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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 00091 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/24/2011 Parcel: 1 S 125DC08700 Jurisdiction: TIG Site address: 7158 SW ASH CREEK CT Project: ASH CREEK ESTATES Subdivision: Lot: Project Description: Installation of residential backflow preventer for irrigation. Contractor: DALTON LANDSCAPE LLC Owner: STERLING SAVINGS BANK 8417 SW BEAVERTON HILLSDALE HWY 111 N WALL ST PORTLAND, OR 97225 SPOKANE, WA 99201 PHONE: 503 - 319 -7577 PHONE: FAX: 503 - 297 -5899 FEES Quantity Description Date Amount 1 ea Backflow Preventer 03/24/2011 $31.27 Specifics: 1 12% State Surcharge - 03/24/2011 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment - 03/24/2011 $41.23 Plumbing Class of Work: OTR Type of Const: Occupancy Grp: Stories: Total $81.20 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 la , • II 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 ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility ∎ otification Center. ose -s are set forth in OAR 952 - 001 -0010 through OAR 952 -00 6.'90. Y. ma obtain a copy of the rules or dir ct questions to OUN• • calli 503.232.1987 or 1.800.332.2344. Issu d By: � � Permittee Signature: V • 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. Plumbing Permit Application , r'' y Building Fixtures "" 1 n, 1 Cl of Tigard Received 2 ti perm No • 131 SW Hall Blvd., Tigard, OR 97223 J 201 Date/By: p/ /�T �� L//�Q // OaD i I Plan Review Other Permit No.: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: I ® See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I 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 312.70 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: , ,s � A.b (Ara_ (�� Catch basin or area drain 18.76 City /State /ZIP: -1 vn_ Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: _ ) Page 2 Suite/bldg. /apt. no.: 1 Project name: ' Manufactured home utilities 50.03 Cross street/directions to job site: -64 t a � ' b A Manholes 18.76 (-1 - 1 lST ` �� 4 . Co *A, TF:\`tT l LF, - Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 1 31.27 bk,: ^i DESCRIPTION OF WORK Backwater valve 12.51 I Clothes washer 25.02 1 TQLL . AC_C�Lr r•t. t41 (- Dishwasher 25.02 1e\(Tl 514... Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 25.02 City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: , � Lp„L>s LAC LL. Water piping/DWV 56.29 Address: kl 5 litcp Q1 Dr .. q`u,.sQp E. }1.4,■-) Other: 25.02 City /State /ZIP: ?D �t�►. -�.. 1 10 Gc Z" iL,S f Subtotal Phone: (Se"3) 3l -1,$1 - Z Fax: (SDI) 7 11 - 5t1411 Minimum permit fee: $72.50 ,p� •� CCB Lic.: 4 ,-L( /RI$t /4 Plumbing Lic. no.: Plan review (25 % of permit fee) r State surcharge (12% of permit fee) 0.70 Authorized signature: TOTAL PERMIT FEE $/ a0 Print name: al '�ve" , Date: -s ,1 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\PLMU- PermitApp.doe 10 /01/09 440- 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 - 1 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/1u $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge 1/2 hour) each additional $100.00 or fraction thereof Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub /Shower ❑ Any new commercial building with water service 2" and Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser Diagram Car Wash Drain ❑ s Isometric or riser diagram is required for new buildings - Domestic - food g q g Disposal - Domestic - food related that meet the qualifications above. - Commercial -food related - Industrial-food related Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lav - Non -food related - Bradley - Commercial-food related - Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer - Clothes Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Permits\PLMF- PermitApp.doc 02/24/2011 2 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 7158 SW ASH CREEK CT, US Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2011-00091 David Young Passed at prior inspection, ﬁnal to close permit. Violation Summary: Inspector Contractor