Permit II ' n CITY OF TIGARD PLUMBING PERMIT
I ° . ` COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00028
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/29/2007
PARCEL: 2S 102 DC - 03600
SITE ADDRESS: 13886 SW ANDREW TERR ZONING: R -4.5
SUBDIVISION: MCDONALD WOODS LOT: 009 JURISDICTION: TIG
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
WINDRIDGE HOMES
11401 NW SKYLINE BLVD. Description Date Amount
PORTLAND, OR 97231 [PLUMB] Permit Fee 1/29/2007 $36.25
[TAX] 8% State Surcha 1/29/2007 $2.90
Phone : 503 784 - 4328 Total $39.15
503 639 - 2021
Contractor:
TRUSCAPES INC
21600 NW ANBERWOOD DR.
HILLSBORO, OR 97124 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 969 -2144
FAX 503 -531 -9216
Reg #: LIC PLUS BACKFL
PLM 7962
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: 72
-e...-3
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
R � R , F � � �r-
Plumbing Permit Application o 1 ,loll oI NlQ► ,,u,. E RoL t ..' a , t,. '1
JAN 2 9 2007 1 , .., r g�, .3 / ;7,� •3 City of Tigard D �e/ B o2' e ! 1261/4----.1 Permit N6'Q� 74) � Z
a 13125 SW Hall Blvd., Tigard, OR 97223 ciTY oi- .' ); , IRD Flan Review
Phone: 503.639.4171 Fax: 503.598.19960J(LDtNP,, DIV1RICti\ Date/By. Other Permit No.:
Inspection Line: 503.639.4175
f 1 G A R D, Nate Ready/By: June F21 See Page 2 for
r; _ Internet: www.tigard - or.gov Notified/Method: Supplemental Information
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' 4 :e t- . e "-, i, T - OF W U S ItK'�'. - > ;: + 0,4, i �t�;i: ^ 6, ` �. `: e k, , a ; ' ° tu. ", Z E E +, t SGHEIDULE,kv$ 1, .,.. ':,
__ � > c _ a f .fi a.. _ +.�', ;,.. ...w �, w `m�dn,13 ` /;, � �S � ° .,.. $ �',��.� +31i e' � ...r.. a _.vie ..r._ .,.4...r,:', �: �"(.,i� ° �` otia
,l 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)
tt..'w;€ r;;h,x ";E 'smrr 'v� > tt- rte;:, .., �.'.. . x"s +v. ".yy';
- :� ; C A T EG OR X''OF CONS /.-,- RUGZ'Y NL S FR
;;r ;��+.f�s�. �i .c ,.�� �sr� •,.�:� _ �- : _ � = -��sw,�i��t +i� 1 ) ()bath 249.20
0- 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:
_ >? " , d 4 � , �,:,. p „ . w. : • '.a ,, „��;> Fire sprinkler ( • , sq. ft.) Page 2
, ; t? C 1,0:* Si TE , ; 0:1tMAT[OLY AND' L " .00 -WN L �. A
u'�-`_.��, r�';��v,��.�.:.,.� x." ,��.„ ,��_ -,.4. -, .. -� "�. ., a�x, r' r.. i , Site utilities
Job site address: 13 $ g 6 $U/ 4I'.!) Wel/U 7 Catch basin or area drain 16.60
City /State/ZIP: l l 6/ 11Iw Of 97113 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name: Footing drain (no. linear ft.: ) Page 2
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: iM C0 bAI41,0 W Q bO S I Lot no.: 9 Water service (no. linear ft : ) Page 2
Fixture or item
Tax map/parcel no.:
Abso sorption valve 1 .
�� " >� ��€ � i A -. r , > „� w.ozs , �+ � w•a.:.�ct-+v + , x =�. 5' F � a .: a .�,.. ��� _ � ip 6 60
1- s ..." a,4 a OF g w- a a
_ « ' . , x " - n��:. :,,< , � .:•..q. � t �_ ._�. ,�� ?a» . ._a J x A Backflow preventer / Page 2
Backwater valve 16.60
I PS DI V( , ,R eI C f lio l/ » ' J CC Clothes washer 16.60
Dishwasher 16.60
41 * ' PROPERTY QWIVER .% `I F * ® :TENANT `+' � � Drinking fountain • 16.60
Ejectors sump 16.60
Name: (/l/ ESj tJ) E W CO Ne er &1 o N Expansion tank .16.60 .
