Permit 74-"-..; -.SAY CITY OF TIGARD
PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00211
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/13/2008
PARCEL: 2S112CC -20600
SITE ADDRESS: 15638 SW 81ST AVE ZONING: R -12
SUBDIVISION: GAGE FOREST LOT: 013 JURISDICTION: TIG
PROJECT: GAGE FOREST
Project Description: Installing backflow preventer.
CLASS OF WORK: ALT 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
Owner:
FEES
CEDAR MILL TOWNHOMES II, LLC
12670 SW 68TH AVE, STE 400 Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 5/13/2008 $36.25
[TAX] 12% State Surch 5/13/2008 $4.35
Phone : 503- 639 -3104 Total $40.60
Contractor:
MULLEN COMPANY, THE
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 640 -0113
FAX 503- 640 -4483
Reg #: LIC 92689
PLM 34 -260PB
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.
I
Issued B. �s � fi ' ermi ee Sign • tine: ,_
/y
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.
r
j „Pei leima Permit Application
Site Utilities ‘ , � FOR OFFICE USE ONLY
City of Tigard Received / ? i ci 'V Q Date/By: J e r- Permit No.: (✓ ,�0
• 13125 SW Hall Blvd., Tiga Fax 417223
0 Plan R iew Other Permit No.: // r
Ph one : 503.639.4171 . 5 3.59Q�19� D : /p�,�j7 CO /73
Inspection Line: 503.639.4175 \`r` At. ® ®
TIGA`RD Y D ate Read /B y Juris: ®See Pa t e 2 for
Internet: www.tigard - or.gov w44 0'21'07 Notified/Method: Supplemental Information
®
TYP OF W a ' b > . v FEE*. SCHEDULE : :
. ,
❑ New construction i 'Demolition For special information use checklist
Description 1 Qty. I Ea. 1 Total
2 ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY' OF CONSTRUCTION a ' - SFR (1) bath 249.20
6121- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
11 Accessory building ID Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
El Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
. :JOB. SITE INFORMATION AND LOCATION;.: g . - 4 Site utilities
Job site address: / ., o ,/ jv 5l -' Catch basin or area drain 16.60
City /State /ZIP: Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: G . 72,-.
Footing drain (no. linear ft.: _) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
A- 1eLy,v a.-.ec $J Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _) 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
DESCRIPTION OF WORK ' Backflow preventer ( Page 2 97
4 ./ /, 6 .T � Backwater valve 16.60
Y Clothes washer 16.60
Dishwasher 16.60
• - Drinking fountain 16.60
• „- . • j- PROPERTY O ',,, ❑' T -' - .-
r Ejectors /sump 16.60
Name: ; ii Ts+r�r .,tv„,,, Expansion tank 16.60
Address: `ig� ?l ,, a,r5,t_ Fixture /sewer cap 16.60
City /State /ZIP: Floor drain /floor sink/hub 16.60
Phone:) 39_ ,:.i.),/ Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
APPLICANT ' . . ' ❑ CONTACT PERSO
" 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: ( ) I Fax:: ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
' CONTRACTOR - • , Water closet 16.60
Business name: z - .� 4 ,, _Li :% Wa, heater 16.60
Address: 3 '- ' / e . e `
A Subtotal
City /State /ZIP: J[ 7 /sberr! d ie q7/"? Minimum permit fee: $72.50
Phone: ( ) �! _Q ((3 e Fax: (i51? pl ,. if `(E"'S Residential backflow minimum permit fee: $36.25 36,g - s
Plan review (25% of permit fee)
CCB Lic.: Uf„ c..4 Plumbing Lic. no.: 311 p�{ State surcharge (12% of permit fee) tf; � �
Authorized signature: v ` /
TOTAL PERMIT FEE L /O 6
Print name: L -A--_-.-a-9.--7 Date ,, , 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:\Building\Permits\PLMU- 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:
... Fee (ea) Total:
Site °,Utilities S: t °uare E oc�ta Permrt,F
Qty. e ; ;
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 V 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
Fee ea ' Total,.;; additional $100.00 or fraction thereof, to and
"Finite OI'Itelll Qty 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
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
•
Commercial 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 l y'(Eizture) Work Performed' greater, except systems designed and stamped by licensed
Fixture Type:' _ ,:Replace' engineer.
. Previou 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 Isoint tric 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\PLMU- PermitApp.doc 2
CITY OF TIGARD _ - q PLdv1 Zoa4- 002
BUILDING DIVISION PERMIT #:..
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111.6/2007
Phone: (503) 639 -4171 *11/ 41ud��� lll+I
Inspection Requests (24 Hrs.): (503) 639 - 4175:`_,_ .
INSPECTION WORKSHEET FOR DATE: Wl13 /2001 TIME: 7 :01AM PAGE: 44
SITE ADDRESS: 15638 SW 81ST AVE CLASS OF WORK:
SUBDIVISION: GAGE. FOREST LOT #: 013 TYPE OF USE:
PROJECT NAME: GAGE FOREST
DESCRIPTION: New SF
OWNER: CEDAR MILL TOWNHOMES II, LLC, PHONE #: 03 639 -.310'1
CONTRACTOR: CEDAR MILL. Tt:)WNHOIV ES II LLC PHONE #: 503 -3104
Inspection Request Scheduled For: Date: 813/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399
Plumbing final 07132 -01 . 603.538 -4630 N
g rp,Ll(, �to W.
Corrections /Comments /Instructions:
B 4 , k ✓✓ 4-. S Q —� e �� Pp f ,.,_: PL A 2.00Z- co 2
D < - k=-TA,
94,_/
X PASS PARTIAL APPROVAL CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: I 1 Date: fn I (.1 10 Phone #: (503) 718-