Permit (184) ft(fsvtI7h 7 /NCC`i b1 treweit i nve •
CITY OF TIGARD 3/ U at PLUMBING PERMIT
PERMIT #: PLM2002 -00026
�wx�l�� DEVE HO BMEN T r SER V I CES 639 • DATE ISSUED: 2/1/02
- 13125 Tigard, (503)
SITE ADDRESS: 16200 SW PACIFIC HWY Y
PARCEL: 2S115BA -00101
SUBDIVISION: TIGARD TOWNE SQUARE ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM ' WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing tenant improvement. Other fixtures to include one(1) trap primer and one(1) Drinking fountain.
Addition to permit on 2/22/02 of 100' of sewer line.
FEES
Owner:
Type By Date Amount Receipt
BIT HOLDINGS LTD PARTNERSHIP PRMT CTR 2/1/02 $166.00 27200200000
BY FORUM PROPERTIES INC PLCK CTR 2/1/02 $41.50 27200200000
FIVE CENTERPOINTE DR STE 290
5PCT CTR 2/1/02 $13.28 27200200000
LAKE OSWEGO, OR 97035 PRMT CTR 2/22/02 $72.50 27200200000
Phone 1: 5PCT CTR 2/22/02 $5.80 27200200000
Contractor: Total $299.08
REQUIRED INSPECTIONS
Phone 1: Rough -in Insp
Reg #: Final Inspection
9 Sewer Inspection
Sewer Inspection
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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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
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Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
FROM : FAX NO. : Jan. 28 2002 04:43PM P1
01.'22'2002 18;10 FAX 5035981960 CITY Q1" TIGARD : 0iil
• y \ . .- 4 ' RECEIVED %,..
.� ?,, � ` .' � Dmereccivett i A o . Permit co.: r clan -000.1 1
e ' r it ,; Tigard CITY OE TIGARD
! • ` ; ` 7 , , : =r 1 SW Hall )WTS10 Sewer pttrmir no,: Bu 16isg paunz nv.: 0
'''c^ Bard • .; Q►1, : • t 3) 639 -417 (� `, Pirdeet/atppl. no -: Expire date: p)
• (503) 598-1966 60l — , 1' sa Daminned: By: I Receipt no,:
I
•
S Land use approval: Caae hie no.: Payment type:
. .
0 1 & 2 :bmily dwelling or eco3sttory Al Cammarc al/Industdal 0 Multi - family 0 Tenant improvement
0 New constrtlaton 0 AddiUon/oleerotionimplaecoont •. 0 Food service Ca Ocher.
,
I. t .tll- 1: 4,N at'Ht \
. 11 <;l , { , III+Fti4IP1 I1I I 11
(1+reei�1vigfe 14:,,,, ti�t c ?s t.I, .
Job address: v IIQ �DO `ate P' Fa I t i ' :�' t Fee (ea. Tomb '
8
Bra :. no,: !Suite raw. •• C ( leitY.far connection)
Tax .. . tax lot/account no.: • St,FR (1) bath .
Lot: It lack StDdtvidan:• IrEfiai0 ;r _
Project name: 6 r / r .. m
city /county: ZIP: en ....Imam] backs it
Dear .,: •, and location .f work on Premises: Sitetuttr' bier
t._, .. .‘ Nr „_ • Catch baaln/ataa drain
Est date of *OM. etion/itwpeetiorr- • • i . ?tfl7,�t ' n.4 :1 5-
, , . r , , ^ -- I
y • L.t, l IS1 N t;ti \ 1 ;t' ( - . sui l iC)
• Buenos name: ` ' • 1J t. • ...•. s
Address: 80K 3 91 :n . in conoecwr
City: €s . : -- ... State:O: ZIP: `. eP Sanitary sewer • o. lin. it.) 121 1.
Phone: 6 3l? -6711 Fax: B —mail: . . total SC.Wer 110. lilt. ft.
CCH ao.: 12ZO (.3 ] Plumb. bum tug. no: 3 - 3 YP!G }' are: sst't•'ice =lie. It m MIII
City/motto lie no.: or
._
Contractor's representative signature: , ua.crA - .&t.11 o valve
Print dame: n .s e " : r v ye .r
Hack w • venter
Backwater I___
, ,,, A':',: < F•> ,, ; .;L 1. a�; PLR ��)N ° ��' �
Na Clothes was -•
Address . war • cr 11111111111•11111
Rote: Erma.,
E i mp g- I17
Name : .. nom • • , 5 sidlEIhab fr
Ell 1
Oarbpgc 4i ' . :- 11111111111111111.1
Malllrl address:
1112C,CMINENiMIE
City: ' State: ZIP:
Phone; - • r rlT 1 -;
Owner installationhos • • mamtenai ee • , y: 'rite aWuel insisilat to ( F'Vd
• I wll1 be made by tan or the main a and repair made by nay regular pirnt • ,, . • .. • , , 111111
I employee ea the pet:party I own as per ORS Chapter 441. Cf.7�11GTr' fi7)1R?fi�
I Owraee's 31 Date: _ _ Li LIIMMI
.a. Name: ° aetors
Ad&reaa: Water heater _ r
oty: State: ZIP: Other: ..
Phone:. C5111111.1111 8411311 1
Not acs i Ic1Iwo smear me " cRaxk Pew ow Waved= rtr tntvr laltimt®tlaa Notice: This permit applioataon Mirl mutr. ee ... ..
10 Hasa a ajar 9' expires if a p ermit is not obtained f lan rev t tat $ _
matt . d - S° ' @VO 7�'' S Furc ttarge (8%)7b..). $ .�
�� wit111n i aQ � ate it has bee:1
TOTAL $
. . m accepted as complete,
� -- AtDOUgt ) . (6�C&4)
- PLUMBING PERMIT FEES:
4:,.) , -,:.7-- , -;_,- .. - °'.: . t. t -s,; ,,. "'PRICE•' °TOTAL New land 24amlly :dwellings:onry.:. _ , `. • • ,'
r° F IXTURES` (individual) - QTY" °.(ea) " ' AMOUNT (includes.all plumbing fixtures.in . - PRICE TOTAL
Sink / 16.60 A 6) 'the dwelling and the`first100 ft. . .QTY :lea)..' . .AMOUNT
for each util
Lavatory '2.- 16.60 �x Zv One (1) bath ity connection) $249.20
' Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet Z 16.60 3 3 O SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal • 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" Z 16.60 3 �� EASE COMPLETE:
2 3" 16.60
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 , . • - , Quantity by Work Performed
Gas piping requires a separate mechanical D 60 Fixture Type: New Moved Replaced Removed/
permit. i Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
Tub or Tub /Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
1 6.60
Other Fixtures (Specify) 33 4s2 Dishwasher
irev far' / I" e'''-. / Garbage Disposal
// •A� . / Laundry Room Tray
7),/ ; nK °N, spun Washing Machine
Floor Drain /Sink: 2"
Sewer -1st 100' 55.00 3"
Sewer - each additional 100' - 46.40 4°
Water Service - 1st 100' 55.00 Water Heater
Water Service - each additional 200' 46.40 Other Fixtures
(Specify)
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Beddow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 62.50 / VIM}
Requested Inspections per/hr COMM N I b KtGAKDINta Ab t.
Ra in Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL f 0
Isometric or riser diagram is required if
Quantity Total is > 9
* SUBTOTAL /6
8% STATE SURCHARGE V'
**PLAN REVIEW 25% OF SUBTOTAL y/
Required only if facture qty. total Is > 9 � i � '
TOTAL $ z 2 4 ‘,1k 14#-, o' 4 \ A FR.
* Minimum permit fee Is h is $3 + state , except Residential Backflow t j 1 %� V 1.1.511 �' 14411 Prevention Device, which is E36.25 . + 8 % state state surcharge.
** Ali New Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review. PESS
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1 :ldstslforms\plm- fees.doc 12/26/01 .
CITY OF TIGARD 24 -Hour _
f BUILDING Inspection Line: (503) 639 -4175 0 b0 2'— z
INSPECTION DIVISION Business Line: (503) 639 -4171
Lf BUP
Received Date R uested [ - 3D AM PM BUP
Location / t 2.60 .c - Suite MEC
Contact Person Ph ( ) s7 / PLM
Contractor Ph ( nn ) SWR
BUILDING Tenant/Owner �-� -� ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Int Sheath/Shear
f
Int Sheath/Shear /
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART IL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
ICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA � ol Ay .
Approach/Sidewalk Date y /�O / Z Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL