Permit •
C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00427
1G00 !` 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/19/2007
PARCEL: 2S103CD - 02200
SITE ADDRESS: 13730 SW FAIRVIEW CT ZONING: R -4.5
SUBDIVISION: HOLLYTREE LOT: 010 JURISDICTION: TIG
PROJECT: LINDERMAN
Project Description: Remodel bathroom; repipe. move (3) fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
LINDERMAN, WALTER +
KATHLEEN S Description Date Amount
13730 SW FAIRVIEW CT [PLUMB] Permit Fee 9/19/2007 $104.80
TIGARD, OR 97223 [TAX] 8% State Surcha 9/19/2007 $8.38
Phone : Total $113.18
Contractor:
AGENT PLUMBING, INC.
9340 SW JASPER DR.
BEAVERTON, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -579 -3132
FAX 503 -579 -3132
Reg #: LIC 175492
PLM PB348
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 estions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B f Permittee Signature: Dlicz-/`6-4 AWL
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.
FROM' : AGENT PLUMBING INC FAX NO. : 5035793201 Sep. 18 2887 OS: 19PM P1
Plumbing mi
Pert Applic F �
S.�"t 1.:()„ I � 1.:()„ 014 USE (11.1
City of Tigard � Received n 2667-772112-7-
/// tJ PermitNo. n
: Phone: 503.639.4171 Fa 13125 SW Hall Blvd., Tiga rd, OR 9722 - . her Permit No.:
! / Plan Review ,I
' 503.598.1960 � t�y Ot
r, t c; A R t) I ns ion line: 503 .639,417.5 , to ' : 63 S l for
P Date Ready/1 X6'
Y CJF° c �ttlli�
lnterttet: www.tigard -0rgov Notitied/Method: �� Snpplemcnta! ]uio rmat i ou
TYPE O :PV ORK ., ' , ..; : ::•': . ..:.' . :,:'. , : : :;', , :, ',. ,
❑ New WnstrucLion 0 Demolition For special information use checklist.
Description ( Qt f E.a. 1 Total .
® Addition/alteration/replacement ❑ Other: _ New 1- 2 family dwellings ( includes 100 ft for each utility connection)
i+;::; �. .... ; ;.,;,, .4 -' SFR (1) bath 24920
'' -; 'GA7Y;GOlffY OF ' •CON :;; � i .;, ' ,_ ..,,.. - > < )
® 0 1- and 2- family dwelling 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 (r..._ sq. 11.) Page 2
'soli : SITE iNrgKltilA1lON ANA : 70C`..4 r _,: ;r , = '< ' S ite ut
Job site address: 13730 SW Fairview Court Catch basin or area drain 16.60
City /State/ZlP: Tigard, OR 97223 Drywc11, leach line, or trench drain 16.60 1
SuiWb1dgJapt. no_: Projct -t name: Footing drain (no. linear ft.: ) Pagc 2
Manufactured home utilities 110.00
Cross stteet/directions to job site: Manholes 16.60
Rain drain connector 16.60
-
Sanitary sewer (no. linear ft.: __ __) Pagc 2
Storm sewer (no. linear 8.: ) Page 2
Subdivision: Lot no _ Water service (no. linear It: 1,01 1 1 Page 2 55.00
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
1)FS CYt1PI' IO ;: O RK' ; i `° `; ;� ? , :='.. ;
•a,. r...;.: ' Backflow prcv cn t cr Page 2
Repipc and remodaL Moving one shower, tub, toilet, and Inv. Backwater valve 16.60
Clothes wash er 16.60
Dishwasher 16.60
plinking fountain 16.60
Ejectors/sump I6.60
Name: Kathy Linderman _ Expansion tank 16.60
Address: 13730 SW Fairview Court Fixture/sewer cap 16.60
City/State/ZIP: Tigard, OR 97223 Floor drain/floor sink/hub 16.60
- Garbage disposal 16.60
Phone: ( ) Fax: ( )
PPANT .. Q' 00$1AC;Ih 0 . , 0 ?a,- `
::,';',..,:',.'•:',.,, c ': .: ® A
;:.: LIC . :.. , . , .., .. l ma 16.60
1 � ak
Business name: Agent Plumbing, Inc. interceptor /grease trap 16.60
Contact name: Steve Moon Medical gas (value: $ ) Page 2 ,
Address: 9340 SW Jasper Drive Primer 16.60
City /StsrteIZIP: Beaverton Olt, 97007 Roof drain (commercial) 16.60
Sink/basin/lavatory 1 16.60 16.60
Phone: (503) 579 -3132 I Fax : (503) 579 -3132 Tub /shower /shower pan 1 16.60 16.60
E -mail: stcvo®a agcntplumbing.com Urinal 16,60
- - `,,. <;% ° ' . 1`: 1 16.60 I6.60
.'.., k re
CONY W atc i a
Business name: Agent Plumbing, Inc. Water hearer 16.60
Address: 9340 SW Jasper Drive Other
Subtotal 104.80
City/State/ZIP: Beaverton OR, 97007
- Minimum permit fee: $72.50
Phone: (503) 579 -3132 Fax: (503) 579 -3132 //) Residential baddlow minimum permit fee: $36.25
CCB Lic.: 175492 1 j1 IJ q Pltmtbin no.: P11348 ?if b l?lan f25 %of cnmibc)
permit
State surcharge (8% of permit fee) 8.38
Authorized signature: TOTAL PERMIT FEE 113.18
Print name: Steve Moon L Date: 09/18/2007 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.
