Permit •
C ITY OF TIGARD PLUMBING PERMIT
" I DEVELOPMENT SERVICES PERMIT #: PLM2006 -00069
6'1. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/8/2006
PARCEL: 2S 112CB -04600
SITE ADDRESS: 08301 SW ASHFORD ST ZONING: R -7
SUBDIVISION: ASHFORD OAKS NO. 2 LOT: 060 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
PAUL GROSE Description Date Amount
8301 SW ASHFORD ST
TIGARD, OR 97224 [PLUMB] Permit Fee 2/8/2006 $36.25
[TAX] 8% State Surchan 2/8/2006 $2.90
Phone : 503 - 598 - 9212 Total $39.15
Contractor:
CREATIVE TOUCH LANDSCAPE
PO BOX 281 REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Contact # : PRI 503 632 - 7390
Reg #: PLM 7367
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. Thos- es - e set forth in OAR
952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of thy:_- rules or . estio' ns. _ NC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: 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.
Building Fixtures _ir - LE.,.., t,1
• Plumbing Permit i e tisa 1 FOR OFFICE USE ONLY'
City of Tigard t) r Received �� �f permit No 7\ 7
13125 SW Hall Blvd., Tigard, OR 97225 E8 0 8 2006 Date /By: _ j) -- y `� 1 t ° \-�-ai U A`7
d
Plan Review Other Permit No.:
Phone: 503.639.4171 Fax: 503.598.1960 "ii,: t yew,i , 1" Date /By:
24- Hour Inspection Line: 503.63 4 i
p �� ��' ��J��' -- "� Date Ready/By: luris. El See Page 2 for
Notified/Method: 1
. Internet: www.ci.tigard.or.us T Notified Supplemental Information
... , TATISTO . u . ., - . FEE * SCHED -
❑ 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 CONS TRUTION, . ' . • , _ SFR (1) bath 249.20
•
❑ I - 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
, 'r. .. 3,OB -SITE' FORMATION; ANT! LOCATION -
- Site utilities
Job site address: ?...3 O J V C 4) , / 5' f Catch basin or area drain 16.60
City/State /ZIP: 7 (' 0 ,. L/ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Jr z 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: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION O F ' WORK Back flow preventer Page 2 _,,...-----'..
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
s❑ PROPERTY' OWNER- .. - ❑ 'TENANT' ' '
' Ejectors /sump 16.60
Name: 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
Hose bib 16.60
'❑.'APPLICANT, 2 ' :❑, CONTACT PERSON ' , .
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: ( ) I Fax:: ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
" ' _ -' CONTRACTOR Water closet 16.60
Business name: ZZ,..-s c i � v ,�i e. ,,K Water heater 16.60
Address: .i j Other:
C, �G Subtotal
City /State /ZIP: .).'�- 4.24 .
Minimum permit fee: $72.50 7
phone: (,a3 ) "� y 3 Q ax: ( ) Residential backflow minimum permit fee:�`6:25 3(,- L�
�/ iii 7-t 3 permit '
, �CB Lic.: . �� J, Plumbing Lic. no.: Plan review (25 %ofpermi
' State surcharge (8% of permit fee) ( -,2 j' Q
Aut erized signature: _ -- "� 3f
TOTAL PERMIT FEE 3q/ t) ----
Print name: . / 7,.. �.. . //(►mot./ Date: '- _/ This permit application expires if a permit is not obtained within
1 � 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
is \Building\Pertmts \PLMF- PermitApp.doc 06/05 440-4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information -
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities . , Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - l' 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 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
FiXtrire.Or "Item - Qty. - - Fee (ea), Total additional $100.00 or fraction thereof, to and
Commercial Back Flow Prevention Device 46.40
including for the first $10,000.00 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 including $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: . Plan Review f or C Structu
Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
•_ ' Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: _ • ' 'Replace ❑ Any new exterior plumbing site utilities.
- - 'P • Capped . Added 'Existing ❑ A commercial building with installation, alteration or addition
Baptistry /Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi /Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor /Water Aspirator are being installed for the food service area
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain
Eye Wash ❑ Any NFPA 13 -D multipurpose fire sprinkler system.
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4" .
Car Wash Drain _ • , Isometric-or Riser Diagram,
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall •
Sink - Bar /Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this ermit results in an
Water Extractor • p
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
is \Building\Permiis\PLM - PermitApp.doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION, PERMIT #: jvi 2006 wow
13125 SW Hall Blvd., Ti6aid, 6 R 97223 DATE ISSUED: 2/0,42006
Phone: (503) 639-4171 ,e#00.
Inspection Requests (24 Hrs.): (503) 639-4175 gu-qi
INSPECTION WORKSHEET FOR DATE: 2/16/2006 TIME: 7:07Am PAGE: 77
gut
SITE ADDRESS: 00301 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS NO. 2 LOT #: 060 TYPE OF USE:
PROJECT NAME: GROSE
DESCRIPTION: 11 preventer for irrigation.
OWNER: GROSE, PAUL PHONE #: 603.59a
CONTRACTOR: CREATIVE TOUCH LANDSCAPE PHONE #: 503,632.73
Inspection Request Scheduled For: Date 21 1612006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 026964-01 W3-632-7390
Corrections/Comments/Instructions:
4 11 CA097
rt,PASS /0/PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL / CALL FOR INSPECTION LII ADDITIONAL FEES ASSESSED
/
Inspector: (
/ Date: Phone #: (503) 718-