Permit , . .
A, . CITY OF TIGARD PLUMBING PERMIT
•
�,L 4.�I�, DEVELOPMENT SERVICES DATE ISSUED: #: : P i 91 -00052
13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171
SITE ADDRESS: 14945 SW SEQUOIA PKWY 100 PARCEL: 2S112AD -01000
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Tenant Improvement - cap off (1) floor drain, cap off (1) sink, reset (1) sink
FEES
Owner: •
Type By Date Amount Receipt
PACIFIC REALTY ASSOCIATES PRMT CTR 2/19/02 $72.50 27200200000
15350 SW SEQUOIA PKWY #300 -WMI 5PCT CTR 2/19/02 $5.80 27200200000
PORTLAND, OR 97224
Total $78.30
Phone 1:
Contractor:
POWER PLUMBING CO
P BOX 23144
TIGARD, OR 97281 REQUIRED INSPECTIONS
Rough -in Insp
Phone 1: 244 -1900
Reg #: 244-1900
52378 Insp existing /capped fixtures
PLM 34 -150P6 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: Permittee Signature:
7/
Call (50 639 -4175 by 7:00 P.M. for an inspection needed next business day
07/13/2001 09:18 FAX 5036847297 City of Tigard Im002
Plumbi Permit Application `
, '444. City Daoett+oeivod: a 9 di_ F+rrm;t j7 ooz_r7vos2
...,41...-.11 . . " "•► of g Sewer permit no.: Building permit no.:
City of-Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 J ea/a
Phone: (503) 639 -4171 t3o ppl, n0.: • Expire date:
Fax: (503) 598 - 1960 • Dateissued: _ By: I Rocciptno.:
Land use approval: . Case file no.: Paymenttype:
T11'L 01 1'J:ItiMIT
❑ 1 & 2 family dwelling or accessory O Commercial/industrial O Multi Xl errant improvement
❑ New construction XAdd idon/alteratlon/teplacement ❑ Food service U Other.
• .1011 SITE INFORMA7 TON FEE SCHEDULE (tor curial information uce checklist)
Job address: /19'15 SW S6q� r PhW y Description Oty. Feo(� Total
Bldg. no.: I Suit�no -: /00 1 New 1- and 2 dwellings only:
(Includes 100 tt, for each utility connection)
Tax map/tax lot/account no.: SFR (1) bath
Lot: (Block: Subdivision: SFR (2) bath
Project name: /( o-'K_ �' e � SFR (3) bath _
City/county: g � : `� 72� Each additional bath/kitchen
Description and location of work on premises: &p -o / A. ( Steafilitiete
1 SeArlt., j Set mw
/ 3 /,u,� i S3• ttsi'i.. jt Catch basin/area drain
Est. date of completionfinspection: Dryavells/leach line/trench drain
Footing drain (no. lin. ft.)
PA Manufactured home utilities
Business:
ola]E� + /w*^ i rhos Manholes
Address: P.O. i3p 194'/8 Rain drain connector
City: E AAmnon I Smm02I ZIP:9 7 2$0 Sanitary sewer (no. lin. ft.)
Phone: �` pop Faxaytyge E-mail: Storm sewer (no..lin. ft.)
CCB no.:,-2,37,6 Plumb. bus. reg. no: 35/../50
ater service (no. Im. (t.
�1 hnctiv lie, no.: / 3,g2- }Mine or item:
Contractor's representative signature 06 Absorption valve
Print name: , 6 e s Date :2 I -eL Back flow preventer
Backwater valve
Basins/lavatory
•
Name: J `OG'l• G Clothes washer
' Dishwasher
Address -n fy( 19
City: ? ` � • e
I State:02 I ZIP: / 12E10 Drinking fountain(s)
eA- we er n A. jectorg/sume_
Phone;'ytf- 00 FaxV4y$$?S E-mail: ension tank
Fixture/sewer cap
Nance (print): cvc - T.... Floor drains/floor si lib Cr p -a / . — / (e -- •
Mailing address: Hose bibb Garbage disposal '
Hose
City: naked I Sts iz_ I ZIP: ice maker
Phone42s f — &36p I Fax:(0�7 5SI 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 o w n as per ORS Chapter 447. Sink(s), basin(s), lays(s) l i t ' > M. ' 33.' =„
Owner's signature: • Date: Sump .
