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Permit
q CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 -00304 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Date Issued: 10/06/2011 TIGARD 9 Parcel: 1 S133DC11100 Jurisdiction: Tigard Site address: 13363 SW LAURMONT CT Project: Scholz Subdivision: ARI GREEN Lot: 2 Project Description: Replace 65' of water service. Contractor: APOLLO DRAIN & ROOTER SERVICE Owner: SCHOLZ, ALBERT 2208 NW BIRDSDALE #8 13363 SW LAURMONT CT GRESHAM, OR 97030 TIGARD, OR 97223 PHONE 503 - 239 -8801 PHONE. FAX 503 - 669 -9568 FEES Quantity Description Date Amount 65 If Water Service 10/06/2011 $62 54 Specifics: 1 12% State Surcharge - 10/06/2011 $8 70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment - 10/06/2011 $9 96 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law 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 .. is suspended for more the 180 days. ATTENTION• Oregon law requires you to follow the rules adopted by the Oregon Utility N. ''cation Cen - r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1090. You may obtain a copy of the rules or direc questions to OU c. lin. 03 232 1987 or 1.800 332 2344. Issue. By: A 4 / � , I Permitt• Signature: A Call 503.639.4175 by 7:00 a.m. for the next available i . ection date. 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. Oct. 6. 2011 3:30PM No. 8987 P. 1 Plumbing Permit Applicat ff • � I Building Fixtures . F op >I E• IISI O . • City of Tigard OCT 0 6 2011 Received �. 13125 S11 Tigard, OR 917,21.10.v DateB : ft ce / I Per No,: /y -i D �9 lit. d, Phone: 503 713.2439 Fax 503 5411196,0‘../r TlGAiID Pl, n Review DateB . Oihtr Permit No.: Inspection Line 503.639.4175 BUILDING DIVISION Date Read B lu lls - 1'IG Ready /By, PI See Pape 2 for Internet, www'tlgard- or.gov Noltfied/Method: SupplemenlolInformndon TYPE OF WORT( FEE* SCHEDULE ID New construction CI Demolition 1 ors'ec1r 1 6r orrrtnlion tine checklist. Descrution Qty Ea Total X . . ddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 10011. for each utility CATEGORY OF CONSTRUCTION SFR (I) bath In 312.70 =� 1 and 2-family dwelling SFR (2) bath 437 } g ❑ Commercial /industrial SFR (3) bath 500,32 ❑ Accessory building El Multi - family Each additional barb/kitchen 25.02 LI Master builder ❑ Other: Fire sprinkler ( sq, fi.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: 07 1 y Drywell, leach line, or trench drain 18.76 City /Stare/ZIP: {t l 0 9. Q 1 t _ t� 2 • Footing drain (no, incar R. • ) Page 2 IM Suite/bldg. /apt no.: Project name: Manufactured home utilities 50 03 Cross street/directions to job site: Manholes 18,76 Rain drain connector 18.76 Sanitary sewer (no linear ft. ) Page 2 Storm sewer (no linear ft.' ) Page 2 Water service (no. linear ft.:(OS ) Page 2 f a Subdivision: Lot no.: Fixture or item: Tax map /parcel no.: Backflow przvcntcr 3127 Backwater valve DESCRIPTION OF WORK 1 51 Clothes washer 25,02 (• • - .v ♦: Dishwasher 25 02 Drinking fountain 25.02 Ejectors/sump 25.02 PI PROPERTY OWNER 1 ❑ TENANT Expansion tank 12.51 Name: 1Y -,t 1Aa 17. Fixture/sewer cap Z j OZ ploor drai,l/floor sink/hub 25.02 Address: 1 .A_ 11 L . Garbage disposal 25.02 City /State/ZIP: 1 $ (AZ. Hose bib 25 02 Phone: ( ) Fax: ( ) Ice maker ■ 12.51 ❑ APPLICANT © CONTACT PERSON Interceptor /grease trap 25 02 Business name: APOLLO