Permit CITY OF TIGARD PLUMBING PERMIT
11 11 x COMMUNITY DEVELOPMENT Permit #: PLM2011 -00121
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/14/2011
Parcel: 2S101DB00610
Jurisdiction: Tigard
Site address: 7705 SW CHERRY DR
Project: Trotty Subdivision: Lot: 0
Project Description: Replace approximately 40' of water service.
Contractor: WESTERN PLUMBING Owner: TROTTI, LOUISE
9460 SW TIGARD, AVE STE 101 7705 SW CHERRY ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 639 -0848
HONE: 503 - 639 -5296
FAX: 503 - 684 -9015
FEES
Quantity Description Date Amount
40 If Water Service 04/14/2011 $62.54
Specifics: 1 12% State Surcharge - 04/14/2011 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment - 04/14/2011 $9.96
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific ' rater. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct estions to O C by c ling 503.232.1987 or 1.800.332.2344.
Issue By: k Permittee Signa
OSP
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
04/14/2011 09:35 5036849015 WESTERN PLUMBING INC PAGE 01/03
Plumbing Permit A licatioECEIVED
Building Fixtures APR 1 4 ?011 l'O1t OFFICE USE °NIA
City of Tigard Rectsved immi�
Permit No.: , s 1 /1-1901A o 13125 SW Fish Blvd, Tigard, OR 9 Y OF TIGARD p iew /
1 ■; Phone: 503.639.4171 Par. iSU1 1)aa�By.
" Ell1NG DIVISION aberQemiitNo.:
Iuapection Line: 503,
'1 IC:Ah0 Iruernet: www.tigota- or.gov Ready/By. Jude- la Ste Page z fan•
Nonfied/Method: Su . , mental Information
OF v1�O SC$ZDtILE
SEE
❑ New construction [] Demolition For special irr(vrnration we checklist __
Description I QtY• I Ea. I Total
Addition /alteration/replacement ❑ Other: New 1,- 2.- faboai y dwellings (includes 100 It- for each utility connection)
'CATEGORY: .OF CO ?STI.RUCfioN SER (1) bath ,_ 312.70
1 and 2 family dwelling ❑ Corramerciailindustrial SFR (2) bath 437.78
Skit (3) bath 500.32
❑ Accessory building ❑ Multi-family
Each additional bsrltekitchen 25.02 j
❑ Master builder Other -
_ -
- _ ❑ Fire sprinkler ( sq. ft.) Page 2 1
B'SrTE INFORMATION AND LOCATION Site utilities:
Jab site address: ) 0 Catch basin or area drain 18.76
Ci /State/Zl '~!' � Drywcll, leach line, or Ut wnoh drain 18.76
` j C56
Suite/bldg./apt. u01 Project name � Footing drain (no. linear 0-: ; )� Page 2
/� IL .t 1� �,� I Ma nufacmred home utilities s 50.03
Cross street /directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no, linear It; ) Page 2
Storm sewer (no. linear tt,: ) Page 2
Water service (no linear ft_: gr.j ) i Page 2 , 54
Subdivision: Lot no.: Future or Rene
Tax map /parcel no.: ... Back -00w pteventer 31.27
Ok WC1Ri<. Backwater valve 12.51
//�,,, ���� Clothes washer 25.02
O A9( L. _, f' li'(CS2. Dishwasher r 25.02
Drinking fountain 25.02
, ..
Ejectora/sump 25.02
°' pl;: JPERI1f' e. V)1'Eit 1 El° ' N ANT, Expansion tank 12.51 •
Name; j � �' Fixture/sewer cap 25.02 IL Floor drain/Bocr sink/hub 25.02
Address !i LL ! i , 11! ° _
Garbage disposal 25.02
City /State/ZIP: Hose bib 25.02
Phone: ("119 cf --0%q A Fax ( ) _ ice maker 12.51
ill AnucA.N ln. corrrAcr PERSON ]nterceptor /grease trap 25.02
Business name; Medical gas (value: $ _ ) Page 2
Contact name: Primer 12.51
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
C Ol *C JTf3R Water closet -- - - - 25.02
. Water heater 37.52
Business name: Western Plumbing, Inc.
Water piping/0W v 56 "29
Address: 9460 SW Tigard Avenue Suite 101 Other 25,02
City/State/ZIP: Tigard, OR 97223 _ Subtotal
Phone: (503) 639 -5296 Fax: (503) 684.9015 Minimum permit fee: $72.50
CCB Lic.: 2439 Plumbing Lic. no.: 34 -29PR -
Plan review (25%ofpermit fee)
�� I State surcharge (12% of permit fee) Will
Authorized signature: , j � i _ ",/ 4.4 fir l i TOTAL PERMIT FEE • • ..
Pmt name: Dana Jensen �� Date: , � This permit application expires ifs permit is not obtained within 180 days
after it has been accepted as Complete. {' /
■F.o «,...w.,.a.,t.,.....� r,., n:_r,,.,,,... ra,,: t,a: « ...a.....,, ��..��, a..a.a 1�j'�l
04/14/2011 09:35 5036849015 WESTERN PLUMBING INC PAGE 02/03
Plumbin! Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Resid ential Fire Suppression Systems:
r---•
:,,w,„<,.1 '.i`tie ,,, er ' () x Square Foot g Pelrmit
Footing drain -1 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 31.52 2,001 to 3,600 5 169.69
3,601 to 7,200 523
Sewer - 1st 100' 62.54 -- -
Sewer - each additional 100' 37.52 7,201 and greater $327.54
Water Service - 1st 100 62,54 y1. Medical Gas Systems:
Water Service - each additional 100' 37.52 . ,
- Valuation Permit Fee:'
Storm & Rain Drain • 1st 100' 62.34 $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
.°t 1 `i11 fe or , Pee s � ( ") 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 $I.54 for
which no fee Is specifically indicated 90.00/br
(nunininm charge 112 hour) each additional $100.00 or fraction thereof. to
and including $25 $ 000 - 00.
Inspections outside of normal business f 90.00fhr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) l each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr
and including $30 440.00_
Additional plan review for revisions 90.00/trr $50,001.00 and up $742.00 fur the first $50,000.00 and $1.20 for
(minimum charge -1 /2 hour) each additional $100.00 or 6 thereof
T Subtotal: . W5‘.1
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", Plan RriTieiv fo1' Plumbin anon s
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.
Qh a ; b (Fistua e) tt>i la Ferfortne¢ " 0 Any new commercial building with water service 2" and
kt> tUf* T3" greater, except systems designed and stamped by licensed
7Ehawluyrr _ ,ty •Added > nze engineer.
Baptistry/Font ❑ New exterior plumbing site utilities for any complex structure
Bath - TuWShower as defined in O.AR918- 780-0040_
- racuzza✓Whirlpool I ❑ Medical gas and. vacuum systems W. -_ Any multipurpose fare sprinkler -Each stall ❑ An multi ysce for health care facilities,
-Drive Thin
sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in (2AR918- 780 -0040
Dishwasher -Commercial
- Domestic Submit 2 sets of plans with any of the above.
a . -, , Fountain
Eve Wash - Isom or' Riser Diagram
Floor Drain/sink - 2" 0 Isometric or riser diagram is required for new buildings
that meet the qualifications above.
Car wash Drain -
Garbage - Domestic
.
Disposal - Commercial
- industrial - Comments regarding fixture work:
Ice Mach /Refri: Drains
Oil separator SGas Station)
Rec. vehicle Dump Station .
Shower -Gang
-mil
Sink -Bar /Lavatory -
- Bradley
-Com.i n ial *Note: If the fixture work under this permit results in an
swims Pool t increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures: