Permit CITY OF TIGARD R EUSED PLUMBING PERMIT
i 1 COMMUNITY DEVELOPMENT // �/ Permit #: PLM2007 -00348
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2007
Parcel: 2S101AD02400
Jurisdiction: TIG
Site address: 12753 SW 68TH AVE 100
Project: GEORGE FOX Subdivision: Lot:
Project Description: Rough -in on (1) hose bib. 2/11/11, permit reinstated for final inspection, good for 30 days.
Contractor: POWER PLUMBING CO Owner: WESTERN EVANGELICAL SEMINARY
P 0 BOX 19418 PO BOX 23939
PORTLAND, OR 97280 PORTLAND, OR 97281
PHONE: 503 -244 -1900 PHONE:
FAX: 503 - 244 -8825
FEES
Quantity Description Date Amount
1 [PLUMB] Permit Fee 08/06/2007 $72.50
Specifics: 1 [TAX] 8% State Surcharge 08/06/2007 $5.80
1 hr Hourly Plumbing Rate 02/11/2011 $90.00
Type of Use: COM 1 ea Hourly Plumbing 12% 02/11/2011 $10.80
Class of Work: ALT Surcharge
Type of Const:
Occupancy Grp: B
Stories:
Total $179.10
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Not . • - _ - - . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir- • questions to OUNC : calli s 03.232.1987 or 1.800.332.2344.
Issued By: /\ / /d /6 , 1,Lvt_44f Permittee Signature: k ji
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
g— o 7
ill a CITY OF TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00348
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/6/2007
PARCEL: 2S 101 AD - 02400
SITE ADDRESS: 12753 SW 68TH AVE 100 ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 032 JURISDICTION: TIG
PROJECT: GEORGE FOX
Project Description: Rough -in on (1) hose bib.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WESTERN EVANGELICAL SEMINARY
PO BOX 23939 Description Date Amount
PORTLAND, OR 97281 [PLUMB] Permit Fee 8/6/2007 $72.50
[TAX] 8% State Surcha 8/6/2007 $5.80
Phone : Total $78.30
Contractor:
POWER PLUMBING CO
PO BOX 19418
PORTLAND, OR 97280 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 244 -1900
FAX 503- 244 -8825
Reg #: LIC 52378
PLM 34-1 50PB
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 di - a uestions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/
Issued = / Permittee Signature: f &- f h er
i iii /// / /�
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.
Aye 03 2007 11:09AM POWER PLUMBING CO. 503 244 8825 p.1
. . 1
.'lambing Permit I ( Application I.O I: a I f I 1 1: 11\1.1
City of Tigard tkittilCii :
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13125 SW Hall Blvd., Tigard, O Review
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: Pho 503.639.4171 Fax: 503.5Me00 4 2007 Plan Other Penult No.:
1" I ` 1 i 1 Inspection Line 503 639 4175 �
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0 New construction Q Demolition Fors
pecial information use checklist.
Description I Qty. I Ea. I Total
❑ Addtuon / 0 Other. New 1- 2-family dwellings (includes 100 ft. for each utility connectioi
.s..: . r_•_ ;r2, ,;::kn.v � ?.,., , _4: 6 , M : •v; - : *.-' SFR (I) bath 24920
❑ 1 - and 2- family dwelling 1 i ial/industrial SFR (2) bath
350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder ❑ Other: Each additional bath/kitchen 45.00
Tier ,,tit
..'>r: �� - . .. , ltespnn sprinkler sq.ft) Page?
