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Permit
ft ~ ' v CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00361 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/3/2008 PARCEL: 25111 BD -00407 SITE ADDRESS: 14940 SW 96TH AVE ZONING: R -3.5 SUBDIVISION: DARMEL NO. 3 LOT: 017 JURISDICTION: TIG PROJECT: SMITH Project Description: Installation of residential backflow preventer for irrigation. 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 VERONICA SMITH 14940 SW 96TH AVE Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 9/3/2008 $36.25 [TAX] 12% State Surch 9/3/2008 $4.35 Phone : Total $40.60 Contractor: MONTERREY IRRIGATION 4715 , 9 OR 97266 R PORTLAND, REQUIRED ITEMS AND REPORTS PO Contact # : PRI 503 -539 -0677 Reg #: PLM 8428 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 • - - - -stions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issu d By: / 1/1/ ,g. „„, .. Permittee Signature: 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. Permit Applicati 1E r g Fixtures " FOR OFFICE USE ONLY City of Tigard SEP 3 Received , f Permit No.: J p GN � 3 p/ n 13125 SW Hall Blvd., Tigard, OR 97223 TVa -' . Phone: ,� ne 503.639.4171 Fax: 503.598.19 TV t S , + Review ® •y - /By: Other Permit No.: Inspection Line: 503.639.4175 1 A, Date Read /B lur . T I GA R D Internet: www.ti and -or. ov o ® Ready /By: 0 See Page 2 for g g ��1` Notified/Method: kee Supplemental Information TYPE OF WORK - _, _ . _ . <_ . ,_ FEE* SC = _ _ HEDULE _ For special information use checklist g New construction ❑Demolition Description I Qty. Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) . .: CATEGORY OF CONSTRUCTION - , _ " . . SFR (l) bath 249.20 2 1- and 2 - family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building 111 Multi-family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JO11i •SITE - `INFORMATION AND LOCATIO N °` : ' Site utilities Job site address: hi q I../ 0 s ( 96' T A-1/ 6 Catch basin or area drain 16.60 City /State /ZIP: a rd ®i A - 2 Z C� Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: l l Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: _ ) Page 2 Tax map /parcel no.: Fixture or item . Absorption valve 16.60 DESCRIPTION. AF -OR • WK Backflow preventer Page 2 ti 3 L Ai j 614 i' Backwater valve 16.60 .Pr/ vl ,L"f - S y s tefr -( Clothes washer 16.60 Dishwasher 16.60 `-.2' PROPE OWNER .. ._`'� ' Drinking fountain 16.60 • ❑TENANT, Ejectors /sump 16.60 Name: V(0_4,0 ru / c f. S 71-a'4 Expansion tank 16.60 Address: /1.-/ 9 /40 sC 76 Aid- Fixture /sewer cap 16.60 : : City /State /ZIP- j ' p -<.,) t © j-- 9 -!- Z V. Floor drain /floor sink/hub 16.60 Phone: ( ) Fa;,(, ) Garbage disposal 16.60 APPLICANT Hose bib 16.60 ❑ ❑CONTACT PERSON , Ice maker 16.60 Business name: /1,40 g, r t-y _)+-F g / - 0 /z , / Interceptor /grease trap 16.60 Contact name: .67S4- c ZO df y l -<-C Z Medical gas (value: $ ) Page 2 )../.7../ Address: )../.7../ s - SE Ul 7 A v Primer 16.60 City /State /ZIP: / t ,. -t- l a p„ 1 0 R__ `71- 2 c . Roof drain (commercial) 16.60 7 1 Sink/basin/lavatory 16.60 Phone: (9-0 3 ) 53 *f.Q 6 7. 7 Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 -. . ' , ,. ONTRACTOR C - . - Wat er closet 16.60 Business name: ,, N-7-,.._R f Y /Zit / C A 7/0/.fl Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 p / i s, Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 a D , 60 " i - CCB Lic.: S' Lt 'L 8 y� �j l0 1 Q Plumbing Lic. no.: Plan review (25% of permit fee) -- -- `� State surcharge (l2% of permit fee) 4 (36 ' Authorized signature: TOTAL PERMIT FEE 44, eye) Print name: L54 r / r 0 01 y �r6,,,�. - 9 Date: - 05 p This permit application expires if a permit is not obtained within �J ! 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1 ABuilding \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 it ties' ° ", � :Qty. Fee (ea)w Total Square Footage : :. Permat Footing drain - 1s 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 lr-..,,. Valu " ' Permit Fee :. ds ;, 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 additional $100.00 or fraction thereof, to and Eixture_ors,Itein��;�; � -, _Qri. � 'IHee(ga),t 'rotal.= 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._ 0 for each additional $100.00 or fraction thereof. Commercial Fixture Work: ��.. Plan''Review forPlui:ii Bing Installations ` <. `E 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 Quanti by fixture WorkPerforined greater, except systems designed and stamped by licensed tY Y (F ) . y engineer. r Fixtbre Ty "pe: ` w , , s . _. • 7., Replace, - ° Previous' Capped Added ;. Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR9I8- 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 ISOitietrie 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\PLM- PermitApp doc 12/27/06 CITY OF TIGARD ¢ _ BUILDING DIVISION PERMIT #: PLM2008- 00361 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/3/2008 Phone: (503) 639 -4171 I isl Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/8/2008 TIME: 7:00AM PAGE: 15 SITE ADDRESS: 14340 SW 96TH AVE CLASS OF WORK: SUBDIVISION: DARMEL NO. 3 LOT #: 017 TYPE OF USE: PROJECT NAME: SMITH DESCRIPTION: installation of residential bacleflow preventer for irrigation. OWNER: SMITH, VERONICA PHONE #: CONTRACTOR: MONTERREY IRRIGATION PHONE #: 503 - 539 -0877 Inspection Request Scheduled For: Date: 9/8 /2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 075201 -01 503. 539.0877 N Corrections /Comments /Instructions: Sze r C a l+c, C J r--.- XPASS H PARTIAL APPROVAL n CANCEL n NO ACCESS I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ► -+ ``5 2 Date: 1 \TIM Phone #: (503) 718-