Permit CITY THGARD PLUMBING PERMIT
I6 DEVELOPMENT SERVICES PERMIT #: PLM2005 -00662
DATE ISSUED: 11/30/2005
-" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 24 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT: JURISDICTION: TIG
Project Description: Repipe water only.
Units 1,23 &
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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
MICHAEL O'GORMAN Description Date Amount
302 ASHLEY DR
UNDERWOOD, WA 98651 [PLUMB] Permit Fee 11/30/200f. $72.50
[TAX] 8% State Surcharl 11/30/200E $5.80
Phone : Total $78.30
Contractor:
PLUMB CRAZY
52683 NE SHEENA PL REQUIRED ITEMS AND REPORTS
SCAPPOOSE, OR 97056
Phone : 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- � "" 66999 � or 1- 800 - 332 -2344. /
Issued By: -2,.. 1,u� Permittee Signatur l
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
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Plumbing Permit A Pli�cat'o 4 � ; , : ` ',;tr.; '' � �( 1 1�N ve6i f iA,
City of Tigard H E t t i V E Received
Date/By. ermit N'.3 ��� 6
y / 1 -1.71 D o: 1� 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598. X960 , r\ 2 005 Gd k� ,/� �.. � ,, . D � /By Other Permit No.:
24 - Hour Inspection Line: 503.639.41'75 c. U , i : Date Ready/By: tuns ® See Page 2 for
Internet: www.ci.tigard.or.us CITY nF TIC-1ARD Notified/Method "rl Supplemental Information
BITPLITIRM'4g�ION FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
JAddition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ l- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ta,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: /I6 5 & _S 76,■ A ? - Catch basin or area drain 16.60
City /State /ZIP: l 7 ar i OF- q L2-3 Drywell, (each line, or trench drain 16.60
Suite/bldg. /apt. no.: J Project name: Footing drain (no. linear ft.: ) Page 2
f �L e+v Manufactured home utilities 110.00
Cross street /directions to job site:
Manholes 16.60
eok1(14, 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 Back flow preventer Page 2
gt le ( Li -4- 2**1 C -Pc,- A / l ,.-. 3 r T Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
El PROPERTY OWNER ' I ❑ - TENANT Drinking fountain 16.60
/ Ejectors/sump 16.60
Name: fi L l Q Gr ,--.14.1 , '^ Expansion tank 16.60
Address: 3 0 .� ,4J /i / (Y Fixture /sewer cap 16.60
VIA r �lcr 6 S
City / State/ZIP: ' 1 Floor drain /floor sink/hub 16.60
v � hi Ik
Phone: (cif() ' . ( - / o/ /Q Fax: ( ) Garbage disposal 16.60
•
APPLICANT ❑ CONTACT PERSON Hose bib 16.60
/ � t� Ice maker 16.60
Business name: - f f t(j (vl Interceptor /grease trap 16.60
Contact name: ii .‘ ‘ r - v - -- , ,, - Medical gas (value: $ ) Page 2
Address: l �� 1 _S S. LiztrJ.r 41. I( N, Primer 16.60
City /State/ZIP: . �Cy(uecC I^Zt' k. OP- q1 06'' Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: (�p! 1 Fax: ( ) Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
" • _ CONTRACTOR Water closet 16.60
Business name: Pi u "1 Ce 2 tie Water heater 16.60
Address: S 2 b W ti 4/C -- J.41 14 L Other:
City /State /ZIP: „ u y • / t T. Subtotal
T.) �(� `' n � " � � Minimum permit fee: $72.50
''MM
Phone: (( ') S ( 6 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.:: / 3g r G - Plumbing Lic. no.: 3 3 L--- Fe Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:
Ai' TOTAL PERMIT FEE
Print n• i,,,„ffiwifigiv Date: P This permit application expires if a permit is not obtained within
1. ....- 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
is \Building\ Permits\ PLMF- PennitApp.doc 06/05 440-4616T(10 /02/COM/WEB)
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site;Utihties Qty, Fee (ea) Tota Square Footage: Permit;Fee
Footing drain - 1 100' 55.00 0 to 2,000 5115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 5160.00
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 Fee: • -
Storm &Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee 572.50
Storm & Rain Drain - each additional 100' 46.40 55,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 51.52 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 65.25 525,001.00 10 550,000.00 $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 first 0.00.
Subtotal: $50,001.00 and up 5742.00 for the e first st $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: - Review for Complex Strctures •
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 building.
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 area
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain
Eye Wash ❑ Any NFPA 13 -D multipurpose fire sprinkler system.
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isometric or. Riser Di
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 in an
Water Extractor p
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 \Permits\PLM- PertnitApp.doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200S -00662
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 - 4175''
INSPECTION WORKSHEET FOR DATE: 11/30/2006 TIME: 7:OOAM PAGE: 21
SITE ADDRESS: 14655 SW 7611 AVE 1 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APARTMENTS
DESCRIPTION: Repipeiwyee;Oi
Units ..,2:37: J�::
OWNER: O'GORIVIAN, MICHAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 50:3 -54 -2160
Inspection Request Scheduled For: • Date: 11/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 040476.01 503-267 -3668 N
Corrections /Comments/ Instructions:
•
t( a
PASS 1 PARTIAL APPROVAL fl CANCEL NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: A Ar, Date: / //3l/1/ Phone #: (503) 718 -" �f
CITY OF TIGARD PL m
BUILDING DIVISION PERMIT # a 0 v S— CDU 6 Co
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
A Inspection Requests (24 Hrs.): (503) 639 -4175 ZIP
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / L,L -s 6, 5 76 } /Vv CLASS OF WORK:
SUBDIVISION: J LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: Q L3 1 PHONE #:
Inspection Request Scheduled For: Date: 3-2_ — D G Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Ac--f ,A C-7 -3� &
vf,v.4
Corrections /Comments / Instructions:
/o - d A-1m.
6a -a k. -. , gc 2A__ 4 _,( 5 ..) "
•
4FASS 1 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ° - Iv "(/ Date Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: PLM2005- 00662
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 .' " 'I..
INSPECTION WORKSHEET FOR DATE: 12/1212005 TIME: 7:02AM PAGE: 5
SITE ADDRESS: 14655 SW 76TH AVE 24 CLASS OF WORK:
SUBDIVISION: 1MMARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APTS
DESCRIPTION: Repipe water only.
Units 1,23 &4.
OWNER: O'GORMAN, MICHAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503 - 544 21 60
Inspection Request Scheduled For: Date: /2/1212005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 023305.01 503-2673668 N
Corrections /Comments /Instructions:
.' / L / ■`t
l
r
PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
U FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: d Date: ! _ Phone #: (503) 718-
CITY OF TIGARD ._ v __. ;
BUILDING DIVISION PERMIT #: PLM2005-00662
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3012005
Phone: (503) 639 - 4171 " .,. ,
I iiG
Inspection Requests (24 Hrs.): (503) 639 -4175 ' °�'I
INSPECTION WORKSHEET FOR DATE: 1219/2005 TIME: 7:04AM PAGE: 1
SITE ADDRESS: 14655 SW 76TH AVE 24 CLASS OF WORK:
SUBDIVISION: IVMARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APTS
DESCRIPTION: Repipe water only.
Units 1, 23 &4.
OWNER: O'GORMAN, MICHAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503 - 544 -2160
Inspection Request Scheduled For: Date: 12/9/2005 Pour Time:
Code # Inspection Description Confirm # C act:.# Message
320 Plumbing rough -in 023216 -01 503- 267 -366a Y
Corrections /Comments /Instructions: i
CA Z /C
f (c/.
`4 PASS Li PARTIAL APPROVAL fl CANCEL 7 NO ACCESS
1 FAIL 1 1 CALL FOR INSPECTION ( ADDITIONAL FEES ASSESSED
�y /
Inspector: Date: S Phone #: (503) 718-
-in CITY OFTIGARD .,,,,-. .
BUILDING DIVISION ` , PERMIT #: PLM2005 00662
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/30/2005
Phone: (503) 639 -4171 / ,,,,,,.., , „�� � A,
Inspection Requests (24 Hrs.): (503) 639 -4175 ! "'I
INSPECTION WORKSHEET FOR DATE: 12/1/2005 TIME: 7:08AM PAGE: 4
SITE ADDRESS: 14655 SW 76TH AVE 24 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APTS
DESCRIPTION: Repipe water only.
Units 1, 23 &4.
OWNER: O'GORMAN, MICHAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503 -544 -2160
Inspection Request Scheduled For: Date: 12/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 022772 -01 503 -267 -3668 N
Corrections /Comments /Instructions:
7
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-
A ' ..L.d.:16411111 IP :
i 15----7- /
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n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspecta1f:/' Date: ` VP Phone #: (503) 718 -
iN