� 16i>l�' � Site nt111tfes
Job site address: 1-22-1 5 ] Sup U► a Yr . S -r Catch basin or area drain 16.60
City/State/ZIP: 6Lot4Ok ) CY Drywell, leach line, or trench drain 16.60
Suite/bldgJapt. no.: Project name: rc Footing drain (no. linear ft.: _) Page 2
Cross street/directions home utilities 110.00
eet/diteetions to job site:
VA! 1✓ Manholes 16.60
ffff 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
Tax map/parcel no.: Fixture or Item
-� Absorption valve 16.60
,.n
DBS 'LOON . F Bacidlow preventer Page 2
MAT4 �� ' S e �� Backwater valve 16.60
Clothes washer 16.60
Dishwasher 1 6.60
• S - .. 1 :.1? .. ,., L! = �t .:-•-..1.::" . ;: E Nr Drinking fountain 1 6.60
Name:
Ejectors/sump 16.60
Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal j 16.60
:; . : ".. •i i, a :: :: Hose btb ' 16.60 i•
, 7a...r "!•,3. -, .. ..T :. _ a . . ., "- -,. ' 1!' ! `6: '_ . .. Ice maker • 16.60
Business name:. :, ~ � -: , Interc
t'P eptor/
W tor/ grease rap 162
Contact name: Medical gas (value: S ) Page 2
Address: . VD , - 1 01 -, C` Primer 16.60
City/State/ZIP: P�$ ( N T a i - '� Roof drain (commercial) 16.60
Phone: ( ) r ) 4 - 4 4 . - - 1 9 0 l ! Fax :: ( ) f DTI y - 1t b a T w ev 16.60
° D v � - Tub/shawerfr /showewe r pan 16.60
E -mail:
,aw Urinal 16.60
F ... - ,; =.. .. - .. Water closet 16.60
Business name: P5 P�.t uir. � Water heater 16.60
Address: W I ! - �, , 11 �-f���> Y Q U ` Other: -
City/State/ZIP :. i u� • .2.,,,5 Subtotal
, / C �� Minimum permit fee: 572.50 6e.
Phone: ( ) �4 10,QV Fax: ( ) 14 S"Sl23 Residential backflow minimum permit flee: 336.25 �2
CCB Lie.: SZ.7S Plumbing Lic. no. 34_ ? sCP8 Plan review (25% of permit fa)
State surcharge (8% of permit fa)
Authorized signature: TOTAL PERMIT FEE ri -,c
Print name: OZ I s J S -ei" Date: ? 07 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.
LlauddurgrPermm ?1JN- PermitApp.doc 06 016/06 4404616T(10/02/COM/WEB)
Ryg 03 2007 11:09RM POWER PLUMBING CO. 503 244 8825 p.2
P4ffinb[ng Permit Application - City of Tigard
• , Wage 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems: •
J5�•t''G' po -! - W Y.' }� •
Footing dram- 1 55.00 0to2,000 5115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 1
3,601 and $220.00 i
Seve - hi 100' :' 55.00 7 7,201 aud � greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas S stems:
Water Service - each additional 100' 46.40 ,' - ,,; ' ,,. •
Storm & Rain Drain • lst 100' 55.00 - ~ :��� - -� . .•�:� "`
$1.00 to $5,000.00 Minimum fee $72.50 - _ ...
;'r
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
V ;.,Y „ `1 -- . `f�qq--/ additional $100.00 or fraction thereof, to and
.... ._,....._L..s � 1 ;i.i- '.' including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 5148.50 for the first$10,000.00 and $1.54 for
Residential Backflow Prevention Device • each additional $100.00 or fraction thereof, to
minimum .omit fee $3625) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 525,001.00 to $50,000.00 $379.50 for the first 525,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
S. cial re . nested in -. - :ons - • er hour 72.50 and including 550,000.00. • •
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: = ,°Bain
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.
accurate r • • ort fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and
F �°- 3 ri; �_° ,t { - ; ;1 ". t• greater, except systems designed and stamped by licensed
: 'h y e r 1 n i t ? � t ai " engineer.
1
_°�� r. - •: k• :4_ ,;:� , .,. ' Any new exterior plumbing site utilities.
BaptistryiFont ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub /Shower • ❑ Any multipurpose fire sprinkler system.
- Jacuzzi/Whirlpool _ ❑ Any complex structure as defined in OAR9I8 -780 -0040.
Car Wash -Each Stall
-Drive Thtu Submit 2 sets of plans with any of the above.
Cttspidor/Water Aspirator
Dishwasher - Commercial ' 4;; � e ."
- Domestic bonn vic or Riser Diagram
Drinking Fountain ❑ Isometric or riser diagram is required for new buildings
Eye Wash that meet the qualifications above.
Floor Drain/sink - 2"
- 4" • Comments regarding fixture work:
• Car Wash Drain
Garbage - Domestic -
Disposal - Commercial •
- Industrial
Ice MachiRefrig, Drains
Oil Separator (Gm Station)
Rec. Vehicle Dump Station
Shower - Gang *Note: If the fixture work under this permit results in an
- Stall increase of sewer EDUs, a sewer permit will be issued and
Sink - Bar/Lavatory fees assessed for the sewer increase must be paid before the
Bradley plumbing permit can be issued.
mm
-Coerc id P $ P
- Service
Swimming Pool Filter
Washer - Clothes
Water Extractor _
Water Closet - Toilet _
Other Fixtures:
Other 9)11, L - .
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