Permit CITY TI CARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 -00576
�i- DATE ISSUED: 10/18/2005
-`'
-� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 24 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT: JURISDICTION: TIG
Project Description: Repipe water only.
Units 24 & 25.
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
BOOTH - HEYDON LLC Description Date Amount
PO BOX 1185
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 10/18/200f. $72.50
[TAX] 8% State Surcharl 10/18/200. $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 direc questions to OUNC by
calling 503-246-6699g 1- 800 - 332 -2344. ' /
Issued By: )/ Permittee Signature OP i << / i _`
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
Plumbing Permit l ,. _I ED _ : e l l c �1_ c ' 1r
City of Tigard . 8 2005 Date/ Recei y. / � / , y _, / /^
� Permit No.T \V.,,, 0 //i's' a j 7 6
� � 1 (N
13125 SW Hall Blvd., Tigard, OR 97 8 Plan Review
Phone: 503.639.4171 Fax: 503.598.7960' • . rr Other Permit No.:
i +< D
'�.; I
24- Hour Inspection Line: 503.639.4175 . y � Date ReadyBy: 1 Jurist ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Not;6 r Supplemental information
' 4 illiksi N FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
1 Addition /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
Each additional bath/kitchen 45.00
❑ Master builder It Other:
. Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address:jy6,L S'W 76-v , Catch basin or area drain 16.60
City /State /ZIP: / i 44 Qg--. / 7Z2 3 - Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: Project name: A �/ Footing drain (no. linear ft.: ) Page 2
' (`" Manufactured home utilities 110.00
Cross reet /directions to job site:
Manholes 16.60
k ,J 7 Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: �t e/ ' i �/ L I Lot no.:
� Water service (no. linear ft.: ) Page 2
z Tjj' Fixture or item
Tax map /parcel no.: {{It
- Absorption valve 16.60
DESCRIPTION OF WORK Back flow preventer Page 2
/ZPill rt t ‘t 04'1 , ..2--,2S, Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
R OPERTY OWNER 1 ❑ TENANT Drinking fountain 16.60
I �� ( Ejectors/sump 16.60 , 9 Name: r yV(4, En Expansion tank 16.60
Address: I Fixture /sewer cap 16.60 City /State /ZIP: V /7/
t/` / k:;1r Q / Floor drain/floor sink /hub 16.60
Phone: (s 3n 14 X l) Fax: ( ) Garbage disposal 16.60
•
APPLICANT, ❑ CONTACT PERSON . Hose bib 16.60
` Ice maker 16.60
Business name:
�)(J (/ Aril Interceptor /grease trap 16.60
'
Contact name: � , � �t i ? f-, Medical gas (value: $ ) Page 2
Address: �li 2 ltiG r c/ / `l f( gl Primer 16.60
City /State /ZIP: eitUr ()// 9 `� 00// Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone:603 ) �. --2 6, p Fax: : LrO3) 6 3 2" 244 Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Pl (t � C J 1 4 L Water heater 16.60
Address: L' 2 ()el N� P1 Other:
City /State /ZIP: S oo V � 7O- Subtotal
Lf {I Minimum permit fee: $72.50
Phone: (...c ) SAL - 11 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: / 3 Wk6 / Plumbing Lic. no.: 343 6�p9 Plan review (25 %ofpermit fee)
State surcharge (8 % m fee)
Authorized si { re: /� ,{ (/ �[� TOTAL PERMIT per FEE
Print nam Date: J,) ! (1 l�? This permit application expires if a permit is not obtained within
( V 180 days after i has been ac cepted of as co Tel mplete.
*Fee methodology set by Tri -County Building Industry Service Board.
i:\ Building \Pernits\PLMF- PermitApp.doc 06/05 440-4616T(10/02/COM/WEB)
•
Plumbing Permit Application - City of Tigard e •
Page 2 - Supplemental Information
Fee Schedule: Residential. Fire Suppression Systems:
Site Utilities Qty.'. Fee (ea) ', Total Square Footage: Permit Fee:
Footing drain - 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 Fiow 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: $50,001.00 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'_Structures -
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 0 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 RiseeDiagram-
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.