IIIIIIIIIIIIIIIIIMMIIIEEESIIZMIIIMIIIIMIIII Tlrbs/shower/shower pan _
Name: Urinal
ame:
Water closet •
Address: Watcr heater
City: • 1 state: _1 ZIP: Other
Phone I Fax: I E-mail: - Total .111s%
Na all j cal azep� i ends. pleue rsU Dem o for inrunnmm Notice: This permit application Minimum fee $ 72 • S�
D Visa aar.Card expires ifs permit is not obtained Plan roview (at _ %) _
D M
t cm" ®eQ / / within 180 days after it has been State surcharge (B %) .... $ 6-. �C
&
Nme or eran®etaer .. man m �du mid �` accepted as complete. TOTAL $ 7R . 3
s
Cadbelda ripa0O Amami 440616 (6� 0∎00m)
•
07/13/2001 09; 18 FAX 5036847297 City of Tigard X003
• PLUMEING PERMIT FEES: . •
- ze :sF;. :i'� ,- � - - . ( ri l l' Fr;":::-';4:571 7^ 7C' F F:r
'L'i;�'`� " `� � ` fit: = � � , ' .. � .F._I �� ,1 '� j;1� ., '.10...."1:','- '.10...."1:','- ,.L l, p : Z
. art- . :.�� l ` :
: _,, :,,; �y'�:] • -
, �'G
rgi tAU1UI , . r t 'I , nl M y
l::.. t v f i T:itri s' "gi (� ' �.i UJ.3. ~ I I C•� Lr[f`��)r +11r,"�15Yi l F i 1 r ," (ter'' I !?;t:� ( � ( L� � SJ e2,51; , � f.7
il:ua'l:.a+:, J t:_, I• � (Z(n , k" 1 ` r ' � cJ p
Sink a. _ �, 2 ,6 33 ?. r �., i i,mi I n.t r, S +QI ; ' u� r r� I, ( 1, r
t
Lavatory - 18.80 xl I', ti _,r ; .ti 'i r�O i'sl1 [v
Tub or Tub/Shower Comb. 16.80
Two 2 bath 5350.00
Shower Only • 16.60 Three 3 bath � $399.00
Water Closet 18.80 SUBTOTAL il,Yf "
Urinal 18.60 r4 STATE SURCHARGE lantINEME •
- Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL REMEREMINil am
Garbage Disposal 18.60 - TOTAL Ir:' ^r "
Laundry Tray 18.80 .
Washing Machine 16.80
Floor Drain/Floor Sink 2 c 16.60 1 6. Lc
3• • 15.60 PLEASE COMPLETE:
4 16.60 .
Water Heater O conversion 0 like kind 16.60 ,r 'r 4 ; i ,' ;dP'e�lu'"�"�7i1U- i . oa)PPri, 3`r_t' , ,
Gas piping requires a separate mechanical
I.
• I `
. - ;�. �+'�, � a� ) r . •� { I , -V"; fl
• permit '.' I' i I_ . u ` ati.:iGiiYi t ' : '4 . [' /a �:.. ..t.''
MFG MFG Home water Service 48.40 Sink 1 / •
• MFG Home New San/Storm Sewer 46.40 Lavatory
Hose Bibs • 16.60 - Tub or Tub/Shower
Combination
Root Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Foctures (Specify) 16.60 _
Dishwasher
Garber Disposal
• Laundry Room T y
Washing Machine
•
. • Floor DraWSink: 2' i
Sewer- 1st 100' 55.00 r
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 & Rein Drain - 1s1 100' 55.00
Sturm & Rain Drain - each additional 100' 48.40
Commercial Back Flow Prevention Device 46.40
Residential Baddlow Prevention Device' ' 27.55
Catch Basin 16.60 -
r
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections , jer/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 18.60 • •
•
QUANTITY TOTAL ;a .. a :, , Al -F
laorrwt or riser diagram la required If % ' A . , , ' r itii'n
Quantity Toter IS > 9 x" l
*SUBTOTAL 1 h} ' .� :,; 7� 50
. 8% STATE SURCHARGE / ': ° ' ?' 6
"PLAN REVIEW 25% OF SUBTOTAL . -.,� ' v T, ' .
Required only H Iti2rre qty. total is > e •• ...,;
TOTAL 1 ?`t - „• !•- :e::.� $te. // "Se
•
'Minimum permit fee le 17250.6% state surcharge, except Residential Bacillar
Pre.erulon Device. which is $36.25 • 9% state surcharge.
" New Con(mereJat Buldings roputre plans each isometric or dew dbg orhd
plan review.
I Ads blfotms\plm•foea.doc 1010/00 •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
d BUP
Date Requested 1 - i 6 AM PM BLD
Location //7 4/S . S - set u . o' 4- fAd I t" Suite MEC
Contact Person Ph Z/( - /Pd € 1 PLM 2011. -G' i L_
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
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
P RT FAIL
Under Slab
Top Out
Water Service
Sanitary Sewer ,
R - in Drains
1 111ML
4::=I PART FAIL
NICAL
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 -- (y �� % l L
Other Date ��! Inspector 7 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
'CID OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received / Date Request - - °� AM PM BUP
Location / ( A .v Suite u MEC
Contact Person Ph ( ) PLM 2 SZ
Contractor Ph ( ) LI y I 0 SWR
BUILDING Tenant/Owner m 17 ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & B
- ier S -b
- ; --
a er ervice
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fin
/"T ( PART FAIL _
CHANICAL
Post & Beam
Rough -Iri
Gas Line �`/1 a (
Smoke Dampers
Final
PASS PART FAIL �
ELECTRICAL cc..// CC-4
Service
ab
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 Dat -6Z Inspector f/ � • Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL