Permit CITY OF TIGARD PLUMBING PERMIT
'.: o COMMUNITY DEVELOPMENT Permit #: PLM201000272
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/20/2010
Parcel: 2S102BD00601
Jurisdiction: Tigard
Site address: 9785 SW MCKENZIE ST
Subdivision: Lot: 0
Project: Adrangi
Project Description: Repiping dwelling and replacing 40 ft. of water service. Electrical permit may be required if
replacement piping effects house grounding.
Owner: FEES
ADRANGI, FARID Quantity Description Date Amount
4289 ORCHARD WAY
LAKE OSWEGO, OR 97035 40 If Water Service 08/20/2010 $62.54
1 ea Water Piping 08/20/2010 $56.29
PHONE: 1 12% State Surcharge - 08/20/2010 $14.26
Plumbing
Contractor:
M D PLUMBING
939 SW WILLOWCREEK DR
BEAVERTON, OR 97006
PHONE: 503 - 267 -3914
FAX: 503 - 533 -2075
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $133.09
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
P1umbine_Pennit Ap®1ics$ron
Building
��Fixtures A � U I 1 1 '1 1i .
City Of Tigard P Received ��� PmmiLNo.. t -� � ( /y �
13123Sw Hall Blvd C
,Tigard,OR l��/,�Y 2 0n O 2010 "M1 Review
• / G�� 4 - JU -(x))
' Phtrnv: 503 - 639.4171 Fax: 503,598.1960 V 1 Q Plan Other Permit No.:
In pec Lion lino: 503.639.4175
' i_1 i Interpol: www,ti std -or. ov i. t 1 ' ` ',., : 1 , h.`. endynly: rtho !1i e p eu r
i I
8 g 15',;,..' °S i NMirbd/Merhad I sePpbme.!<I Idarm.ttcn
r TYPE oF- WOIt1C r.;: Li i '11 i S ; {;!''• YEE* SCHEDULE,
0 New axrrstructico 0 Demolition liee special iafersdma see cheekliol
Dmeriptioe I Qty. I 13a. 1 Total
likAdditladslRaetioinimplsrtrtx:nt ❑ Ott: New 1.2. dwellings (includes 100 R for each stilitZ oonnectiext)
CATEGORY OF coNs'rR )CrloN SFR (1) bath 312.70
a1- and 2- family dwelling 0 Commarcial/ndustriel SFR (2) bath 437.78
0 Accessory building 0 Multi- r�nnily SFR (3)u.16 too 32
Fads addidonel batMkimeben 25.02
0 Masten' builder 0 Other. Fire sprinkler sq. IL) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job Rho addrea6: y 7I5 j w M c Kern z : s'- Catch basin or area drain 18.76
Cily/S�utP/LIP: 7-60.-a. �� -! �2� � Drywall. latch lino, or trawl trawl chain 18.76
/ Fooling drain (no. linear 1L: J Page 2
Suite/bldg./apt. no.: Project mate (� w al/1 ail home utiHtim 50.03
Cis scaet/diroclians tojob site: 3V/ pGe I 4;t_.. E4 al/119 !w
y Manholes 18.76
Ram drain connector 18.76
Sanitary sewer (no. linear tl:) Page 2
Stan sewer(no. Sneer ft.:, ,,,,�) Page 2
r.
Water service (no, linear fl.: WI) Page 2 4 S 4 i
Subdivision: J I O9 not: wizto a e/. fame _ .
Tax utap/pnreol no. Baatr ptaverder 31.27
DESCRIPTION OF WORK llaok9mrer valve 12.S1
/ Clothes wisher 25.02
h44e.g- Sex ore. , 0.e,it kMhwmsber 23.02
Drinking rot ustain 25.02
Ejc 1urahump 23.02
• gi.,INnoPRRTY OWNER 1 0 'i'ICNaNT Fx toaak 1251
Naha 4.•444 ' A rte.V1 j Fixture/sewernap 25.02
Ad�B:
VV Flom dram/ ➢one sink/hub 25.02
- atxbage disposal 25.02
City/Slake/JP: Heseb0, -
25.02
Phony: ( ) Fax ( ) Ice maker 1151
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
liminess name:
Medical gas (value: 9 ) Page 2
- - Prima, 1251
- _ Roof drain(oemmeroial) I251
Address: Sink/bemdlsvatery 25.02
C Sty /StaMl7JP: Saba moils (potable water) 62,54
Phan. ( ) 1 Roc : ( ) Tab/eha►edsbowor pan » 1151
E -mail: Urinal 25.02
. - - _Witter closet 25.02
-CONTRACTOR Wni haler 37.52
MO ?I 1341
Adt)Ieas Cf 5 W��',/kw c„,,,,,,... dr O mtvn 25.02
City/Statd71P: .0 , 0 ,t'ex. 4\ .. Subtotal n8.6
Phone: (S01)247 - 31444-7 - Max (SO") S 33 247 a + ' Minimum permit fee: $72.50
CCB Iric.: 1,24324 p '�-
,', 1 plumbing Lie. no.: . Pmt review (2596af permit fee)
. �, Stew surcharge (1296of permit fee) iLj •71.9
Autholizod5a, ,.. -/ TOTAL P£RMrr EE - - - ''i 33 .d`!
Print ttamo: " pen
will pelt appOeiliw airbus airb If a permit b ahtslaed width 180 dale
i .. ,AP /12 afar it has bus. urss$ d es eompieta
'Feu molhadolay eat by TO -County bechtittt incanny 8etviee Rosati
I:13e09{a4\IermeelPLMU- PeuaitApp.due 1091/09 490
MG of Ld leas
2/I 'd 096I86S20S :01 :WONJ LT :8T 0T02- 6I -Jfd
,Cyi
(uaw lIry by (Fixture) Wert Psrfornrod
Prime=
Cagzed
Added
Release
Ensign _ „
Bar isby/Font
Bath -Tab/Shoaa
,TaouT7i/Whirtpsoi
Footing ( - cash additional IMP
3379.30 ter the fist 325,000.00 and $1.45 for
arch additional 5100.00 or fraction thereof; to
mid including 530,000.00.
3732
$742.00 far the fart 550,000.00 and S1.20 for
each additional $100.00 or fraction themof-
Sewer. le 100'
6254
Gar Wash -Ruch Stall
-Drive nuo
37.52
Water Sevioe - let 100'
j
62.54
t e.
Water Scrvioe - each additional 100'
Cas. 'dor/Water .Muer
37:52
Storm d Rain Drain - tat 100'
Dishwasher -remarramial
- Domestic
W
Stamm id Rain Drain • each additiono1100'
3732
Other inspections or Fees
Qt9.
Fee (m)
Drinkin, Fountain
Inspection of existing plumbing or for
which no foe is apacifiucdly indicated
(minimum charBe- I/2 haw)
90.00/be
Eye Worth
90.00/lbr
-
Reiuspattion Foot
Aar 1)n in /sink - 2"
- 3"
- 4"
Cdr Wash Drain
-.-
Additional plan review for revisions
(minimum charge - 1t2 hour)
90.00/hr
I
Subtutat:
-
- .
Garbage - Domestic
Disposal -Commercial
.lndnstrial
Toe Maok/Rcfrig. Drains
Oil Separator (Gee Stator)
Rec. Vehicle Damp Station
---...■..",,,
Shower -Gang
-Stall
S - Bar/Lavatory
- Bradley
-Commercial
- Seavoe
,
.,...,
swimming Pool Filter
Washer- Clothes
Water Extractor
.D....,R
- -,
Water Closet - Toile.
Urinal
Other Fixtures:
Site Utilities
Qty
Fee (ea)
'fatal
Fooling dram -1' 100'
S72.30 for the feat $5,000.00 and $1.52 for
each additional sI W.u0 re fraction thereof, to
and inoludink$10 000.00.
50.03
514830 for the first 510,000.00 and S1.34 for
mash additional 5100,00 or fraction thereof, to
and including $25 - 00_
Footing ( - cash additional IMP
3379.30 ter the fist 325,000.00 and $1.45 for
arch additional 5100.00 or fraction thereof; to
mid including 530,000.00.
3732
$742.00 far the fart 550,000.00 and S1.20 for
each additional $100.00 or fraction themof-
Sewer. le 100'
6254
Sewer- ad edditiaeal 100'
37.52
Water Sevioe - let 100'
j
62.54
t e.
Water Scrvioe - each additional 100'
37:52
Storm d Rain Drain - tat 100'
62.54
W
Stamm id Rain Drain • each additiono1100'
3732
Other inspections or Fees
Qt9.
Fee (m)
Tow
Inspection of existing plumbing or for
which no foe is apacifiucdly indicated
(minimum charBe- I/2 haw)
90.00/be
inspections uetaide of normal business
hour (minimum charge - 2 hours)
90.00/lbr
-
Reiuspattion Foot
90.00/hr
Additional plan review for revisions
(minimum charge - 1t2 hour)
90.00/hr
Subtutat:
Plan Review for Plumbing Installations
Pint review is required for any of the following
Please check all that apply.
O Any new commercial building with water service 2" and
water, wcvcpt systems designed and stamped by licensed
engineer:
0 New exterior plumbing silo utilities fur any complex structure
us defined in 0AR918.7g0.0040.
0 Medical gas and vacuum systems for health cane facilities -
0 Any multipuipone fro sprinkiex system.
0 Any complex shuctum as defined in OAR91 &780 -0040.
Submit 2 net of plans with any of the above.
Isometric or R ise r Dia
Isometric or riser die gtnnl is required for new buildings
that meet the qualifications above.
Valuation:
Permit Fee:
SI.00 to $5,000.011
Minimum fee $72 -50
_. -
_ Ss,001.00 to 510,000.00 ""
S72.30 for the feat $5,000.00 and $1.52 for
each additional sI W.u0 re fraction thereof, to
and inoludink$10 000.00.
510,001.00 to $25,000.00
514830 for the first 510,000.00 and S1.34 for
mash additional 5100,00 or fraction thereof, to
and including $25 - 00_
533.00100 to 5300110.00
3379.30 ter the fist 325,000.00 and $1.45 for
arch additional 5100.00 or fraction thereof; to
mid including 530,000.00.
$50001-00 and up
$742.00 far the fart 550,000.00 and S1.20 for
each additional $100.00 or fraction themof-
Square Footage: _
Pe rmit Fee:
o to 2,000
$121.90
2,001 to 3,600
$169.69 -
3,601 to 7,200
5233.20
7.201 and muter
5327.54
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule:
Commercial FiXtaute Worlc
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately resort fixtures could result in increased sewer fees*.
C,\Users darkllkeuncnta\tigard permitdoc
£/2'd 096T86S£0S :01
2
Residential Fire Suppression Systems:
Medical Gas Systems:
Comments regarding fixture work:
*Note: if the fixture work under this permit results in an
increase of sewer EDUs, a sewer permit will be Issued and
fees assessed for the sewer increase must be paid before the
plumbing permit can be issued
:WONA LT :8T 0102- 61 -91lb
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CITY OF TIGARD/ .- ,---- ptit-i24/0 — 0 Oini 2:
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BUILDING DIVISION"' t / / — PERMIT #:
13125 SW Hall Blvd.; Tigard, OR 97223 - DATE ISSUED:
Phone: (503) 639-41-71 ' 2 . *.. l ootivigtiliti .
1 Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: g 0 TIME: PAGE:
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. SITE ADDRESS: q 7 ir- - ill/ 9 (...L24.... t ' i -e 6 CLASS OF WORK:
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PROJECT NAME: 1, j •-••
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DESCRIPTION: ..,4, / ) 1
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-.OWNER: . PHONE #: 7— - 39 if 9
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Inspection Request Scheduled For '-, D:0 /5 3 - O / Pour Time
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Code # - • Inspection Description ," 11 Confirm # . Contact # Message ql
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