\ Building \Pertnits\PLM - PennitApp.doc 07/06/05
�
CITY OF TIG PLUMBING PERMIT
i� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00576
}I 1` DATE ISSUED: 10/18/2005
= -- , 4 ' 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 24 & 25. 8/16/06: This pemit is reinstated for purpose of final inspection
for a period of 30 days.
CLASS OF WORK: OTR 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'GORMAN Description Date Amount
302 ASHLEY DR
UNDERWOOD, WA 98651 [PLUMB] Permit Fee 10/18/200f. $72.50
[TAX] 8% State Surcha 10/18/200f $5.80
[HRPLM] Hourly Plum 8/16/2006 $57.87
Phone : [HRTAX] Hourly 8% St 8/16/2006 $4.63
Total $140.80
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.
f � i
Permittee : r /
—
Issued By: ��zL, 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.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005- 00576
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/20/2005 TIME: 7 :09AM PAGE: 105
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 24 & 25.
OWNER: O'GORMAN, MICHAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503-544 -2160
Inspection Request Scheduled For: Date: 10/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 018764 -01 503 -267 -3668 Y
Corrections /Comments/ Instructions:
R 0 uk .1 -4 t^L) \ 1 Co (A fi 2 ` (�t.�: a 1— 244
PASS [X PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Qrd ; 1 Date: ) O Io/ O`er Phone #: (503) 718-
CITY OF ��mo n n�pm— mun��������
BUILDING DIVISION ',`'
~°~,,~~~�,,~=° ~=,°,~,,~°,~ PERMIT #: PLh820060067G
1312SSVV Hall Blvd, Tigard, ORA7223 DATE ISSUED: 10/18/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 "�� nw- • p����`
INSPECTION WORKSHEET FOR DATE: 9K20/2006 TIME: 7:O1Ahd PAGE: 7
SITE ADDRESS: 14G58 SAN 76TH AVE 24 CLASS OF WORK:
SUBDIVISION: MARCIENE (1 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE 11 APARTMENTS
DESCRIPTION: Rwpi evvaiwronk/.Unbo24 & 26. 8/16/06: This pemit is reinstated pwpoe of tinal inspec:tion for
a period of 30 days.
OWNER: 0G0RKAAN. K8|CMAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503
Inspection Request Scheduled For: Date: 8/20y2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final Oa6D95~D1 503-267-3668 N
Corrections/Comments/Instructions:
/
4Ir
~'8S | PARTIAL APPROVAL | |CANCEL 1 NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
�
Inspector: k� \� ^^ Date: ( ��� /> �° Phone #: (503) 718- ��/ ,/
� "�u � � ` '
I` CITY OFTIGARD
BUILDING DIVISION _ PERMIT #: PLM200L -00 976
13125 SW Hall Blvd., Tigard, OR 97223 s DATE ISSUED: 10/18/2005
Phone: (503) 639 -4171 r11..
Inspection Requests (24 Hrs.): (503) 639 -4175 J. 1 �..
INSPECTION WORKSHEET FOR DATE: 9/18/2006 TIME: 7:01AM PAGE: 61
SITE ADDRESS: 14 €55 SW 76TH AVE 24 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APARTMENTS
DESCRIPTION: Repipe water only. Units 24 & 25. 8/16/06: This pernit is reinstated for purpose of final inspection for
a period of 30 days.
OWNER: O'GORMAN, MICHAEL PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503..EA4 -2160
Inspection Request Scheduled For: Date: 9/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 036660 -01 503-267-3668 Y
Corrections /Comments /Instructions:
A
_ 'L ® ` _ ■
/"
n PASS P ARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: / / � v Date: 1 4 Phone #: (503) 718 - ,r1/0)