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Permit
7 �� CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00236 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/6/2007 PARCEL: 2S 111 AD -21000 SITE ADDRESS: SW NO ADDRESS TRACT "A" ZONING: R -4.5 SUBDIVISION: LADY APPLE LOT: OOA JURISDICTION: TIG PROJECT: LADY APPLE 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 BEACON HOMES 12703 SW 67TH AVE. Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 6/6/2007 $36.25 [TAX] 8% State Surcha 6/6/2007 $2.90 Phone : 503 -570 -8828 Total $39.15 Contractor: CONTOUR LANDSCAPING INC 12485 SW TOOZE RD SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 682 -1302 FAX na Reg #: LIC 5698 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR' Specialty Cayes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if {vork is not to ed within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires yQu to follow ru es adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 0001 -0010 through OAR 952-010 -01 10. YoU mAy obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. • .i { Issued By: Permittee Signature:A GA, If Call 503.639.4175 by 7:00 a.m. for an inspection that busin 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 Application RECEWED OFFICE' USE 'ONLY ' 2007 Received City of Tigard I I �N 0 Date/B D "� Permit N ra i 7 6941 , ,, 14 - q 13125 SW hall Blvd., Tigard, OR 972 6 Rev Other Permit No.': Phone: 503:639.4171 Fax: 503.59 960 „,,- _, -� Date/By Inspection Line: 503.639.4175 G E I` C i 1 € �D D ate Read /B luri See Pa e 2 for TI GARD. pp `, g; p Ready /By: S Internet: www.tigard- or.gov BUQDINc�. DIVISION Notified/Method: Supplemental Information TYPE OF. WORK . FEE *. SCHEDULE , Et 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) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building III Multi-family SFR (3) bath 399.00 , i J(Vt Each additional bath/kitchen 45.00 CI Master builder they: / �( L Fire sprinkler ( sq. ft.) .) Page 2 JOB ,SITE,; INFORMATION AND LOCATION, Site utilities Job site address: tADy i4- ?FL (, 1 -T � Catch basin or area drain 16.60 City /State /ZIP: -r --, � 0 - � 9 Drywell, leach line, or trench drain 16.60 t D c f Footing drain (no. linear ft.: ) Page 2 Suite/bldg./apt. no.: Project name: ( 1 (�� Manufactured home utilities 110.00 Cross street/directions to job site: j; _ .- S " FT L vJ © Manholes 16.60 -�,(,� Rain drain connector 16.60 S I TL- f� to S -,- � - c� (�`1•3 Sanitary sewer (no. linear ft.: ) Page 2 l Storm sewer (no. linear ft.: ) Page 2 Subdivision:_y 4 - P r (J i Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: 1 E e 1 -A--- Absorption valve 16.60 DESCRIPTION WORK Backflow preventer Page 2 � /V Backwater valve / 16.60 Clothes washer 16.60 Dishwasher. 16.60 . ROPERTY OWNER [1 TENANT Drinking fountain 16.60 Name: �� i7�GU;�J ko 5 Uv L„,:)1 Ejectors /sump 16.60 u " Expansion tank 16.60 - Address: ) 7+-03 .L,3 (6)9--- . V t Fixture /sewer cap 16.60 i City /State /ZIP: l( �(L- , 0S , q - a - Floor drain /floor sink/hub 16.60 Phone: (5j3)o 68 a,6 Fax: ( ) Garbage disposal 16.60 D. APPLICANT ❑ CONTACT ,PERSON . Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 . E -mail: Urinal 16.60 C ONTRACTOR Water closet 16.60 Business name: (13 )Q' f 0 (.3 0- /s Water heater 16.60 Address: ' D.4 4 V,5----sri11 00 2 v A_ Other: City /State /ZIP: v F-L.L �'� Q 42-- '� -1 ' 1 0 Subtotal '. iJ i � Minimum permit fee: $36.25 Phone: (y2:7)) d Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Co e i J Plumbing Lic •.; Plan review (25% of permit fee) Authorized signature: ✓ / State surcharge (8% of permit fee) TOTAL PERMIT FEE,. I s ) Print name: 144 A - 12 - V.--- �7s - (\ 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. 1:\ Building \Permits\PLM- PermitApp doc 12/27/06 440- 4616T(10 /02 /COM/WEB) - ry e Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: - Residential Fire Suppression Systems: Site.Utilitie , . k Qty. Fee_(ei) .Total Square Footage :, Permit Fee: 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 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 • Storm & Rain Drain - 1st 100' 55.00 Valuation: 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 Fixture, or Item - Qty.' Fee (ea) Total additional $100.00 or fraction thereof, to and 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 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: Are you capping, adding or replacing fixtures? If "yes ", Plan Review for Plumbing Installations` 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. Quantity_ by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: Replace greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918- 780 -0040. - Jacuzzi /Whirlpool Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities. Drive Thru ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Submit 2 sets of plans with any of the above. - Domestic Drinking Fountain Eye Wash Isometric or Riser Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings 3 >, that meet the qualifications above. - 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 *Note: If the fixture work under this permit results in an - Bradley - 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.\ Building \Permits\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007- 00236 ` 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2007 Phone: (503) 639 -4171 / vA Phi A A Inspection Requests (24 Hrs.): (503) 639 -4175 ,. ' I �.. INSPECTION WORKSHEET FOR DATE: 6118/2007 TIME: 7:04AM PAGE: 44 SITE ADDRESS: SW NO ADDRESS TRACT "A" CLASS OF WORK: SUBDIVISION: LADY APPLE LOT #: 00A TYPE OF USE: PROJECT NAME: LADY APPLE DESCRIPTION: Sarkflow presenter for irrigation. OWNER: BEACON HOMES, PHONE #: 603- 570 -8828 CONTRACTOR: CONTOUR LANDSCAPING INC PHONE #: 503 - 6811302 Inspection Request Scheduled For: Date: 6/18/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 050343 -01 - 503 - 682 -1302 Y Corrections /Comments /Instructions: /, . ,.. li, / � / e-e&i,-t"-- ( 1 PASS ri PARTIAL APPROVAL n CANCEL I I NO ACCESS FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: - Date: v f i g • A Phone #: (503) 718 -