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Permit ' * ° „ CITY OF TIGARD PLUMBING COMMUNITY DEVELOPMENT PERMIT #: PLM200 PERMIT 7 00563 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2007 PARCEL: 2S 109 DA - 02100 SITE ADDRESS: SW NO ADDRESS ZONING: R -7 SUBDIVISION: ARLINGTON HEIGHTS NO. 3 LOT: JURISDICTION: TIG PROJECT: ARLINGTON HEIGHTS NO. 3 Project Description: 75' water service to flag lot. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 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: 75 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES OVERLAND DEVELOPMENT 12475SW BEEF BEND Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 12/19/2007 $72.50 [TAX] 8% State Surcha 12/19/2007 $5.80 Phone : Total $78.30 Contractor: BRUNER PLUMBING PO BOX 23985 TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 624 -4880 FAX 503- 624 -2173 Reg #: LIC 81837 PLM 26 -445PB 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: � r - , �� - -- Permittee Signature - __. 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. Plutbing Permit Applicit 7-00 ` --Ooo f7 Builtrffiit Rai , . FOR OFFICE USE ONLY (At( �r i / City of Tigard S bTL. I : 2001 Dateiv Received / p�/ l R Q PS Permit No f� /_ O ' 3 - a 1 3125 SW Hall Blvd., TigareDui197223 L pp Plan Review y: .1, Phone: 503.639.4171 Fad S A 1 0 tigiVIE Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639. I V /�� p��6d IN Date Ready /By: lu g Internet: www.tigard- o1gQ�1CDING71IJI� KIN / Supplemental SeePa Page l Ir Notified/Method: Supplemental Innformation TYPE OF WORK FEE* SCHEDULE ®New construction ❑Demolition For special information use checklist. Description Qty, I Ea. 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 1___K W' and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 1:1 Accessory building El 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: I,/ 2v5/ 73 , i,,...) € ( Ai( Catch basin or area drain 16.60 City /State /ZIP: Drywell, leach line, or trench drain 16.60 �r� �e 7 ZZ Suite/bldg. /apt. no.: I Project name: A Footing drain (no. linear ft.: _) Page 2 Cross street/directions to job site: `b J Manufactured home utilities 110.00 � �'� J--- Manholes 16.60 (Q. --' ,*--f- e (�a.,—.. 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.: 7 Page 2 S Fixture or item Tax map /parcel no.: Absorption valve 16.60 • DESCRIPTION OF WORK Backflow preventer Page 2 I. et 'r �( KQA� '1"10 �( 1,1,4 � Backwater valve . 16,60 - =r ( v! Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 • i Ejectors /sump 16.60 Name: 41 A A.-k. -Lei `�� _ - " Q Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State /ZIP: taC/j Floor drain /floor sink/hub 16.60 ■ Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT Hose bib 16.60 ❑ CONTACT PERSON 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: 1, �- pc_ 13 C. I h ` Water heater 16.60 Address: e o 6 Pc 2-31 e S Other: Subtotal • City /State /Z1P: 77 4c..,_, O (Z °(7Z' (- 3cl V S / Minimum permit fee: $72.50 Phone: (5 a3) ( z/ 5 K U Fax: (5d 3) 6 Z cf a \ 7 3 Residential backflow minimum permit fee: $36.25 72 Jb / CCB Lic.: '7 _ -7 Plumbing Lic. no.: 2,(,,,- cf S4 j e� Plan review (25% of permit fee) State surcharge (8% of pennit fee) 5 , 80 Authorized signature: � �� % TOTAL PERMIT FEE 7 b u 3O Print name: ���d`� C �j , L't- �_. Date: / L�, 07 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\PLMF - PermitApp.doc 12/27/06 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard , 1 - ' _. Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: Site Utilities ' Qty. Fee (ea) Totar. - Square Footage:: - ; Permit Fee: . . Footing drain - 1" 100' 55.00 0 to 2.000 1 $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 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 and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50 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. Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees*. ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture :Type: Replace' engineer. . Previous ' Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram . • Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" -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 - Bradley *Note: If the fixture work under this permit results in an - 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 • BUILDING DIVISION PERMIT #: PLM2007- 00563 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/190007 Phone: (503) 639 -4171 j Inspection Requests (24 Hrs.): (503) 639 -4175 639-4171 4 11111 1 ( 1 11' Inspection INSPECTION WORKSHEET FOR DATE: 17J21/2007 TIME: 7:03Am PAGE: 53 SITE ADDRESS: SW NO ADDRESS CLASS OF WORK: SUBDIVISION: ARLINGTON HEIGHTS NO. 3 LOT #: TYPE OF USE: PROJECT NAME: ARLINGTON HEIGHTS NO, 3 DESCRIPTION: ?.5 Water service to flag lot. OWNER: OVERLAND DEVELOPMENT, PHONE #: CONTRACTOR: E3RUNER PLUMBING PHONE #: 603-6241 -4600 Inspection Request Scheduled For: Date: 12/2/12007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water setvic:e 06202301 103.624- 4t380 N Corrections /Comments /Instructions: I " ' _e � ..d c c� � �� �-�1, f mil) PL- w �A-�✓ i 'rah I� e 2 cA L©. 2 0 s" c ("-)4-41. W I 1 )\1 ‘" vow � ► Ze, o ✓ e7:6 v At. 1 r I t.i o.+ r at -- ❑ PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: c -6 Date: b2 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 Oti563 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /2/18/2007 Phone: (503) 639 -4171 ?� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 12120/2007 TIME: 7 :01AM PAGE: 39 SITE ADDRESS: NO ADDRESS CLASS OF WORK: SUBDIVISION: ARLINGTON HEIGHTS NO 3 LOT #: TYPE OF USE: PROJECT NAME: ARLINGTON HEIGHTS NO. 3 DESCRIPTION: 75' water servic=e to flag lot. OWNER: OVERLAND DEVELOPMENT, PHONE #: CONTRACTOR: ;RUNER PLUMBING PHONE #: 503••624 -41880 Inspection Request Scheduled For: Date: 12120/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 W ter It ervir e 0E1926 -01 503.624 -4880 N Corrections /Comments/ Instructions: �� -�e✓ �� ✓ uJc e. ,cL i \ e S Z . 4 4a P - ✓ o k, P2 °IVO �. � „cc, P✓d vi` Jz_ r l . -t�vC , LJlvi 1 C0 ca L-A, \ V�A6e - - e a- , 6 — rL. (2) � G -k- , ✓vbLe � ✓w. Ny - �b Mou'1 'Z er b P Piro v 1 Ag_ t—o 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (7 I'1 ' 1 � - Date: L 2 r 2t 01 Phone #: (503) 718- Case Activity Listing ( 10/8/2008 CCELI '" Case #.IPL 2007 -00563 `— Assigned Done Updated Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes PLM1010 Application received 12/19/2007 None RECD BB 12/19/2007 BLD PLM1020 Permit created 12/19/2007 None DONE BB 12/19/2007 BLD PLM1030 Check for parcel tags 12/19/2007 None DONE BB 12/19/2007 BLD PLM1260 PLM signature on 12/19/2007 None DONE BB 12/19/2007 application BLD PLM1280 Issue permit 12/19/2007 None DONE BB 12/19/2007 BLD • wll PLM2330 Water service 12/19/2007 12/20/2007 12/20/2007 None FAIL JW 12/20/2007 061926 - 01 — 503 624 - 4880 — VM - STI N — 180 PLM2330 Water service 12/20/2007 12/21/2007 12/21/2007 None PART JW 12/21/2007 062023 - 01 — 503 - 624 - 4880 — VM - STI N _ 180 ) 6J 7 / 1,s a t (Lc rg, 1 S Page 1 of 1 CaseActivity ..rpt