Permit 7 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00452
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/22/2008
PARCEL: 2S 109AA -02000
SITE ADDRESS: 14450 SW 130TH AVE ZONING: R -7
SUBDIVISION: WOODFORD ESTATES LOT: 008 JURISDICTION: TIG
PROJECT: PANGARES
Project Description: Replace 40' sanitary sewer.
CLASS OF WORK: ALT 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: 40 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
CARY & TRA PANGARES
14450 SW 130TH Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 12/22/200€ $72.50
[TAX] 12% State Surch 12/22/200€ $8.70
Phone : 503- 624 -1557 Total $81.20
Contractor:
ARS RESCUE ROOTER
PO BOX 2830
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -235 -8784
FAX 503 -491 -2932
Reg #: LIC 127325
PLM 34 -168PB
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: Vg1QI Permittee Signature: &SZ AppIt'04Y-4.)1\
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.
MAY -22 -2004 21:44 P.001
PlRmbin Perm A pplication
��4 i9�� D
Building Fixtures i of °Fr[cr. USE. olvLY • '.N
City of Tigard DEC 18 2008 Received
Dater'B ., 12 . lei- o :. _'♦ Permit No.. p Vn2o.:. ■ rt.1
1 SW Hall Bl d.. Tigard. OR 97223 Plan RcVas
2 Phone; 503.639.4171 Fax: 503.598. 503.598.1ffry oil DatnB Other Permit N
Inspection Line; 503.639.4175 TiGARD -
TIC A rt O Intcmet: wvtiw tigard- or.gov BUILDING DIVISION Date Readying• bunt ® 5cc Page 2 far
Notified/Method: _j 1 Supplcmentsl Information
TYPE OF WORK FEE* SCHEDULE
❑ New constniction ❑ Demolition For special ir(/brmation use checklist
Desen.tion Qty. 2a, 'rota]
%Addition/alteration/replacement El Other: _ New I -2- family dwellings (includes 100 ft the each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
r
1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (31 bath 399 00
Each additional bath/kitchen 45.00
T
❑ Master builder ❑ Other:
Fire sprinkler ( sq, ft,) 1 Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: / eg ,, sk / f Catch basin ur area drain 16,60
City/State/ZIP: 776,412.0 4?-7207 Dowell. leach line, or trench drain 16.60
Suite/bldg. /apt, no.: Project nam / Footing drain (no, linear ft.: _) Page 2
Cross strcct /directions to Job site: Manufactured home utilities - 110.00 i
Manholes 16.60
- _ Rain drain connector 16,60
Sanitary sewer (no. lineat� lit- j_ Page 2
W Storm sewer (no. linear it,: 66 _ . ) Page 2
Subdivision: Lot no.: _Water service (no. linear ft.: �) Page 2
Tax map /parcel no.: Fixture or item
Absorption valve 16.60
OESCRWTION OF WORK Backflow preventer Page 2
'/ - 7 2 44. 41 5 �� Backwater valve 16,60
Awl 4.74°-.4 ..
Clothes washer 16.60
Dishwasher 16.60
[PROPERTY OWNER • . . . Q, TENANT Drinking fountain 16.60
Ejectors/sump 16,60
Name: �' / _
Af L - �GG�" Expansion tank 16.60
Address: / zis-D 5•1 re_.._
Fixtureisewcr cap 16.60
Cit)• /State /ZIP: 1 � Floor drain/floor sink/huh 16.60
Phone: ( ) I J �Rq /s ) Garbage disposal 16.60
A' APPLICANT f ] CONTACT PERSON Hose bib — 16,60 "—
Ice maker 16.60
Business name: ARS dba JACK IIOW I: /Rescue Rooter Interceptor /grease trap IG.60
Contact name: JOYCE DENNIS . _. _ Medical gas (value: S ____ 1 Page 2
Address: P.O. BOX 2831) _m Primer 16,60
City /State/ZIP: CLACKAMAS, OR 97015 Roof drain (commercial) T 16.60
Phone: (503) 235 -8784 ax:: (503) 491 -2932 Sink/basin/Iavatory 16.60
Tub/shower/shower pan 16.60
E -mail: JOYCEl7JACKHOWK.CONT
Urinal 16.60
CONTRACTOR 16.60
Water closet —
Business name; ARS dba JACK HOWK /Rescue _ Rooter Water heater 16,60
—
Address: P.O. BOX 2830 Other
EMI
City /State /ZIP: CLACKAMAS, OR 97015 „ Subtotal
503 491 -2932 Minimum permit fee: $72.50
( ) Residential backtlow minimum .emit fee: $36,25 O
Phone: (503) 235 -8784 Fax;
CCB i.,ic.: 127325 PI nbin8 Lie, no.; 34 -168 P Plan review (25% of permit fee)
Authorized signature: , /
State surcharge (12% of permit fee) WM/
/� TOTAL PERMIT FEti .Mr
Print name: //// �Tl� D0j This permit application expires if a permit is not ob inc,id' .
