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Nt. l ost • ":' ' . 4 t *` 1.'#'1.,,,•• ry a Y . v i . s 14 j•. f, �3r y Yom `t ",‘....$: a }{ 1 r. • • CITY OF TIGARD PLUMBING PERMIT tR` tr Q f COM MUNITY DEVELOPMENT Permit #: PLM2010 00063 T {GAR Q; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/21 /2010 Parcel: 2S101 BC00900 Jurisdiction: Tigard Site address: 12291 SW KNOLL DR Subdivision: Lot: 0 Project: The Knoll at Tigard Project Description: Site utilities, install (4) catch basins /area drains, (2) manholes, (12) raine drain connectors, up to 1000' footing drain, 100' of sanitary sewer, 200' water service, and up to 900' storm sewer. Owner: FEES THE KNOLL AT TIGARD Quantity Description Date Amount PO BOX 23206 TIGARD, OR 97281 -3206 4 ea Catch Basin or Area Drain 04/16/2010 $75.04 PHONE: 503-293-4038 1000 If Footing Drain 04/16/2010 $387.71 2 ea Manholes 04/16/2010 $37.52 12 ea Rain Drain Connector 04/16/2010 $225.12 Contractor: 100 If Sewer Service 04/16/2010 $62.54 LAUZON CONTRACTING LLC 900 If Storm and Rain Drain 04/16/2010 $362.70 13577 SE WILLINGHAM CT 200 If Water Service 04/16/2010 $100.06 CLACKAMAS, OR 97015 1 Plan Review 04/16/2010 $312.67 PHONE: 503-482-5445 1 12% State Surcharge - 04/16/2010 $150.08 Plumbing FAX: 503 - 482 -5446 Type of Use: MF Class of Work: NEW Type of Const: VA Occupancy Grp: R -2 Stories: 4 Total $1,713.44 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: / Permittee Signature: Call 503.639.4175 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 Annlication Site Utilities FQIZ t1FFIcI.: usi: °N1s •" , FEB 5 City of'1'igttrd ?010 D acolvca a 13125 SW )Intl Blvd., Tigard. OR 97223 ntcrD 1 _ , I'cnmr Nn.: m�l(" • -- 1 C Piwnc: 107.(39.•1171 Fax: 503.598. 21TY OF T Plan Review J irGAR : Dnteiny; Other Permit No.. �` Inspection Line: 503.639.4175 S LSQ' 1 l( I) BUILDING D1VI51C I " " !'' ' "lY: t^ 1� Scc I'nxc 2 for !memo: +v+r+r.tigard•ar.gov _ o `) SupPtcrncntnl tnforulnllnn TYPF /'OF WORK • - - 'Pk* SCIIK�UI.f, O Ncw construction - ❑ Demolition - -- r or s a5.1a/ It(foinrurinlr use checklrR _ Description 1 r t . i tsn, Total - 0 Addilion /alteration /replacculenl ❑ Other: Nen I- 2 -Ii inIIy dwelllm s (includes 100 R. fin each utility connection) CATEGORY Olt CONSTRUCTION SPI((I) bath - • • 312.70 ci 1 • and 2•fnmily dwelling ❑ (: onunercinl /i lulu 5Irin! SFR (2) Intlll 137.18 ShR (3) bath 500.32 ❑ Accessory building �Mulll- family _..•_ - - -.._ . -._. _ -- -- - Each additional bath/kitchen 25.02 Master builder ❑ Olhcr: - Fire sprinkler (_ sq. 11.) Page 2 . ' 401 }•SlT6 1NFORMA'17QN,AND.LOCATION Site utilities: - _. - .__ Job site address: I ; • • .... .r, • . : - � � nt • - ••• Crotch basin or area drain t8.'l6 - 7 - 5 - ] 7-6.14- - City/Stater/.11 T -� C>?.. 972- M24/ - o ' 1)ry++Acll, leach line, Of tr drnin - 18.76 t A P Footing Muhl On linear 11.: ) - Page 2 - 607 •'7 1 Suite /bldg. /apt. no.: I Pr*" mime' - K•Ao 4,-1- ?- --( CR/. p Mn iurnclurcd home utilities -- 50.03 - - Cross slreeVdircclionsto job site: _ ______ ..-__ ro - N co 4?- t- :4.t?- o{ S V\I EloNt -L'k Manholes .Z• 18.76 37.52 Rnin d rain connector_ 18.76 _ 22` - 7 . 1 5v -1 01.t z t t lZ _- 1 2- - Sanitary sewer (no. linear R.: ) - Page 2 62 5.1 " -' Storm sewer (no. linear 0.: ) Page 2 34 0 - - - -- - - - -- - -- - -- Water service (1111. linear R.: _) -- Page 2 1 00.0( Subdivision: 1.01 no.: 1 slier or Itcoi �- _ .__ - - Tits map(parcol no.: Zt 1 0 ( h3c. - o O BO - OOq O -• O 1 O b Rackllow provcnlcr _ 31. '_ • . • • - Backwater valve 12.51 DESCRIPTION O F WORK . - _. -�..._ __ _. -�- -- -_ -,(_ --- - Clinks washer 25.02 1 • Ft tJ.1 `1 B ` U t1 -5.1. :S4Z.tiL.i d.. ' Dishwasher - -- 25.02 - c�Vt71 J _ -_._ l(�( ----- �+7 S f�nf0 -- �x -S:��{.'L1012- . Drinking 25.02 l 1 OV Wlv(.s.TS Ejectors/sump - w -- - - 25.02 -- fli PROPERTY OWNER • ' • ❑ TENANT lixpansiou Ina - -^ 12.51 Fixture /sewer cap 25.02 Nun kr4o1a T� a LtrC % I�IR {-iNK - .---- •-- ._-- ..._.. -- - - -_ -- --- - gt KID tD / / - c -�-- I- `-- -• FI_o, drain /floor si 25 Address: 1 O � x Z 3 2, O (o ^- �h nhage disposal - _ �� 25.02 - C'ityJStatcl "'7,11': ^rl a(Z `1 - 72.e11 - 3 2 0 _ _ -. C4 7. ®P 1? I- - -.- 1(05c bib 25.02 _ Phone: (0 o Fnx - Phone: ?j) � e 3$ ( ) lee 12.51 ' . - • f APYI ❑ ;C.OH'I'ACT PERSON .. Inlerccplor /grease trap - 25.0? A Il1Stne66 name: G aryt - XTo,4 A tt ' A (t,G}{ l� ta-�. Medical gas (vnlnc - -) ......- - - - ^- - Pngc 2 - - - - -- °- Roof iI _ _ 12.51 Contact n :nme: V 'k {y v � - Roof _ dtmin (cnnnucrcinl) - - 12.51 -- - Address: 3 t� � S� v/� - - - - -.. P,_, ^ _ -_ - -- _ Sink/basinn/Iavat t 25.02 City /Stuta"/.IP: ' o -�s�p O 72 Oc. Solar units (potable water) 62.54 Phone: (503) 2 . 0 ( 0 - 3 i 7 , 4 . Fax:: ( ) '1116 /shnwcr /s6nwcr pan 12.51 t�mmil�jGvA.1/J A GO- Y(c..40v`�15-T cr. ol� Urinal - 25.02 -- -- ... - 2 CONTRACTOR Water closet 25,0 + = ..-- - ------ --- .-- .._-_._ -- ' Water heater _ 37.52 Ilusincss name: {--- Pi L1 Z O �__- L �„iA • -h .. I V Winer piping/UW V - 56.29 Address: .. y 01 r t .. ti t:. 1 '.- k-... Other: - 25.02 Cily /Slur /7.1Pf - L Subtotal \k ` ' L Fax: ( %(;. 7 S - - - -- __ Min Munn permit Icu: 572.50 q - T _ - flan review (25% of permit fee) 3j2•fo'7 � Q/ COI l.ic.: 3 e % _._ of permit fee) 150 .08 _ -- .. - -- stoic stnrrlmrge (12 % ‘ a Authorized signnturc �! = in _ 71 // _ ITOTAL PERM IT PIII: 1'7 c ( 115110: - 1/�� Dale raw '1 hiv p ult en applicnllan _ e6Plr II • pen Is not ubtlincd oithln 1/40 dayy's o __ _ nA It bus been accepted 00 cnrnplMC. " I'ee nwdmd set by 'I'rl.('nuuty tuildulg Indu.nry Scr.ice Nord 1 rnun,to.oO ntil'1.\m:.i'6.nir.\pp dm::0 4.10.461611 1a°Ll I '\G \ C P 1t S CC; c LA A CIA-St I e+- l'lutrtbing Permit Application - City of Tigard Yugo 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: _ Site Utilities • .• Qty. rco(en) , Thant. S(!(lat•e l!oo(age: _ _ Fee: •_..._._�_— hooting drain - 1" 100' I 50.03 5 0 .03 0 to 2,000 --- . _ A - -- S 1219D __..._..___.._.. ' 2,001 10 3,000 5169.6!) Fuotingdrain • each aaliIitiannl 100 37,52 33y.6L 3 601107200 5233.20 6 2.54 - - - Sewer - I st 100' 1 ( p •S� 7 . 20 1 and greater 532.7.5 -� - --- Sewer - each additional 100' 37.52 Water Service • 1st 100' — -; - - 62.51 4,2.SL{ Medical Gas Systems: Water Service -each additional 100' ` 37.52 37.52 _ Valuation: PCI'ttlit' ce: ` _ Slot R Rain Drain - 1st 1 00• 1 6;2.5 42.5` silt() to 55,1100.00 Minimum fcc'072.5o —�— Slam & Rain Drain - each additional 100' 6 37.52 300.1 c 55,001.00 10 510,000.00 572.50 for the first 55,000.00 ands 1.52 for Of Fee ea : fatal other inspections or Fet Y' ; each additional $ 00.00 or fraction thereof, to and inclining 510,000.00. Inspection of existing plumbing or for 5103m 1.00 to 525,000.00 _ *i148.50 for lho first 510.000.00 entl 51.5 for which no fee is specifically indicated 90.00 /hr each tldditiaud $100.00 or fraction ;hereof. to (minimum charge- 1/2 hour) _ - mad including 325,000.00. Inspections outside of animal buslnesa 90.00Air S25,001.00 to 550.000.00 5379.50 for the first" 525,00a for (tours (minimum charge -- 2 hours) _ - _ —•_ -_- catch additional 5100.00 or ITncliOn iltercuf, to Rcinspcctiait Fees 90.00 /hr _ and including 550,000 00. Additional plan review for revisions 90.00thr S50.001.00 and up 5742.00 for the first 550,00000 and 51 .20 for 6nininnun charge_ 1/2 hnnr) - each additional 5100.00 or Iinetion thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", lliin•1teview. for Plumbi g Installations please indicate work performed by fixture. Failure to Phut review is required I'0r any of the following. accurately report fixtures 00u1d result in increased sewer fees". Please check all that apply. Quantity by (Fixture) Work Performed I1 Any new commercial building with water service 2" and Fixture Type: lteplsac greater, except systems designed and stamped by licensed I'revlans Capped - Added E Mang engineer. Haplislry /Font _- -__ - -- - -, _ ❑ Nov exterior plumbing site utilities for any complex stntcture Had+ - Tab/Shower ns defined in 0AR910.700.0040. - Jacuzzi /Whirlpool _ ❑ Medical gas and vacuum systems fur health care facilities. Car Wash -I'uch Stull -Drive Thu ❑ Any multipurpose tiro sprinkler system. Cuspidor/Water Aspirator -- � T ❑ Any complex slrue1lI c as defined in OAR9I8- 71I0•0040. Dishwasher -Commercial -_ —_ _ - Submit 2 sets of plans with any of the above. - Domestic Drinking Pountnii . liyc Wash — -- .;ISonictric,_01 Riser Dngrani ' • ;_' Floor Drain/sink 2'' _ - -. ❑ Isometric or riser diagram is required for new buildings - 3 _ —_._.— _.__ __ —._ —_— Ihat meet the qualifications above. Car Wash Drain Garbage •Domestic 1)isposal •Comnicrcint r r - Industrial Comments regarding fixture Work: _Ice tvlachJRcfrig. Drains _- _ ___ ._...__. ____ 011 Separator (Ulu Station) —_ -.-__ - - -____- nee. Vehicle Dump Slntiou - Shower -(sang -Stall Sink - tSar /l.avntnry - Bradley - -- ...__ -- - Commercial __. ''Note: If the fixture wort( under this permit results in no - Service — _ increase of sewer EI)Us, a SCWCr permit will be issued and Swinu Paul Filter -- -- Washer - Clothes fees assessed for the sewer increase must be paid before the - -- plumbic); permit can be issuc(I. Water Extractor Water Closet - Toilet Ur inat (711icr Fixtures: 1 \Ruilding\PUrutits\PI. \'I J- PerotiIApp.doe 2