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Permit
CITY OF TIGARD PLUMBING PERMIT ` a " COMMUNITY DEVELOPMENT Permit #: PLM2010 -00232 T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2010 Parcel: 2S103DD05500 Jurisdiction: Tigard Site address: 10895 SW GARDEN PARK PL Subdivision: GAARDE PARK Lot: 38 Project: Demaree Project Description: Install 125' of new storm sewer and replace roof drains. Owner: FEES DEMAREE, THOMAS Quantity Description Date Amount 10900 SW GARDEN PARK PL, #A TIGARD, OR 97223 125 If Storm and Rain Drain 07/21/2010 $100.06 PHONE: 1 12% State Surcharge - 07/21/2010 $13.51 Plumbing 1 ea Rain Drain - Single Family 07/21/2010 $12.51 Contractor: Dwelling THE EXCAVATORS LLC PO BOX 690 YAMHILL, OR 97148 PHONE: 503 - 708 -2706 FAX: 503- 662 -3513 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $126.08 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to NC by calling 503.246.6699 or 1.800.332.2344. Issued By: / 7 d Permittee Signature: /(1 / .../0 6_ / C 77D /V _ 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. Jul 21 10 08:47p Gary G. LaRue 503.662.3513 p.1 B7/21/2010 12:00 5e1311MIVED CITY OF - 1.1CSANU . ......_ plumbina Permit Application ;.,..,..,., ,.....::...,..., ._. . Building Fixtures JUL 2.ti4)... : .... , , ,,,. d‘..r.i, i: ( ;..: R.:Lived , , jr,, City of Tigard i y e T1 lAA 201G - ,./gy. Ey N - 13125 SW Hall Blvd.. Ti t.i. .... g , ' 14 • Phone: 503.639,41.71 nt-I'Ll". , : 1 ?Inn Review Code/Flyi WU: Minsk No.: Inspection Line: 503.639.4175 . (ATV:" - .7 See Page 2 ror Intone: wwwtigard-orgov 5t y l',..c.v.- 7; '. .; rir.%; thliiktindelhod: Air ,ip. 4 .1cinenhai Incitniation ''''''' ''''..' • . 14,1-41W :: ' ' '.: '' 'ilrea":1***Cible .. .: .: . .-..:..'- ::- :6-1 '" For special infonfrathifit use checklist. [3 Ncw cxmstruction 0 Demolition Dcsai . :on .. . P.a. TO1$1 ;". .. dditien/atterationimplaccment 0 Other mc,.. 1- 2-0imily dwellings inclutim 10011. for each utility conncelion) • ::'.. :':•': .--•:- ::. ••• -..: .: .- - • :,•:. 47CtillittOtig4Migagteglitlt04141:7,',..:.! - - • - •••• SFR. (1) bath 31170 SER (2) bads 437.78 tp 1- and 2-fttnily dwelling 0 Commercia1Andustrial 5FR (33 bath 50032 El Acccs,nry buildina 0 Multi-flunily Each additional babincitdicn 25.02 0 Master builder 0 Mbar. Fire sprinkler (__ sq. ft.) 1 Page 2 1 : . . ' '''•"' :-.. -:'. ' VD lkWibte ' • • Site utIlltlem Catch basm or arca drain 18.76 Job site address: Le f p 75 .5 c E --"/ Ag i o t Drynell leach line, or trench drain 18.76 City/State/DP: Footing drain (no, linear ft: ____) Page 2 Suite/bldg./apt no.: Project um= 4ii6E-r- Manalludaucd home Militias 50.03 Cross street/directions In job site: Manholes 1816 . . Rain drain connector 18.76 • Sanitary scum (no. linear R.: ) Page 2 Storrs sewer (no. lineal' ft.: ) Page 2 Water service (no. linear R.' ___) Page 2 Subdivision:. 1 Lot. no.: Fixture Or KM: Backflow Presenter 31.27 Tax map/parcel 110.! ' " • '''• • .• ::ivi'..titertittlitf44:--.::. • • Backwater vain • , 12.51 .. . , , Clothes washer 25.02 /AIS,7e S027- -C6711672-. f Dishwasher 25.02 A G - - i 0 eiY- E Am.