Permit 7 // g ( 0- 7 w 7 7
C
( I l Y O F TI GA
a PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00305
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/16/2007
PARCEL: 1 S135BB -00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I -
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HEMCON
Project Description: (2) 2" floor drains. 7/18/07, ADDING (3) ADDITIONAL FIXTURES, ALL RELOCATES.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 0
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
HEMCON MEDICAL TECHNOLOGIES
10575 SW CASCADE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/16/2007 $72.50
[TAX] 8% State Surcha 7/16/2007 $5.80
[PLUMB] Permit Fee 7/18/2007 $10.50
Phone : 503-245-0459 [TAX] 8% State Surcha 7/18/2007 $0.84
Contractor: Total $89.64
CASCADE MECHANICAL SYSTEMS INC
PO BOX 399
ESTACADA, OR 97023 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 630 -4492
FAX 503- 630 -5510
Reg #: LIC 127012
PLM 3 -324PB
•
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 r s or direc estions • OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss ed By: 4 Permittee Signature: �``
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.
` CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00305
•
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/16/2007
PARCEL: 1S135BB-00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I -
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HEMCON
Project Description: (2) 2" floor drains.
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: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 0
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
HEMCON MEDICAL TECHNOLOGIES
10575 SW CASCADE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/16/2007 $72.50
[TAX] 8% State Surcha 7/16/2007 $5.80
Phone : 503- 245 -0459 Total $78.30
Contractor:
CASCADE MECHANICAL SYSTEMS INC
PO BOX 399
ESTACADA, OR 97023 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 630 -4492
FAX 503- 630 -5510
Reg #: LIC 127012
PLM 3 -324PB
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 B / Permittee Signature
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.
Plumbing Permit Applica� — ` ; ij
s � ``° FOR OFFICE USE ONLY
Building Fixtures
111111 City of Tigard JUL 16 Zo % Received 7 P ermit N M n .90305 • 13125 SW Hall Blvd., Tigard, O 9 223 E Plan Review
�(o/D 1313 1 \�� l
Plan Review � �7
_ . Phone 503 639 4171 Fax. 503.5518h 9 4 0 O . 1 J 1 1 a ateBy Other Permit N c � ( , ) � / . e 7 , 7 7
T I G A R D Inspection Line 503 639 4175 I r Ti n ate Ready/By lures . El See Page 2 for
Internet www tigard -or govt L - 1 J( j , a fied/Method• J Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition For special information use checklist
Description I Qty I Ea. I Total
i d 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 e'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: !QS' -75 stcl C Catch basin or area drain 16.60
City /State /ZIP: ! -_ ,�J � � ,D---4 2 � Drywell, leach line, or trench drain 16.60
C � �3 Footing drain (no. linear ft ) Page 2
uite/�Idg. /apt. no.: r 3 p I Project name: We-191C-491/1 .
�� 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
tlid rap - -N ooa .. . g Backwater valve 16 60
Clothes washer 16 60
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 / oZ 16 60
•
Phone: ( ) Fax: ( ) Garbage disposal 16 60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16 60
Ice maker 16 60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value $ ) Page 2
Address: Primer 16 60
City /State /ZIP: Roof drain (commercial) 16 60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 16 60
Tub /shower /shower pan 16.60
E -mail: Urinal 16 60
CONTRACTOR Water closet 16.60
Business name: r ce 7e. t�.
� s Water heater 16 60
Address: /10 4 /(44, PP
all Other
City /State /ZIP: 1� s oe. 97o 3 _ Subtotal
57 C4 i Minimum permit fee $72 50
Phone: (5o3 ) to 3ey- L fc1q Z Fax: (o3) 6,30 , ( d Residential backflow minimum permit fee $36 25
CCB Lie.: c 776 1 L Plumbing Lic. no.:"� -3, 13 Plan review (25 % of permit fee)
6 ` State surcharge (8% of permit fee) �/
Autho zed signature: j TOTAL PERMIT FEE l b. 3,
Pr « ` 7 Dat ' Th is permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
'7 — /6 .6 *Fee methodology set by Tri -County Building Industry Service Board.
t\Bwlding\Permns\PLMF- PermuApp doc 12127/06 440- 4616T(10/02 /COM/WEB)
Plumbing Application - City of Tigard .
