Permit k� CITY OF TIGARD PLUMBING PERMIT
II
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00230
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/4/2007
PARCEL: 25111 DC -04200
SITE ADDRESS: 15635 SW ALDERBROOK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 357 JURISDICTION: TIG
PROJECT: COTE
Project Description: Install landscape backflow device.
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
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Owner: FEES
COTE', OLIVER PAUL + VIRGINIA B
15635 SW ALDERBROOK DR Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 6/4/2007 $36.25
[TAX] 8% State Surcha 6/4/2007 $2.90
Phone : Total $39.15
Contractor:
DENNIS' 7 DEES LANDSCAPING
7355 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRl 503- 777 -7777
FAX 503- 777 -2399
Reg #: LIC 5009
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 B • . / 44 ` ' I / Permittee Signature: i ro _*'
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 Appli�n �'
City of Tigard 1 9 (r Received r � /� P ermit No.
f i(y Date/B G 4 1v � rLM 60230
13125 SW Hall Blvd., Tigard, OR 97223 i Plan Review
Phone: 503.639.4171 Fax' ;503.598.1960 ty OF +l `t i; �)J�' + Date/By: Other Permit No.:
24: Hour Inspection Line:' 503.639:4175 'ard.or.us � e t. : � Date Ready /By: ®S Page 2 [or
Internet: www.ci.tigard.or.us f r' " ""
g t Notified/Method:
le a
Supplemental lnformatioa
��.��.,��.��:�:: ��,,,< tea. :�:r,� ^..,,�... „....:... >:�`� °: " "'.� Y.��,;;.7,' ii.': :<.<< " "� z =`�.�r
,,.;��,,- - FEE,.. SGHEDLIL'•
TYP ���:� -
ns.. <.,.�.,. �1.. .. r. �.�» -z -� ,,.pk,. � ..� v.s .._<_;..� ., .. �_. ,.. ...�.:� _z ....._ '- ��.._g.�...._...r,..._<y.�, .r::��.�._..,- �-":�'�a.y;.
❑ New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ® Other: LANDSCAPE New 1- 2- family dwellings (includes 100 ft. for each utility connection)
E`r ,* - '.,., - CATEGORY OF' C ONSTRUCrION� M.. - , M ,.. r_ - SFR (I) bath 249.20
0 -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
; . JQB SIT E INFORMATION AND LOC
...<- ..... ". , _., _...a -,. .r.. Site utilities
Job site address: / 5 13 S 5Z/,1 ,41 I / i 4. 1 Catch basin or area drain 16.60 ,
City /State /ZIP: 7(64 aK ! ? ,91../ - Dr leach line, or trench drain 16.60
1 Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: (6 /'
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
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.:
Absorption valve 16.60
x �:_� wry. ,� >.,. ,� yDESCRIP CIU111�'OF. OKIC ' <� � �: =F -'�
N' Backflow preventer 1 Page 2 )6 '15
INSTALL BACKFLOW DEVICE Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
„<. Drinking fountain 16.60
PROPERTY ; OWNER 4 - ` t' ' ' ❑ _ TENAN
/ j � Ejectors /sump 16.60
Name: ()&( / /t Gel" Expansion tank 16.60
5 I i
Address: om v `'t Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16 -60
�
Phone: (3 ?) �j�''7 t��(e 9' Fax: ( .) Garbage disposal 16.60
- - .'..x�: J Hose bib 16.60
f f < i - AP'PLICi1NTF`< .:a- # -�..: a . CONT, CT PERSON.,
1 :�
. . � 0.. , 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
Phone: ( ) Fax: : ( ) Sink/basin/lavatory 16.60
- Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
g .. s . ..... rF' ECONTRAGTOR .... �......., : .. i < x . Water closet 16.60
Business name: DENNIS' SEVEN DEES LANDSCAPING, INC Water heater 16.60
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Address: 7355 SE JOHNSON CREEK BOULEVARD Other:
City /State /ZIP: PORTLAND, OR 97206 Subtotal
Minimum permit fee: $72.50 /, 7
'Phone: ( 503 ) 777 - 7777 Fax: (503 ) 777 - 2399 Residential backflow minimum permit fee: $36.25 v ' L �
CCB Lic.: 5009 11/ 30 /(5 Plumbing Lic. no.: 05LIBDI Plan review (25% of permit fee)
j State surcharge (8% of permit fee) d.-90 Authorized signature: ��/�� 001 /1 ! TOTAL PERMIT FEE 3q.(5"
Print name: DEAN SNODGRASS Date: 5/ / t' This permit application expires if a permit is not obtained within
fff 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
i. \Building \Permits \PLM-PermitApp doc 12/03 440- 4616T(10 /02!COMJWEB)
. •
Plumbing Permit Application - City of Tigard
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Page''2 Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
. Fee ea Total
. :a are�Foo t a _ .. e i.; _ = °P er>itii ,.
Footin -.,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 to 7,200 $220.00
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 •
alu n Per mlt�_il
Storm & Rain Drain - I st 100' 55.00 a�IQ " �':: "" .. • "__° . <' . - `, - _ _
$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
• Fee (ea j . . ,4 additional $100.00 or fraction thereof, to and
Fixture oraItem .. Q tY 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 including $50,000.00.
specially requested Inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"yes", please indicate work performed by fixture. Failure to ,
accurately report fixtures could result in increased.sewer fees * .
; <,? , Hd ,. ° Quantity:by :(Fixture }= WorktPerformed:
i u "r ' ; ::v x ;: :., :: } ,�:YRepince/ Ev, ,, .r..r, :: "'s:,
'M`Moved . Exisd' ' _ , .
� . �;:`�_ -e per' Comments regarding fixture work:
7e
Baptistry/Font
• - Tub /Shower
- Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher - Commercial
- Domestic
Drinking Fountain
Eye 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 increase of sewer EDUs, a sewer permit will be issued and
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall
Sink - Bar/Lavatory
Ouantity Total
- Bradley
Commercial Isometric or riser diagram is required if fixture quantity
Service total is >9.
•
Swimming Pool Filter •
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- PermitApp doc 3/03
CITY OF TIGARD
BUILDING DIVISION r PERMIT #: PLM2007- 00230
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1t1/2007
Phone: (503) 639 -4171 �,� 4 �9 .illi\
Inspection Requests (24 Hrs.): (503) 639 -4175 a..
INSPECTION WORKSHEET FOR DATE: 10/23/2007 TIME: 7 :00AM PAGE: 40
SITE ADDRESS: 15635 SW ALDERBROOK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 357 TYPE OF USE:
PROJECT NAME: COTE
DESCRIPTION: Install landscape bacisflow device.
OWNER: COTE', OLIVER PAUL a- VIRGINIA B, PHONE #:
CONTRACTOR: DENNIS' 7 DEES LANDSCAPING PHONE #: 503-777-7777
Inspection Request Scheduled For: Date: 10/23/2007 Pour Time: J d/ 1
N
Code # Inspection Description Confirm # Contact # Me-.age 4, trifi(
395 Mice. inspection 058132 -02 503.777 -7777 1` Corrections /Comments /Instructions: 4,3p4
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v A--1,/,
f
. / '-- # 27 47 41 L■_, 4il •-‘
PASS d p.. 4 4
p ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
CoZ3( Phone #: (503) 718-
Inspector: `� Date: �1`