Permit il n CITY OF TIGARD PLUMBING PERMIT
l COMMUNITY DEVELOPMENT
PE COMMUNITY PLM2008 -00368
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/11/2008
PARCEL: 1 S133CA -07600
SITE ADDRESS: SW NO ADDRESS TRACT 'C' ZONING: R -25
SUBDIVISION: BARROWS ROAD ESTATES LOT: OOC JURISDICTION: TIG
PROJECT: BARROWS ROAD ESTATES
Project Description: Installation of backflow preventer for irrigation. Located in Tract C, near south side of Merritt St.
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
MILESTONE HOMES LLC Description Date Amount
3800 SW CEDAR HILLS BLVD STE 1
BEAVERTON, OR 97005 [PLUMB] Permit Fee 9/11/2008 $36.25
[TAX] 12% State Surch 9/11/2008 $4.35
Phone : 503 -641 -3147 Total $40.60
Contractor:
PREMIER GARDENS INC
7539 SW BAYBERRY DR
ALOHA, OR 97007 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -515 -1357
FAX 503- 848 -3150
Reg #: LIC 8627
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 Noti ' • enter. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these r es or direct • esti. • OUNC by calling 503.246.6699 or 1.800.332.2344.
�� �r
Isst. d By: /� �I " / , Permittee Signature: -.� { . // " 1i
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 Pern><it'Application
Building Fixtures FOR OFFICE USE ONLY .
City of Tigard Received
q " if e' Permit No.: .�� g
a 13125 SW Hall Blvd., Tigard, OR 97223 y
= Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date /By. Other Permit No.:
Inspection Line: 503.639.4175 Date Read B l El See Page 2 for
TIGARD Y Y y�
Internet: www.tigard- or.gov Notified/Method: /i Supplemental Information
. . TYPE OF `WO ' `
RK ,. . FEE UL
' * SCHEDULE, '
,K) New construction ❑ Demolition For special information use checklist
Description I Qty. Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
' CATEGORY OF CONSTRUCTION . • , SFR (I) bath 249.20
❑ 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:
Fire sprinkler ( sq. ft.) Page 2
' ° JOB SITE. INFORMATION 'AND LOCATION " Site utilities
Job site address: l ,�� -(_o - Catch basin or area drain 16.60
City /State /ZIP: - f ,K2,, .o OA? Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name:BACR(,US Reibripze Footing drain (no. linear ft.: _ ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: •4 / C)Z4,�' // �r ,g5/0/0..4-' Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
� Storm sewer (no. linear ft.: ) Page 2
Subdivision: gt - ite h [� L ot no.: Water service (no. linear ft.: _) Page 2
�C Fixture or item
Tax map /parcel no.: Absorption valve 16.60
- `DESCRIPTION OF WORK - Backflow preventer I Page 2
�fis7s ��A 9 Ar/Ws c) c5'!/J_P /lf Backwater valve 16.60
f j K 6 I " e 2 T e _ � 4 _ , , i . . . c 3 / 4 / Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
,0 "PROPERTY OWNER - .. - v 1 ' . III "TENANT _. ni, ._ `
Ejectors /sump 16.60
Name: ,/% -' f' /� /4/2,6:c 2.,_6G Expansion tank 16.60
Address: .'6a5 s w 667w, a' :*'kw 5 1 3 /Or Fixture /sewer cap 16.60
City/State /ZIP: J CJ/(� 9 70(9-r--
0 Floor drain /floor sink/hub 16.60
Phone: ('3) d #/ - 3/97 Fax: ($p,?) dry 3 -$MOs Garbage disposal 16.60
Hose bib ' 16.60
n- A PPLIC A NT IR CONTACT =PERSON ..
Ice maker 16.60
Business name: J "/ P It ill per' , AC. Interceptor /grease trap 16.60
Contact name.`D Jam,/ Medical gas (value: $ ) Page 2
/
Address: 75 StAj „, „de Primer 16.60
City /State /ZIP: � .� e51--X' 9 ® a 7 Roof drain (commercial) 16.60
4 Sink/basin/lavatory 16.60
Phone: (�3) .S'/� /.?,.( --7 / Fax: : (3 ) 9 ? /Sj
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
•. CONTRACTOR. - Water closet 16.60
Business name: .-",�'-dl_.-4;e/43 Water heater 16.60
Address: 7x-37 J'A j ,a� Other:
City/State /ZIP: 401.440,_ C Subtotal
Minimum permit fee: $72.50 ?/
•
Phone: 512 f'f',� /., 7 Fax: („33 ) ,// E/4 Residential backflow minimum permit fee: $36.25 dCO •
GCB Lie.: pg c? s ,1%: Plum g Li/ o.: 1_ y0 Plan review (25% of permit fee) Cr f .��7 /j/. ? S
Authorized signature: / // `�j'/
- TOTAL PERMIT FEE O. 60
Print name:Z:jszpv.4. #7�'��&�e9- 011ZE'!, Date:97/1 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\PLMF- PermitApp doe 12/27/06 440- 4616T(l0 /02 /COM/WE13)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site.Ut ;.Qty= Fee (eel Total Square Footage: P'er><ait`Fee
Footing drain - 1s 100' 55.00 0 to 2,000 $115.00
•
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
Sewer 3,601 to 7,200 $220.00
ewer - 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
Storm & Rain Drain - 1st 100' 55.00 Va Permit. 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 $5,000.00 and $1.52 for each
additional $100.00 or fraction thereof, to and
Fixtuite:dr item. < ' Qty. ;,,,Fee (ea) Total 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 Backflow 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
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
and includ
specially requested inspections - per hour 72.50 the $50,000.00.
Subtotal: $50,001 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 Re " for P 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 * . ❑ Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Type: ' � .: �.; - a. P i engineer.
Fixture
Re lace
Previous Capped •Added_,, _ Existing: ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ 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 Riser biagram ... -
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
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
Water Closet - Toilet
Urinal
Other Fixtures:
•
i \BuildingTermits\PLM- PermitApp doc 12/27/06
CITY OF TIGARD - \!••
BUILDING DIVISION
PERMIT #: PLM2008-00368
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9111/2008
Phone: (503) 639-4171 - w - iAlfitiii ir
Inspection Requests (24 Hrs.): (503) 639-4175 Affi■ 1.L.
INSPECTION WORKSHEET FOR PAGE:
DATE: 10/21/2008 TIME: 8:10Am 2
SITE ADDRESS: SW NO ADDRESS TRACY 'C CLASS OF WORK:
SUBDIVISION: BARROWS ROAD ESTATES LOT #: 00C TYPE OF USE:
PROJECT NAME: BARROWS ROAD ESTATES
DESCRIPTION: Installation of backflow preventer for irrigation. Located in Tract C, near south side of Merritt SL
OWNER: MILESTONE HOMES LLC, . PHONE #: 603-641-3147
CONTRACTOR: PREMIER GARDENS INC PHONE #: 503-515-1357
Inspection Request Scheduled For: Date: 10/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077000-01 503-515-1357 N
Corrections /Comments/ Instructions:
c12. u
c ck re
PASS fl PARTIAL APPROVAL Ei CANCEL 0 NO ACCESS
I I FAIL I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: goAn(d'.-A.---/ \ \,■, ) Date: )4 le) A tog) Phone #: (503) 718
. , _