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Permit • CITY TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00226 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/1/2007 PARCEL: 2S112BC -03400 SITE ADDRESS: 14660 SW 83RD AVE ZONING: R -4.5 SUBDIVISION: HAMBACH PARK LOT: 018 JURISDICTION: TIG PROJECT: WALDO Project Description: Installation of backflow preventor for irrigation. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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 KENNETH WALDO 14660 SW 83RD AVE Description Date Amount 14660 SW 83RD [PLUMB] Permit Fee 6/1/2007 $36.25 TIGARD, OR 97224 [TAX] 8% State Surcha 6/1/2007 $2.90 Phone : 503- 684 -2785 Total $39.15 Contractor: r OWNER .� REQUIRED ITEMS AND REPORTS O • Contact # . Reg #: 'P . 1 H(6r VZ,1 • aN > i =,�i:ax aMP�rrkyAA�t * sY +tG ` :,,o: 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 - Ge. ter. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of ' these rules or direct que . ons- toOUNC by calling 503.246.6699 or 1.800.332.2344. �� Issued B • ��i�.�S� - ' Permittee Signature � ii-� r � �� % / , r _:.,_ 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 #: PLM2007-00226 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/12007 Phone: (503) 639 -4171 a �,�ii� fili 1 I\ Inspection Requests (24 Hrs.): (503) 639 -4175 J .J 1 INSPECTION WORKSHEET.FOR DATE: 6/1812007 TIME: 7:04AM PAGE: 38 • i SITE ADDRESS: 14660 SW 83RD AVE CLASS OF WORK: SUBDIVISION: HAMBACH PARK LOT #: 018 TYPE OF USE: PROJECT NAME WALDO DESCRIPTION: Installation of bacl4low preventor for irrigation, OWNER: WALDO, KENNETH PHONE #: 503 -684 -2785 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 611•12007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 050353 -01 503 -6814- 2785 N Corrections /Comments /Instructions: .Ps'f Zer°. d i7/41 i PW/I / , I I PASS r P rTIAL APPROVAL ❑ CANCEL NO ACCESS n FAIL ' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: I V Date: , Phone #: (503) 718 - INSPECTOR'S SIGNATURES ARE NOT Inspections Required for. gOo —CO ,REQUIRED. ON GREEN INSPECTION CARD. By Code Inspection Description � PASS Date B ✓ Code Inspection Description PASS Date By ✓ I � BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground /slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG- Structure grading /footing 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post /beam structural 150 Hot tub /spa /pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors 199 Electrical final 240 Exterior sheathing 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG- Structure set -up MEC - Mechanical Permit 280 Insulation 605 Post/beam mechanical 285 Drywall nailing 610 Gas line 287 Suspended ceiling 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG- Structure final 625 Duct work 498 Grading final 630 Fire damper 299 Final inspection 635 Smoke detector shutdown 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 305 Plumbing underslab 915 Fire alarm rough -in 310 Crawl drain 920 Suppression trip test 315 Post/beam plumbing 995 Misc. inspection: 320 Plumbing rough -in 998 Alarm final 322 Shower pan 999 Sprinkler final 330 Water service 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 345 Culvert/catch basin 405 Excavation 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: "205. Footing 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit ,495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I:\ Building \Forms \InspCard- AOP- Blankdoc 02/02/07 c1;YZ ^y CITY OF TIGARD PLUMBING PERMIT .=' COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00226 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/1/2007 PARCEL: 2S112BC-03400 SITE ADDRESS: 14660 SW 83RD AVE ZONING: R -4.5 SUBDIVISION: HAMBACH PARK LOT: 018 JURISDICTION: TIG PROJECT: WALDO Project Description: Installation of backflow preventor for irrigation. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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 KENNETH WALDO Description Date Amount 14660 SW 83RD AVE 14660 SW 83RD [PLUMB] Permit Fee 6/1/2007 $36.25 TIGARD, OR 97224 [TAX] 8% State Surcha 6/1/2007 $2.90 Phone : 503- 684 -2785 Total $39.15 Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact # : Reg #: 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 e ' ' .tion Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of the: - rules or direct que on . OUNC by calling 503.246.6699 or 1.800.332.2344. r Issued By: i lt,04/4/LI Permittee Signatur- At / 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. Plural •mit.A Iication • ,.. ' : " 3 , : 6 , Ov k i#l' OFFICE' .' tfe*. 14: ON iY+ il '� v t: ; t: _,� Permit No.: i.TIC a t `° City of Tigard Received 1>A / / / �� ! ti .: g w DO T/' ' L /7' j ��v° XJ Sr:; Date/By: �, 4 a 1 3125 SW Hall Blvd., Tigard, OR 97223 !e Plan Review . C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.: +FO^ - 1 Inspection Line: 503.639.4175 Date Read /B 1 RI Pa e 2 for �TI GnRDi' Ready /By: B ,, , .1 ir° Internet: www.tigard - or.gov Notified/Method: 6 Supplemental Information ' . . TYPE OF WORK • FEE* SCHEDULE ' ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION . SFR (1) bath 249.20 ❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ 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: j 4(4:6 g:A) 8 ' 114-4e Catch basin or area drain 16.60 City /State /ZIP: t �'�� 0 R 97 2' f Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: ,�' jA1 �� Footing drain (no. linear ft.: ) Page 2 L" 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 Stone 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. . Backflow preventer / Page 2 4' 95 14/.-I� f- � 1-491)-(--`2-- Backwater valve 16.60 `�'� Clothes washer 16.60 Dishwasher 16.60 ' I�rROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: / - � N / �- - -. E L, L D O Expansion tank 16.60 Address: 11 (l� c c, Q _ X.y.e Fixture /sewer cap 16.60 City /State /ZIP: "-c-- .Q � ) p 9 ' 2_2_ of Floor drain/floor sink/hub 16.60 Phone:( SAC z7- s Fax: ( ) Garbage disposal 16.60 - ❑ 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 Sink/basin/lavatory 16.60 Phone: ( ) I Fax: :( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 . CONTRACTOR Water closet 16.60 Business name: Water heater 16.60 Address: t /�� Other City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) �_ y0 Authorized signature: 1 /G��'CJ 46 X �� TOTAL PERMIT FE (y, Print name: ��E \ .) E- j am- Date: This i,- 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. 1: \ Building \Permits\PLM- 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 S i uare:Footage: Permit Fee: • Footing drain - 100' 55.00 0 to 2,000 $I 15.00 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 Storm &Rain Drain - 1st 100' 55.00 Valuat1 n:. � Permit:Fee:. , $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: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", • Plan Review for.Plumbing Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. • Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: • ' Replace . greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure Jacuzzi /Whirlpool as defined in OAR918- 780 -0040. Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities. Drive tall ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash • • Isometri or. Riser D iagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. -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 *Note: 'If the fixture work under this permit results in an - Bradley P - 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 L 4 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 4", Inspection Requests (24 Hrs.): (503) 639 -4175 ...' .• a& INSPECTION WORKSHEET FOR DATE: TIME: PAGE: („` /, e5S e S SITE ADDRESS: CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: 11 -- ii WN=: .Sr L // 0 l/‘" j1.ny j PHONE #: CONTRACTOR, s j PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 344 ' - .AA) - 4.21/4.1■` C Corrections /Comments / Instructions: 1 1/4 t o Coo Aura . C.. o - 7 - 0 0 - 2 . - ? ) S --4 ; - - /t 2 S 12-6 133 '? A--e - (_?() — 1--v a (a. — Oa 344 0 g 1 L o Ve.:1 I t NIGj -1 V - % C ?1)i 26-40 - 06 2 : - 7 - ) s - /. 0 . -- ra,S 4- e ..?0 \ nett r ‘ (I ( ' 4F- Ai r l;Se‘ , i t -- e q ‘ 1 A . C POWL ° - 7 --- 6 0 q i .mss - - 16 Z C:x.-"..4-4z,v los t.., n, 4 MI—.1 Lo— I 4 4 , 1 — 1 3 2 . s c i — 0 * 1 O D \ 4 - ii . i k e - - 1 2 . , 42 . CQLI' - 1,b d G Oo' 1 CF) �� _ I PASS P RA TIAL APPR VA 4- _ CANCEL T NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718-