Permit r ! L v CITY ��� PLUMBING PERMIT
: COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00228
,Ticn . 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 5/21 /2008
PARCEL: 2S 103DC -04800
SITE ADDRESS: 13875 SW 114TH AVE ZONING: R -4.5
SUBDIVISION: VIEWMOUNT LOT: 036 JURISDICTION: TIG
PROJECT: BABCOCK
Project Description: Replacing kitchen sink, dishwasher and disposal.
CLASS OF WORK: GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
RON BABCOCK
13875 SW 114TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 5/21/2008 $72.50
[TAX] 12% State Surch 5/21/2008 $8.70
Phone : Total $81.20
Contractor:
ROBERTSON PLUMBING INC
PO BOX 1329
BORING, OR 97009 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 658 -5818
FAX 503- 658 -7106
Reg #: LIC 88717
PLM 3 -184PB
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•" .. �i/ �_ �� •ermittee Signatures
— I
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.
Plumbing Permit Application
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Building Fixtures *: } I�I °RN' F E ZUSE, ON I A a ' t '. "9'
City Of Tigard 11 1 ■ Received �"Fr � • /L . A
+1r a 13125 SW Hall Blvd., Tigard, OR 97223 ^(: QQ% Date/By: ermtt No.: L44.41 1
I
t Plan Review
11 C � Phone: 503.639.4171 Fax: 503.598.1960 kA F ( 2 Date/By: Other Permit No.:
.. - - Inspection Line: 503.639.4175
T IGA'RD;; SG Date Ready/By: luris: ® See Page 2 for
a O
t ay;yp ;, Internet: www.tigard- or.gov all QI ,Sl o t i fied/Method: r 1 p Supplemental Information
• TYPE OF WORK � a . FEE* SCHEDULE '
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. Ea. 1 Total
A Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
•
)C1 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
(( 0 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: C , $ 7 5 ,....) i ( L Catch basin or area drain 16.60
City /State /ZIP: /` ll Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: 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: I 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
L+�-C ` 1‹.( 7C ic f -5 �.l ij f c _ ( K ) D 1 5 H ∎ i'g, -th (C Backwater valve 16.60
D t 5 05 Clothes washer 16.60
P I
-c Dishwasher ( 16.60 ( 1p
0 PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
'� Ejectors /sump 16.60
Name: (I ' Y CD C t i �( Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal ( 16.60 i to
❑ APPLICANT . ❑ CONTACT PERSON Hose bib 16.60
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
Phone: ( ) Fax:: ( ) Sink/basin/lavatory i 16.60 / (
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
. CONTRACTOR Water closet 16.60
Business name: p n t i 7T &A.. p Z C Z Water heater 16.60
Address: p ' 0 r D (i 13 Other: City /State /ZIP: � N • / D �� L'(. Zpn - Subtotal
Minimum permit fee: $72.50
Phone: (5-03 6 ( $- Fax: ( 5b3 Co s 8' - 7i o c, Residential backflow minimum permit fee: $36.25 . 2 a.
�
CCB Lic.: 6 7 7 Plumbing Lic. no.: 3 - 12i y 195 Plan review (25% of permit fee)
State surcharge (12% of permit fee) I:1,70 Authorized signature: O
�e_(ic.t £ /� 5/ , v -7" TOTAL PERMIT FEE q (,
Print name: 9 ip ?- 7 �� Date: y -- 7 2....1 4 5 ., This permit application expires if a permit is not obtained within
‘i)11/(7 p �J Ff� 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
I:\ Building \Permits\PLMF- 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 - I S' 100' 55.00 ; 0 to 2 ;000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3;600Y $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 - Ist 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) 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
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan. Review for Plumbing Installations.
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and
Quauti* by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918 780 - 0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator • Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3 „
-4 „
Car Wash•Drain
Garbage - Domestic Comments regarding fixture work:
• Disposal - Commercial
industrial
Ice Mach. /Refrig. Drains •
Oil Separator (Gas Station)
. Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter • • plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water. Closet - Toilet •
Urinal
Other Fixtures:
i: \ Building \Permits\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD - •
BUILDING DIVISION PERMIT #: Pi 0022$
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: r/21/2(103
Phone: (503) 639 -4171 ,,,•���
Inspection Requests (24 Hrs.): (503) 639- 4175�!i
INSPECTION WORKSHEET FOR DATE: 7121/2008 TIME: 7:01AM PAGE: 56
SITE ADDRESS: 13875 SW 114TH AVE CLASS OF WORK:
SUBDIVISION: VIE:WMOUNT LOT #: 036 TYPE OF USE:
PROJECT NAME: BAI3CO CK
DESCRIPTION: Replacing kitchen :::ink, dishwasher sa nd disposal.
OWNER: BAl3COCK, RON PHONE #:
CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503 -658 -5318
Inspection Request Scheduled For: Date: 7/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 072867-01 503-380-2129 1`
Corrections /Comments /Instructions:
Carc
gJ PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - 1A1 -- Date: ) l 2 � i %0 Phone #: (503) 718-
CITY OF TIGARD . : -
BUILDING DIVISION PERMIT #: PI-M2008- 0O228
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/21/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' A_..
INSPECTION WORKSHEET FOR DATE: 5/23/2008 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 13875 SW 1'I 'ITH AVE CLASS OF WORK:
SUBDIVISION: VIE.WMOUNT LOT #: 036 TYPE OF USE:
PROJECT NAME: BAf3COCK
DESCRIPTION: Replacing kitchen sink, dishwasher and disposal.
OWNER: BAF3COCK, RON PHONE #:
CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: E,03-658-5818
Inspection Request Scheduled For: Date: 51213/100B Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 PI rough -in 070321 -01 503 380-22 50 N
Corrections /Comments /Instructions:
%PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
Li FAIL 1 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 9 A`_, Date: (Si ''') 1/DT) Phone #: (503) 718-
CITY OF
��mu n v��m� m w�����m�� ` ~
BUILDING DIVISION ' PERMIT #: MI2008-00228
1312SSVV Hall B|vd.. Tigard, OR07223 DATE ISSUED: 5/21/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 .��m-� -
INSPECTION WORKSHEET FOR DATE: 5/2I12008 TIME: 6i59AK8 PAGE: 11
SITE ADDRESS: 13B75 CLASS OF WORK:
SUBDIVISION: V1EW LOT #: 036 TYPE OF USE:
PROJECT NAME: BABC0CK
DESCRIPTION: Replacing kitchen uk, dishwasher and disposal.
OWNER: BABCOCK.RON PHONE #:
CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503
Inspection Request Scheduled For: Date: 6/2312008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 P|xmNnQ/ouQ|+in 070276'01 50I380-2260 N
Corrections/Comments/Instructions:
.L 0 y-�� ~T- /s^-,
�
PASS [ 1 PARTIAL APPROVAL CANCEL ri NO ACCESS
FAIL CALL FOR INSPECTION || ADDITIONAL FEES ASSESSED
Inspector: GlitA4.4_J1 \\)\m.~~~ Date: Phone #: (503) 718-