Permit s II 2,1to -
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14 - , CITY OF TIGARD PLUMBING PERMIT
a
', COMMUNITY DEVELOPMENT Permit #: PLM2010 00213
T I G A R D. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2010
Parcel: 2S111 C601719
Jurisdiction: Tigard
Site address: 10170 SW KABLE ST
Subdivision: HOOD VIEW NO. 2 Lot: 18
Project: Giraud
Project Description: Connect existing house to sewer service. Reimbursement District #45 fee paid.
Owner: FEES
GIRAUD, GEORGE & PATRICIA L Quantity Description Date Amount
10170 SW KABLE ST
TIGARD, OR 97223 100 If Sewer Service 06/30/2010 $62.54
PHONE: 503-620-1820 1 12% State Surcharge - 06/30/2010 $8.70
Plumbing
10 ea Minimum Fee Adjustment - 06/30/2010 $9.96
Contractor: Plumbing
ALL WAYS EXCAVATING USA LLC
PO BOX 238
HUBBARD, OR 97032
PHONE: 503 - 982 -3544
FAX: 503- 982 -3654
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 Notifica •• • - - ter. 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 • •estions to 0 C by calling 503.246.6699 or 1.800.332.2344.
/ �,
Issue By: — ■ ? ; /� " `� Perm ittee Signature: ( L
L��
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 PLUMBING PERMIT
2 COMMUNITY DEVELOPMENT Permit #: PLM2010 -00213
iGARb 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date, Issued: 06/30/2010
Parcel: 2S111CB01719
Jurisdiction: Tigard
Site address: 10170 SW KABLE ST
Subdivision: HOOD VIEW NO. 2 Lot: 18
Project: Giraud
Project Description: Connect existing house to sewer service. Reimbursement District #45 fee paid.
Owner: FEES
GIRAUD, GEORGE & PATRICIA L Quantity Description Date Amount
10170 SW KABLE ST
TIGARD, OR 97223 100 If Sewer Service 06/30/2010 $62.54
PHONE: 503-620-1820 1 12% State Surcharge - 06/30/2010 $8.70
Plumbing
10 ea Minimum Fee Adjustment - 06/30/2010 $9.96
Contractor: Plumbing
OWNER
PHONE:
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 toQUNC by calling 503.246:6699 or 1.800.332.2344.
a t[264 , (4 , 40/ Issu d By: Permittee Signature: / 2
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.
SEWER' CONNECTION PERMIT
CITY OF TIGARD
r -, COMMUNITY' DEVELOPMENT Permit #: SWR2010-00092
Date Issued: 06/30/2010
ARIA 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111CB01719
Jurisdiction: Tigard
Site address:. 10170 SW KABLE ST
Subdivision: HOOD VIEW NO. 2 Lot: 18
Project: Giraud
Project Description: Connect existing house to sewer service. Reimbursement District #45 fee paid.
FEES
Owner:
GIRAUD, GEORGE & PATRICIA L Description Date Amount
10170 SW KABLE ST Sewer Connection Fee 06/30/2010 $3,600.00
TIGARD, OR 97223 Sewer Inspection - Residential 06/30/2010 $35.00
PHONE: 503- 620 -1820
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: ALT
Install Type: Line Tap and Building Sewer
Fixture Units:
Number of Dwelling Units: 1
Total $3,635.00
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 permitwill expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notif ion Centen,Those rules are sefforthTin OAR 952-001-0010 through OAR 952 -001 -0100. You may obtain a copy of the rules
or direct uestions to OUNe ca 'ng 503.246.6699 or 1.800.332.2344.
Permittee Signature: /
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.
Plumbing Permit Application .
Building Fixtures -,,- - $ F011 l 'OF FE use I ON i
R eceived
City of Tigard P No.: , /n ,
q 13125 SWcHall Blvd., Tigard, OR 9.7223= Date/By: Cp Uj:! �� L / /ssa - ) '3_
C 1 Plan Review . 3 ) n . _/ Q" !J[/C/ M�
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: .598.1960 Other:Permit �� , N
1nspecti0n'Line: '503.639 :4175 Dafe Read /B orri See Pa e 2 for
'1`I Ci A It D Ready /By: g
Internet: www Notified/Met}_iod: Supplemental Information
TYPE "O} ,WORK FEE* SCHEDULE
El New construction ❑ Demolition • For spe information use checklist
Description 1 Qty. t Ea. 1 Total
❑ Addition/alteration/rePlacement ❑ Other: New 1,2- family dwellings (includes 100 ft. for each utility connection)
`., rc ,_ 'CATEGORY OF CONSTRUCTION ` ^- ` FR (1) bath th 312.70
❑ 1- and 2- family dwelling ❑'Commercial /industrial SFR (2) 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 d Site. utilities: .
