Permit Er CITY O F• TI GA R D PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007-00425
DATE ISSUED: 9/18/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S125CA 03800
SITE ADDRESS: 07412 SW CEDARCREST ST ZONING: R -4.5
SUBDIVISION: CEDARCREST PARTITION LOT: 016 JURISDICTION: TIG
PROJECT: CEDARCREST PARTITION
Project Description: Installation of 100' of private water service for future lot.
CLASS OF WORK: NEW 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:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
LAWRENCE RESOURCES INC Description Date Amount
6770 SWALFRED ST
TIGARD, OR 97223 [PLUMB] Permit Fee 9/18/2007 $72.50
[TAX] 8% State Surchar€ 9/18/2007 $5.80
Phone : 503- 975 -6560 Total $78.30
Contractor:
G & B PLUMBING
2810 SE 39TH LP SUITE I
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503-640-2311
FAX 503- 640 -6360
Reg #: LIC , 19907
PLM 34 -44PB
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.
"
Issue By: # ' _ . /, Permittee Signature /
Call 503.639.4175 by 7:00 a.m. for an inspection that busines
tt
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 P/..1 -00065 : &A)6A6c S
Building Fixtures , . - FOR OFFICE USE ONLY ' `
City of Tigard Received (J / Q D � P Permit P S
_ Plan Review
? (J o
11
a 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready /By: 1 El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: r 7 Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑Demolition For special information use checklist
Description Qty. I Ea. 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
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
ID 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: 7/ g, (MJ C�72 (2,O7 - ---- Catch basin or area drain 16.60
City /State /ZIP: i i G . o,,,,, (a,K- y' 7 3 Drywell, leach line, or trench drain 16.60
�
Suite /bldg. /apt. no.: Project name: Footing drain (no. linear ft.: _ ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
64. `'✓ 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. /CG• Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
714/17 i y /rot.6i11 4-/ /�i/7 rids-" Backwater valve . 16.60
fy14/ -'. - . 7 - X• „z ,,,,,, - $O , /=. r % ,,1 '� Clothes washer 16.60
/yam /_ Lc� /G>.� i ./..-‘,/, 6z-% Dishwasher 16.60
X. PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: zAGu rcG .,„� / -7 f5 .. ` 4 „„-s, liiei - (d4' /,74te- ,..94.-f- Expansion tank 16.60
Address: 7 SGc./. ,/IGGd‘v s7 Fixture /sewer cap 16.60
City /State /ZIP: �" C fj,g' ,e, Floor drain/floor sink/hub 16.60
/ y7Z- Z 3
Phone: (.5 ) ."7
3 � --G U Garbage disposal 16.60
,�,� " �_ Fax: ( )
aktip I - ❑ 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
' CONTRACTOR . Water closet 16.60
Business name: 6.- / a ,, / ,.,/ e 0--- Water heater 16.60
Address: G 5.;7 �.G g ��� L sv.-7 _L Other:
City /State /ZIP: r /lS,0-,,,Y - Subtotal
�/ 7/Z Minimum permit fee: $72.50 - ,6t)
Phone: (.. ,3) 6 / Fax: (5 )64/4 - ,�- 3'6 e. Residential backflow minimum permit fee: $36.25
CCB Lic.: / 9 9e2 '7 Plumbing Lic. no.:3i /� t /c/�p Plan review (25% of permit fee)
�� j � State surcharge (8% of permit fee) `S t ZCI
Authorized signature:
,-.7 // %�, /'4 -ems /d •- • TOTAL PERMIT FEE 7 3
1 5
Print name: Ge./L� � Date: �1/7 This permit application expires if a permit is not obtained wi hin
180 days after it has been accepted as complete.
/I / >i�G -7 t.. *Fee methodology set by Tri- County Building Industry Service Board.
1:\ Building\Permits\PLMF- PermitApp doc 12/27/06 440- 4616T(10 /02ICOMIWEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information • •
•
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities ' . Qt', Fee.(ea) Total . Square Footage: Permit Fee: •
Footing drain - 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: P ermit 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
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
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: Plan Review for Plumbing Installations
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
•
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed •
Fixture Type: Replace engineer.
Previous Capped _ Added _ Existing ❑ 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
Drinking Fountain Isometric Of Riser Diagram
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
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
- 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 #: Pi M2007 -00425
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/180007
Phone: (503) 639 -4171 u �� iil
Inspection Requests (24 Hrs.): (503) 639 -4175 ...+i "__..
INSPECTION WORKSHEET FOR DATE: /013/20071 TIME: 7:02AM PAGE: 35
SITE ADDRESS: 07412 SW CEDARCREST ST CLASS OF WORK:
SUBDIVISION: CEDARCREST PARTITION LOT #: 016 TYPE OF USE:
PROJECT NAME: CEDARCREST PARTITION
DESCRIPTION: Installation of 100' of private water service for future lot.
OWNER: L.AWRENC:E RESOURCES INC, PHONE #: 503.975.5550
CONTRACTOR: G & B PLUMBING PHONE #: 503-640-2311
Inspection Request Scheduled For: Date: 10/3/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water se ice 056863 -01 503. 975.6560 Y
Corrections /Comments /Instructions:
k y" IA4vr 0, .. ) . ,a/.,r.4-4 V1.-ii F■coti- --. R, r oams Mt-4-1 c Pfo -p.e✓ '=
N 4 "4- f `.,.,, ,.b ; .„, {fie , --,y -r W `" \ I CO V eve C ,o ,..4.4 c.,4-/li..■ -t) (V\t A-c.i d- S tv .
Cek f e., '' .-----A--- y .
•
.i PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: LvM -.A \`4* -. -• Date: by? Phone #: (503) 718 -