Permit •
CITY TIGARD PLUMBING PERMIT
I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00122
�•� DATE ISSUED: 3/24/2005
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CC -12900
SITE ADDRESS: 08420 SW BONAVENTURE LN ZONING: R -12
SUBDIVISION: TANIA PARK LOT: 004 JURISDICTION: TIG
Project Description: Irrigation backflow preventer.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GIVENS, LESTER L + ELSIE J Description Date Amount
8420 SW BONAVENTURE
TIGARD, OR 97224 [PLUMB] Permit Fee 3/24/2005 $36.25
[TAX] 8% State Surcharl 3/24/2005 $2.90
Phone : 503 620 - 1497 Total $39.15
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Phone:
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503 -246 -6 9 or 1- 800 -332 -2 44.
Issued By: ; Permittee Signaturec
Cali 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
IL
q r r : r x4�. +T i"u" ?.G s t * ''�Irtclo a +,rl r,. k, � IVITAT '" ; 4
Plumbing Permit 1 t' . " ; 1 � ,$ ' ' FOR' O S ON r
���
City of Tigard Received
I
13125 SW Hall Blvd., Ti a d; 72 ' Date/By: - _ , 'V M I
g t 5� 6f I'IGARD Plan Review
Phone: 503.639.4171 Fax 5 8. (f0 7 � j , n , DateBy: Other Permit No.:
24- Hour Inspection Ling 1 a 1G D'I d I SI �.J , - Juns: e 2 for
c.�. 7 ! l I Date Ready/By: W Y B Y
Internet: www.ci.tigard.or.us Notified/Method: \ }y El S ee Page \�\ Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ['Demolition For special information use checklist -
Description Qty. Ea. 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
E t- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building - 1=1 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 Site utilities
Job site address: 8 s . A oN AY�Tu,t94 L I4 E • Catch basin or area drain 16.60
City/State /ZIP: ,"' i `'. A / L, r OA at -712:1-14 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
(E) -�j� Manholes 16.60
•I 4 To L 1 ' (E) 1 z► Rain drain connector 16.60
& 2 N • ( So T " °.
(� b" A � f'��„
g�t (e, Sanitary sewer (no. linear ft.: ) Page 2
c w `` 1, V �� 5 Storm sewer (no. linear ft.: ) Page 2
Subdivision: /1 Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
1 ,, l / L %
DESCRIPTION OF WORK p� Backflow preventer ( , Page 2.
- o51 (L 1JA"T l T' L �T gi, PLy: - - - - _L::ck;vater - • -- -- 16.60 - _ .
• Clothes washer 16.60
• Dishwasher 16.60
PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
` / Ejectors /sump 16.60
Name: L E STEM-- 1 tl e S Expansion tank 16.60
Address: 84. to S_sz 1/4 ,9 0Ai gt € LSE Fixture /sewer cap 16.60
City/State /ZIP: T( C-7 Pc ti.,D 1 0 A. 9 ? -2.1-4-4. Floor drain/floor sink/hub 16.60
Phone: (S03) G71.0 , . /49 -1 Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
• ❑ APPLICANT' • - ❑ CONTACT PERSON
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
Sink/basin/lavatory 16.60
Phone: ( ) Fax: : ( )
Tub /shower /shower pan,_, - . -, _ -_ 16.60 '--
E -mail: Urinal J 16.60 •
CONTRACTOR Water closet 16.60
Business name: DOS , 1 ri I( Water heater 16.60
Address: Nj C" Other:
Subtotal
City/State /ZIP:
Minimum permit fee: $72.50 Q , a
Phone: ( ) Fax: ( ) - Residential backflow minimum permit fee: $36.25 pl
CCB Lic.: i J mbin Lic. no.: Plan review (25% of permit fee)
:Sr , ` State surcharge (8% of permit fee) a, 9()
Authorized signature: -S ` TOTAL PERMIT FEE 09. /.,
Print name: Les V ) v .5 Date: 3 "', g 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.
i:\ Building \Permits\PLM- PermitApp.doc 12/03 440- 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) l 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 $10.0.00, 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:
Are you capping, moving or replacing existing fixtures? If
"yes ", please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * . •
Quantity by (Fixture) Work Performed . . , . • , .. , .
Fixture Type: Replace
New Moved Existing Capped Comments regarding ffixture'work: • •
Baptistry/Font
Bath - Tub /Shower
- Jacuzzi /Whirlpool •
Car Wash -Each Stall
Drive Thru
Cuspidor/Water Aspirator ;
Dishwasher - Commercial `
- Domestic '
Drinking Fountain
Eye Wash
Floor Drain/sink - 2"
-3"
-4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial *Note: If the fixture work under this permit results in an
- Industrial
Ice Mach./Refrig. Drains increase of sewer EDUs, a sewer - permit will be issued and
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall
Sink - Bar /Lavatory
Quantity Total
-Bradley Isometric or riser diagram is required if fixture quantity
- Commercial
- Service total is >9.
