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Permit y CITY TIGARD PLUMBING PERMIT l'‘ DEVELOPMENT SERVICES PERMIT #: PLM2004 -00451 '` '� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 9/27/2004 SITE ADDRESS: 14335 SW 125TH AVE PARCEL: 2S109AA -00800 SUBDIVISION: ZONING: R -7 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace sink drains and move laundry. FEES Owner: Description Date Amount CHRISTIAN DELKE 14335 SW 125TH AVE [PLUMB] Permit Fee 9/27/2004 $72.01 TIGARD, OR 97223 [TAX] 8% State Surcharp 9/27/2004 $5.80 Total $77.81 Phone : 503 - 579 - 5188 Contractor: BABBITT PLUMBING INC 7611 SW ALDEN ST PORTLAND, OR 97222 REQUIRED INSPECTIONS Phone : Rough -in Insp Top -out Insp Reg #: MET 00004156 Final Inspection LIC 30869 PLM 26 -86PB 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 -66 . / ��/ Iss d By: / 'emu ; L i Signatu- j �` �,_ - Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Building Fixtures I RECEIVED Plumbing Permit Application, 2 4 21 � FOR OFFICE USE ONLY f City of Tigard , Received f PO Permit No , 13125 SW Hall Blvd., Tigard, OR 97223 CITY OF TI' AR Date/By: Q A .� ,„ .ile, Phone: 503.639.4171 Fax: 503.598.1960 13 UILD%NG h,,, +,1. Plan Review Date/By: Other Permit No.: 24- Hour Inspection Line: 503.639.4175 -I I •i l� Date Ready/By: J °� ®See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information a l +t ' 4 r't.§ '' P n:.. .,, „ 176. ■ ;.x if a' F . °- 1 k ="G' Z da, lG .. o " _. . . ❑ New construction ❑ Demolition For special information use checklist. Description Qty. I Ea. Total Ci Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) xl _F'�" , t § 4, : :, .f II. .., .1 ac°+ x L r i ul` �. �L ,_ -u. 4 i -.y°. ,44: SFR(1)bath 249.20 `'Y 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: y ,, v . n „ .. -- „ � Fire sprinkler � sq. ft.) Page 2 arm. i tt� a q o )' .: ; , mss t ` Site utilities Job site address: /133$' 5 j / j J _ Catch basin or area drain 16.60 City /State/Z1P: - 7 llv/7 Q Q,... / C✓ R1t-e. (37 -223 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: y( � a ,..,., Y 9 '", 't 0 ' Manufactured home utilities 1 16.60 y Manholes 16.60 /d � 5 -- tvviA tilrr-s.2Jt , Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no µ ;ys Absorption valve 16.60 w Tfr l Y . i '. n� T `�w C . 3A �� 0 xa�$u �� �f5.l 1f< K ..rte . r,.,, _ - , :rs Backflow preven ter Page 2 I�/� , w Backwater valve 16.60 flAt 1 44 Clothes washer / 16.60 i Dishwasher • 16.60 ; ,- ' _� : =x� _ ^ATM j Drinking fountain 16.60 • - ..1 "�'Y , .i�� �S .:, � 'n,177 . t. l L h ° ',, l' , I `; r 1'' ` I b) ' _ ._., t �t >�. {. ` __ n _�z, , ��� E /sump 16.60 Name: �/,�1 u /' /"I rf /• `V 5 G N! r SOPJ�GV` Oei �° Expansion tank 16.60 Address: /4 3 35 - S iW 1 A Fixture/sewer cap 16.60 7 -,,a,,,/ City/State/ZIP: V' 7 e ? Floor drain/floor sink/hub 16.60 Phone: (503 ) 63y q 4' I Fax: ( ) Garbage disposal ) 16.60 i L'm"�'r` •'a avr r.� > I t �� , s„"7 . + � t ,� g sr � � 'n {° �; is e9° _'�, Hose bib 16.60 .r'''� t, r rt a 3 t ! eltit d ' ° m r �. - F �, ` ccl '' ty 4r7 .�. �' :. is 2.7k:'' in... Stf' _.tr t k ..t ,i x , : _ r -2, !? .. '?. "�� ti; } � � ice maker 16.60 Business name: a 7 - U J . c f Ac Interceptor /grease trap 16.60 - Contact name: G e N. e411 l it. Medical gas (value: $ ) Page 2 Address: 77/ -Cr l t /4 /de l, SIE Primer 16.60 City/State/ZIP: R i d ©`,., 9722_3 Roof drain (commercial) 16.60 O h 2K Phone: 5'03) A vi/ � j a 7 Fax: Sink /basin lavatory 16.60 v ( 9 I (! b 3) 02 S d 7 3� Tub /shower /shower pan 16.60 E -mail: NO qe Urinal 16.60 rr1 1 F^ S 1 S ', ∎q 'VI. g P, " `r t r 4. + �, .. f ∎I g 1 t '1;. t I _ . t Xt',6'iK.. - �a .,,. '} , d � .