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Permit CITY TIGARD PLUMBING PERMIT fin E�I, I DEVELOPMENT SERVICES PERMIT #: PLM2005 -00112 i 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 3/18/2005 PARCEL: 25111 BD -01602 SITE ADDRESS: 14865 SW 98TH AVE ZONING: R -3.5 SUBDIVISION: ALDERBROOK FARM LOT: 005 JURISDICTION: TIG Project Description: Installation of 130' of sewer service to connect existing house to sewer service. Septic tank is to be pumped, filled and inspected. Reimb. & sewer fees paid. CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 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: 130 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES MORLAN, DENNIS M + ANN T TRS Description Date Amount 14865 SW 98TH ST TIGARD, OR 97224 [PLUMB] Permit Fee 3/18/2005 $101.40 [TAX] 8% State Surchari 3/18/2005 $8.11 Phone : 503 639 - 3574 Total $109.51 Contractor: IVAN MCBEE EXCAVATING 28104 S REDDING LN REQUIRED ITEMS AND REPORTS MULINO, OR 97042 -9708 Phone : 503 239 - 2620 Reg #: LIC 1944 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 -000 - 010 t rough OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OU , N by calling 03- 246 -669 o' - ► 1- 332 -2344. Issue By: / 4 Permittee Signatur 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. Building Fixtures P?um'ting Permit Application FOR OFFICE USE ON ' • City of Tigard ' Received DateBy- O .�l Permit No.: # 4 , 13125 SW Hall Blvd., Tigard, OR 97223 i 'h '4 divb Phone: 503.639.4171 Fax: 503.598.1960 an Review Inspection Line: 503.639.4175 a ` Internet: www.ci.tigard.or.us �,r Date Ready/By: Ja ys H See Page 2 for Notified/Method: Supplemental �"�:; > 1« s;;'' 1�,'" �r��,' � .� "�a��:�.;��'.�:�.:., >.'e.�. =_ ••�.�a,,,�. _ entalInformation . +dv L '. �5:. i ,..,: °«+, ..'. P -. •m r "� :'�;' ^-; =' - sg: r.:s +2;: z n -. ` ° " t a tt .,11*' -7a /l 'VDRII a .. ., *�?�,, ^� r } ar .,. '.sax :I1, - �. 'i'•a 3%M. =.R� ;t?.,;'�: ;A , -a� A n !�, ' t '�Y" �; "' �:y ,:x + : n ,� "ra�:�E s?..x F�i g. •'�� r 1c .��.,.,. -.. �: ..; 4.,�,�.,. �.�.,��r .,,...,. > ;� �:`��. E�...�: �,a'. r.:. „t:b.�c,:E,:;‘S E Dru:, E t.;" ❑ New construction ❑ Demolition For special information use checklist. Description Qty. Ea. j Total ❑ Addition/alteration/replacement ❑ Other: „ New 1- 2- family dwellings (includes 100 ft. for each utility connection) :zF`��,"& ". � i °•KS?*,.:a�:vF'� � ,e - s., fas�a:�a���sz.�°w.- r* • ' .?. ° :GORY:-O ,�. "i s' 't=''3 r w.,' r ;,.. '"ia '€. ' " ' "' ,. G ATE C ONSLI2U«, Q � V " "s..." , "'1 :11 r _ 1 SFR (1) bat ° � " � � t ` �' bath 249.20 ��:�:.. Fitt.. �.. x.; c.. �'g' `;�:�,�,m:a°'�"'^�:a.:� ( ) ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 • Each additional bath kitchen 45.00 ❑ Master builder ❑ Other: Site utilities > °a "'s a`ra;.. a, la M:3' ... _. ..._ Fire sprinkler ( sq. ft.) Page 2 <R � T OB tgi eji :OC'A ON E ' - 1- tom- _ " ies Job site address: /48‘..S. „,5;W . 70 • uf�v v A Catch basin or area drain 16.60 City/State /ZIP: 7'/ .4/2.0 ©/ 6) 5 72, 211 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: HQ /eLf& Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: 01) 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 ;3 ; a = ..;. •:., m:_,: � Absorption valve 16.60 v1'r ,a:" �; Wi t _ ' i ; ;,.�.i : ESGRIP OF W a at' °" s Backflow preventer Page 2 Backwater valve 16.60 . Clothes washer 16.60 Dishwasher 16.60 ` sr; xt.a3 -g - e - :� r'� z e r 4; s g'` ° � PROPE.RTT OWNS I # t ✓ , MMA4 % � 1 , n + Drinking fountain 16.60 Name: r)114/..s c Atm) IAL.A� Ejectors /sump 16.60 MIA tank 16.60 Address: 148C 6' c 9�1 Fixture /sewer cap 16.60 City/State /ZIP: 77(74,4j) 9 72 2"/ Floor drain/floor sink/hub 16.60 Phone: (D3) C & �S 7 4 Fax: ( ) Garbage disposal 16.60 ; ; ` ' > . 4" G ONii T PERSON .W,tf Hose bib 16.60 o���� � _ �r .. tA�reW.,..rIf 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: ( ) Fax:: ( ) Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 a Urin 60 - ,? ` �` ON1'RA CT O R is �"s s + * - �.;. 16. ,, . .: 3�, " _ � ..:1�• ,. ;� n T , , ', :: , .� *60A Wat closet ` � 16.60 Business name: / V/ ) /� , xe /4-77 Water heater 16.60 Address: a Oe{ t o b / � -r ' v 4 _� Other: City /State /ZIP:Hu_ Li /J� D g. 4701{2, - 91708 Subtotal 2 �// 7 w s � / Minimum permit fee: $72.50 00 Phone: ( 3 2 2� 2 6 Fax:633) t� Residential backflow minimum permit fee: $36.25 • 0 t! CCB Lie.: /q4,7( Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) • // Authorized signature: TOTAL PERMIT FEE b f,S/ Print name: /OW //ca., Date: 4/ /8 /p 5 This permit application expires if a permit is not obtained v`• 180 days after it has been accepted as complerr *Fee methodology set by Tri -County Building Industry Sc i:\ Building \Permits\PLMF- PemutApp.doe 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: S><e tilit esa n Qty e (ea) '1?:; e Pe F - Footing drain - 1 t 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 Sewer 3,601 to 7,200 $220.00 ewer - 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 $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 Flxture�oI'ten, Qty ( e`a) Tlotal� 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 specially requested inspections - per hour 72.50 and including $50,000.00. 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: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . W kf � , � � Quantttyby (Ftxture)XorkT'erformed i 'i ur Taype 1 I s 1,„ '' s*°�Beplace � ` , * st g c ap ed Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru • . . • Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" -3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit,will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory _ Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter • Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: • is\ Building \Pemvls\PLM- PemvtApp.doc 3/03 0, . }. '.ALLDABLE SEPTIC SERVICE - -a P.O.BOX 1130 WILSONVILLE, OR 97070 '� (503) 5921929 FAX (503) 570 -07 ?9 CUSTOMER'S ORDER NO. PHONE DA , .3 -,2c-- NAME '4 ADDRESS -- ..41, , 6 7 72.23 i SOLD SY / CASH -- C.O.D. CHARGE ' ON ACCT. MDSE. RET'D. PAID OUT f / QT Y. DESCRIPTION PRICE AMOUNT ' i'' /G'd d , ,-.7 ,Ce ,--„e a /c c___ 2? - ......—..— A 7 . , D — , , -a C p m /t1 ASS / a 0 1 i Y d j 1 A i IC // j .a ,I :.(--- 'I y a 1 • 1 o 5 TAX RECEIVED BY TOTAL - 7 , , � . — . All claims and r @tnrne oods MUST be accompanied by this bill. /Mar/ To Reorder. THANK YOU L - 800-225-6380 or r>abs.ran CITY OF TI ARD C G BUILDING DIVISION PERMIT #: PLM2005-00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2005 Phone: (503) 639- 4171 "����gN„ y pitr a bl4 Inspection Requests (24 Hrs.): (503) 639 -4175 `__.. INSPECTION WORKSHEET FOR DATE: 3/29/2005 TIME: 7:11AM PAGE: 95 SITE ADDRESS: 14865 SW 98TH AVE CLASS OF WORK: SUBDIVISION: ALDERBROOK FARM LOT #: 005 TYPE OF USE: PROJECT NAME: MORLAN DESCRIPTION: Installation of 130' of sewer service to connect existing house to sewer service. Septic tank is to be pumped, filled and inspected. Reimb. & sewer fees paid. OWNER: MORLAN, DENNIS M + ANN T TRS, PHONE #: 503 - 639.3574 CONTRACTOR: IVAN MCBEE EXCAVATING PHONE #: 503- 239.2620 Inspection Request Scheduled For: Date: 3/29/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 350 Septic tank 003035.01 503.639-3574 N Corrections /Comments /Instructions: Ae i / „ ei r r i alkar C ,, 'AiztX/ L 1 (, Si ' ; SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS F7 FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date:, 3 -7 26-1 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005-00112 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2005 Phone: (503) 639 -4171 .��d�9N�iq��l L Inspection Requests (24 Hrs.): (503) 639 -4175 �:� INSPECTION WORKSHEET FOR DATE: 3/25/2005 TIME: 7:07AM PAGE: 91 SITE ADDRESS: 14865 SW 98TH AVE CLASS OF WORK: SUBDIVISION: ALDERBROOK FARM LOT #: 006 TYPE OF USE: PROJECT NAME: MORLAN DESCRIPTION: Installation of 130' of sewer service to connect existing house to sewer service. Septic tank is to be pumped, filled and inspected. Reimb. & sewer fees paid. OWNER: MORLAN, DENNIS M + ANN T TRS, PHONE #: 503 - 639.3574 CONTRACTOR: IVAN MCBEE EXCAVATING PHONE #: 603 - 239 -2620 Inspection Request Scheduled For: Date: 3/25/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 002829.01 503 - 639.3574 Y Corrections /Comments /in_ "4" s • -. .4 . '- 11 • PASS PARTIAL APPROVAL El ❑ NO ACCESS (l FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED — Inspector: G Date:/ I Phone #: (503) 718-