Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2005 - 00692
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/30/2006
PARCEL: 2S 112AC -03000
SITE ADDRESS: 14775 SW 74TH AVE ZONING: I -
SUBDIVISION: METRO PART /MLP2002 - 00008 LOT: 001 JURISDICTION: TIG
Project Description: Site utilities. 50 - 30 - 06 Backflow preventer for irrigation added.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: 2 WATER HEATERS: CATCH BASINS: 1
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: 356 ft
Owner: FEES
HORNEL LLC
PO BOX 159 Description Date Amount
AURORA, OR 97002 [PLUMB] Permit Fee 5/30/2006 $367.20
[PLMPLN] Plan Review 5/30/2006 $91.80
[TAX] 8% State Surcha 5/30/2006 $29.38
Phone : 503-651-1878 [PLUMB] Addl Permit 5/30/2006 $46.40
[TAX] 8% State Surcha 5/30/2006 $3.70
Contractor: Total $538.48
PREMIER PLUMBING
20 SW 131ST AVE
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 469 -8631
Reg #: LIC 124547
PLM 34 -318PB
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: , , f ,.fi v otzot Permittee Signature: , A . / /1
•
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.
Site Utilities
r� tt II P.1-002. - oo ,
'
Plumbing Perm li cation ' ,
Q FOR' Ol 1 U ONLY ,.:
City of Tigard
Received �� D jitA1 Permit N,,.p a oD, DOw l
13125 SW Hall Blvd., Tigard, OR 97223,
Phone: 503.639.4171 Fax: 503.598:1:960 L /r�i R -I•' Date By. / � / 9 /O��L� Other Permit No.!
• . 24- Hour Inspection Line: 503.639.4175 , LL mrs.
Internet: www.ci.tigard.or.us = " "' Date Ready/By: S See Page 2 for
(. I' 1 y or `„ .,� Supplemental Information
TNol QRh fsG.t 1
ITT R�� O W �I1 FE SCHEDULE
infix
•
! New construction ❑ Demolition For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
❑ Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ I- 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 N776 s ut/ 7 17 "Li C Catch basin or area drain / 16.60 l�
City /State /ZIP:174 irlP , t2/2. 9 7 z. I Z 5 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name: LYOP(�L Footing drain (no. linear ft. j Page 2
Ott` 1111 �t��i� Manufactured home utilities 110.00
Cross street /directions to job site: -� Manholes 16.60
A04)16 • 04)1 .9
? - I /f
Z 1 7 �` Rain drain connector 16.60
Sanitary sewer (no. linear / 0O•) r. Page 2 MUM
Storm sewer (no. linear 11,;3..4 jel) nil Page 2 'frill
Subdivision: Lot no.: 7 i Water service (no. linear It / 00 • / Page 2 MIMI
Tax map /parcel no.: Z $ ! 12. t Fixture or item
�"r Absorption valve 16.60 9 r
DESCRIPTION OF WORK
Back flow preventer Page 2 ;"
e0.7046,0 4) 6(,J A V /[. D/ )c/Z Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
PROPERTY OWNER
1 ❑ TENANT
Ejectors/sump 16.60
Name: Any Et-, L C. C-_ Expansion tank 16.60 .
Address: t r7 e / 5 Fixture /sewer cap 16.60
City /State /ZIP: /9-07/ 1 On_ 9 7 & Z Floor drain/floor sink/hub 16.40
Phone: (C )G 5 - 1 ---1 g - 7 Fax: (573) C5 - /9 / i Garbage disposal 16.00
Hose bib 16.60
g APPLICANT ❑ CONTACT PERSON
Ice maker 16.60
Business name: ffoRN -0 L L c__
Interceptor /grease trap 16.60
Contact name: G ,f-Le - iffi 0 i) Medical gas (value: $' ) Page 2
Address: 77 /50.,e rs Primer 16.60
City /State /ZIP: / 2 O re
d 7Z `f 70 U "2 Roof drain (commercial) 16.60
Phone: ($ZAP )C57-4578 9 (')fig'/ - /5' / d Sink /basin/lavatory 16.60
E -mail: 0.4_,L.-- / C 0 p �J Tub /shower /shower pan 16.60
�N/U »9 #W 57' Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: l \ra ~--li r ` Water heater 16.60
• _ Other:
Address: ��
.) r-- 1. ) �
City /State /ZI * • - 4C tJi ` 0 r -,
�p e �✓ � Subtotal �/��
l Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 ' x1
CCB Lic.: 1C Plumbing Lic. no.: 3(7-- 3J g / Plan review (25% of permit fee) ` i
Authorized signature: ✓ State surcharge (8% of permit fe' '!LT'i�
l TOTAL PERMIT FEE 5 ,f
o Print name: 6 /[ c 1.----- 1.----- V ia�
.F / E - Date: / This permit application expires if a permit is not obtain 5 i in
180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Servic oa d
i:\ Building \Permits\PLMU- PennitApp.doc 06/05 440.4616T(10/02/COM/WEB) / �) .c3
V
U
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' /1/ 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 Back Flow 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
specially requested inspections - per hour 72.50 and including $50,000.00.