- r�.§�i "'2 . - s`9t '$."�`.�Zf3 Lx��" _ � ..�E .. ..- s...�t3 n�..i .- ,t ., • Water closet 16.60 or ,l Business name: 0 • / , UM • / N� k t Water heater II 16.60 Address: 61 f 5: 1, A. Id S Other: /Artie I r y �'ra y f City/State/ZIP: fD 4 ti rl ,DNe 97.22.3 / Subtotal Minimum permit fee: $72.50 GC r tea Phone: (S 2 ) ,? tf t 5- .7 I 4 Fax: (S 3 ) c2gc,, n 73 Residential backflow minimum permit fee: $36.25 'IX � -:.p CCB Lic.: 30 G'I 1 �� l Plumbing Lic. no.: R6, - g 6 ' Plan review (25% of permit fee) r ` e)'NA Ll) 5� I T D r n Authorized signature: h 4 7 t l `C State surcharge (8% of permit fee) r 3 b TOTAL PERMIT FEE 7/ .6 r g r Print name: , c A o p e BciLbK Date: 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 is\ Building \Permiu\PLMF- PerrnitApp.doc 12/03 440- 4616T( I 0 /02/COM/WEB) k • Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su ression Systems: e. ` 1 ,age5` . ;, -. tR4 Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 _ 2,001 to 3,600 $160.00 Sewer - 1st 100' 55.00 3,601 and d ,g $220.00 7,201 and gree ater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas S stems: 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 143 n ¢cen_} r � • u i including $100.00 0 0 or fraction thereof, to and 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 .ermit 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. s.eciall re.uested ins.ections - .er hour 72.50 Subtotal: $50,001.00 and up $742.00 for first 0 0 and for each ach additional $100.0.0 or fraction or fraction thereoereo f. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately re . ort fixtures could result in increased sewer fees * . 1 ��t n Comments regarding fixture work: Ba.tis. /Font - - -_ Bath - Tub /Shower - -- - Jacuzzi/Whirl.00l Car Wash -Each Stall - - -- -Drive Thru - - -- Cu .idor /WaterAs.irator - - -- Dishwasher - Commercial - - -- - Domestic - - -- Drinkin: Fountain - -__ E c 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./Refri:. Drains - - -- increase of sewer EDUs, a sewer permit will be issued and Oil Se.arator Gas Station - - -- fees assessed for the sewer increase must be paid before the Rec. Vehicle Dum. 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 afffrAl - 0 hr total is >9. Swimmin: Pool Filter MM. Washer - Clothes - - -- Water Extractor - - -_ Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal - - -- Other Fixtures: - - -- i:\ Building \Permits\PLM -Pere itApp.doc 3/03 U - CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date Requested /a - AM PM BUP Location / 'f 3 S /— Suite MEC Contact Person Ph ( ) 4 1 - 50 1 -7? PLM ;60 ' d/) 4 Contractor Ph (C-r —C• ) 3 /oZ ` 8'973 SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: ) �l 40.7 SIT Post & Beam / Q �/ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler � Fire Alarm Susp'd Ceiling 411W Roof Other: Final PASS PART FAIL PLUMBING ' _ —110/ / - Post & Beam Und: Slab - ou!h -I, Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 111 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA 1/� Approach/Sidewalk Date Inspector Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL