Permit CITY TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00154
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/19/2007
PARCEL: 25111 BA - 03200
SITE ADDRESS: 14125 SW 98TH CT ZONING: R - 4.5
SUBDIVISION: MCDONALD ACRES LOT: 007 JURISDICTION: TIG
PROJECT: DAVIS
Project Description: Kitchen remodel.
CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: SR3.3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
DAVIS, LINDA A
14125 SW 98TH CT Description Date Amount
PORTLAND, OR 97224 [PLUMB] Permit Fee 4/19/2007 $72.50
[TAX] 8% State Surcha 4/19/2007 $5.80
Phone : 503 - 624 -5880 Total $78.30
Contractor:
ROBERTSON PLUMBING INC
PO BOX 1329
BORING, OR 97009 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 658 -5818
FAX 503- 658 -7106
Reg #: LIC 88717
PLM 3 -184PB
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.
Issued By: Permittee Signature: SCZ., /7
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.
Plumbing Permit Application
�� FOR OFFICE USE ONLY
City of Tigard Qom+ IV ll Received Pit N ,1
q 13125 SW Hall Blvd., Tigard, OR 97223 an : Pennit o.: PL �"12�/�v/� ' � ��I S� 1
Plan Re
14
Phone: 503.639.4171 Fax: 503.598.1960A i '100? Other Permit No.:
DateB
PlRe view
Inspection Line: 503.639.4175 Date Read /B Juris: Fa See Page 2 for
TI.GARD. Internet: www.tigard- or.gov Ready /By: g
C17Y OF i IGr�RD Notified/Method: Supplemental Information
TYPE OF WO1U UILDlNG DIVISION FEE* SCHEDULE . .
❑ New construction ❑ Demolition For special information use checklist
X Description Qty. � 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
1K- 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: f 7 9 t-. ! I 5 L,..) ? Q C Catch basin or area drain 16.60
City /State /ZIP: - r ' j -.J___5 / ,� V 2 2 Y Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: / I Project name: / 7 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
Fixture or item
fax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
. f\ f 7 if i g t v7i a 2t L Backwater valve 1 6.60
Clothes washer 16.60
Dishwasher # 16.60 ( I /
❑ PROPERTY OWNER I ❑ TENANT.
Drinking fountain 16.60
Ejectors /sump 16.60
Name: t__‘00 A D Awl t 5 Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: G. " Floor drain/floor sink/hub 16.60
Phone: ( 503 Co 2 Y -,158 �"ax: ( ) Garbage disposal / 16.60 ( ( ,,
APPLICANT ❑, CONTACT PERSON' Hose bib 16.60
N
C,
Ice maker r 16.60 � F-
�
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: ( ) Fax: : ( ) Sink/basin/lavatory 16.60
62 0
E -mail: Tub /shower /shower pan ( 16.60 1 b �-
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: g 0 G i 1� s a � ,(� , ( 6 � iC Water heater 16.60
Address: ?, 0... 0D/� 1 l ip Other:
y ( ( p 7307 Subtotal (p(p
Cit /State /ZIP: 7
Minimum permit fee: $72.50
Phone: (5-03 0 �8 / b Fax: ( 5- t 3 G cs - ?i DS Residential backflow minimum permit fee: $36.25 � 2 . 5 0
CCB Lie.: y� 7 1 7 Plumbing Lic. no.: 3'� 1� Cr / e, Plan review (25% of permit fee)
����_ Q A / State surcharge (8% of permit fee) S ,WO
Authorized signature:
l /""� 1 5 iyf .u7 TOTAL PERMIT FEE 7g, `„D
Print name: O This permit application expires if a permit is not obtained within
�' I ' ` 2 �� F ^ lSo��J Date: t / ,���� 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1 \ Building \Permits\PLM - PermitApp.doc 12/27/06 440- 4616T(10 /02 /COM/WEB)
i
•
Plumbing Permit Application - City of Tigard
, Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sup pression Systems:
• Site Utilities Qty. Fee (ea) Total. Square Footage: ' Permit Fee:
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
Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee: .
$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) 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
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", Plan Review for Plumbing Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
Quantity by (Fixture) Work Performed' ❑ Any new commercial building with water service 2" and
Fixture Type: Replace greater, except systems designed and stamped by licensed
Previous Capped 'Added ' Existing engineer.
Baptistry/Font
Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918- 780 -0040.
- Jacuzzi/Whirlpool
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive Thru ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash I or Riser Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-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 #: PLM2007 -00154
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007
Phone: (503) 639-4171 414901.
1
Inspection Requests (24 Hrs.): (503) 639 -4175 !J' 4'L I..
INSPECTION WORKSHEET FOR DATE: 6/19/2001- TIME: 7 :01AM PAGE: 85
SITE ADDRESS: 14125 SW 98TH CT CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: Kitchen remodel.
OWNER: DAVIS, LINDA A, PHONE #: 503 - 624 -5880
CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503- 658 -5818
Inspection Request Scheduled For: Date: 6/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 050425 -01 503-380-2129 N
Corrections /Comments /Instructions:
/ l
❑ PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: /Y . / J( Date: / • 1 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION ,„ -
. .
PERMIT #: PLM2007 -00154
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007
Phone: (503) 639 -4171 �o� fil?I
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:' `:_..
INSPECTION WORKSHEET FOR DATE: 4/20/2007 - TIME: 7:00AM PAGE: 34
SITE ADDRESS: 14126 SW 98TH CT CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: Kitchen remodel.
OWNER: DAVIS, LINDA A, PHONE #: 503 -624 -5880
CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503 - 658.5818
Inspection Request Scheduled For: Date: 4/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 20 Plumbing rough -in 046886.01 603-380 -2129 N
Corrections /Comments/ Instructions:
V VT Otve.,_ 0...
•
iA PASS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q7 6.4w `t \I Date: LII 2 o 02 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION _ ` - PERMIT #: PLM2007- DO'154
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007
Phone: (503) 639 -4171 l iPi�� i
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 7/13/2007 is TIME: 7:00AM PAGE: 67
SITE ADDRESS: 14125 SW 98TH CT CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: Kitchen remodel.
. --
OWNER: DAVIS, LINDA A, PHONE #: 503 -624 -5880
CONTRACTOR: ROBERTSON PLUMBING INC . PHONE #: 503-558- 5918
Inspection Request Scheduled For: Date: 7/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # M-s-age
399 Plumbing final 051835-01 503.349 -5789 Y
Corrections /Comments/ Instructions:
ffii-N .
..,.:
i. AMP / /.■44■14E/
� _J _; ~ r/
/
_ I -.
U PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: M' , (1 Date: / 0 Phone #: (503) 718-
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 00154
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007
Phone: (503) 639 -4171
Jir rl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/20/2007- TIME: 7:03AM PAGE: 83
SITE ADDRESS: 14125 SW 98TH CT CLASS OF WORK:
SUBDIVISION: MCDONALD ACRES LOT #: 007 TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: Kitchen remodel.
OWNER: DAVIS, LINDA A, PHONE #: 503 - 6245880
CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503 - 658 -5818
Inspection Request Scheduled For: Date: 7/20/2007 Pour Time:
Code # Inspection Description -: - ' # Contact # • Message
399 Plumbing final 0552179 -01 • 503-598-7428 �, Y
Corrections /Comments /Instructions:
30 1211 3��
D A)
,PASS n PARTIAL APPROVAL n CANCEL [ I NO ACCESS
❑ FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `- ‘ 1 '01 Phone #: (503) 718- 1 4 " '