Permit T CITY OF TIGARD PLUMBING PERMIT
°.. COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00183
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/1/2008
PARCEL: 2S102CA - 00213
SITE ADDRESS: 13205 SW ASH DR ZONING: R -4.5
SUBDIVISION: VIEWCREST TERRACE LOT: 011 JURISDICTION: TIG
PROJECT: KING
Project Description: Replace rain drains.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: 4
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 99 ft
Owner: FEES
PAUL KING
13205 SW ASH DRIVE Description Date Amount
TIGARD, OR 97223 [TAX] 12% State Surch 5/1/2008 $14.52
[PLUMB] Permit Fee 5/1/2008 $121.00
Phone : Total $135.52
Contractor:
ABILITY PLUS DRAINAGE CO.
1813 SW MOSS ST
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PORTLAND, OR 97219 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 246 -0474
FAX 503- 236 -9930
Reg #: LIC 106644
PLM 26 -785PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to folio Jules adopt= • by thOregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 - 0100. may o• - copies o
these r. es or direct- •uestions to OUNC by calling 503.246.6699 or 1.800.332.2344. / /
Issue: By: — / tObi v ) Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbjng Permit Application
L ` • I FOR OFFICE USE ONLY
� City of Tigard Rak
Date/By: : ,'S / b g" Permit No ' G / ./ .. 9 0 .1_ 4 :Z/1"5
y
a 13125 SW Hall Blvd., Tigard, OR 97223 hV 1 20Q$ Plan Review
C :.. Phone: 503.639.4171 Fax: 503.5981'40 ® DateBy: Other Permit No.:
T►GARD Inspection Line: 503.639.4175 y 1W! �� is: ®
Date Ready /By: � See Page
Internet: www.tigard- or.gov riTY IC ° I' i 16 6" Notified/Method: Supplemental Information
TYPE OF WORKR ; -; E , � -- FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. I Ea. Total
iti Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF 'CONSTRUCTION SFR (1) bath 249.20
(g• 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: ) 3`� 5 W L_ 1,) Catch basin or area drain 16.60
City /State /ZIP: '� 1 (r,,,-. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: f Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes / 16.60
4 47 \A U. e Rain drain connector L-Y 16.60 , •
titot
Sanitary sewer (no. linear ft.: _) !!! Page 2
Storm sewer (no. linear ft.: _) y „y Page 2 S
Subdivision: Lot no.: Water service (no. linear ft.: _) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
Vq .. Y� i3 c p 0 1 y-fA I 4. yet N Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
P OPERTY OWNER ' ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: aW 1 k,1 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
APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: c �.{ l ( A4_, .ly`C. C _ Interceptor/grease p ►`r Y tra 16.60
Contact name: (: ce _ 1 ;1,.,� L. et. ( ( Medical gas (value: $ ) Page 2
Address: 6 3 . 27. J (y, i -- ' / „„- Z7 b Primer 16.60
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City /State /ZIP: N-.4 ( 6 -Q_ 9 ' 2,3 9 Roof drain (commercial) 16.60
Phone: (f) 51i q g, 3 Fax: : (Q3) Z.3 ( 9.9 3a Sink /basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
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' CONTRACTOR Water closet 16.60
Business name: s E I 4--v c Water heater 16.60
Address: Other:
City /State /ZIP: Subtotal
Minimum permit fee: $72.50 00 Phone: ( ) Fax: ( ) _ Residential backflow minimum permit fee: $36.25 / ^/'
CCB Lic.: )661,44 j' c if : ( it lumbing Lic. no.: � 7 e S re) Plan review (25% of permit fee)
�r I , � ' State surcharge (12% of permit fee) / , Fj it.
Authorized signature: I� /
a[�/A. ∎& TOTAL PERMIT FEE /;‘,'". SZ
Print name: ,,.e ) Date: G l 60 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 PermitApp.doc 12/27/06 440- 4616T(I0 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
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Fee Schedule: Residential Fire Suppression Systems:
Site. Utilities - Qty. Fee (ea) 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
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
Valuation: • Permit Fee:
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
Fixture' or Item .Qty. Yee, (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 111 New exterior plumbing site utilities for any complex structure
as defined in OAR918- 780 -0040.
- JacuzzilWhirlpool
-Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Car Wash
Each tall ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash Isometric or Riser Diagram
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Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
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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
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- 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: •
1: \Building\Permits\PLM- PermitApp doc 12/27/06
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PLM2008-00183
13125 SW Hall Blvd., Tigard, OR 97223 .
DATE ISSUED: 5/1/2008
Phone: (503) 639-4171 ittm
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 51202008 TIME: 7:00AM PAGE: 1
SITE ADDRESS: 13205 SW ASH DR CLASS OF WORK:
SUBDIVISION: VIEWCREST TERRACE LOT #: 011 TYPE OF USE:
PROJECT NAME: KING
DESCRIPTION: Replace rain drains.
OWNER: KING, PAUL PHONE #:
CONTRACTOR: ABILITY PLUS DRAINAGE CO. PHONE #: 503 246-0474
Inspection Request Scheduled For: Date: 6/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
336 Rain drain 069289-01 503-519-9893
Corrections/Comments/Instructions:
C ' P l■- teiA, A i
C re_ ck, LicAe-e4 94,-)
14 PASS LII PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
111 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 01 Date: 61 '24' Phone #: (503) 718-