Permit 77 ' CITY OF TIGARD PLUMBING PERMIT
. 2 x COMMUNITY DEVELOPMENT Permit #: PLM2010 00254
it t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 08/03/2010
Parcel: 25111 BA01901
Jurisdiction: Tigard
Site address: 9845 SW VIEW CT
Subdivision: INGEBRAND HEIGHTS Lot: 4
Project: Everett Greer
Project Description: Backflow for irrigation.
Owner: FEES
GREER, PHYLLIS M TRUST & Quantity Description Date Amount
GREER, EVERETT W TRUST, 9845 SW VIEW
CT 1 ea Backflow Preventer 08/03/2010 $31.27
1 12% State Surcharge - 08/03/2010 $8.70
PHONE: Plumbing
41 ea Minimum Fee Adjustment - 08/03/2010 $41.23
Contractor: Plumbing
GREEN GROWTH LANDSCAPE
MAINTENANCE LLC
PO BOX 774
PHONE: 503 - 710 -1287
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: � � di'mittee Signature: [� ►A� //1 i � r���jf ell
-
CaII 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.
Plumbing Permit Application
Building Fixtures �� R eceived
Sel F OR OfFICF USL ONLY
City of Tigard Q Date/By: 1 ' /,O err Permit No.: � - 0O. - S 13125 SW Hall Blvd., Tigard, OR 97) P lan Review
: a Phone: 503.639.4171 Fax: 503.59 .1960 r3 2�� Other Permit No.:
WC/
Inspection Line: 503.639.4175 DateJBy.
TIGARD A o Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov OF 1` G` N � Hot ad/Method: 71 Supplemental Information
TYPE OF WORK COZY �,OASE �� FEE* SCHEDULE
® New construction r, 1 , • • tlrj For special information use checklist
Description I Qty. I Ea I Total
❑ Addition/alteration/replacement ❑ Other. New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCT1ON SFR (l) bath 312.70
® 1- and 2- family dwelling El Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ 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: 9845 SW VIEW CT Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State /ZIP: TIGARD, OR, 97224
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: EVERETT GREER Manufactured home utilities 50.03
Cross street/directions to job site: SW 100 AVE. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: _) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
NEW IRRIGATION SYSTEM
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: EVERETT GREER Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 9845 SW VIEW CT
Garbage disposal 25.02
City/State /ZIP: TIGARD, OR, 97224 Hose bib 25.02
Phone: (503)6393786 Fax: ( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON interceptor /grease trap 25.02
Business name: GREEN GROWTH LANDSCAPE MAINT. LLC Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: HERMINIO CRUZ
Roof drain (commercial) 12.51
Address: PO BOX 774 Sink/basin/lavatory 25.02
City /State/ZIP: AURORA, OR, 97002 Solar units (potable water) 62.54
Phone: (503) 710 -1287 Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: greengrowth @wbcable.net Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: GREEN GROWTH LANDSCAPE MAINT. LLC Water piping/DWV 56.29
Address: PO BOX 774 Other: 25.02
City /State /ZIP: AURORA, OR, 97002 Subtotal
Phone: (503) 710 -1287 Fax: ( ) Minimum permit fee: $72.50 7). r)
CCB Lic.: 8752 Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) j! 76
Authorized signature: ' / /I//O t it, TOTAL PERMIT FEE S I ,
Print name: HERMINIO CRUZ Date: 08/02/2010 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 \Pennits\PLMU- PermitApp.doc 10/01/09 440- 4616T(I0 /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', . 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
Storm &Rain Drain - 1st 100' 62.54 Valuation Permit Fee.: , a .
$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
Qt - 'Fee (ea) Total each additional $100.00 or fraction thereof, to
Other Inspections or Fees 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
as defined in OAR918- 780 -0040.
- Jacuzzi/Whirlpool
Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive Stall ❑ 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 o r Riser Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
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: lithe 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 paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
C:\Documents and Settings \Owner\My Documents\PLMF- PermitApp.doc2