Page 2 - Supplemental Information 1
'
Fee Schedule: R Fire Suppression Systems:
' Site'Utilities '' - -, - _ .' `Qty• `Fee'(ea)'_' ` Total ,,SgaarevFoo - 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
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' 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
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 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 care 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
Drinking Fountain Isometric or Riser Diagram
Eye Wash : ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
• -3"
-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 . *Not . I t he fixture work under this permit results in an
- Commercial increase of sewer EDUs,'a sewer'permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing, permit can be issued.
Washer - Clothes '
Water Extractor , • ' t' !.
Water Closet - Toilet -
Urinal
Other Fixtures -
I \Bwldmg\Permns\PLM- PermnApp doc 12/27/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PtA 2 O7- 003x75
13125 SW'Hall Blvd., Tigard', OR 97223 DATE ISSUED: 7/1€/2007
Phone: (503) 639 -4171 ' �+ ��
Inspection Requests (24 Hrs.): 639 -4175 °''IL
INSPECTION WORKSHEET FOR DATE:' 4 /Mt:ZO08 TIME: 7:08AM PAGE: 14
SITE ADDRESS: 107; SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE
PROJECT NAME: FIEMCON
DESCRIPTION: (2) 27 flea '1r`a:ns .7118I07, ADDING (3) ,ADDITIONAL ; IX:l'URES, ALL REI OCATES.
OWNER: HEM(. :01 MEDICAL 'TECHNOLOGIES, PHONE #: 503-215-0459
W
CONTRACTOR: CASCADE M CHANI CAL SYSTEMS INC PHONE #: W3-00 =1492
Inspection Request Scheduled For: Date: 4/30!220,t)3 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
•
4 ;9 PItimi inn final ,069089 -03 503.6238802 y •
•
Corrections/Comments/Instructions: �^ t� o /�
P l (/L1 -r �O l ■n G� T (t,f1/kl PL/ v l G.) D 0 02, i (n Are 1rio J (j 1 2 5iV M
•
•
•
•
•
•
[ PASS ❑ PARTIAL APPROVAL 111 CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION • ❑ ADDITIONAL FEES ASSESSED
Inspector: Qrb Date: (4 (2; Phone #: (503) 718-
CITY OF TIGARD z f- . -
BUILDING DIVISION PERMIT #: PLM2007- 00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/16/2007
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/19/2007 TIME: 7:03AM PAGE: 39
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: (2) 2° floor drains. 7/18/07, ADDING (3) ADDITIONAL FIXTURES, ALL RELOCATES.
OWNER: HEMCON MEDICAL TECHNOLOGIES, PHONE #: 503 - 245.0459
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503 - 630 - 4492
Inspection Request Scheduled For: Date: 7/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 052351 -05 503 - 523-8802 Y
Corrections /Comments /Instructions:
c L, d ob �-. �� v V a-- 01 c.-A.
X PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: — 711 4 / / ),07 Phone #: (503) 718-
•
CITY OF TIGARD .
BUILDING DIVISION PtRM�
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 /16/26., • -
Phone: (503) 639 - 4171 $ ! 1
Inspection Requests (24 Hrs.): (503) 639 -4175 L. "'I
INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 40
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: (2) 2" floor drains.
OWNER: HEMCON MEDICAL TECHNOLOGIES, PHONE #: 503 - 245 -0459
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503 - 630 -4492
Inspection Request Scheduled For: Date: 7/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 052136-01 503 -523 -8802 Y
Corrections/Comments/Instructions:
IA a `.gr Lab S.e /v.Cer goo i^-..,33
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7//) JO Phone #: (503) 718-
CITY OF TIGARD . • ,.
BUILDING DIVISION PERMIT #: PLM2007 -00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/16/2007
Phone: (503) 639 -4171 j +�
Inspection Requests (24 Hrs.): (503) 639 -4175 �! ' I „
INSPECTION WORKSHEET FOR DATE: 7/17/2007 TIME: 7:03AM PAGE: 383
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: (2) 2 °' floor drains.
OWNER: HEMCON MEDICAL TECHNOLOGIES, PHONE #: 503 - 245.0459
CONTRACTOR. CASCADE MECHANICAL SYSTEMS INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing undersiab 05213u --02 503- 523 -8802 N
Corrections /Comments /Instructions:
X PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cij li ^-t- -/ +' i l 3 '' 2 — Date: ? J)) /6 Phone #: (503) 718-