Permit i
CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 - 00367
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/26/2007
PARCEL: 25101 DA - 01900
SITE ADDRESS: c ! ! n SW VARNS ST ZONING: C -P
SUBDIVISION: NELSON VIAL OFFICE LOT: 003 JURISDICTION: TIG
PROJECT: NELSON VIAL OFFICE ADDITION
Project Description: Site utilities.
CLASS OF WORK: NEW 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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: g0 ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: 200 ft
Owner: FEES
NELSON VIAL, LLC Description Date Amount
7000 SW VARNS ST
TIGARD, OR 97223 [PLUMB] Permit Fee 4/26/2007 $156.40
[TAX] 8% State Surcha 4/26/2007 $12.50
Phone : Total $168.90
Contractor:
PRO DRAIN & ROOTER SERVICE, INC
3300 NW 185TH AVE #213
PORTLAND, OR 97229 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -533 -0430
FAX 503- 715 -4989
Reg #: LIC 108504
PLM 26 -776PB
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 Noti _ - - ter. Those rules are set forth in OAR 952 -0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these es or direct que- 'o • OUNC by calling 503.246.6699 or 1.800.332.2344.
,/ 41111Ik
sued By: / / � Permittee Signature: A 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.
7 loa_501 .
Site Utq ities
Plumbing Permit An 1 vE® `i„,:...,,, FOR OFFICI . U:L ONI_1
City of Tigard Received "� Permit o
13125 SW Hall Blvd., Tigard, OR 97223 2 $ 2006 Date/By Plan Review / . - 1 • L1" 7
Phone: 503.639.4171 Fax 503.598 I96QgU\- un„ ai ' � Date/By Other Permit No.
s ection Line: 503.639.4175 I ''• I , Y
24- Hour In
Internet: www.ci.tigard.or.us CITY OF TI GA R _ • I., _ � I Date Ready/By Iu "s ® See Page 2 for
g G D1Vl • Notified/Method (� Supplemental Information
WLDIN
TY P E WORK FEE* SCHEDULE ;,
❑ New construction El Demolition For special information use checklist.
Description I Qty. I Ea. I Total
y i,Addition/alteration/replacement ❑ Other: New 1 -2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY,00 'CONSTRUCTION. • ' _ SFR(1)bath 249.20
❑ I- and 2 -family dwelling 'Commercial /industrial SFR (2) bath 350.00
El 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 INFORMA AND LOCATION Site utilities
Job site address: 700 0 Sto 1/Q4 I .s,>(• Catch basin or area drain 16.60
City /State /ZIP: fc r +144,4 0• 97 --'3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: kelsokq 1/;41,1 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... ?0 0 ) Page 2 /0/ • Yv
Subdivision I Lot no.:
Water service (no. linear ft.: 1 00 ) Page 2 55
Fixture or item
Tax map /parcel no.. Absorption valve 16.60
p y DESCRIPTION OF WORK Backflow preventer Page 2
5 14€ () ti !f / 1 [ .S Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
PROPERTY OWNER 0 TENANT
^' � 1 I � Ejectors/sump 16.60
Name: (Q; 1:�1 01 V i Expansion tank 16.60
Address: 1 O y D 5 g. kr.e,r Fixture /sewer cap 16.60
City /State /ZIP: "Ho 11s b v/ O Or 9 7(.. 3 Floor drain/floor sink/hub 16.60
Phone: (7) 62_8- a it z. - 2 __ Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
- 1g1L APPLICANT ❑ CONTACT PERSON
t Q/
Ice maker 16.60
Business name:
1 IA.,/ II fLGY�9�1 L L r, Interceptor /grease trap 16.60
Contact name: 11 Am_ e Medical gas (value: $ ) Page 2
Address: 7! 4 $- Sw VOt- 5 S J . T / . Primer 16.60
City /State /ZIP: e81-. or q7,2,-"?-, Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
,9u
Phone: (2 7-G O 0 l a - 5 Fax:: ( ) -
)� I', Tub /shower /shower pan 16.60
E-mail: f 1e3� (i U 4 k 4r7 • CO ell Urinal 16.60
CONTRACTOR _ Water closet 16.60
Business name: 1 0K y. Water heater 16.60
Address: Other:
City /State /ZIP:
Subtotal
Minimum permit fee: $72.50 �� it
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 (lb
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) -e-
Authorized signature: p State surcharge (8% of permit fee) ‘ .5,U
TOTAL PERMIT FEE A
Print name: f. f v 4 Pt in Date. 7/ 4 This permit application expires if a permit is not obta . e . within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t\ Building \Permits\PLMU- PermitAppdoe 06/05 440-4616T(l0 /02/COM/WEB)
I
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 - I g 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,00110 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'
l Medical Gas Systems:
Water Service - each additional 100' 46.40
Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit • Fee: .