rABeldh„dP nu\arat n rv.doc 0625/06 44o.46t6T(10a02/COHvwt'.u)
"Plunibin2 Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
�f;v •. _:F.. ' a "k -ii•, n °:b.. Y , r..f.i
..Sate., ah � ^:- Q,. , c.,.r"iP�.. , c,::- `�., .�, a� .:ia[' >,e,• ;o]1t S es,, -:,;; ;'.,, t. ., ::c ;;:k,:,�'��•:; as:-- ::,:. <_•
Footing dram - 1 4 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 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' 46A0
Water Service - 1st 100' 55.00 55, on Medical Gas Systems:
Water Service - ouch additional 100' 46.40 ;_.., Y.,•
Storm & [Lain Drain - 1st 100' 55.00 arii�AI.i�Eittr
$1 -00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.0010 $10,000.00 $72.50 for the fast $5,000.00 and $1.52 for each
additional Si 00.00 or fraction thereof, to and
including $10,000.00.
Commercial Back /low Prevention Device 46.40 $10,001.00 to $25,000.00 5148.50 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 Dram, single family dwelling 65.25 • 525,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 51.45 for
Inspection of plumbing or each additional $100.00 or fract thereat to
and unclad
specially requested inspections - per how' 72.50 first 0.00.
Subtotal: 55.c0 $50,001.00 and up $742.00 for the a first $50,000.00 and $1.20 for
, each additional $100.00 or fraction thereof.
•
Fixture Work: q'r ` i >q 4taGila tvns:.:
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 waver service 2" and
y , - •., :Pat�ie'cfonniett "; greater, except systems desig red and stamped by licensed
• trt"
-;' a, .: ; :. b � 1 • v engineer_
11 ! xg sx'yi :i � ` ;. ''; ;, _ y:'Ji . ,;: ' 11!!_gg6
ti '?i-': , , : "�;.'!�t: �' .'' �'� �;pI�CV101L4; `�d,�j1Clti:� �' ":'� "' E_�'4:ir.XtJfftll�ii; ❑ Any new exterior plumbing site utilities_
Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub/Shower ❑ Any multipurpose fire sprinkler system.
- Jacuzzi/Wbiulpool _ _ ❑ Any complex structure as defined in OAR918 780 - 0040.
Car Wash - Each Stall _
give Thru _ Submit 2 sets of plans with any of the above.
Cuspidor /Water Aspirator
Dishwasher -Commercial S' a':r. "j. "i;: :n. .: ?y1:•lA;: •, „', ,ii -,. '.4 ;.;:.
Domestic -I.' , .. , az '?,` F.( F `.,y.
Drinking Fountain _ ❑ Isometric or riser diagram is required for new buildings
Eye Wash that meet the qualifications above.
Floor Drain/sink - 2"
3" Comments regarding fixture work:
- 4"
Car Wash Drain
Garbage - Domestic •
Disposal - Commercial
- industrial •
Ice lvlach./Refrig. Drains
Oil Separator (Gas Station) .
Rec. Vehicle Dump Station
Shower - Gang *Note: If the fixture work under this permit results in an
- Stall increase of sewer EDUs, a sewer permit will be issued and
Sink - Bar/Lavatory fees assessed for the sewer increase must be paid before the
- Bradley -- • plumbing permit can be issued.
-Commercial
- Service _
Swimrninn Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toile -
Urinal
Other Fixtures:
i:\ nwldmg \PmnitAPL.I,f- PccpitApp•doc 09/22,/t4 •
•
CITY OF TIGAR®
BUILDING DIVISION PERMIT #: PLM; OO7 -01 +27
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1912007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: • 11/1 TIME: 7 :01AM PAGE: 40
SITE ADDRESS: 13730 SW FAIRVIEW (T CLASS OF WORK:
SUBDIVISION: HOLLYTREE LOT #: 010 TYPE OF USE:
PROJECT NAME: I.I NDERM AN
DESCRIPTION: Remodel bathroom; repipe. move (:3) fixture::.
OWNER: f RMAAN, WALTER +, PHONE #:
CONTRACTOR: AGENT PLUMBING, INC PHONE #: 503 579
Inspection Request Scheduled For: Date: 11115/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 069704 -01 503 -f79- 3132 N
Corrections /Comments /Instructions:
A./4,1i1 9
PASS (l PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
� ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CP Lv1,,�,.� \1 A.-�_ Date: (l I i Phone #: (503) 718-
CITY OF TIGARD . , - .
BUILDING DIVISION PERMIT #: PL M2007-0042.7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9119/200-/
Phone: (503) 639-4171 44: i
Inspection Requests (24 Hrs.): (503) 639 -4175.
INSPECTION WORKSHEET FOR DATE: 9/28/2007 TIME: 7 : 0 0AM PAGE: 75
SITE ADDRESS: 13730 SW F AIRVI UV CT CLASS OF WORK:
SUBDIVISION: hi oLLYTRF.E. LOT #: 010 TYPE OF USE:
PROJECT NAME: LINDERMAN
DESCRIPTION: Remodel bathroorn; repipe. move (3) fixtures.
OWNER: LINDER •. MAN, WALTER PHONE #:
CONTRACTOR: AGENT PLUMBING, INC. PHONE #: 503 - 578`3132
Inspection Request Scheduled For: Date: 9/28/7007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 056509-01 503 - 579`3132 N
Corrections /Comments /Instructions:
PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k'Nw - Date: oi 1 2- 107 Phone #: (503) 718-