Job site address: /0/ 7_0 Sco • ,.r11 k u rl tT� Catch basin or area drain 18.76
City /State /ZIP: t� Drywell, leach line, or trench drain 18.76
�� l �a 43 � U Footing drain (no, linear ft.: ) Page 2
Suite /bldg. /apt. no.: Project name:, G vT Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear fi. /')F): 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 31.27
;`a DESCRIPTION OF, WORK, y ., ` L Backwater valve 12.51
�" Clothes washer 25.02
- C Lt f. 1GU `1 V - QA..IJR� (AA 4, Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
,
y i PROPERTY OWNER '' I s ® TENANTS t - " -
0 Expansion tank 12 :51
Name: i'fR ( C I A ('t- e-e)RGE Cr-1 la Future /sew f l o o r 25.02
Floor Main/floor 25.02
Address: / 01 740 S c3 K lq 6Lr <T•
Garbage disposal 23,02
City /State /ZIP: --1 , 0 te. q 7-a ;Y -'41618 Hose bib 25.02
Phone: (S03) 6 a - l E1 0.o Fax: ( ) Ice maker 12.51
'' APPLICANT ' , .:' a 4® CONTACT ,PERSO N Interceptor /grease trap 25.02
Busines's name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
' City /State /ZIP: - Solar-units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail Urinal 25.02
,., . g Water closet 25.02
,. - 'CONTRACTOR: a W ..
Water heater 37.52
Business name: Water, 1 in WV 56.29
Address:
/Jcft"2._ p P
�
Other: 25.02
City /State /ZIP: • Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee: $72.50
Plan review (25% of permit fee)
CCB Lic.: Plumbing Lic. no.:
State surcharge (12% of permit fee)
Authorized signature:�� `�� �� TOTAL PERMIT FEE. -
Print name: Pg-k \.c 1 A L, G_,12ROI Date: vo - 30 _ app This permit applicate 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.
I:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440 -4616T(10 /02 /COM/WEB)
Plumbing Permit Application - City of Tigard -
Page 2 - Supplemental Information
•
Fee Schedule: Residential Fire Suppression Systems:
z e_s Qh Fee (ea) ' T,otal j Square,1Footage Permit
Footing drain - l' 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 $1.00 to $5;000.00 Minimum fee $72.50
Storm & Rain Drain.- each 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
`Otl►er Inspec'tioris or..Fees . Q ty r ,! FeeP(ea) 4 Total ; each additional $100.00 or fraction thereof, to
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 $100.00or 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 andincluding,$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 $100.00 or fraction. thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", Plan Review" for Plumbing'In'stall``at><ons
please indicate workperformed 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.
+.
„ Quanhtby (Fixfure) ❑ Any new commercial building with water service 2" and
F�xtar&Type " Replace greater, except systems designed and stamped by licensed
el ':Previois. Ca'pp'ed':. _.,Added. Ezi "stink,, engineer;
Baptistry/Font
Tub /Sowr ❑ New exterior plumbing site utilities for any complex structure
Bath - hower
Tub /S erlpool as defined in OAR918- 780 - 0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health facilities.
Drive Thru ❑ 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 WashY Isometr cvorRiser D agram •
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 paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
- Urinal -
Other Fixtures:
•
I:\Building \Permits \PLMF - PermitApp.doc 2
SF3G17).1ath,
312.71
SFR (2)'Li air
• 437,76
SFR itliatli
500
•
EasWadtlitional batKrttitchen
25.02
Fire spriidder t__,sq. 11.)
i
Pagc.2•
. -
Cateh.lbasin en.arce drain
18.76
D(yvVe11, !Oath line „or With disin
18.76
Eopting.dtain (no.; lincor'fi.: __ J
Page 2
•
Marwfeloreii home utilities
50.03
Manholes
i
18.76
Rein.drain emingctor
18.76
Sanitary sower (Tao. linear ft. r-{;04)
Page 2
S(arm sewer (nu. linear ft,: _„,)
Page 2
Waits enlace (no. liners 9.: )
Page 2
08/12/2010 11:04 5035981960
'Plumbing Permit Application
Building Fixtures
City of Tigard,
13125 Svi:74a0 1V"d,: titian!, OR 97223% .
Phone: 503,63:4117.1 -Pat:' 303.598.1960
lmpee►ion;L• Incl. 503i639.44.r75'
dtaemc wwalv'tigmdrargo '
E- mail:
.'d
:.r
Phhnblrig Lis.
P99£
CITY OF TIGARD
Suite/bidgiapl. no.-
Cross strvct/diredions to jab site
Project amnei' -
Aati s: 10174 S (-4.2QLE gam.
Cityfl$tateiziP: - o, pg. c TalVq— . .2618
P.116.g:(5) b•ao'1B,as Pori: )
g% eib3) 98‘
❑ l ■few•oo stntction
0 Addition/elterntionhrplacarncat
Job site address` /Qr 7o Stu . i3/-& cSTRAr*
Busmcis nanf
Octane' Mule -
Melreas:
City /State/11P:
8itsisaess name:
Cliy!Statc/zlP:
CCB
AuthoiizeH sig orun:;
Print .name:
❑ •
D'Commcrcia industrial
❑ MvI(i= fnrnily
G Other:
Fin weeial beamed,' are clieral11't
] Ea. i Tot
t �t
Dominion
Lion
Now Jki fitriiilJ d+fellings (includes 100 R for eet3rutil cbrgaecl
sub them
inure- r
Seekfiovw inverter
31.27
Hose bib
25.02
lee -maker
12.51
Hatksvtaer valve
Clatter washer
25.02
Dishwasher
25.02
Dr nkiiig:fountain
25.02
Ejectnrs/sump
25.02
E, xpenss�•pn rank”
12.5
Fii tOrdisbsiieFCap
25.02
F.1ndi dFaiNfloorsinulbab 1 f 25.02
O *Sngv disposal 1 1 25 : 4/2
Intercept rigmasebap 1 J 25.02
Medical gas (value: 5a,.) Page -2
PriMet
_12.51
tm chnm (cammercia f f 12.51
Sink/basin/lavatory I 1 25 :02
•Solvinunits (potab1c watcr) 1 1 62.54
TubishowcNshowcr ptaa 1 J 13.51
Urinal 1 J .25.02
Wirer. dose! i 1 aft
Water hFator 37'52
Vkalet;pipinWt3WV
Other
•56.29
25.412
• SL'bmtal
Minimumpermitlee 572.50
Plan eeview (25% or penhit fcc)
Sum surcharge (12%04 pencil Ica)
TOTAL PERMrT FEE.
7160 expire' if a metal if &If tibfiffileffwffhiii AN at
Wier It inn tier aceq*td r complete.
•Fla medrodelvgy in try Tri -County 8uilding1.11aydy,Scrvipo.8ogd
6u118n8ox3 sAe AA- II V
PAGE 01/01
dL1Z606Z6
- CITY OF TIGARD
. ...... ei 13125 SW Hall Blvd.
th
Tigard, OR 97223
603.639,4171
inspection Requests: 503.639.4175
a.
Permit No l.11,42010-00213
Site Address 10170 SW KABLEST
Zlonnect existing house in sewer service.
Description
Reimbursement District #45 fee paid.
... .
ontractor
----
hone No
, -
•
Inspection Request Scheduled For:
Date August 19, 2010
Pour Tin) 1/A
—
Inspection Code 505 Sanitary sewer
. —
Request Comment )14923-01 503-959-1828
Requesters Phone 503-989-1828
S
Result Comments •
1. provide a copy to the City of Tigard of the septic tank pump receipt
showing volume of removed material.
2- provide a copy to the City of Tigard of the receipt of delivery of , •
approved fill materiel le: slury, sand, pee gravel.
3. approval will only be issued after proof receipts have been received
by the City of Tigard.
4. OK to cover excavation and make final connections to the house
• sewer.
—..........
•
Results MIL
. ......--- ..–....,—
inspector Mike Baird
Date _ August 19, 2010
Phone No 503-718-2424
. ' .
a/SO 39Vc1 3NaLSel3NelOD 8SLL8L9E121S ZO :TT 0 TOZ/Ti3/60