Permit IN - � CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00479
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/24/2007
PARCEL: 25111 AD -19500
SITE ADDRESS: 14931 SW 88TH AVE ZONING: R -4.5
SUBDIVISION: LADY APPLE LOT: 019 JURISDICTION: TIG
PROJECT: LADY APPLE
Project Description: Install sprinkler 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
Owner:
FEES
BEACON HOMES NW, INC.
12703 SW 67TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/24/2007 $36.25
[TAX] 8% State Surcha 10/24/2007 $2.90
Phone : Total $39.15
Contractor:
CONTOUR LANDSCAPING INC
12485 SW TOOZE RD
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 682 -1302
FAX Same as above
Reg #: LIC 5698
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of O' Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire i' ork is no : ed within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires yo , • follow les opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -4Oh -0100. ou ma obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Aft
Issued B //j f, , - / Permittee Signature: i A ■
Call 503.639.4175 by 7:00 a.m. for an inspection that bus' ess day.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
M
Plumbing Permit Application RECEIVE
Building Fixtures FOR OFFICE USE ONLY
O C T 2 4 R eceived
City of Tigard (0 5 Per No.:/ A
IN gi
p,/ 2 / "/ 7E11
13125 SW Hall Blvd., Tigard, OR 97223 CITY U� I IuHIiV Da Rv. r / l�
Phone: 503.639.4171 Fax: 503.598.1 lUILDINGDIUISIO 1 Plan RDateBy: eview Other Permit No.:
T I �_ ,` R D Inspection Line: 503.639.4175 Date Ready/By: 0 See Page 2 for
Internet: www.tigard or.gov Notified/Method: , Supplemental Information
�
' TYPE OF WORK FEE* SCHEDULE
N Nvew construction ❑ Demolition For special information use checklist
Description I Qty. 1 Ea. I 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
LI 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: (.t/ ` ' At/6 Catch basin or area drain 16.60
City/State /ZIP: 69l9-se4) e,r2 - ' 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:
_ � Rain drain 16.60
[ � �C �f� ii. 3�� � �- l�� Ra dain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: L14-1ThY / y�- Water service (no. linear ft.: _ ) Page 2 p� I Lot no.: /
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Y-t-'" :s e / Backwater valve 16.60 25
Clothes washer 16.60
Dishwasher 16.60
ROPERTY OWNER I 0 TENANT Drinking fountain 16.60
�� M � Ejectors /sump 16.60
Name: r Expansion tank 16.60
Address: ear40 6c,u co c Fixture /sewer cap 16.60
City/State /ZIP: '- (9y2-) og._ q,F-a Floor drain/floor sink/hub 16.60
Phone: (6i-sy 5 5 ) 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: ., i G_/s Water heater 16.60
Address: 6 f85 $L,) Z-9Za--- / 2.4j Other:
City/State /ZIP: t9'a� D r2-- Subtotal
Phone:
5b3) ce e a /2 0 Minimum permit fee: $72.50
- Fa x: ( Re sidential ba ckflow minimum permit fee: $36.25 36 25
.
CCB Lic.: P1 sing c. no.: Plan review (25% of permit fee) 45 �/ / State surcharge (8% of permit fee) 2 .g d
Authorized signature: f _iii..„,„ TOTAL PERMIT FEE
Print name: i ' / 9-/L8�> Date: /o -p 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\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 e 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) l 27.55 3(0. ZS 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 existing plumbing or each additional $100.00 or fraction thereof, to
Ins of
p g p g and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: 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 ❑ 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'
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.doe 12/27/06
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: K;4ugEj7..0ac7g
13125 SW Hall Blvd., Tigard, OR 97223 t DATE ISSUED: 10/2.412007
Phone: (503) 639 -4171 ' A ariv, 11111tili
Inspection Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 11/1/2007 TIME: 7:02AM PAGE: 49
SITE ADDRESS: 14931 SW 138TH AVE CLASS OF WORK:
SUBDIVISION: l ADY APPLE-: LOT #: 019 TYPE OF USE:
PROJECT NAME: LADY APPLE
DESCRIPTION: Install sprinkler S rstem.
OWNER: BEACON HOMES NW, INC., PHONE #:
CONTRACTOR: CONTOUR LANDSCAPING INC PHONE #: 503- 682.13302
Inspection Request Scheduled For: Date: 11/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 058750`01 503 -774 -0305 N
Corrections /Comments /Instructions: p
D evic e "��2 -7 1., l
Care i►...w. fr
g PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gb Vlate),' \S -n-- Date: i i 1 ) 1 b7 Phone #: (503) 718-