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Permit • CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00266 T[GAR.D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/21/2007 PARCEL: 1 S 135BB -00501 SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I - P SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG PROJECT: HEMCON Project Description: 30' of trench drain and (1) 4" floor drain; other fixtures include (1) primer. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: F1 FLOOR DRAINS; 1 TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES HEMCON MEDICAL TECHNOLOGIES Description Date Amount 10575 SW CASCADE TIGARD, OR 97223 [PLUMB] Permit Fee 6/21/2007 $72.50 [TAX] 8% State Surcha 6/21/2007 $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 -0 to ou m- obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. j Issued By: G j / j � `� 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 Applicati t nt, pJ - - g-uJ .242 00 7.-00/ r ti�1 Building Fixtures JUN 2 1 2007 FOR OFFICE USE ONLY City of Tigard Dat ( 2-I o SL Permit No.. pi_ 6 _se — is • 1 4 ■ 13125 SW Hall Blvd , Tigard, OR r a I. n Review (3u9 19 I Phone' 503.639 4171 Fax: 503. 9 0 ur i ��pli p ` .'te/By Other Permit No.. TI G A RD Inspection Line. 503639.4 175 y , � � , T � �� 4 � y� i R eady/ th o lu See Page 2 for Internet www tigard -or gov lJ j� 1j� �/ �4 e d/M ethd 1 Supplemental upplemental Wormation TYPE OF WORK FEE* SCHEDULE ❑ New construction 0 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 (1) bath 249 20 ❑ 1- and 2- family dwelling ,ommercial /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: OF _.. 5 � G a v / e /30 Catch basin or area drain 16 60 City /State /ZIP: -J5 6,,,. 0 972 72 Drywell, leach line, or trench drain 16 60 1� I / c'p y Footing drain (no. linear ft _) Page 2 / Suite/bldg./apt. no.: Project name: Manufactured home utilities 1 10 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 1 ` �'rPl�t c k �r,• I ►� 30 Backwater valve 16 60 Clothes washer 16 60 Dishwasher 16 60 ❑ PROPERTY OWNER ❑ 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 I 16 60 I( .00 Phone: ( ) Fax: ( ) Garbage disposal 16 60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16 60 Ice maker 16 60 Business name: Prom r ,P� � �, j tee f e 1 _O bi t P hie U Interceptor /grease trap 16 60 Contact name: Medical gas (value $ ) Pagc 2 Address: /OS S af C c ask clr l_L/e Primer 16 60 ! � _ (610 City /State /ZIP: -/ > c� .ci _OP 9> 2 Z - Roof drain (commercial) 16 60 s I r Sink/basin/lavatory 16.60 Phone: (53) 2 ( _as/ S - s/ , Fax:: ( ) Tub /shower /shower pan 16 60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16 60 Business name: ' J C de pe st, q , ; . c / n/f, y� � S Water heater 16 60 Address: R�� x ( � Other Subtotal City /State /ZIP: j-- ./..,,,, Cq c ,,/, ‘ `9 E. 97 Minimum permit fee $72.50 Phone: ( ) 0 . . . . 7 0 .-9c./7 z Fax:) �2 Q — 7 O Residential backflow minimum permit fee $36 25 2 CCB Lic.: /? > , ) Plumbing Lic. no.: 20? Plan review (25% of permit fee) Authorized signature: State surcharge (8% of permit fee) 5 - grj A _ TOTAL PERMIT FEE '39,10 Print name: � �' /T ��a Date: -- . r_07 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 1 \Building\ Permits\PLMF- PermiApp doc 12/27/06 440- 4616T(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information , .. " 'ILJE i g t4UL - , Fee Schedule: Residential, Fire Suppression Systems: `,Site Utilities " - - ` - 'Fee•(ee) , . To l ' 'Square Footage: 'Permit Tee,: , 1 Footing drain - l' 100' 55 00 0 to 2,000 , • i • " ' $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 &Ram 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 thcrcof, 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 $50,001 00 and•up' • . $742 00 for the first $50,000.00 and $1 20 for Subtotal: 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 1 - 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. ' - . - ( :u • Car Wash Drain - ,. 'Garbage , - Domestic > Comments regarding fixture work: ' Disposal - Commercial 1 . - Industrial ' Ice Mach /Refrig. Drains - • • , Oil Separator (Gas Station) u 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 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 \Buildmg\Permus\PLM- PermitApp.doc 12/27/06 ., ' CITY OF TIGARD BUILDING DIVISION - - PERMIT #: PLM2007 -00266 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2007 ,_ . Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 s '• "•) �.. INSPECTION WORKSHEET FOR DATE: 6/22/2007 TIME: 7:03AM PAGE: 44 SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK: SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE: PROJECT NAME: HEMCON DESCRIPTION: 30' of trench drain and (1) 4" floor drain; other fixtures include (1) primer. OWNER: HEMCON MEDICAL TECHNOLOGIES. PHONE #: 503 -245 -0459 CONTRACTOR. CASCADE MECHANICAL SYSTEMS INC PHONE #: 503- 630 -4492 ' U d Inspection Request Scheduled For: Date: 6/22/2007 Pour Time: j V Code # Inspection Description Confirm # Contact # Mes: -•- tl 320 Plumbing rough -in 050769 -01 503 -523 -8802 Corrections /Comments /Instructions: y�5 ` Y I PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Lit" Z Lf Inspector: Date ",12 �� Phone #: (503) 718- 2'4 CITY OF TIGARD BUILDING DIVISION — PERMIT #:' PLM2007- 00266 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2007 Phone: (503) 639 -4171 f � l � Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/28/2007 TIME: 7:01AM PAGE: 5 SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK: SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE: PROJECT NAME: HEMCON DESCRIPTION: 30' of trench drain and (1) 4" floor drain; other fixtures include (1) primer. OWNER: HEMCON MEDICAL TECHNOLOGIES, PHONE #: 503 -245 -0459 CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 503 - 630 - 4492 Inspection Request Scheduled For: Date: 6/28 /2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 051143-01 - 503- 572 -6246 N Corrections/Comments/Instructions: I' / PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I Date: ?/a ) Phone #: (503) 718-27