Swimming Pool Filter
Washer - Clothes
• Water Extractor Plan Review ' •
• Water Closet - Toilet Plan review is required if fixture'quantity total is >9.
Urinal
Other Fixtures:
i:\ Building \Permits\PLM- PennitApp.doc 3/03
• 7 c4
C TY PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: P 24/200 -00122
JJI '" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/24/2005
PARCEL: 2S112CC -12900
SITE ADDRESS: 08420 SW BONAVENTURE LN ZONING: R -12
SUBDIVISION: TANIA PARK LOT: 004 JURISDICTION: TIG
Project Description: Irrigation backflow preventer. 2/15/06 Permit reinstated for a period of 30 days for purpose of final
inspection.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GIVENS, LESTER L + ELSIE J Description Date Amount
8420 SW BONAVENTURE
TIGARD, OR 97224 [PLUMB] Permit Fee 2/15/2006 $36.25
[TAX] 8% State Surcharl 2/15/2006 $2.90
Phone : 503 [PLUMB] Permit Fee 3/24/2005 $36.25
[TAX] 8% State Surchar1 3/24/2005 $2.90
Contractor: Total $78.30
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
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 By: NS t . /ulQ d 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.
111 16
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200& -00122
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/24/2005
Phone: (503) 639 -4171 Aav
Inspection Requests (24 Hrs.): (503) 639 -4175 °_.:
INSPECTION WORKSHEET FOR DATE: 3/28/2005 TIME: 7:10AM PAGE: 56
SITE ADDRESS: 08420 SW BONAVENTURE LN CLASS OF WORK:
SUBDIVISION: TANIA PARK LOT #: 004 TYPE OF USE:
PROJECT NAME: GIVENS
DESCRIPTION: Irrigation backfl preventer.
OWNER: GIVENS, LESTER 1. + ELSIE J, PHONE #: 503 - 620 -1497
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 3/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
325 RP /backflow preventer 002985-01 503-620-1497 N
Corrections /Comments /Instructions:
t 2- "/ -' - — C- y)
, „7,,,/
.0., .
r
(Op
A . _IWA /WI . . ---
n PASS [PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / 77 - 1-- - el Date: ) # Phone #: (503) 718-
January 30, 2006
Re: Expired Plumbing Permits
Lester & Elsie Givens
8420 SW Bonaventure
Tigard OR 97224
Dear Contractor:
Our records indicate that you have been issued plumbing permits for a backflow
preventer and these permits have no final inspection or approval.
Failure to call for inspection within 24 hours of completion of the work is a violation of
OAR 918- 785 -0210 and failure to call for a re- inspection within 30 days is a violation of
OAR 918 - 785 -0230.
These permits have been expired by limitation and a new permit must be obtained, or
these permits may be reinstated for final inspection. The fee in either case is the same.
Reinstated permits are only valid for thirty days, by which time the work must be
inspected and final approval given. The permits in question are:
PLM2005 -00122
If these permits are not replaced with new permits or re- instated for final inspection by
the close of business February 17, 2006, this report will be forwarded to our Codes
Enforcement Officer for further action.
If you have questions, call Jeanne Temple at 503- 718 -2433
Sincerely,
i t
Darrel "Hap' Watkins &�
Inspection Supervisor
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
CITY OF TIGARD
BUILDING DIVISION : \, PERMIT #: Pi .M2005-00122
2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2410.00f)
Phone: (503) 639 -4171 Allviipriii'\.-
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7., / TIME: •f) AI PAGE:
hi4a, LAWrxtr
SITE ADDRESS: 0 420 SW I. ONAVEN'f1JRE LW CLASS OF WORK:
SUBDIVISION: i AMA PARK LOT #: 004 TYPE OF USE:
PROJECT NAME: ilvlht`s
DESCRIPTION: Irriclatioai bac f!o prey enter. 2/15/06 Permit reinstated for a period of 30 days for purpose of Sinai
inspection.
OWNER: GIVENS, LEST ER L + ELSIE j, PHONE # • 503.820.1497
CONTRACTOR: O o FR PHONE #:
Inspection Request Scheduled For: Date 7i7 /2QO6 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 027077-01 603- 6201.107 N
C' ections /Comments /Instructions:
fr 4 2. l 2�� `' A C." • ' sdiL ! " .o „l
• -- ' S- / - - 1 Z__, --- Z ,o • 4 1 ,
_ilit5Sesb Lf�.o 46 ertgregit—b-•
gc1 A iN1
•
-' PASS `A - t APPROVAL ❑ CANCEL n NO ACCESS
,I
A '' A IL M' A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Z "�'70 (503) Inspector: Date: Phone #: 503 718- Z "' - ‘ /7