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Permit C TIGARD CITY O 1 PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00426 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/18/2007 PARCEL: 1S125CA -03600 SITE ADDRESS: 09265 SW 74TH AVE ZONING: R - 4.5 SUBDIVISION: LAWRENCE PARTITION LOT: 010 JURISDICTION: TIG PROJECT: LAWRENCE PARTITION Project Description: Installation of 100' of private water service for future lot. CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R1 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: ft WATER CLOSETS: WATER LINE: 100 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES LAWRENCE RESOURCES INC 6770 SW ALFRED ST Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 9/18/2007 $72.50 [TAX] 8% State Surchart 9/18/2007 $5.80 Phone: 503- 975 -6560 Total $78.30 Contractor: G & B PLUMBING 2810 SE 39TH LP SUITE I HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS Contact # : PRI 503-640-2311 FAX 503- 640 -6360 Reg #: LIC 19907 PLM 34 -44PB 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 callin .246.6699'o .1.80!. 2.2344. Issue By: L 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 H a Add 7 - Do 2 / g,c)601607 -0c53 Btillding Fixtures - FOR OFFICE . USE ONLY Received ,,rr, City of Tigard Date /By: / g V , 1) Permit No.: 2-a)7 n 13125 SW Hall Blvd., Tigard, OR 97223 III Phone: 503.639.4171 Fax: 503.598.1960 Plan Review . Date /By: Other Permit No.: Inspection Line: 503.639.4175 Date Read /B Jyi+t ® See Page 2 for Internet: www.ti TIGARD and -or. ov Ready /By: / g g g Notified/Method: I � S upplemental Information TYPE OF WORK FEE* SCHEDULE yiNew construction ❑ Demolition For special information use checklist Description Qty. Ea. Total ❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. 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 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: 9 g(D s 71./1 levy Catch basin or area drain 16.60 City /State /ZIP: / - , y ,,,.. , el 3 Drywell, leach line, or trench drain 16.60 Suite /bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: _ ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: `G 4G Cc, Manholes 16.60 Rain drain connector 16.60 J,LJ /4 ✓- 7'/ t -A Sanitary sewer (no. linear ft.: _ ) Page 2 Storm sewer (no. linear ft.: _) , Page 2 Subdivision: Lot no.: Water service (no. linear ft./e4 Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION' OF WORK Backflow preventer Page 2 Aiit,oa -' /y3 �te- -• 4i, - .1Se, Gil/!✓ f - sue , /, -- Backwater valve . 16.60 7' � ,,,,,, If 5 , r�� Gr iYT 6 / . - Clothes washer 16.60 Dishwasher 16.60 (/ 1fi/iir/ p.c <i�G' <L7 il'e=i E 3Fa.:0 `Er PROPERTY OWNER ❑ TENANT. Drinking fountain 16.60 / Ejectors /sump 16.60 Name: /.4w „e,..eti. 721 t s , , . . . e . s „ 4 . - - - , „ e _ . , (044 G i�'e - 0 Expansion tank 16.60 Address: 7-7 .5 - .4 ,2 lGI _577- Fixture /sewer cap 16.60 City /State /ZIP: - 77 / p ,,,_ q 2 L Z 3 Floor drain /floor sink/hub 16.60 Phone: (...4i/3 ) 97s_ s; L: v 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 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: 6 ✓ p' - j ? / /-/l Water heater 16.60 Address: t , .: > • Other: v vg- /o .s. , 39 b G< 5�/ 1 - /State /ZIP: / c,Pe, Subtotal City/State/ZIP: y �'LC.s f�' ©.�' �7 /Z � Minimum permit fee: $72.50 Phone: Sx G ) 4 �O Q 3 , / Fax: 3 ) /p G U 3G Residential backflow minimum permit fee: $36.25 7 • S CCB Lic.: / 9 917 Plumbing Lic. no.: 31/ - z /y,e0 Plan review (25% of permit fee) , � 3G /lam i �J State surcharge (8% of permit fee) t � ° i Authorized signature: // TOTAL PERMIT FEE ' /U y :'�1G /.�ir.cr Print name: Date: �� This permit application expires if a permit is not obtained within / 00,.� L rc -� 180 days after it has been accepted as complete. ✓J�ll'fic ��/� * Fee methodology set by Tri -County Building Industry Service Board. I:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10 /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' 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 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. Fixtdre•Type: Replace engineer. Previous Capped Added Existing ❑ 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 Mach. /Refrig. 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: i:\Building\Permits\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007-00426 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9,18/2007 Phone: (503) 639-4171 Milli, It\ Inspection Requests (24 Hrs.): (503) 639-4175 ; INSPECTION WORKSHEET FOR DATE: 10/1012007 TIME: 7:01AM PAGE: 51 SITE ADDRESS: 09265 SW 74TH AVE CLASS OF WORK: SUBDIVISION: LAWRENCE PARTITION LOT #: 010 TYPE OF USE: PROJECT NAME: LAWRENCE PARTITION DESCRIPTION: Installation of 100' of private water service for future lot. OWNER: LAWRENCE RESOURCES INC, PHONE #: 503-975-6560 CONTRACTOR: (3 & B PLUMBING PHONE #: 503-640-2311 Inspection Request Scheduled For: Date: 10110/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 057285-02 503-975-6560 N Corrections/Comments/Instructions: A i" td ..4-t_z LS:e , ,' e A, Z (-4-4 1 1,J - PG( no 6 re-ei 1',3 c..,':-N-r.--- tvAtA-c." c Co 4.4-4e, (-41 - TO TJRA-L) L.01/14-c2+Aux.- MT Co ‘ CA. rt., X PASS l PARTIAL APPROVAL fl CANCEL NO ACCESS FAIL El CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: 6:M \Vila,. h-ca... Date: hi tt) 141 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 -00426 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 118//2007 Phone: (503) 639 -4171 vvdNp�N 6 Inspection Requests (24 Hrs.): (503) 639 -4175 --Ji 11. INSPECTION WORKSHEET FOR DATE: 10/10/2007 TIME: 7:01AM PAGE: 52 SITE ADDRESS: 09265 SW 74TH AVE CLASS OF WORK: SUBDIVISION: LAWRENCE PARTITION LOT #: 010 TYPE OF USE: PROJECT NAME: LAWRENCE PARTITION DESCRIPTION: Installation of 100' of private water service for future lot. OWNER: LAWRENCE RESOURCES INC, PHONE #: 503.975.656a CONTRACTOR: G R B PLUMBING PHONE #: 503-640-2311 Inspection Request Scheduled For: Date: 10/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 057285 -01 503.875 -65G0 Y Corrections /Comments /Instructions: PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \VM.J 1 Date: 10)/ Phone #: (503) 718 - ~_ . • ��~�� N�� ' ' " _ ��mm w OF mn��nm�� ^ BUILDING DIVISION PERMIT #: RA42007..00476 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1Ey2007 Phone: (503) 639-4171 |napooion Requests (24 Hrs.): (503) 639-4175 .4- All- . INSPECTION WORKSHEET FOR DATE: 10y9/2007 TIME: 7:00AM PAGE: 1 SITE ADDRESS: D92GGSVV74TMAVE CLASS OF WORK: SUBDIVISION: LAWRENCE PARTITION LOT #: 010 TYPE OF USE: . PROJECT NAME: LAWRENCE PARTITION DESCRIPTION: trillon of 100 of privat water &ervice for future lot. OWNER: LAWRENCE RESOURCES INC ' PHONE #: E03.976655O CONTRACTOR: G & 8 PLUMBING PHONE #: 503-640'2311 Inspection Request Scheduled For: Date: 10/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 067235-02 503-976-6560 N Corrections/Comments/Instructions: ` , PASS fl PARTIAL APPROVAL ACANCEL fl NO ACCESS , ri FAIL ~ CALL FOR INSPECTION | | ADDITIONAL FEES ASSESSED Inspector: GI \ Date: hO \ O‘ � ~)~7 Phone #: (503) 718- ' - CITY OF TIGARD ? . • BUILDING DIVISION PERMIT #: PLM2007-00426 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: + ri$/:c007 Phone: (503) 639 -4171 , ll i i j / j Inspection Requests (24 Hrs.): (503) 639-4175 - ! + t INSPECTION WORKSHEET FOR DATE: 10/9/2007 TIME: 7 :00AM PAGE: 3 SITE ADDRESS: 09265 SW 74TH AVE CLASS OF WORK: SUBDIVISION: LAWRENCE PARTITION LOT #: 010 TYPE OF USE: PROJECT NAME: LAVVREPCE PARTITION DESCRIPTION: Installation of 100' of private water service for future lot. OWNER: LAWRENCE RESOURCES INC, PHONE #: 503- 975"6660 CONTRACTOR: 0 & B PLUMBING PHONE #: 603 - 640.2311 Inspection Request Scheduled For: Date: 10/9/2007 Pour Time: • Code # Inspection Description Confirm # Contact # Message 330 Water service 057235 01 503 - 975 -6560 Y Corrections /Comments /Instructions: n PASS n PARTIAL APPROVAL Ni CANCEL 1 I NO ACCESS n FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED • Inspector: CIS} l -1N Gj% t31---, Date: 0 I aI ID 7 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007- 00826 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13nt1)7 Phone: (503) 639 -4171 , iliitli Inspection Requests (24 Hrs.): (503) 639 -4175 -a'_�a INSPECTION WORKSHEET FOR DATE: 10/8/2007 TIME: 7:00AM PAGE: 55 SITE ADDRESS: 09265 SW j MTH AVE CLASS OF WORK: SUBDIVISION: LAWRENCE PARTITION LOT #: 010 TYPE OF USE: PROJECT NAME: LAWRENCE PARTITION DESCRIPTION: Installation of 100' of private water service for future lot. OWNER: LAWRENCE RESOURCES INC, PHONE #: 503975-055Q CONTRACTOR: t.a & 8 PLUMBING PHONE #: 503-640-2311 Inspection Request Scheduled For: Date: 10/8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 067/36-01 503 -9755 -6560 Y Corrections /Comments /Instructions: PASS U PARTIAL APPROVAL ❑ CANCEL 1 NO ACCESS X FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: crb1A1.&. ► i i L.— Date: lot T J' 7 Phone #: (503) 718 - CITY OF TIGARD ,.. • - 7..- BUILDING DIVISION . PERMIT #: PLM2007-00426 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1812007 Phone: (503) 639-4171 :NMI p. Inspection Requests (24 Hrs.): (503) 639-4175 ‘,.......w ''---• INSPECTION WORKSHEET FOR DATE: 10/812007 TIME: 7 oakm PAGE: 54 SITE ADDRESS: 09265 SW 74TH AVE CLASS OF WORK: SUBDIVISION: LAWRENCE PARTITION LOT #: alo TYPE OF USE: PROJECT NAME: LAWRENCE PARTITION DESCRIPTION: Installation of 100' of private water service for future lot. OWNER: LAWRENCE RESOURCES INC, PHONE #: 503-976-6560 CONTRACTOR: 0 & E3 PLUMBING PHONE #: 503.640-2311 Inspection Request Scheduled For: Date: 10/0/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 057137-01 503-975.6560 N Corrections/Comments/ Instructions: MT .. 1 PASS 0 PARTIAL APPROVAL I CANCEL I 1 NO ACCESS X FAIL pi CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: CD '4'A.._ t, I t.-„,.. Date: 10\ cfkol Phone #: (503) 718-