Permit r
CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00268
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/16/2008
PARCEL: 2S 113AB -00300
SITE ADDRESS: 16037 SW UPPER BOONES FERRY RD 150 ZONING: I -L
SUBDIVISION: FANNO CREEK PLACE LOT: JURISDICTION: TIG
PROJECT: 20/20
Project Description: Installation of (3) break room sinks.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
OPUS NW Description SW FIRST AVE #1100 escription Date Amount
PORTLAND, OR 97201 [PLUMB] Permit Fee 6/13/2008 $72.50
[TAX] 12% State Surch 6/13/2008 $8.70
Phone : 503- 916 -8963 Total $81.20
Contractor:
MARXMEN PLUMBING INC
BEAVERTON, OR 97007 O AVE
BEA VER REQUIRED ITEMS AND REPORTS
BEA
Contact # : PRI 503 -579 -2200
FAX 503 -579 -2201
Reg #: LIC 102432
PLM 34 -161PB
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 Notif - I Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -010r ou may obtain copies of
these r -s or direc estions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue. By: / lord !� Permiftee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that busines • day.
This permit card shall be kept in a conspicuous place on the job site until comp : • .'n of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbin Permit An licatiQn ru ED
Building Fixtures iU FOR OFFICE USE ONLY
City of Tigard J� i 2008 Received /_ / 2 O G P No , � g.� ' �to g
II
• 13125 SW Hall Blvd., Tigard, OR 7223 Plan Review
llJ d b
C Plan Review
Phone. 503.639.4171 Fax:, .M..11960r 60, ARE" Date/By
Permit No 4102 8 -64090,
).1 n R I� Inspection Line 503.639.41t51 1 1 ` 11 (� Date Ready/By ® See Page 2 for
Internet www.tigard -or gcpo Op �(.,, � m 0 � 7`. � _ Notified/Method t (., Supplemental Information
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 (I) 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 INFpIj, ON AND L ATION i Site utilities
! 7
Job site address: /6 0 Gll//�� & ors JI Uy � I `" _ Catch basin or area drain 16.60
City /State /ZIP: Drywell, leach line, or trench drain 16 60
r Footing drain (no. linear ft. ) Page 2
Suite bldg. /apt. no. Project name: a ti lt � yTj��
Manufactured home utilities 110.00
Cross street/directions to job site:
V 1 n ` -W Manhol 16 60
( l
�./ 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
"TT. Backwater valve 16 60
Clothes washer 16 60
Dishwasher 16 60
I�PROPERTY OWNER I ❑ TENANT Drinking fountain 16 60
// L Ejectors /sump 16 60
(� eu Name: 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
A, P 1.(1Nn a A Ice maker 1660
Business name: Ni Interceptor /grease trap 16.60
Contact name: 114 4,,w Site z4cii Medical gas (value $ ) Page 2
Address: /6,1 g_2 W -C6 3 4 I x. Primer 16.60
City /State /ZIP: ES2a Roof drain (commercial) 16 60
L 3 cn1^
Phone: (5p+3) s_4(1.--)...20d Fax:: ( 7 t� d " +' ,Z2.0, Sink/basin/lavatory 5 16.60
' iA � Tub /shower /shower pan 16 60
Wt E -mail: , _S - Jl lq�''ociMR <U Q tVt
, u Urinal 16 60
CONTRACTOR Water closet 16.60
Business name: 54,144k/e- Water heater 16 60
Address: Other:
City /State /ZIP: Subtotal
Minimum permit fee $72.50 Ste,
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee $36 25 12
r ? I Lic. ��br c �' Plan review (25% of permit fee
CCB Lic.: if
1�2 i �( l Plumbing umbing c. no.
S tate surcharge 8 f
Authorized signatur:
�1 I. ge (12% of permit fee) TOTAL PERMIT FEE
Print name I„I pnl ai � ��' V Date: 1, - t3- This permit application expires if a permit is not obtaine within
F r • - 180 days after it has been accepted as complete.
• *Fee methodology set by Trr- County Building Industry Service Board
i \ Building \Permits\PLMF- PcrmitApp .oc 12/27/06 440- 4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1' 100' 55 00 0 to 2,000 $115 00
Footing drain - each additional 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 100' 46 40
Water Service - 1st 100' 55 00 Medical Gas Systems:
Water Service - each additional 100' 46 40
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55 00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46 40 $5,001 00 to $10,000 00 $72.50 for the first $5,000 00 and $1 52 for each
Fixture or Item Qty. Fee (ea) Total additional $100 00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001 00 to $25,000.00 $148.50 for the first $10,000 00 and $1.54 for
Residential Backflow Prevention Device each additional $100 00 or fraction thereof, to
(minimum permit fee $36 25) 27 55 and including $25,000.00
Rain Drain, single family dwelling 65.25 $25,001 00 to $50,000 00 $379.50 for the first $25,000.00 and $1 45 for
each additional $100 00 or fraction thereof, to
Inspection of existing plumbing or
and including $50,000 00
specially requested inspections - per hour 72 50
Subtotal: $50 00 and up $742 00 for the first $50,000.00 and $1 20 for
each additional $100 00 or fraction thereof
Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health cart facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
-Domestic Isometric or Riser Diagram
Drinking Fountain
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-4'
Car Wash Drain
Garbage -Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach /Refrig Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service 3 fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures.
I \Budding\Permits\PLM- PermitApp doc 12/27/06
CITY OF TIGARD r '` - •
BUILDING DIVISION PERMIT #: PLM2008 002 %B
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/20013
Phone: (503) 639 -4171 /I
Inspection Requests (24 Hrs.): (503) 639 -4175 �. _
INSPECTION WORKSHEET FOR DATE: 7/3012008 TIME: 7:01AM PAGE: Q5
SITE ADDRESS: CLASS OF WORK:
16037 SW UPPER BOONES FERRY RD 15(
SUBDIVISION: FANNO CREEK PLACE LO #: TYPE OF USE:
PROJECT NAME: 20/20
DESCRIPTION: Installation of (3) break room sinks.
OWNER: OPUS NW, PHONE #: 503- 916 -8963
CONTRACTOR: MARXMEN PLUMBING INC PHONE #: 503-579 -2200
Inspection Request Scheduled For: Date: 7/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 073437 -01 503.579 -2200 N
Corrections /Comments /Instructions:
C are C5L.-c, 0
o
)g ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 07/ i i (.i ^,....2- Date: -2 ((! 0 7) Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: pLM 200F =ovZ6 8
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ( I C � O Q
Phone: (503) 639-4171 Ak,
f � l
.. 1
Inspection Requests (24 Hrs.): (503) 639 -4175 F :_..
INSPECTION WORKSHEET FOR DATE: G. i 1 at 1 07. TIME: PAGE:
SITE ADDRESS: /6 03 - 7 SLJ lopes G J o L.c..- F"e.✓ 4. CLASS OF WORK:
SUBDIVISION: Sv; 4-c., (sp LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: 0 etn 5 MA PHONE #:
CONTRACTOR:MVri(M00 pIvii_lo(N PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 (i6..,1uS1,.9, 11! 219 DU
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: 0 \ \\ ►rat— Date: & \ 1.6k\ OT) Phone #: (503) 718-