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Permit
CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00147 �. •,� �I DATE ISSUED: 5/12/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD - 01601 SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 ZONING: I - P SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 001 JURISDICTION: TIG Project Description: Add 1 clothes washer. Capped (2) sinks. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES PACIFIC REALTY ASSOCIATES 15350 SW SEQUOIA PKWY #300 -WMI Description Date Amount PORTLAND, OR 97224 [PLUMB] Permit Fee 4/20/2006 $72.50 [TAX] 8% State Surcha 4/20/2006 $5.80 Phone : Total $78.30 Contractor: HEINZ MECHANICAL INC 2615 NW ST HELENS RD PORTLAND, OR 97210 REQUIRED ITEMS AND REPORTS Contact # : PRI 220 -0855 Reg #: LIC 43866 PLM 34-165PB 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. Issued By: Permittee Signature: L ` l 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. ! S 1_ ► D II Plumbing Permit Appl �) . L ) \�., _ I FOR OFFICE USE ONLY City of Tigard � DateB y (J Permit No.:e o 4 , . p /y7 r 2C • 13125 SW Hall Blvd., Tigard, OR 97223 .• ,J15 Plan Review . Phone: 503.639.4171 Fax: 503.598.1960 !� I Other Permit No. Date/By: .Ic16V6 � 0 74/ �/ 24- Hour Inspection Line: 503.639.4175 0 , OF 1 f �,. c. � Date Ready/By: yis ` la See Page 2 for Internet: www.ci.tigard.or.us 86W_l7fiil(` Milli °ItI4 Notified/Method: , Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total ISA Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ I - and 2- family dwelling IJ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 16 1 S S 5 w S elQ l.t. C9 1L ,A, ' vg_L,) 7 Catch basin or area drain 16.60 City/State /ZIP: X, / O Drywell, leach line, or trench drain 16.60 Suite /bItIrtaptrrto.: - - Project name: C R•• G % . lsP:/1 (' Footing drain (no. linear ft.: ) Page 2 -,� Manufactured home utilities 110.00 Cross street/directions to job site: 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 A 0 0 V +■fl-em Ar W (q-5 bl -e-a- .1 p X • Backwater valve 16.60 Clothes washer 4, 16.60 Dishwasher 16.60 n PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: p r G,, t ---zL V G GR ? o 2Ps E G e-- 1∎0 -' Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City/State /ZIP: Floor drain /floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT CONTACT PERSON Hose bib 16.60 . Ice maker 16.60 Business name: to lit- #Z CVN,L- f ,q 1.L/}. L ....C, Interceptor /grease trap 16.60 Contact name: G A,d' L b 2 1., p G Medical gas (value: $ ) Page 2 Address: 2t' / s r y L L Liz re 0 Primer 16.60 City/State /ZIP: po L. 4 L A 1`r ` 02 C 1 LID Roof drain (commercial) 16.60 Sink/basin /lavatory 2 16.60 Phone: (503) 2.-2._c) - O e , 5-s- I Fax: : (603) - 2_ - 2_0 -026 a Tub /shower /shower pan 16.60 E -mail: e 0...l- e © t\eI. n^ a C- b4• Cow, Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: v } C L , ILI 2 i n... t G (rf fi I_-k L c A' (. t'tsL.G, Water heater 16.60 Address: 'LCo 6 6 1.1 W s' T H 1.5 e- Kis 2 9 Other: City/State /ZIP: P p/2.... T V 4 O 69 Q. ct., - 1, 3 t, 0 Subtotal Minimum permit fee: $72.50 Phone: (So7.,.) 22_c1 Q if 6 - Fax: (6o31 7_,2_c) - c72 6e1 Residential backflow minimum permit fee: $36.25 7a .cc) Plan review (25% of permit fee) CCB Lic.: 4 g c to Plumbing Lic. no.: z 4... b (g2 PIS State surcharge (8% of permit fee) S Authorized signature: TOTAL PERMIT FEE 17 . 30 Print name: (2 1. a ..