Permit •
n CITY OF TIGARD C, PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2009 -00010
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/16/2009
PARCEL: 2S103CB - 03300
SITE ADDRESS: 12365 SW MARION ST ZONING: R -4.5
SUBDIVISION: WILLAMETTE NO.2 LOT: 038 JURISDICTION: TIG
PROJECT: DUTZ
Project Description: Replumb water piping to (2) lays, (2) tub /showers, (2) water closets, and (1) washer box.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
CAMERON DUTZ
12365 SW MARION ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 1/16/2009 $116.20
[TAX] 12% State Surch 1/16/2009 $13.94
Phone : Total $130.14
Contractor:
MP PLUMBING CO
P.O. BOX 393
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 655 -9161
FAX 503- 650 -7050
Reg #: LIC 5002
PLM 3 -17PB
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: Qt n Q Permittee Signature: ( m Q (i 1
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.
11umbing Permit Application
Btilding Fixtures RECEI coR oeelci; use ONLY
IC
City f Ti and Received
II Ty g 16 20 Date/By: I. 1(,p • 04 pZ Permit No.: � line • C3OOIC
• 13125 SW Hall Blvd., Tigard, OR 97223 JAN Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 • nn Other Permit No.:
Inspection Line: 503.639.4175 OFTIG Dat�
T I G A R p to Ready /B Avis: 63 See Page 2 for
Internet: www.tigard- or.gov WIPING DN1S1O p a te (r Supplemental Information
TYPE OF WORK FEE* S�ULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
lddit' alteratio lacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
Accessory building SFR (3) bath 399.00
El ry g ❑ Multi - family
❑ Master builder Each additional bath/Idtchen 45.00
❑ Other: Fire sprinlder (_ sq. ft.) Page 2 _
JOB SITE INFORMATION AND LOCATION Site utilities
lob site address: ` SW Njta-p..1 01J ST: Catch basin or area drain 16.60
City/State/ZIP: T 61,619^q O 0 114.-77 22 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: 3,01" 2 e_.4.-.4 p Footing drain (no. linear ft.: _) Page 2
f Manufactured home utilities 110.00 -
Cross street/directions to job site: (J,4 _fJ u r -r ( Z k s-r T'o Manholes 16.60
ir-4 ,042 4 c -1 S. Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.afXr Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK
Backflow preventer Page 2
(0 - PI Pe- 13A- NR,p01`€ Backwater valve 16.60
Clothes washer ( 16.60
Dishwasher 16.60
I YPROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
� Ejectors/sump 16.60
( A-
Name: .4 p 9 '1i._ Expansion tank 16.60
Address: (234 S st/.S IIAA...1 O /J '9 , Fixturesewer cap 16.60
City/ State/ZIP: I l C f. D / ,T . 9 Y1 Z 3 Floor drain/floor sink/hub 16.60
Phone: 64S) 3) S'�• g p \ C r Far l �f__-..-) Garbage disposal 16.60
Hose bib 16.60
❑ APPLICANT ❑ CONTACT PERSON
Ice maker 16.60
Business name: MP PLUMBING CO., INC. Interceptor/grease trap 16.60
Contact name: TAMI Medical gas (value: $ ) Page 2
Address: PO BOX 393 Primer 16.60
City/State/ZIP: CLACKAMAS OR 97015 Roof drain (commercial) 16.60
Phone: (503) 655 -9161 J Fax:: (503) 650 -7050 Sink/bas' vatory 2 16.60
E -mail: TAMIG@MPPLUMBING.COM Tub /shower /shower pan 16.60 r,�`-�
Urinal 16.60
CONTRACTOR Water closet 2 16.60
Business name: MP PLUMBING CO., INC. Water heater 16.60
Address: PO BOX 393 Other.
City/ State/ZIP: CLACKAMAS OR 97015 Subtotal
Minimum permit fee: $72.50 11, - ZO
Phone: (503) 655 -9161 Fax: (503) 650 -7050 Residential backflow minimum permit fee: $36.25
CCB Lic.: 5002 Plumbing Lic. no.: 3 -17PB Plan review (25% of permit fee)
Authorized signature: ai ' " j State surcharge (12% of permit fee) i - 3.91.