- 461-4-..../ Drinking fountain 25.02 ,... Elm:tots/sun" 25_02 I • :'. . .101tippitery.****...,7.-r..-:...1,1!77::-: .•.-::,•si:',41:1-riarosIOT • -. . ,.. . Expansion tank 12.51 --77.-.- Fixtureiscwa cap 25.02 Name: 77,e / 4bZ 4 Floor &min/Roof sinIclhub 25.02 Address: . . e 64 900 g e0 Ce-te,b& ii- Garbage disposal 11.111 25_02 City/State/ZIP: 776 I (5/Z 97,2 2 .3 --or .9 Hon bib MI 25.02 Phone: _ ,S 2 - 9 •3 Fax: ( ) Ice maker 12.51 ; c . - c - .;t: i: ;t7:74 ..7: ...;. -,: beercepter/grease tons • 25.02 111111 Medical gas (value: $ _ ) Page 2 Business name: et.dArt. Rimer 1151 COlIttel name: Ronf drain (commercial) 12.51. Address: Sink/basia/lovatory 25.02 • City/StatcrBP: Solar Unit, (POtabIC 'a ater) 62.54 Plione: ( ) Fax: : ( ) Tohishowerisbower pan 111.11 12.51 1.1tinal 25.02 E-mai 17 : • a • A ir e ft : __,-• . dr..." - , A r • 1 LW . ..:-...:v --:..:.: -;•-.:::- .i;...:: . 7: ...::::':::::,;:-: • '..- .. . --.: .• , ..;44:..i.Z.::4:, ,,- ...`..".;.s..*::.„ • , .1 , ..- ' .7: • Water cieset 25.02 - • -- • • • 37.52 Business name: 7 cli- et9-777' c Water piping/GwV 56.29 Add re ss: i , 9 0 Other 25.02 City/Stoic/7 7,r9.05/74.e...c.., 49Z- 97/ ift:e Subtotal PliDn "'-A7194. Fax t.co. 66A - .352.3 Minirnum permit fee: 872.50 a Lic.: / .-g g_,, 111u,;.s..r.....::.:L_ 4 a--.3 Plan review (25% of permit fee) 5 State surcharge (12%0f. permit fee) MI Authorized signature: • 4 ,, A ....M.M1117 - TOTAL PERMIT FEE 7 ..:^7 /0 TUI permit .• Orono. cnotrai if • vomit Iv iuct obtrineci letlkin IND (1.p. C=111 'irlIFW Date. ' after R. his been occepeea its complete. i ee n • • .. logy act by Iri-Counly Building Industry service Board. / V .-,5tio 66 7 -.5 -. , 5 - 9 e - / F 4 0 •f :0/01 109 acr-ulbroarcarcomiwErs) 7 ytrz<_.. . "e_c_ Plumbing Permit Application c g pEev..- ; Fixtures � ,� a h �r� � :I oHI lci Building lisF. ��t � . .�_ . .. ' City of Tigard Received �7 �,�( /) s� g JUL 21 20 1 0 DateBy: 2, /p`Z / / / rJ i'(y/! Permit Noi001a0 /Q- QL,t753� q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review J J C • Phone: 503.639.4171 Fax: 503.598.196 r , r y Other Permit No.: Inspection Line: 503.639.4175 6 ITY O F T - D ateB PG• RD T I G A Ir I) ��^ Date ReadyBy: .12 See Page 2 for Internet: www.tigard-or.gov 6U1LDIN . V!S +o�u l, Notified/Method: 77 H upplemental Information b' TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total kddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION ' SFR (1) bath 312.70 r 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 building SFR (3) bath 500.32 ❑ Accessory g ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: /06 9 5 $ j / /°Z Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: �/yr5 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: Page 2 jQ 0 , (4:-. Water service (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK • Backwater valve 12.51 Clothes washer 25.02 / N S 7 ) - S r/7 E� Dishwasher 25.02 A� ( E I fr -f /f _ -C I .4 - Drinking fountain 25.02 Ejectors /sump 25.02 . KPROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: � . /t -,5 6-' Fixture /sewer cap 25.0 - ` 9 00 LC) - 2I � AV--X- PL Garbage drain/floor disposa l 25.02 sink/hub 25.02 Address: � � d Garbage disposa City /State /ZIP: 6,g� j d2 d 7a ��" Hose bib 25.02 Phone: (,C 2, - 4 #0 75 -3 Fax: ( ) Ice maker 12.51 ❑ APPLICANT • CONTACT- PERSON Interceptor /grease trap 25.02 Business name: ©tuAt�� ,�� Medical gas (value: $ ) Page 2 / Primer 12.51 Contact name: V - ��, , Roof drain (een+ntetciaf}- �S i 12.51 �a , Si ` Address: / Sink/basin/lavatory 25.02 City /State /ZIP: / t Solar units (potable water) 62.54 Phone: ( ) Fax: : : ( / Tub /shower /shower pan 12.51 IL / Urinal 25.02 E - mail: 7n.cZ ? /)') a /-, a //� o n . 1-...4 n--1 k _ CONTRACT 6R i! � Water closet 2 5.02 1 Water heater 37.52 ,∎ Business name: 7/5`t�EX c► G e , 9 _ / 0 p.S c fric), Water piping/DWV 56.29 Address: Cit /State /ZIP: () )c / a Other: 25.02 City/State/ZIP: ,44. ? Subtotal 4,Z...5/ .6 Phone: t� J) % , A -704, / O 7/ y� Fax: (5 o S 6 6 a - 3.5%5 Minimu permit fee: $72. v / s-0 3 3 3 0,0 g 9 Plan review (25% of permit fee) CCB Lic.: Plumbin Lic. no.: State surcharge (12% of permit fee) ;3, S/ Authorized signature: 7/ / � ( TOTAL PERMIT FEE `vZ6 0 Print name: 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. / T)C 6 -C__ ro .5"03 S c P - 94,0 ")/9/66 1: \ Building \Permits\PLMU- PermitApp.doc 10/01/09 440 - 46167(10 /O2JCOM/WEB) /` � /C r/4_6 . 7/� //0 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: • Site Utilities • Qty. Fee (ea) Total Square Footage: Permit Fee: . Footing drain - 1' 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' • 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm &Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other ec Ins tions or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to Inspections and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial 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 Tub /S i/Whirlpool as defined in OAR918- 780 -0040. Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities. Each t o l ❑ 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 Isometric or Riser Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings 3 that meet the qualifications above. -4" Car Wash Drain Garbage - Domestic Disposal - Commercial - Industrial Comments regarding fixture work: Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory - Bradley - Commercial *Note: If the fixture work under this permit results in an - Service increase of sewer EDUs, a sewer permit will be issued and Swimming Pool Filter fees assessed for the sewer increase must be aid before the Washer - Clothes p Water Extractor plumbing permit can be issued. Water Closet - Toilet Urinal Other Fixtures: 1: \Building \Permits \PLMF - PermitApp.doc 2 1 TO C IT 'r L iii-P_. E A i 5 5 j 1, 1 130 /t/ )it, 6 11.2 4 /' ''' r -- *corm/en , LL' L, ' il V L U JUL 21 2010 CITY OF TIGARD BUILDING DIVIS101`,/ • ,„-g. okoi: - 1 0oi - ,„ ?.. 5 EXISTiA/C 4," AV ' A IN , t ot D(..)iot.ex 1\i' 4 10”5 1. 6, 1 S -- ft ti- CAP.0.5A, fu>° r/91StS rt/tCE 4 1 , 0