Address: Fixture /sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
.,„ ; r# ti . .t tz..,x� «,v,. 1. ,r� ... . ,,.,, :...,. ^ , -J 1, Hose bib 16.60
'' ' 1ci" g`;a6:r'tarAP;,L'tiICANT � - - f T4 ^ $ ® !
p t, . °�,_ b W�� ,,,.., e; i maker 16.60
Business name: 7U s ( e,S L L, C Interceptor /grease trap 16.60
Contact name: Tag y f EN) (,q - Medical gas (value: $ ) Page 2
Address: 2/LOO/ , V W f 00 � ;;,, i� C /1 e (Ds P . Primer 16.60
City /State/ZIP: ( H/ (� F ax:
S, PO b 0 f q ) / L 1
/ p Roof drain (commercial) 16.60
(D)3) - 9 b R , z l ()3) S3/ -3i Sink/basin/ 16.60
Phone:
Tub /shower /shower pan 16.60
E -mail:
.. , , _'', , ,t 7Aiw. i " "' ° t . ;. , . b : ' ; -4 ,�.:t : ,:. r : 7 " : Urinal 16.60
-, ' • :: 't _ : : : : r :CONTRA ; '" t ' r. $ ' . - .• :: iz., ' `' `s n
.ta_k� ,: =� -:, t „� r- � � � . " .' � ��.� ' .4.% ' 1 0 `'''-'7,1 ".. 41E ; a �a� Water closet. 16.60
Business name: Tat , �U y L L C Water heater 16.60
Address: 2,1600 NW / n ,-M g E rA.) 60D DR. Other:
N ) Po R 97)2y fee: $72.
City / State/ZIP: (/(, S o , 6 Minimum permit fee: $72.50 0
Phone: (5 ) ( - 2,11/4 Fax: ( ) 3) ,5 2) - 1 Z 1-6 Residential backflow minimum permit fee: $36.25
CCB Lic.: L Y 1 6 Z Plumbing Lic. no.: Plan review (25% of permit fee)
J n State surcharge (8% of permit fee)
Authorized signature: / (�/ TOTAL PERMIT FEE
Print name: 1 1' C ) (4 K. Date: I -- Z 9- t 7) 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.
t\ Building\ Permits \PLM- PamitApp.doc 06/26/06 440- 4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
� I �s utter i . � r ° �� �� �'. +� new.- ���..� � � ^'� �t
Qty Fer ` (ea)w'Total , - e
Site.IItiliti N e S " ware Foota Permat Fee
p„ r' � � rte � �, ,r.� +�. °�a � �t�"nr � .9 5 � .`�e
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 sF a.F ry .y
Storm & Rain Drain - 1st 100' 55.00 v$1Qat1011 6Permlt,�Fee � .'r ts,�, "'rk
$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
-Flg `'' "" a �'° " Fee; ea - Total +�r` additional $100.00 or fraction thereof; to and
t4 C 1' I eel °, , + Q r!• .I ) , ° �,n 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 include $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.
Fixture Work: ' Plai Review `for ° `'
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
g reater, except systems designed and stamped by licensed
h � , '. * °�� °re�y��` ,����'� � Quao 6y_(Fi xtiire)° Worli.Pert'orbted:��
`aFixture TYpe: " k nF� { , $i :' y T ry m ; . R epla c e ' engineer.
=s _� �wP.rewous1 e<Capp if'; iii€ _ rc zExisting : ❑ New exterior plumbing site utilities for any complex structure
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
- Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
- Domestic '" 1�'��``" • ;;��' w:� xr.� ��:�s.� +. , �� �s�,�e."�vw rnj
Drinking Fountain '�w ' 1SOitidi felin lieri ) iagram ` IVA
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink - 2" that meet the qualifications above.
-3"
-4"
Car Wash Drain Comments regarding fixture work:
Garbage - Domestic
Disposal -Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
- Stall *Note: If the fixture work under this permit results in an
Sink - Bar/Lavatory increase of sewer EDUs, a sewer permit will be issued and
- Bradley fees assessed for the sewer increase must be paid before the
- Commercial
Service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i PermitApp.doc 09/22/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007-00028
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/2007
Phone: (503) 639-4171 balk
Inspection Requests (24 Hrs.): (503) 639-4175 ,Aid■
INSPECTION WORKSHEET FOR DATE: 3/13/2007 TIME: 7:02AM PAGE: 50
SITE ADDRESS: 13886 SW ANDREW TERR CLASS OF WORK:
SUBDIVISION: MCDONALD WOODS LOT #: 009 TYPE OF USE:
PROJECT NAME: MCDONALD WOODS
DESCRIPTION: Backflow preventer for irrigation.
OWNER: MNDRIDGE HOMES, PHONE #: 503-784-4328
CONTRACTOR: ` 1 itW4ES, PHONE #: 60$.689-2W4
Inspection Request Scheduled For: Date: 3/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 044713-01 503-969-2144
Corrections/Comments/Instructions:
"TIAL APPROVAL fl CANCEL El NO ACCESS
I I FAIL - • • INSPECTION fl ADDITION L FEE ASSESSED
NM/ Phone #: (503) 718-