TOTAL PERMIT FEE
Print name: TAMI RILEY I Date: /' � 9 I This permit application expires if a permit is not obtained athin
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
l:\ Building \Pamits\PLMF.PaminApp.doc 12/27/06 440- 4616T(IO/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 -.Supplemental Information
a ,
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (as) Total Square Footage: Permit 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
Sewer - 1st 100' 55.00 3,601 to 7,200 $220.00
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 $25,001.0010 $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
•
Commercial Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing futures? 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 futures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
Qaan by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture qypw Repbee engineer.
Previous Capped Added Ito.ttna ❑ 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 MachJRefrig. 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:
isBuilding \Pamits\PL.M- PamitApp.doc 12/27/06
CITY OF TIGARD
BUILDING DIVISION ft, PERMIT #: PLM2009.00010
13125 SW Hall Blvd., Tigard, OR 97223 �'I � 1 � DAT%ED: 1I1&12il0
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 s ' . /Des 3
J
INSPECTION WORKSHEET FOR DATE: 2/10/2009 TIME: 7 :01AM PAGE: 4
SITE ADDRESS: 12365 SW MARION ST CLASS OF WORK:
SUBDIVISION: W11.LAMETTE NO.2 LOT #: 038 TYPE OF USE:
PROJECT NAME: DtJTZ
DESCRIPTION: Replumb water piping to (2) lays, (2) tub /showers, (2) water closets, and (1) washer box.
OWNER: DUTZ, CAMERON PHONE #:
CONTRACTOR: MP PLUMBING CO PHONE #: 503-655 -91G1
Inspection Request Scheduled For: Date: 2/10/2.000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 Shower pan 0804513.01 503-524 -8016 N
Corrections /Comments/ nstr tions: A
4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V L' je Date: Phone #: (503) 718 -
_.: .
CITY OF TIGARD 4) • :
eN,
BUILDING DIVISION (.1 ` PERMIT #: PLIN2009-00010
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/16/2009
Phone: (503) 639-4171 AllotopO
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/29/2009 TIME: 7:01AM PAGE: 17
SITE ADDRESS: 12'366 Sw MARION ST CLASS OF WORK:
SUBDIVISION: WLLAMFITE1‘10.2 LOT #: (J TYPE OF USE:
PROJECT NAME: DUTZ
DESCRIPTION: Replumb water piping to (2) lays, (2) tub/showers, (2) water closets, and (1) washer box_
OWNER: DUTZ, CAMERON PHONE #:
CONTRACTOR: MP PLUMBING CO zorcaco PHONE #: 603-665-9161
•
Inspection Request Scheduled For: Date: 112912009 Pour Time:
Code # Inspection Description Colifern-# Contact # Message
320 Plumbing rough-in 080118-01 503-467-91M \ Y
) 52-4- 4 8016
Corrections/Comments/Instructions: '''--- ----7 /2
t% 0 \) of c, yvvAil-
' 11 ' • V.010 : ._ . , 1:V.
to 0
«'4 't3 i 0 SVC, 1 4 \k .i()
r -
* S, 1 • G-Np-viSbli\lo (,.3i(i
IS tc)/- asD 16
lems'ia...‘Aifctaa._ ccal Me tN1S' __,
CL' "
Grimo NU ' ' gtOD Fb
PASS El PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
Ti FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: • i\ i Si 6 1.-. Date: 1 - 2.3 -1 Phone #: (503) 718-
City of Tigard, Oregon • ' - Page 1 of 2
City of Tigard, Oregon , ,• ;. °=■
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12365 SW MARION ST
Property Summary
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Property Owner Info
Tax ID Number: 2S103CB03300
Tax Account Number: R475337
Site Address: 12365 SW MARION ST
Site City:
Site ZIP: 97223
Owner: DUTZ, CAMERON P & LISA Z
Owner 2:
Owner 3: 12365 SW MARION ST
Owner Address:
Owner City: TIGARD
Owner State: OR
Owner ZIP: 97223
Acres: 0.46
Sq Ft: 20,037.6
Bldg SF: 3,080.00
Bldg Value: $ 175,580
Land Value: $ 182,810
Total Value: $ 358,390
Taxable Ass'd Value: $ 237,190
Sale Price: $ 237,500
Sale Date: 11/07/01
Year Built: 1958
District & Community Info
Municipality: Tigard
Tigard Urban Sery Bndry: YES
http: / /tiggisiw /mox52_multimap/ index. cfm? fuseaction = property. summary &CFID = 100746 &CFTOKEN =... 1/29/2009