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Permit CIT OF TIGARD PLUMBING PERMIT r DEVELOPMENT SERVICES PERMIT #: PLM2006 -00533 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/3/2006 PARCEL: 2S 103C B - 04500 SITE ADDRESS: 12210 SW MARION ST ZONING: R-4.5 SUBDIVISION: WILLAMETTE NO.2 LOT: 024 JURISDICTION: TIG Project Description: Connect existing house to sewer service. Septic tank is to be pumped & filled. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM 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: 30 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES NORTON, CLAYTON E 12210 SW MARION ST Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 11/3/2006 $105.00 [TAX] 8% State Surcha 11/3/2006 $8.40 Phone : Total $113.40 Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact # : Reg #: 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: Permittee Signature: �. 74412 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}_ ; • • °.t ,. - Building Fixtures -- ' 1-6•' ' " ' g City of Tigard eceived ( /3796" . . L/ �,, �1 a 13125 SW Hall Blvd, Tigard, OR 97223 NOV f� 0 3 2 006 o��r. Permit N i` 1 111 41 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No Inspection Line: 503.639.4175 'Y .�I Y tL ( , Date Read /g Y S r urir• ® See ✓ ✓✓✓ Paage 2 for TIGAI - t) �" Ready /By: www.tigard - or.gov • 'Tr� T T L � �fL` Notified/Method: Supplemental Information • • TYPE OF WOR t • , �>f FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 R for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 • • ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: f 22 /o Se f 71,1 ,7 Catch basin or area drain 16.60 City /State/ZIP: T.'��1�d ©{� 7 '7,.',0 Drywell, leach line, or trench drain 16.60 P Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: W ©2 l Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 _ Sanitary sewer (no. linear tt •,gai Page 2 „ - __ Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map/parcel no.: Absorption valve 16.60 /� 1 1 DESCRIPTION OF WORK Back flow preventer Page 2 C !14,7 Gc'�7 7O SG eie Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER l ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: Chiiy7-04/ /th�/4/ Expansion tank 16.60 . Address: /LZIO - W 192/9!ZlO,7 Fixture/sewer cap 16.60 City/State/ZIP: 7j'(j ` 6 ,OX _ 9 7223 Floor drain/floor sink/hub 16.60 - Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 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 Phone: ( ) I Fax: : ( ) Sink/basin/lavatory 16.60 • Tub /shower/shower pan 16.60 E-mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: oW G4 Water heater ��j 16.60 Address: (Z21 SGJ /'!?/�i2Lare Ot Poi- a'•0 • City/ State/ZIP: l 4 G � Subtotal • 'S -� Minimum permit fee: $72.50 / Phone: p3 ) 5 - 7 _ t� 7 Fax: ( ) Residential backflow minimum permit fee: $36.25 / _ CCB Lic.: �� Plumbing Lic. no.: Plan review (25 % ofpermit fee) - Authorized signature: /�� State surcharge (8% of permit fee) T. 4 69 (�C� - TOTAL PERMIT FEE 1/3 . 4/0 . l Print name: C /X �' r ; 4 41 ,v I Date: 4I 27a6 I 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. I:tBuildiag\Permits\PLM F PamitApp.doc 04/06/06 4404616T(10/02/COM/WEB) Plumbine 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' 55.00 0 to 2,000 $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: $50,001.00 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 ❑ Any new exterior plumbing site utilities. Baptistry/Font ❑ Medical gas and vacuum systems for health care facilities. Bath - Tub /Shower ❑ Any multipurpose fire sprinkler system. -Jacuzzi/Whirlpool ❑ Any complex structure as defined in OAR918- 780 -0040. Car Wash -Each Stall -Drive Thu' Submit 2 sets of plans with any of the above. Cuspidor/Water Aspirator Dishwasher -Commercial - Domestic Isometric or Riser Diagram Drinking Fountain ❑ Isometric or riser diagram is required for new buildings Eye Wash that meet the qualifications above. Floor Drain/sink -2" - 3 " -4 Car Wash Drain Comments regarding fixture work: Garbage - Domestic Disposal -Commercial - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory *Note: If the fixture work under this permit results in an - Bradley increase of sewer EDUs, a sewer permit will be issued and - Commercial fees assessed for the sewer increase must be paid before the - Service plumbing permit can be issued. Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal • Other Fixtures: is Building \PermitxWLM- PennitApp.doc 09/22/06 Os 6/ Invoice , , , • .(,,..... ,1„ i � : CALLER DATE/TIME & LITDN) 10 ' 1 • Ee 1 NI j PHONE NO. ORDER TAKEN BY 679 -' -itoO, C Goodman Sanitation, • ALT PHONE $QUOTED 931 NE Harlow Place - Troutdale, Oregon 97060 /J it _ DEQ #34611 P -1 Troutdale /Gresham: (503) 666 -2280 - www.goodmansanitation.com Hoodland: (503) 622 -1111 _ Damascus: (503) 658 -3922 SERVICE ADDRESS: 1 2.2 1 a 1, (.3 !M A Jc 1V sr TC,. .B COUNTY: ((,J ASi 4/"J67� eC.1K /u 1� r, C.TN BILLING NAME /ADDRESS (if different): JOB DESCRIPTION: Cfri . T l( A E/ .D0l1 mE1`1T , el' n 17F CAN .46N d7,) i COP 13 C IC. CrvAScao ... PUMPING TOTAL: 36y DATE SCHEDULED: TIME: Or r /0—/S(' LABOR: T HNICIA D DATE COMPLET (IXt N: /0 - 11 - �[ TRAVEL: ((JJ SIGNATURE (I hereby acknowledge the completion of the above described work) PAY THIS AMOUNT:30 X Thank ou, We App date Your Business! . . Sh 4 ,.. 4 , p „.;.,. , f ••• I . , . ■ 10/19/2008 4:03 PM • Satas Order #5281 Store: 1 Ordered: 10/19/2008 Associate: Aaron N Valley Landscape Center 18230 SW Pacific Hwy Tualatin OR 97062 503-692-0606 Bill To: Norton 53-789-7825 • • . _ Ship To: William Norton 12210 SW Marion St. . .• ligard, OR 97223 53-789-7825 INSTRUCTIONS: 9-11 • Xst= Gaarde/ 122nd Order Status: Open . Product . . 3/4" minus crushed rock ' 2.5 Yard(s) $28.00 70.00 • • . Delivery - Zone 1 Dump . I $35 00 $35 00 . 9-11am delivery 1 $0.00 $0.00 ..,,.,., Tctal Item(s) Ordered: 4.5 • Total Itenns) Delivered: 0 Tote: Iturn(s) Due: 4.5 • . • • Subtotal: $105.00 TOTAL: $105.00 • . Balance $0.00 ' . Balano. ;Ale $105 00 . _ Percent Unfilled: 100 _ • - .. _. ..... . .-, All deliVeries inside curbline al.:: al III,- ,i:••.:••ti:.)n and risk of the customer. • -.---.------------------_ . ..- -. • . . • . . , • • ..,. • . • • . • • ,.._ • . CITY OF TIGARD - ���,�� d� , �d �33 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 ���9�u�ii�g � Inspection Requests (24 Hrs.): (503) 639 -4175 � "� �.. INSPECTION WORKSHEET FOR DATE: , �l �Q / b� TIME: �; � � 1 PAGE: SITE ADDRESS: 1 �� J lJ � (Jt/!I l�N� �� CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # � Contact # Message Corrections /Comments /Instructions: I �' I�-�� 1�v�e.SS G� 1 �4 2� o � ��. S I ,� �� � �- � `� , ., ❑PASS ❑PARTIAL APPROVAL ❑CANCEL NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: ���` t/�,. -`� Date: � � / �� 6 � Phone #: (503) 718 -�'� �'� CITY OF TICaARD '� ' ������� � ���Z BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 � �u�IN��ypiq���(�'� Inspection Requests (24 Hrs.): (503) 639 -4175 � �__.. INSPECTION WORKSHEET FOR DATE: � /?j'� /() � TIME: PAGE: SITE ADDRESS: 1 Z� l V ��� (�� �� e CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: � PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message ��,��� QL M �� Corrections /Comments/ Instructions: ��"_� l� ��//���/( I _ // �y �� y J/ �� �� /� !\ �/��/)������ � ` j/A / ��////�-�-���/(/� '� /�� `� v '� -C�(� Gin � � �-.S �-'� �.-�' I�'v�.. C� �S � ' -�- 1�tG� �- -� � �;�, � s � �� � � / �; � � �.. � %tom �� � �-�� . 1 PASS ►� PARTIAL APPROVAL ❑CANCEL NO ACCESS ❑ FAIL U CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED Inspector: �� C� Date: � /�� b � Phone #: (503) 718- �� �T CITY OF TIGARD r �' � � -- BUILDING DIVISION PERMIT #: P�,�r�2�p(xUC1�;3� 13125 SW Hall Blvd., Tigard, OR 97223 � DATE ISSUED: 'f'U;i/�U06 Phone: (503) 639 -4171 ��'4N��yiuq��i Inspection Requests (24 Hrs.): (503) 639 -4175 � �__.. INSPECTION WORKSHEET FOR DATE: �1��!'�0�}7 TIME: 7:f�QAPVi PAGE: 'i$ SITE ADDRESS: ���°�Q `ate! R4,ARION�+T CLASS OF WORK: SUBDIVISION: V�iLLAMETi - E 6�lO.� LOT #: O��J TYPE OF USE: PROJECT NAME: Nt7R�rUE�t DESCRIPTION: Gr�nnert �.xisting hraus�a to sewer service. Septic tank is tra lie pumped � filled. OWNER: ht�7RTGt11 CLAYTt3h! E , PHONE #: CONTRACTOR: t�Wl`!ER PHONE #: Inspection Request Scheduled For: Date: aJ�Ql2(tQ7 Pour Time: Code # Inspection Description Confirm # Contact # Message ��5 MisG. insp�acti�an 0148007 -Q3 5Q�7f3;�762�; 'f Corrections /Comments /Instructions: n � �L �J J / ,� i ,. �- ,� ���) PASS n '� RTIAL APPROVAL ��: CANCEL � NO ACCESS FAIL ,j CALL FOR INSPECTION ; � ADDITIONAL FEES ASSESSED Inspector: V \�� �� Dater __ � � � Phone #: (503) 718- 1\ U '� CITY OF TIGARD �� BUILDING DIVISION PERMIT #: PLM ?C�f16�t�Q5�3 13125 SW Hall Blvd., Tigard, OR 97223 — DATE ISSUED: 1'i/�1"�1�U6 Phone: (503) 639 -4171 �����Ii�Hliil����� Inspection Requests (24 Hrs.): (503) 639 -4175 �.�_�� -:_.. INSPECTION WORKSHEET FOR DATE: 5l2g1��7 TIME: 7:01"lAM PAGE: 19 SITE ADDRESS: '�2�'I(J �Pd hl1AR1t�N �aT CLASS OF WORK: SUBDIVISION: �ILL.$METi'E NC�..� LOT #: 024 TYPE OF USE: PROJECT NAME: Nt�RTt71� DESCRIPTION: G4nneGt e}iisting house to se►nrer service. Septic tank is fry be pumpers R� filled. OWNER: iV(.`�RTON GLAYTt�N E , PHONE #: CONTRACTOR: OlAfNEF2 PHONE #: Inspection Request Scheduled For: Date: 5t�4l�gQ7 Pour Time: Code # Inspection Description Confirm # Contact # Message 5tJ5 Sanitary severer i3a�007 -Q� 5Q3 -7f3� -713 5 Y Corrections /Comments/ Instructions: ❑ PASS PARTIAL APPROVAL � CANCEL ❑ NO ACCESS FAIL �j CALL FOR INSPECTION � � ADDITIONAL FEES ASSESSED Inspector: � I. �I-� � Date: G � Phone #: (503) 718- . �G CITY OF TIGARD '� � ~� BUILDING DIVISION PERMIT #: PLhfi�Ot�GCIf}a33 13125 SW Hall Blvd., Tigard, OR 97223 � DATE ISSUED: 'i'fl:�l2ilfDr'i Phone: (503) 639 -4171 �41�ii����ll� Inspection Requests (24 Hrs.): (503) 639 -4175 �� =�� �:_.. INSPECTION WORKSHEET FOR DATE: �92�/�007 TIME: �7':17�fY) PAGE: :� SIT ADDRESS: '1�71Q SVg! hliAF2lOhl �T CLASS OF WORK: SUBDIVISION: N�JILL�MIwT�O`Ir NC�.2 LOT #: Q�4 TYPE OF USE: PROJECT NAME: hlORTUN DESCRIPTION: Connect eacisting h�o�se to se�rQr ser�iGe. Septic tank is to k�e pump�:c� r� fillad. OWNER: hlORTfJN CLAYTC?N E , PHONE #: CONTRACTOR: C�Y�NNER PHONE #: Inspection Request Scheduled For: Date: �at��,�l20p� Pour Time: Code # Inspection Description Confirm # Contact # -. � - 5Q5 Sanitary Geiser QQg082 -d1 50�- 78� -7€�2� �7� .�-- -- Corrections /Comments/ Instructions: ����� �-� ��o -� ! r ,���' � 'ASS fj 'ARTIAL APPROVAL CANCEL NO ACCESS FAIL , FOR INSPECTION ADDITIONAL FEES ASSESSED �� .- �/ Inspector: - Date: -� �S � Phone #: (503) 718- . � ,