_r 150 days after It has been accepted as comp .
`�.� *Fee methodology set by Tri County Building Industry Service Board.
I mmai(ding(Permita,Pr.MF -p. Please FAX. BAC . to: 5 -2 93
MAY -22 -2004 21:44 P.002
_.,,Plumbing Permit Application - City of Tigard
Page. 2 - Supplemental Information
Fee Schedule: _ Residential Fire Suppression Systems:
Site Utilities Qtr. fee (ea) Total Square Footage: Permit Fee:
Footing drain - l u 100' 55.00 0 to 2.000 $115.00 - ti
Footing drain - each additional 100' 46.40 2 001 to 3.600 $ 160 00
MK If ` 55.00 ----/-..* --4
to 7,200 $220 -00
Sevier - 1st I
f 1/ 1s 7.201 and greater $309,00 -
Seller - each additional 100' 46,40 " ___
Water Service - 1st 100' 55.00
Medical Gas Systems:
Water Service - each additional 100' 46.40 Valuation: Permit
Storm & Rain Drain - 1st 100' 55,00 ermit 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 S5A00.00 and $1,52 for H ach
Fixture. or Item Q4' Fee (ea) Total additional $100.00 yr traction thereof to and
inoludin , $ 10,000.00.
C'ommerciai Back Flou Prevention Device 46.40 $10.001.00 to $25,900.00 $ 148.50 for the first $10,000.00 and $ 1,54 for
Residential Back flow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fcc $36.25) _ 27.55 and includin $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 51.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
s acuity re uested inspections - er 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.
Commercial Fixture Work: Plan Review. for Plumbing, Installations
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees*. ID Any new commercial building with water service 2" and
• . Quantity_ b g?',Ixture) Work Performer! greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous ' pent , Added Eitatin}t, El New exterior plumbing site utilities for any complex structure
Baptista /Font as defined in OAR918 780 - 0040 -
Bath -Tub /Shower Li Medical gas and vacuum systems for health care facilities,
- Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system,
Car Wash -Each Stall ❑ Any complex structure as defined in OAR918 -780 -0040.
-Drive Thru _
Cuspidor /Water Aspirator
Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic
Drinking Fountain Isometric or Riker Di pi
Eye Wash - El 1sotneh'ic or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
3 "
- 4.'
Cur 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
Wales Closet - Toilet _ _
Urinal
Other Fixture]:
i'l auiidma\PrrnfAiPLM- PernutAppeoc 1 2/27/w
r . . . .
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
RA1008-00452
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED:
12122/2008
Phone: (503) 639 ..44,
Inspection Requests (24 Hrs.): (503) 639-4175 4'J "LL
1
INSPECTION WORKSHEET FOR DATE: i2/2E) 2008 TIME: 7:00AM PAGE: 9
v ,
SITE ADDRESS: 14460 SW 130TH AVE CLASS OF WORK:
SUBDIVISION: WOODFORD ESTATES LOT #: 008 TYPE OF USE:
PROJECT NAME: PANGARES
DESCRIPTION: Replace 40° sanitary sewer.
OWNER: PANGARES, CARY & TRACEY . PHONE #: 603_6244657
CONTRACTOR: ARS RESCUE ROOTER PHONE #: 603.235_8784
Inspection Request Scheduled For: Date: 12/2912008 Pour Time:
Code # Inspection Description Confirm # Contact # Message tE46,4_4_)1
, :p re ttl
399 Plumbing final 079231-01 503-635-0784 0
Corrections/Comments/Instructions:
.. 7
.....) - iti o ----- —A - CA." • ..
_.......,_
, ' )
Z1,40 of PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
El FAIL Vi 'ALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
..,....-- zoil
Inspector: ..e...—. _ Date: izki oti Phone #: (503) 718-
W
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