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Permit ,o PLUMBING PERMIT t�, -�� CITY OF TIGARD ' " COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00229 DATE ISSUED: 6/4/2007 pTIgg 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 25111 CB -00102 SITE ADDRESS: 10150 SW MURDOCK ST ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: ALEXANDER Project Description: Line work to connect sewer. Septic system to be pumped and filled or removed. CLASS OF WORK: NEW 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: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES ALEXANDER, RONALD E MARY T Description Date Amount 10150 SW MURDOCK [PLUMB] Permit Fee 6/4/2007 $72.50 TIGARD, OR 97223 [TAX] 8% State Surcha 6/4/2007 $5.80 Phone : 503- 639 -0359 Total $78.30 Contractor: CANTRELL & SONS CONTRACTING 6860 SW NORSE HALL RD TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 638 -0800 Reg #: LIC 97005 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: 16 ..,, Permittee Signature: ( Call 503.639.4175 by 7:00 a.m. for an inspection that business da 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 Ap 7._, >u.. q ., . �.;�, s� .s:s, ' � s 4 s ac � ; � � lt+� �I N� m illy �t'"!G'1',�k`r �:`t '� I �'ilo 1 i ' 4r"t, r 0 i' s i -" w a 1r i, P , y � r igttt FO USESONLYE t ,;, 'O��' .. � . -- �', '..„ _,.,,. . „,.. _,R. , ?i'Ati l . .l 'w�.�+C'r [ 't,,,t� I1i�"51." ft 44 I, w. n. ci i ;1 ' PPIOS City of Tigard DateBy e vo ' N 1 Permit No.: �L- h'jow67.(J .7 ` ' `a 13125 SW Hall Blvd., Tigard, OR d Plan Revie 4: r, 0 ''... Pho ne: 503.639.4171. Fax: 503. $.19b�J 2�U1 Other Permit J DateBy: J IZol� r 3 4 t , M _ ) Inspection Line: 503.632`4 1 ,, 1 ,. Date Read /B orr is: la See Page 2 for TvI r Ready /By: B lmr ito5,, Internet: www:tigard -or a 1 ;� l k a ti , tic I ,% Notifed/Method: ' Supplemental Information tittleICAtel R J .j2 ;• ITri FEE*" SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 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 U '- 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 ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: //� 50 i �1 S 0 Catch basin or area drain 16.60 City /State /ZIP: V� d i C Q C 3 - 1.1 a 4 Drywell, leach line, or trench drain 16.60. Suite/bldg: /apt. no.: Projec ame: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 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: 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 ( .- W CI L /A ) � j t. Backwater valve 16.60 ✓'� Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT • . Drinking fountain 16.60 Ejectors /sump 16.60 Name: %--- `V irbkaa /,(. Expansion tank 16.60 Address: 1 0 1 6 0 5u Fixture /sewer cap 16.60 City /State /ZIP: Floor drain/floor sink/hub 16.60 Phone: 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: Cl..-v Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) 1 Fax:: ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR • • Water closet 16.60 Business name: C Mit -ALAI' Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum.permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) 1 Authorized si • . urejA -n / State surcharge (8% of permit fee) !j KU _ / / - TOTAL PERMIT FEE 7 g, so 4 T his application expires Print name: IL � _ _ t , Date: _ D permit a lication ea Tres 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 \PLM- PermitApp.doc 12/27/06 440- 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 Storm &Rain 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 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 $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: Are you capping, adding or replacing fixtures? If "yes ", Plan Review for Plumbing Installations. please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that'apply. ' • . Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Types • Replace greater, except systems designed and stamped by licensed Previous. Capped Added Existing engineer. Baptistry/Font Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure -Tub/Shower as defined in OAR918- 780 - 0040. , Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities. Drive tall ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or Riser Diagram • Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. Car Wash Drain Garbage - Domestic Comments regarding fixture work: • Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory *Note: If the fixture work under this permit results in an - Bradley p - 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: • 1:\ Building \Permits\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 -00229 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/4/2007 Phone: (503) 639 -4171 4'44101 4\ Inspection Requests (24 Hrs.): (503) 639 -4175 Ail. . 64 ! INSPECTION WORKSHEET FOR DATE: 6/11/2007 TIME: 7:OOAM PAGE: 11 SITE ADDRESS: 10150 SW MURDOCK ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ALEXANDER DESCRIPTION: Line work to connect sewer. Septic system to be pumped and filled or removed. OWNER: ALEXANDER, RONALD E, PHONE #: 503639 -0359 CONTRACTOR: CANTRELL & SONS CONTRACTING PHONE #: 503. 6313 -0800 Inspection Request Scheduled For: Date: 6/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 04997601 503 - 638.0800 N • Corrections /Comments/ Instructions: d'Al■ ■// f i ►2 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: /14 f Date: 9 Phone #: (503) 718 - J" A /1020 - 6 1 7 Ua zz� • ORVALL T. CADE JOB INVOICE BYER'S SEPTIC TANK SERVICE, INC. P.O. BOX 549 []7 Wants Morn. 9 OREGON CITY, OREGON 97045 CUSTOMERS ORDER NO. D T ORDER D (503) 656 -3326 gE oE A � ORDER TAKEN BY DATE PROMISED ❑ A.m. Grace 6 -8 ❑ P.M. PHONE BILL TO Scott 312 -1363 Gene Cantrel MECHANIC • I - ADDRESS • HELPER CITY JOB NAME AND LOCATION ❑ DAV WORK 101 -5 SW Murdock / off 103rd. ❑ CONTRACT DESCRIPTION OF WORK ❑ EXTRA I � OUAN N T PRICE 1 AMOUNT DESCRIPTION OF MAT IAL USED � - Tank pumping • • • I I I - ' > • HOURS LABOR - AMOUNT TOTAL • MECHANICS MATERIALS • TOTAL HELPERS LABOR • • I hereby acknowledge the satisfactory I TOTAL LABOR TAX completion of the above described work. SIGNATURE DATE/ OMPE TED TOTAL • F _1. I I I ; I �1 - -: 1 i -1 I' _ - 1 I I , i 1 �'I - -- - -- I 1 1 , - 1 � i - - , - -- 1 � — - , .__i___ f . -- - �� I I � I � I � � i I i -, ' i--I- I -1 ; - I i - -- I ' - i - - , .___ ,. ; , i - i _ _I -I0 �- ;� ; ! - �- -r 1 - - �-- -- - -_� -' - - -- ,_ 1 _; 1 ! I 1 ' I 1 I I I : , . ' (7 -- ,:a-.! i 1- ; 1 1 , IA 1 I 1.G `� ! ' 0, 'N ! 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