Permit y n CITY O F TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00241
".,.� DATE ISSUED: 6/13/2007
ITIGAREi 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112BD
SITE ADDRESS: 14790 SW 79TH AVE ZONING: R -
SUBDIVISION: BRITTANY MEADOWS LOT: 055 JURISDICTION: TIG
PROJECT: OLSON
Project Description: Replace 87' of water service to new meter location.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF 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: ft
WATER CLOSETS: WATER LINE: 87 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GRANT OLSON
14790 SW 79TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/13/2007 $72.50
[TAX] 8% State Surcha 6/13/2007 $5.80
Phone : Total $78.30
Contractor:
EAGLE PLUMBING ENTERPRISES INC
13801 S FORSYTHE RD
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 650 -8703
FAX 503- 650 -8720
Reg #: LIC 47914
PLM 3 -154PB
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 . es or .ire .uestions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/
Iss ed By: _ 4 �/ � � �` 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.
1. ,
Plumbing Permit Application i iA. ` ,ztv . , . ?, z i, n i iF 4 , ; F i:, 4 �
F n L � M Sn�,..
: L 1 : r tA''' + i .
F Date received: f p Permit no.: 'LA i b1 "Oa,
, ,. :,,
y City of Tigard
I , City b Sewer permit no.: Building permit no.:
_ - - -- Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: Receiptno.:
L and use approval: Case file no.: Payment type:
�� 7 e r g. 7r T - A � � r i � �
' s ' - i , 3 , 444004 'f ', o ' . ;; �� ,ATE: O F ; PEEZMIT � + �k 4 . � ... ; - n .- _ ' , "'` Ni " 3 ' ' '
' s w...Si +c . .- rr"xr,.. stsb .:.a r ..,..e '.. w4 r
l 1 & 2 family dwelling or accessory ❑ Commercial/industrial CI Multi- family ❑ Tenant improvement
❑ New construction CI Addition/alteration /replacement 0 Food service ❑ Other:
J'r 40. `JOB INFORMATION I 4 " " , ... FEEjSCIIEDULE (for spectal, u se checklis " .%' '
Job address: ' 4 ° 0 $GJ 7 :, ' i Descri tion Qty. Fee(ea.) Total
Bldg. no.. Suite no.: New 1- and 2- family dwellings only:
. (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: Block: Subdivision: SFR (2) bath _ —_ '
Project name: W , /e, �__. SFR (3) bath
City /county: ; / ZIP: Each additional bath/kitchen _
Description and locat•on of work on premises: Siteutilities: ■-.
Catch basin/area drain
_ Est: date of completion/inspection: Drywells/leach line /trench drain _
u 44 ,, ; , , LUMBINGC r� 7OR , ,, .; ,, Footing drain (no. lin. ft.) =I
s'., ; , 7 . F � 0P,ONI RAC, K � ` w t '' ,,,, Manufactured home utilities
Business name: 4 �.� / Manholes —
Address: P A.I. _..�, s / A-A_ Rain drain connector —
t^ Stater/2— ZIP: q' wq Sanitary sewer (no. lin. ft.) IIMI , _
\ Phone: '' C S'o -a"7o3 y, , E - mail: Storm sewer (no. lin. ft.) MI .
CCB no.: if `7 4 Plumb. bus. reg. no: S`c+
_ PA Water service (no. lin. ft.) MLM —I- '
'
. 'i City/metro lic. no.: 3 7 7 Fixture or item: .
Contractor's representative signatures_ �_ : Absorption valve
Back flow preventer ..1 .
Print name: , r L rIeVS Date: A�' Backwater valve
',a t.45.,u1'.'..} ,;, t ° , YYi. . la I.*, , rt - '. ''- Basins/lavatory e
'��'� CONTACT =PERSON � s
Name: Clothes washer MI
Address: Dishwasher _ —_ _
Drinking fountain(s) • _
City: State: ZIP: Ejectors/sump MI
Phone: Fax: E -mail: Expansion tank - _
r u < �'' - a .? \\ u OW1 i1 ER , t 4 } , 4 n °', Fixture/sewer cap •
Name (punt): A ,+` Floor drains/floor sinks/hub
Mailing address: Garbage disposal _
Hose k M
City: State: ZIP: Ice maker er
Phone: Fax: E -mail: Interceptor /grease trap _
Owner installation/residential maintenance only: The actual installation Primer(s) _
will be made by me or the maintenance and repair made by my regular Roof drain (commercial) _
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) _
Owner's signature: Date: Sump _
ts ?� LNGIIV> ER` ; '. , ' Tubs/shower /shower pan ���
Urinal
Name: Water closet _
Address: Water heater _
City: State: ZIP: Other: =
Phone: Fax: E -mail: Total " — n
Not all jurisdictions accept credit , please call jurisdiction for more information. Minimum fee $ 701
__ Notice: This permit application Plan review (at _ %) $
tsa ❑ Mas r ye �� r * , - , . y. ; e xpires if a permit is not obtained �. r5 V
re lit card numb i � Z.l:r i� 'r_ K . _�.�� . .•% 1 �� w i t hi n 180 days after it has been State surcharge (8 %) .... $
,1, ---7 . . i _. - ��-� xpr s TOTAL $ I'5 . 1 )P
Name of car. ,o r as sho on credit and accepted as complete.
$
Cardholder signature Amount 440.4616. (6/00/COM)
? ,e CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00242
TIGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/13/2007
PARCEL: 1S13300-08600
SITE ADDRESS: 11692 SW 128TH AVE ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 123 JURISDICTION: TIG
PROJECT: AMMANN
Project Description: Installation of residential backflow preventer for irrigation system.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
i
Owner: FEES
ANA AMMANN
11692 SW 128TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 6/13/2007 $36.25
[TAX] 8% State Surcha 6/13/2007 $2.90
•
Phone : 503 - 524 - 1840 Total $39.15
°Ir e Contractor:
•
OWNER ti
02, - - - REQUIRED ITEMS AND REPORTS
2 ---4\-/?‘C' •k:
Contact # : ;d Q
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V n� E��
Reg #: }, . VI �/� r v
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.er°di - : esti. s to OUNC by calling 503.246.6699 or 1.800.332.2344.
I A Issudd By: I� r �r iv//!, Permittee Signature: f( j�� �Allihil`_ _
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 - CLH- 1 0 0 2 - 42
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 **till l
Inspection Requests (24 Hrs.): (503) 639 -4175 ,4A I..
INSPECTION WORKSHEET FOR DATE: 6 9Ok"' TIME: /'ge PAGE:
SITE ADDRESS: \ \ (0 \2 4\ , j 4 : CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: •
(6WNER . S PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
-P-4
Corrections /Comments /Instructions:
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n FAIL CALL FOR INSPECTION n ADDITIONAL FEES A ESSED 6 / Inspector: Date: ( Phone #: (503) V/74
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CITY OF TIGARD '...,:' 'LK2®O1"' 0 o �� •
k. BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
- Phone: (503) 639 -4171 � !/dill l iii ` Na'!'""
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Inspection Requests (24 Hrs.): (503) 639 -4175 ...�-±.��i i
INSPECTION WORKSHEET FOR DATE: 6 30/6 e•
6e• TIME: /30 PAGE:
SITE ADDRESS: \ \ 't2 \ 2- ' CLASS OF WORK: :
SUBDIVISION: LOT #: TYPE OF USE:.
PROJECT NAME:
DESCRIPTION:
OWNER, S a I N PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
`' - Code # Inspection Description Confirm # Contact # Message
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Corrections/Comments/Instructions: s
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n PASS ❑ PARTIAL APPROVAL 4 ' ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION I l ADDITIONAL FEES ASS
Inspector: Da � / Phone #` (503) 718 -1 2
INSPECTOR'S SIGNATURES ARE NOT
Required for: ON GREEN INSPECTION CARD.
Inspections eq kile07-00;
✓ Code Inspection Description PASS Date By • Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing • 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain - 145 A/C or heating unit circuit _
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall •
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 MVIisc. inspection:
265 Masonry 199. Electrical final
270 Reinforcing steel (rebar)
275 Framing •
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line .
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
. 498 Grading final . 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab • PLM - Plumbing Permit
• 910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test
315 Post /beau plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
. 410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing X 399 Plumbing final
210 Foundation walls
_ 215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection - 599 Final inspection
I: \ Building \Forms \InspCard- AOP- Blank.doc 02/02/07 •
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection)
One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain /Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
Tub or Tub /Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
16.60 Urinal
Other Fixtures (Specify) Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Sink: 2"
Sewer - 1st 100' 55.00 3"
Sewer - each additional 100' 46.40 4" _
Water Service - 1st 100' 55.00 `Nrier Heater
Water Service - each additional 200' 46.40 Other Fixtures
(Specify
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
-
QUANTITY TOTAL
Isometric or riser diagram is required if
Quantity Total is > 9
*SUBTOTAL
8% STATE SURCHARGE
**PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9
-
TOTAL $
* Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backfiow
Prevention Device, which is $36.25 + 8% state surcharge.
** All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
• ^�,��' aim �� ��I).
i:\dsts \forms\plm- fees.doc 10/10/00
CITY OF TIGARD
BUILDING DIVISION : -;--- PERMIT #: PLM2007-00241
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/13/2007
Phone: (503) 639-4171 .. tiklii f i l x
Inspection Requests (24 Hrs.): (503) 639-4175 .i
_SI■ 1,1.
INSPECTION WORKSHEET FOR DATE: 6/14/2007 TIME: 7:00Alvl PAGE: 23
SITE ADDRESS: 14790 SW 79TH AVE CLASS OF WORK:
SUBDIVISION: BRITTANY MEADOWS LOT #: 055 TYPE OF USE:
PROJECT NAME: OLSON
DESCRIPTION: Replace 87' of water service to new meter location,
OWNER: OLSON, GRANT PHONE #:
CONTRACTOR: EAGLE PLUMBING ENTERPRISES INC PHONE #: 503-650.8703
r Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 050228-01 503.740-1216 N
Corrections/Comments/Instructions: ta
yo
, •
■:N. PASS FiaRTIAL APPROVAL 1 1 CANCEL 0 NO ACCESS
1 FAIL /
ALL FOR INSPECTION 7 ADDITION L FE S ASSESSED
Inspector: Date: 6 / e
Phone #: (503) 718- •