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' i 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 Backfiow 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
Inspection of existing plumbing or each additional $100.00 or fraction thereof to
•
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001 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 Complex Structures • -
Are you capping, adding or replacing fixtures? If "yes ", A `complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
' Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: Replace ❑ 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 providing services to human beings.
Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA I3 -D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the'above.
-3"
4" .
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for 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 Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet 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 \Budding\Permns\PLM- PermitApp doc 07/06/05
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ht.M2006 G03ti7
13125 SW Hall Blvd., Tigard,' OR 97223' "' DATE ISSUED: 4/26/2(107
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1 44
INSPECTION WORKSHEET FOR DATE: '10/5/2007 TIME: 7 :01AM PAGE: 10
SITE ADDRESS: 0699E SW VARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE
DESCRIPTION: Sito utilities. 7124/07 ADD 30' of sewer line.
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: PRO DRAIN & ROOTER SERVICE, INC PHONE #: 50_633_0 00
Inspection Request Scheduled For: Date: 10/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 057059.02 503-209-7779 N
Corrections /Comments / Instructions:
Cu res
•
•
•
•
gl PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CID ' 11 \ Date: 16 � S O., Phone #: (503) 718-
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PL.M200S -00367
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR - DATE: 10/2/2007 TIME: 7:04AM PAGE: 39
SITE ADDRESS: 06996 SW YARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE
DESCRIPTION: Site utilities. 7/2'1/07 ADD 30' of sewer line.
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: PRO DRAIN & ROOTER SERVICE, INC PHONE #: 503533 -0430
• Inspection Request Scheduled For: Date: 10/2J2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 056775.01 503209.7779 N
Corrections /Comments /Instructions:
P .� U; dk( A -ccr✓' Se ✓Yi c Co C.4,1 i 6 i E V ov
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: gl Date: / Ohl di. Phone #: (503) 718 - •
•
•
•
CITY OF TIGARD . , _ r
BUILDING DIVISION PERMIT #: PLIVI2005-00367
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2612007
Phone: (503) 639 - 4171 , 1i�1
Inspection Requests (24 Hrs.): (503) 639 -4175 �_'.. " _..
INSPECTION WORKSHEET FOR DATE: 10/2/2007 TIME: 7:04AM PAGE: 40
SITE ADDRESS: 05996 SW VARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE
DESCRIPTION: Site utilities. 7/24/07 ADD 30' of sewer line.
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: PRO DRAIN & ROOTER SERVICE, INC PHONE #: 503 - 533 -CA30
Inspection Request Scheduled For: Date: 10/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
C:05 Sanitary sewer 056774 -01 503.209.7779 N
Corrections /Comments / Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: � T Date: /d /21 Cr? Phone #: (503) 718 -
CITY"OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006.00367
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4126/2.007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/27/2007 ') TIME: 7:00AM PAGE: 13
SITE ADDRESS: SW VARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL OFFICE ADDITION
DESCRIPTION: Site utilities.
OWNER: NELSON VIAL, LLC, PHONE #:
CONTRACTOR: PRO DRAIN & ROOTER SERVICE, INC PHONE #: 503
Inspection Request Scheduled For: Date: 4/27/2007 Pour Time: _ A
Code # Inspection Description Confirm # Contact # Me- .g-
Av `./
335 Rain drain 047287 -01 503- 740-.012v Y
Corrections /Comments /Instructions: , / A Q�
l ?/0Of0. 000/0 I C 4
- y1 6-c
4.610 qn
`'■S s k QLr-c
(19 A
•
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
l VlA 411'1- (b1 Inspector: A Date: Phone #: '(503) 718- ��