{ l�'-i yt , p G e Date: 4 . L4'- CA 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. i:\ Building \Permits\PLM- PernitApp.doc 06/05 440 -4616T(10 /02/COM /WEB) Accumulative Sewer Tally Parcel # 2S112DD -01601 Tenant Name; 'ridgeport MRI This SWR# SWR2006 -00074 Site Address: 15755 SW Sequoia parkway '. This PLM #'PLM2006 -00147 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #s values Baptisery/Font 4 0 0 0 0 0 Bath - Tub /Shower 4 0 0 0 0 0 - Jacuzzi/Whirlpool 4 0 0 0 0 0 Car Wash - Each Stall 6 0 0 0 0 0 - Drive through 16 0 0 0 0 0 Cuspidor/Water Aspirator 1 0 0 0 0 0 Dishwasher - Commercial 4 0 0 0 0 0 - Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 0 0 0 0 -3inch 5 0 0 0 0 0 - 4 inch 6 0 0 0 0 0 - Car Wash Drn 6 0 0 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 0 0 0 0 0 - Commercial (to 5 HP) 32 0 0 0 0 0 - Industrial (over 5 HP) • 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 • 0 0 0 0 0 Oil Sep (Gas Station) 6 0 0 0 0 0 • Rec. Vehicle Dump station 16 0 0 0 0 0 Shower - Gang,(per head) 1 0 , 0 0 0 0 - Stall 2 0 0 0 0 0 Sink - Bar /Lavatory 2 0 0 0 0 0 - Bradley 5 0 0, 0 0 0 - Commercial 3 0 0 0 0 0 - Service 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 1 6 1 6 Water Extractor 6 • 0 0 0 0 0 ' Water Closet - Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 0 0 1 6 1 6 Current Fixture Value 6 divided by 16 = 0.4 Current EDU 1 EDU = $ 2,600 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change 6 divided by 16 = 0.4 over (under) $ 1,040.00 • Enter EDU Change Here; 0.4 Notes: Authorized Name /Signature: BARBARA BUTLER Date: i 4/20/2006 .. ' ' Building Division • ' Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. is \Building \Sewer Tally \SewerTallySheet.xls 7/1/05 CITY OF TIGARD BUILDING DIVISION PERMIT #: Pf M2006 -00147 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 Phone: (503) 639 -4171 41114fit Inspection Requests (24 Hrs.): (503) 639 -4175 , 1L. INSPECTION WORKSHEET FOR DATE: 8/7/2006 TIME: 7 :02AM PAGE: 78 SITE ADDRESS: 16765 SW SEQUOIA PKWY 100 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE: PROJECT NAME: BRIDGEPORT MRI DESCRIPTION: Add (1) clothes washer, cap (2) sinks, resulting in no increase of EDU. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: HEINZ MECHANICAL INC PHONE #: 220.0655 Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 034422 -01 X371- 563 -369 Y Corrections /Comments /Instructions: L 1 6 or f /____ _.,, frI I" - / .yi,p SS ❑PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS L FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: s ) Phone #: (503) 718- �t 'S Y W ' CITY OF TIGARD BUILDING DIVISION PERMIT #: R-M2006- 001E1/ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 51 Phone: (503) 639 -4171 , �.r `� Inspection Requests (24 Hrs.): (503) 639 -4175 �' 1 L INSPECTION WORKSHEET FOR DATE: 5/15/2006 TIME: 7.O4AM PAGE: 98 SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 CLASS OF WORK: SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE: PROJECT NAME: BRIDGEPORT MRI DESCRIPTION: Add 1 clothes washer. Capped (2) sinks. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: HEINZ MECHANICAL INC PHONE #: 220 -08355 Inspection Request Scheduled For: Date: 5/15/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 20 Plumbing rough -in 029I34601 971-56'3 N Corrections /Comments /Instructions: , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED . k_., , Inspector: fl I Date: a . Phone #: (503) 718 -