Permit CITY OF TIGARD
PLUMBING PERMIT
r, i� DEVELOPMENT SERVICES PERMIT #: PLM2006 - 10054
,��I DATE ISSUED: 3/30/2006
' - - - - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 1128 D -00700
SITE ADDRESS: 14655 SW 76TH AVE 11 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT: JURISDICTION: TIG
Project Description: REPIPE 1ST FLOOR WATER ONLY UNIT 11 AND 12
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 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'GROMANI
302 ASHLEY DR. Description Date Amount
UNDERWOOD, WA 98651 [PLUMB] Permit Fee 4/6/2006 $72.50
[TAX] 8% State Surcha 4/6/2006 $5.80
Phone : 503- 386 -1980 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: ti Permittee Signature: e39.7 /� „�J�.,�•/'u ,�-y
' /
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.
Buildi Fixtures , CE � :� I `P9 s.+�nlr' .9�i 'tip a a a^ 1 '%r* ? .,r c i. ,
Plumb Permit App ic ati on w , ,i F, r, � , � .i -`' ' r'. " > I t , z lr t q
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City of Tigard MAR 3 0 2006 y . 3v�,r�b 66 Permit No.. r LA Ow06, _ AD06 • ,
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.5980M
OF TIGARD i4r,r�; .` of Permit No.:
24- Hour Inspection Line: 503.639 z 1 " � . l � ' Date Ready/By ....f. ® See Pa
P I�I�iLDIfV DIVISIO:�+���'_. S. Page 2 for
, g
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
-
- TYPE OF WORK FEE* SC EDULE..`
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. 1 Ea. 1 Total
j -Addition/alteration/replacement ❑ Other: Newt- 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
1:1:1 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 J Site utilities
Job site address: //74 6 SS ,, W T ( `i� y / � ' , // / Catch basin or area drain 16.60
City/State/ZIP: ----r- Q r C (7R 2 7 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ✓ ( Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site:
Manholes 16.60
74-i ,, Rain drain connector 16.60
i
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: l 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 t
41 / .49i•-•
(� 9 rt? ' r - (,./cot Q f c o ( / 7 Backwater valve 16.60
� / Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER . ❑ TENANT Drinking fountain 16.60
/f/ Ejectors/sump 16.60
Name: /(/l (c LG e 0?-044 G') Expansion tank 16.60
Address: ?" i
e I _ / �-J i (� Fixture /sewer cap 16.60
City /State /ZIP: v_ (U J / Floor drain floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
� Ice maker .
Business name: ( 'f f
Interceptor /grease trap 16 60
Contact name: L 1 i .. ti Medical gas (value: $ ) Page 2
Address: 1 6 . i L J U/a i t 1 7/ fe,.� Primer 16.60
City /State /ZIP: e q id t /rit/ k i� q 7 00 'T Roof drain (commercial) 16.60
• Phone: J I ) `TT 3 2 t5 F ax:: ( q ) Sink/basin/lavatory ory 16.60
v Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
' CONTRACTOR Water closet 16.60
Business name: A L Lc r4 Z Q9 Water heater 16.60
Address: S J r 43 /)E- i l e e h 4 /v / Other:
City /State /ZIP: r p Subtotal
�Q 1 cJ O� ( O s Minimum permit fee: $72.50
Phone: (SU) ) S5 2-1 E L ,+ 0 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee)
S • State surcharge (8% of permit fee)
Authorized si 1 r TOTAL PERMIT FEE 17 •
Print name: 4 V� Date: This permit application expires 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.
i:\ Building \Permiu\PLMF- PennitApp.doe 06/05 440.4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard , \\ 1` 4
; ,,;. l' L ' 4. •
0
Page 2 - Supplemental Information
Fee Schedule: • Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) ' Total . Square Footage: ''. . Permtt: 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
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 Back flow 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 $25,00l.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: $50,001.00 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 Struc
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.
_ Quautity (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 ❑ Any NFPA 1 3-D multipurpose fire sprinkler system.
Eye,Wash '
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain Isom etric -or RISer "Diagram ,
Garb ge - Domestic ❑ Isometric or.riser diagram is required for new buildings
Disp sal -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 \Pennits\PLM- PetmitApp.doc 07/06/05
CITY OFTIGARD
- BUILDING DIVISION PERMIT #: PLM 200 -100 4 . .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30/:2006
Phone: (503) 639 -4171 ��1�����
Inspection Requests (24 Hrs.): (503) 639 -4175 .�--«i _ �r,_..
INSPECTION WORKSHEET FOR DATE: 77/2006 TIME: 7 :07AM PAGE: 9
SITE ADDRESS: 14655 SW 76TH AVF 1.1 CLASS OF WORK:
SUBDIVISION: MARCIENF II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE APTS
DESCRIPTION: REPIPE 1ST FLOOR WATER ONLY UNIT 11 AND 12 ,
OWNER: MICHAEL O "GROMANI, PHONE #: 503.306_1980
CONTRACTOR: PLUMB CRAZY PHONE #: 503.514 -2160
Inspection Request Scheduled For: Date: 9/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 037250-C14 503 -267 -3668 Y
Corrections /Comments /Instructions:
7
Z - 0 4 - ---- - - - A (4/- d‘a I e . - - -1 r ,)' r
(' 631.---11, .,(/, K - 7 2-10---)
...----)
p LFASS _ PARTIAL APPROVAL l] CANCEL NO ACCESS
FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: e rl° 1-: )) 6 ( Phone #: (503) 718- vi
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006- t0054
13125 SW Hall Blvd., Tigard, OR 97223 r —.:, DATE ISSUED: 3/30/7006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 2!���'�'�� .
INSPECTION WORKSHEET FOR DATE: 8,14l2006 TIME: 7:01AM PAGE: 10
SITE ADDRESS: •14655 SW 76TH AVE 11 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: M ARCIENE ANTS
DESCRIPTION: REPIPE 1ST FLOOR WATER ONLY UNIT 11 AND 12
OWNER: MICHAEL O't3ROMANI, PHONE #: 603.3j0.19 )
CONTRACTOR: PLUMB CRAZY PHONE #: 503 - 544.71 Go
Inspection Request Scheduled For: Date: 8/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 034914 -03 503 - 266-5720 Y
Corrections /Comments /Instructions: C9-2
—
C
l
C
Fl PASS n PARTIAL APPROVAL ❑ CANCEL U NO ACCESS
n FAIL 1 1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
I
CITY OF TIGARD C -
Ali BUILDING DIVISION 1 J / PERMIT #: 2 Q G — / oacy
13125 SW Hall Blvd., Tigard, OR 97223 i. - DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 * 1 1
INSPECTION WORKSHEET FOR DATE: 3/3 Op TIME: PAGE:
SITE ADDRESS: / ki 6 s-- 7 / ^~ CLASS OF WORK:
SUBDIVISION: LOT #: t TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: 41 PHONE #: 7_ 7 '3 4 6 k
Inspection Request Scheduled For: Date: Pour Time: c' Q i - `--"'�
Code # Inspection Description Confirm # Contact # Message
G�
3 Pt4.(44 h ,& (L Piv.
Corrections /Comments /Instructions: i
7/77 ___, .e.4.— - 4._ ._ / %OP
•
Q 4--IPA‘.. SS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL _ CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED
Inspector: T2r\ 4 Date: Phone #: (503) 718 -