2005 TIME: 7:05AM PAGE: 92
SITE ADDRESS: 12244 SW SCROLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREENWAY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: DOLLAR TREE
DESCRIPTION: Replace existing fixtures. Other fixtures: (1) drinking fountain.
OWNER: BPP RETAIL LLC, PHONE #:
CONTRACTOR: R A WARNER PLUMBING PHONE #: 360 - 896.0370
Inspection Request Scheduled For: Date: 11/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 022486-01 360- 601 -7940 Y
Corrections /Comments/ Instructions:
•
V ' SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 d Phone #: (503) 718 -
P D ! ( )
CITY OF TIGARD eL_ n1 /
BUILDING DIVISION : s: `_ ; PERMIT #:ad0S- oO -
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 hadook lilt
Inspection Requests (24 Hrs.): (503) 639 -4175 , :y/ II
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / a (f CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: //— I - 7 -- 05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3Z Cgeo0 - L-‘.-) )
cid AIL-
Corrections/Comments/Instructions:
3(e0 (o - 7 / /
/) 77
J
PASS +PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i ' ` 4 Date: 1 / ` /6 Phone #: (503) 718-
CITY OF TIGARI)
BUILDING DIVISION "Y PERMIT #: PLM2005.00635
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2005
Phone: (503) 639- 4171wupt
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 76
SITE ADDRESS: 12244 SW SCHOLLS FERRY RD CLASS OF WORK:
SUBDIVISION: GREEh1W_AY TOWN CENTER LOT #: TYPE OF USE:
PROJECT NAME: DO B—TL
DESCRIPTION: Replace existing fixtures. Other fixtures: (1) drinking fountain.
OWNER: ESPP RETAIL LLC, PHONE #:
CONTRACTOR: R A WARNER PLUMBING PHONE #: 360-896 -0370
Inspection Request Scheduled For: Date: 11/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 021400 -01 360 -772 -2490 N
Corrections /Comments/ Instructions:
/
AINV.7
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-