Permit CITY OF TIGAR®
PLUMBING PERMIT
'DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00682
=� � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/9/2005
PARCEL: 2S 112B D -00700
SITE ADDRESS: 14655 SW 76TH AVE 16 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT: JURISDICTION: TIG
Project Description: Repipe water only.
Units 13,14,15,16.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF 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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BOOTH - HEYDON LLC Description Date Amount
PO BOX 1185
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 12/9/2005 $72.50
[TAX] 8% State Surcha 12/9/2005 $5.80
Phone : Total $78.30
Contractor:
PLUMB CRAZY
52683 NE SHEENA PL
SCAPPOOSE, OR 97056 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503 -543 -3920
PRI 503 -544 -2160
Reg #: LIC 138864
PLM 3436 -PB
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: l/ /� 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.
Building Fixtures �
rnbilrlicr Permit Application ` :: 'Qs 4 l 11l It (NI :. ;
City 'of Tigard { l I -(`, 2 R ece ived ., 1 g [ < Date/By i i A - ./1") OM Permit Nd . /4 . 't.
13125 SW` Nall Blvd:; Tigard, OR 97223 IT D -
I= - IGA Plan Review
Phone: 503.639.4171 `Fax: 503.598.1960 C // • .,r_ O t h er P ermit No.:
24- Hour Inspection Line :503.639.4175 BUILDING . ifi J Date Ready/By: t ° " Iii See Paget for
Internet: www.ci.tigsrd.or.us Notified/Method ) I Supplemental Information
TYPE OF WORK FEE* SCHEDULE , .. . .
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
,tddition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ulti- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE r INFORMATION AND LOCATION Site utilities
Job site address: /44 6SJ' S W 6 /J (J _ ( Catch basin or area drain 16.60
City / State/ZIP: • / , �/ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name:,, • , t _ �W Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site:
Manholes 16.60
J ah ,dA Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
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
DESCRIPTION OF WORK Back flow preventer Page 2
t fst`munorr�`_'!ati0d , Backwater valve 16.60
/'� A INW 11il Clothes washer 16.60
Dishwasher 16.60
_RO ERTY OWNER I ❑ TENANT Drinking fountain 16.60
1 Ejectors/sump 16.60
Name: � t I / � d Expansion tank 16.60
Address: 3 b 2 d ( ( �``��Y � c "-' - .. Fixture /sewer cap 16.60
City /State/ZIP: f / r r�ed r A 9 I Floor drain/floor sink/hub 16.60
Phone: ( ) V t Fax: ( ) Garbage disposal 16.60
A APPLICANT ❑ CONTACT PERSON Hose bib 16.60
L Ice maker 16.60
Business name: C Jr, Interceptor /grease trap 16.60
Contact name: i i g' 6 , `""et.... Medical gas (value: $ ) Page 2
Address: likli raf a7Ar/` Primer 16.60
City/State/ZIP: e exeve'ttrcei n_ q7 0 7 L Roof drain (commercial) 16.60
Phone: ( sw� j) 632 '7-1/(J-C'
li-C Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
• � /� � � C�T Z R - Water closet 16.60
Business name: v Water heater 16.60
Address: S2/ k3 /t/c A al...L P/
City /State/ZIPS k pod rrww 011... ! 7 05 /
• Other:
(O Subtotal
del Minimum permit fee: $72.50
Phone: (S ) i /s C - 6 o Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: / 3 I PJ umbing Lic. no.: 3 *3 6.
Plan review (25% of permit fee)
' i/ / State surcharge (8% of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name ` i��a I Date: /_✓7 ✓0s This permit application expires if a permit is not obtained within
\(j ' [ 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\ Building \Pennnits\PLMF- PemnitApp.doc 06/05 4104616T(10/02ICOM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information �``
Fee Schedule: Residential Fire Suppression Systems:
Site .Utilities Qtr. Fee (ea) Total Square Footage: Permit ,--_ .
Footing drain - l' 100' 55.00 0 to 2,000 $11 5.00
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 F
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
specially requested inspections - per hour 72.50 and including $50,000.00.
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 Complex St
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report.fixtures could result in increased sewer fees *. Please check all that apply.
, Quantity by (Fixture)' Work Performed ❑ Any new commercial buildin
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
- Previous Capped Added . Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi /Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
•
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service • -
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain
❑ Any NFPA 13 -D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4 „
Car Wash Drain Isometric -or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains •
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory .
- Bradley .
-Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results i
Water Extractor p erm resu in an
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: - plumbing permit can be issued.
i:\ Building \Pennits\PLM- PennitApp.doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION iii ' PERMIT #: PLM2006-00682
.
13125 SW, Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1219/200.5
Phone: (503) 639-4171 A
,, ■ill i ;
Inspection Requests (24 Hrs.): (503) 639-4175 ..,......,._fa ow 4 1L.
—
INSPECTION WORKSHEET FOR DATE: U/30/2.')Q5 TIME: 7 PAGE: 1.9
•
SITE ADDRESS: 14655 SW 76TH AVE 13 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIE:14E H APARTMENTS
DESCRIPTION: Repipe t
ti.!:i.t.)‘
OWNER: O'GORMAN, MICHAEL PHONE #: 503-306-1980
CONTRACTOR: PLUMB CRAZY PHONE #: 503-514-2160
Inspection Request Scheduled For: Date: 11/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 040476-03 503-267-3668 N
Corrections/Comments/Instructions:
7 K7ASS fl PARTIAL APPROVAL 7 CANCEL fl NO ACCESS
I I FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector:
O0/ i V -r.. Date: / t Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION - - ; i PERMIT #: PLMvi2OOE- OOCG82
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/%200E
Phone: (503) 639 -4171 ° 2 , ., , i ii0
Inspection Requests (24 Hrs.): (503) 639 -4175 ±i 1_..
INSPECTION WORKSHEET FOR DATE: 8/14/2006 TIME: 7 :01AM PAGE: •i2.
SITE ADDRESS: 14656 SW 76TH AVE 13 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: • TYPE OF USE:
PROJECT NAME: MARCIENE II APARTMENTS
DESCRIPTION: Repipe water only.
Units 13,14,15,15.
OWNER: BOOTH HEYDON LLC, PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503.5414 -216()
Inspection Request Scheduled For: Date: 8114 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 034314 -01 503 - 266 - 5720 N
Corrections /Comments /Instructions:
•
PASS n PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' i i{(7 /
Date: / L G Phone #: (503) 718- 2�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLIV1i200.: :-.00632
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: //412005 TIME: 6:L AM PAGE: 3
SITE ADDRESS: 14656 SW 7GT1 AVE 16 CLASS OF WORK:
SUBDIVISION: MARCIENE 11 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE 11 APARTMENTS
DESCRIPTION: Repipc.1 water only.
Units 13,14,16,16.
OWNER: 1300TH- i LL(:, PHONE #:
CONTRACTOR: PLt1MB CRAZY PHONE #: 503 - 2160
Inspection Request Scheduled For: Date: 1141 2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 024362 -01 503-261-3660 Y
Corrections /Comments /Instructions: f c ufivA
Airr
rtg PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
_ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: M Date:' t6 Phone #: (503) 718 -
CITY OF TIGARD t
BUILDING DIVISION M PERMIT #: PLM200 A -00682
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/9/2005
Phone: (503) 639 -4171 - '� 1�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_.
INSPECTION WORKSHEET FOR DATE: 12/12/2005 TIME: 7:02AM PAGE: 4
SITE ADDRESS: 14655 SW 76TH AVE 16 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APARTMENTS
DESCRIPTION: Repipe water only.
Units 13.14,15,16.
OWNER: BOOT H - HEYDON LLC, PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503544 - 2160
Inspection Request Scheduled For: Date: 12/12/2005 Pour Time: .
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 023305 -02 503-267-3668 N
Corrections /Comments / Instructions:
* .' ' AP
. ! i _
•
PASS ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
irili
a/ p ) /9f P hone #:
Inspector: Date: (503) 718-