Permit =
-1i,;;:;,; OF TIGARD
PLUMBING PERMIT
° ti COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00093
' � DATE ISSUED: 3/6/2007
TIGARD: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BB-02600
SITE ADDRESS: 16335 SW GREENLAND DR ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 040 JURISDICTION: TIG
PROJECT: RALSTON
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BILL RALSTON Description Date Amount
16335 SW GREENLAND DR
TIGARD, OR 97224 [PLUMB] Permit Fee 3/6/2007 $36.25
[TAX] 8% State Surcha 3/6/2007 $2.90
Phone : 503 -516 -1299 Total $39.15
Contractor:
r
GREENCO LANDSCAPE 3
20625 SW 65TH AVE
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
O
Contact # : PRI 503- 638 -6212 ' '' . "x' "
FAX 503- 638 -7088 r
Reg #: PLM 7442 EXP�EC®
j /` �6 f
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. /—)
q
Issued By: >' , r. -� Permittee Signature •'. 2 e „9' -=-'
t,
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.
INSPECTOR'S SIGNATURES ARE 'NOT
Inspections Required for. PLM2007 -00093 REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough in 305 Plumbing underslab
915 Fire alarm rough -in
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing X 399 Plumbing final
210 Foundation walls
_ 215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\ Building \ Forms \InspCard- AOI'- Blankdoc 02/02/07
` � CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00093
.TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/6/2007
PARCEL: 2S114BB-02600
SITE ADDRESS: 16335 SW GREENLAND DR ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 040 JURISDICTION: TIG
PROJECT: RALSTON
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BILL RALSTON
16335 SW GREENLAND DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/6/2007 $36.25
[TAX] 8% State Surcha 3/6/2007 $2.90
Phone : 503 -516 -1299 Total $39.15
Contractor:
GREENCO LANDSCAPE
20625 SW 65TH AVE
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 638 -6212
FAX 503- 638 -7088
Reg #: PLM 7442
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: �� 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.
• Plumbing Permit Applic ><o>r� l oIi oH lcL��s �o�L ` '
City of Tigard Received, -- , 7 f` .: Permit No
. : al 13125 SW Hall Blvd., Tigard, OR 97 2 :,7 �j 2001 eR } /' \��°�� 7 O 0 <7
Plan • ; ®, 3, Phone: 503.639.4171 Fax: 503.598 1 960 Daze/By. Other Permit No.:
Inspection Line: 503.639.4175 17ate iteady ions: RI See Page 2 for
TIG.AK
Internet: www or. ( a I 'S �3i`°� Notitiedf
1 A Supplemental Information
.:!", ,. a, : i ' "k�;t7 �
i- t • 3 "''•�; "TYPE: FJR` P' „ :•:7 a+.FEE ,J ER I'E ".
❑ 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)
n ,
o-4 . . '.,., . ,: x,.,..,,^.. - . , . x ..y� S I bat 24
f'' '''.' ; sCATEGORlf ` OF'CONSTR[JC I IO ° ' 4 ' h" r
�� "r ° � .. r s ; ,.! ` � _. , ..:...,,..... . -. .. <- � ` �� �':; ` h�. O 920
1- and 2 -family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
r i = ° =r . r Sl . t �.. - •, . ...<r ;�:•, a,..,.. Fire sprinkler ( sq. ft.) Paget
"' ;''' `Y; -k ' s! AOB• ieiVFO RMrfliii 'r11 Vk i," i k ATIONe 4 . 4 ' : ::, �'''*�':
,s,.. :a. .r „ = lj.h f . :- ^^^.42,. .. ,, e, "1,1,` . - u...:,, ,- • ' - , ,. t : !"C - k" . d Site utilities' .
Job site address: ! g j - , 14J ( (WO� f7 d d Catch basin or area drain 16.60
City /State/ZIP: ; 0/e' 9 7227 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Z..f7it.) i _. Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site: /ZJ�/! ( y
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: ' f CjC ( s' L4-4/O/ I Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.:
Fixture or item
,3- • - . r .,,•, . fi .. ; s s ,. Absorption valve 16.60
u
: : :4? f .T � *, . , :' 0 , DESCRIPTION I OFY' VV OItI :( :: 4 4.r .- x F ° .1r z /
,,,,. ^ , , . _., ,„ , . a,„ .'€,+'" Backflow preventer / Page 2
.4!4 :, r/0 -- 20 're QX- or - icie_ Backwater valve 16.60
r „�R�D Clothes washer 16.60
Dishwasher 16.60
ma Y,;- M : ' ...;,� , F..,.,, t, N ss:
'i". '�" � u EROF'ERTYOWNER �?;�'� °'. y "-;: •I` "�;� ''� '4.' ® TENAN � ` ;. � . ;`, � °' Drinking fountain 16.60
,
4 ..< '' "'r'., � :''f''', ' e '9 ' .. p er ,! n . ^ + ,. _, „ '''''' ..,_ Ejectors/sump 16.60
Name: 1/ �} i y e Z/� le,42 /'� Expansion tank 16.60
/�., �-
Address: /6, 3 S Gt..) / T_p_j2/ ! (�. j/- Fixture/sewer cap 16.60
City /State /ZIP: t D� .?'02■92-11 Floor drain/floor sink/hub 16.60
Phone: f 1 j) . 5 - 7 -/2 9 Fax: ( ) Garbage disposal 16.60
;' `f *-- ;:= rr:•<'r :i A s, ,..... Hose bib 16.60
„e : V`1 . x ;',. .:ICANT., l, t ∎p t RSON ,�,..
. : �: _� &.44',:p4 ��' . . .--.: . ��.� la�� ,, `.. F: � �'�:'�. <' COIVT A CT : PE
Ice maker 16.60
Business name: _ L � , f' #.0,
Interceptor /grease trap 16.60
Contact k
name: J� 4 i s g
� ■ ;� � Medical gas (value: $ ) Page 2
Address: �6,ps- S 6S ---- A Primer 16.60
City /State/ZIP: (7, 9 7416 ,L Roof drain (commercial) 16.60
Phone A 7) 6j, 602/c2..„ Fax: :?..6.31.538-- » ® D,¢ Tub/shower/shower w
Sink/basin/lavatory 16.60
�J V Tub /shower /shower pan 16.60
E -mail:
„ : _ I Urinal 16.60
.• ; : k 1'- ;.:` x , ,�a ,CO NTRA ' C T OR ,x., . ,; , .. , ; �:. .. .. � .;
"° _ , ' ,. -
' ., - . ,.. - Water closet 16.60
Business name: �� Water heater 16.60
Address: j S� f� Z ' ' Other:
/� ��
Subtotal
City /State/ZIP: L�CGJ(/ rte. cJ 76l
7 Minimum permit fee: $72.50
. d.1
PhoneJ ) �6� 2 Fax: (6 K32 ✓70s Residential backflow minimum permit fee: $36.25
CCB Lic.: Cf , Plumbing Li , no.: ° Plan review (25% of permit fee)
jJ-� State surcharge (8% of permit fee)
Authorized signature, �� y f attt0�
/1��LlIlG�/y TOTAL PERMIT FEE
eflifffr ' , - r Z� Date: 3- _--- This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\ Building \Pe,mits\P1.M- PennitApp.doc 06/26/06 440-4616T(l 0/OVCOM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
S1tesUtihti 3 ° "n , z fi � l lite, (ea) w * Totat }¢S lla$ ` e' �z a� 5 Ce '��"
•. ��t� vtr�r � a �,� .- � a'�� +�.�.��'s�a;�,:: ,H (� t �iCaf �: �; w� ;��e$'IIllt�'F, . . ..,, � , ».v
Footin 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
3,601 to 7,200 $220.00
Sewer - 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
;Wat.-~ a:
y @
I iIEATi . "v +Permit.":.,.CC:?
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
additional $100.00 or fraction thereof to and
Fee. ea Total;
;Pizture' or; sz Q•r�" ::,M )'° f
��� �a��tz u��i�� . �"ea�i+� - .,.� �� .�r, i'rxm °�wr:4 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 Back flow 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 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
• Fixture Work: P lan R -for Plu mb ng'Installat ons° u ? `
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 * . ❑ Any new commercial building with water service 2" and
"
greater, except systems designed and stamped by licensed
. fi ;^` Quntity "by'(Fizttlie)tWork nied
Fiitdre "'Typ ,'"l ` "�-. `"}f"' `d ` a n �' y`gy :;;{ "",: �+x, . ` ";. :rORep■iite, engineer.
', ' ❑ New exterior plumbing site utilities for any complex m4�T��'`8 x �r��v,.r� "._��. lbi
r�,Previous "xa '�.Capped�� ,��Added , .�6idstleR� p g i ili f Y lex structure p
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
J acuzzi/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 �. z ,.
Drinking Fountain r: « "Z *,fe;?,f ISOillC r1C� OI' R1e D1 I'a1Tl
Eye Wash • ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
-3"
-4"
Car Wash Drain Comments regarding fixture work:
Garbage - Domestic
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station ti
Shower -Gang
- Stall *Note: If the fixture work under this permit results in an
Sink - Bar/Lavatory increase of sewer EDUs, a sewer permit will be issued and
- Bradley fees assessed for the sewer increase must be paid before the
- Commercial
Service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i:\ Buiiding \Pennits\PLM- PennitApp.doc 09/22/06
CITY OF TIGARD (,`% Ve-4 (2e,..\-
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DAT ISSUED:
Phone: (503) 639 -4171 -u, III Di
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: LA S SS.e, c CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER, �) : PHONE #:
NTRACTOR: . L
5 , l j o'` Wr '� tj `_ s PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 4 ( - c AA.) 0 - L..,n.a.A.
Corrections /Comments /Instructions:
t 1 01 `. /5.\)--e_ . C P Zo o`s— 06 - sci b
s ir-ziLAA -can - ' -1.--.e cl
14 6(0,5 01 `I` Ar . C poi - LAO 4 o0 S 1 o )
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- 7 4 . . ( . 4 A — ” r te - - s - .- —
.1 11 4 0 V r o l 64- -. L2(.LC1. 2.0 ( Q - co 3 3 W) •
PASS PARTIAL APPROVAL H CANCEL TES NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CA Date: Phone #: (503) 718-