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 Complex Structures
Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing
p lease indicate work performed by fixture. Failure to system that meets any of the following criteria
accurately report fixtures could result in increased sewer fees. Please check all that apply.
Quantity by (Fixture) Work Performed Any new commercial building.
Fixture Type: Replace Er Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi /Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
-Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system.
Eye Wash •
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial - three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
• • - Bradley
• -. - Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
P
• Water Closet 'Toilet increase of sewer EDUs, a sewer permit will be issued and
•• Urinal fees assessed for the sewer increase must be paid before the
Other.Fixtures: plumbing permit can be issued.
\ Building \Pennits\PLM- PennitApp.doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00692
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/29/2006 TIME: 7 :04AM PAGE: 5
SITE ADDRESS: 14775 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: METRO PART /MLP2002 -00008 LOT #: 001 TYPE OF USE:
PROJECT NAME: FANNO CREEK BUS. PARK
DESCRIPTION: Site utilities. 5 -30-06 Bacl4love preventer for irrigation added.
OWNER: HORNEL LLC, PHONE #: 503 -651 -1878
CONTRACTOR: PREMIER PLUMBING PHONE #: 503 -469 -8631
Inspection Request Scheduled For: Date: 11/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 040394 -03 503 - 939.9575 N
Corrections /Comments /Instructions:
i
PASS 1 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Pt 14 Date: It 6/ Phone #: (503) 718- 2g3)
CITY OF TIGARD PLm
BUILDING DIVISION > _ PERMIT # X05- 6v 6 C
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 a i.. l ' liiv "ilIll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / 7 7 5 7 4L
-I k CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: ' -/ 5 0 (' Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 as • ,Li4 frwi9L -5 ?,mot /C / c„h . 93 ? - q$ 73
Corrections /Comments/ Instructions:
ei
/ .. / '
PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector:
/11,1/30/
' `' v Date: 1 Phone #: (503) 718- 5
(`)-7
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2006-00692
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2006
Phone: (503) 639-4171 .._ 7(tili t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/2/2006 TIME: 7:08AM PAGE: 19
SITE ADDRESS: 14775 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: METRO PART/MLP2002 LOT #: 001 TYPE OF USE: -
PROJECT NAME: •FANNIO CREEK BUS. PARK
DESCRIPTION: Site utilities. 50-30-06 Bacl4low preventer for irrigation added.
OWNER: HORNEL LLC, PHONE #: 503-661-1878
CONTRACTOR: PREMIER PLUMBING PHONE #: 603-469-8531
Inspection Request Scheduled For: Date: 612/2006 Pour Time:
. plAr'
Code # Inspection Description Confirm # Contact # ■ . -ssag.
605 Sanitary sewer 031018-.02 603-939-9575 Y
Corrections /Comments/ Instructions:
ASS pi PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
. 17 (it (1-C.
Inspector: Date: k P Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION . PERMIT #: PLM200S- 00682
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/300006
Phone: (503) 639 -4171 / r�i9lufpi�ll I�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/2/2006 TIME: 7:08AM PAGE: 21
SITE ADDRESS: 14775 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: METRO PART /EMLP2002 00000 LOT #: 001 TYPE OF USE:
PROJECT NAME: FANNO CREEK BUS. PARK
DESCRIPTION: Site utilities. 50.30 -06 Backflow preventer for irrigation added.
OWNER: HORNEL LLC, PHONE #: 503-651-1878
CONTRACTOR: PREMIER PLUMBING PHONE #: 503 - 469.8531
Inspection Request Scheduled For: Date: 612/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 031017 -03 503- 939 -9575 Y
Corrections /Comments /Instructions: f ,
-- P4 54
"-()
PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 Date:(9 2 o (0 Phone #: (503) 718- l L-{