DRt.N & ROOTER SERVICE 11NC Medical gas (value, $ ) Page 2 Contact name: CH1.1STLNE KAFEL J Primer 12.51 Roof drain (commercial) 12,51 Address: 2208 NW BIRDSDALE N 8 Sink/basin/lavatory 25 02 City /State /ZIP: GRESHALMI OREGON 97030 Solar units (potable water) ■ 62.54 Phone: (503 -239 -8801) I Fax: : (503 - 669 -9568) Tub /shower /shower pan 12 51 E -mail: CHRISTINE@APOLLODRAIN.COM Urinal 25.02 CONTRACTOR Water closet 25,02 Water hearer 37.52 Mil Business name: APOLLO DRAN & ROOTER SERVICE INC. Water piping/DWV 56.29 Address: 2208 NW BIRDSDALE /1 8 Other, ■ 25 02 City /State /ZIP: GRESHA111 OREGON 97030 Subtotal Phone: (503 -239 -8801) Fax: (503-669-9568) Minimum permit fee' $72 50 Plait review (25% of permit fee) - CCB Lic.: 49418 Ding Lic. e� 5331 '. t 1I - State surcharge ofR PERMIT fee) . . Authorized si2npt ` 8 �. �. .�� _. y � TOTAL TAL PERMIT FFF I " ` s This permit appliephon expires if a permit Is not ob tained within 1811 days Print name: CARL l E KAFEL Date: ` after it has been accepted as complete. v o� • ,(_J 'FeemethOdology set by Tn -Cesmty Building industry Service Board, I t0u idingwermits \PL\WU- PermtlApp.doo 10)01/09 440- 016TO /02/COM/WE13) Oct. 6. 2011 12:42PM No. 8982 P. 3 PIumbing Permit A Iication - 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 - In 100' 50.03 0 to 2 000 $121.90 Footing dram - each additional 100' 37.52 2,001 to 3,600 $ 169.69 Sewer- 1st 100' 62,54 3,601 to 7 200 $233.20 7,201 and greater $327.54 Sewer - each additional 100' _ 37 52 Water Service - 1st 100' 62,54 Water Service - each additional 100' 37 52 Medical Gas Systems: Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: Storm g Rain Drain - each additional 100' 37.52 Si 00 to 55,000.00 Minimum fee $72.50 Q Fee (ea) Total $5,001 00 to $10,000.00 572,50 for the first $5,000.00 and $1,52 for Other Inspections or Fees each additional $100,00 or fraction thereof, to Inspection of existing plumbing or for and including $10,000.00. which no fee is specifically indicated 90.00/hr 510,001 DO to 525,000,00 $148.50 for the first 510,000 00 and S1.54 for (minimum charge - 1/2 hour) each additional $100.00 or fraction thereof, to Inspections outside of normal business 90.00 /hr and including $25,000 00. hours (minimum charge -2 hours) _ $25,001.00 to 550,000.00 $379,50 for the first 525.000,00 and $1.45 for Rcinspection Fees 90,00/hr each additional $100.00 or fraction thereof, to Additional plan review for revisions 90,00/hr and including 550- 000.00 (minimum charge 1/2 hour) $50,001,00 and up $742.00 for the first $50,000.00 and 51.20 for Sublolnl each additional $100 00 or fraction thereof. • Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture, Failure to _ — accurately report fixtures could result in increased sewer fees*. Plan Review for Plumbing Installations Quantlh' by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2" and Baptist' /Font greater, except systems designed and stamped by licensed Bath - Tub /Shower engineer. Iacuui/Whirlpool ❑ New exterior plumbing site utilities for any complex strucnire Car Wash -Each Stall as defined in 0AR918 -780 -0040. -Drive Thru Cuspidor/Water Aspirator ❑ MedicaI gas and vacuum systems for health care facilities. Dishwasher Commercial - - El Any multipurpose fire sprinkler system. Domestic 1E1 Any complex structure as defined in OAR918 - 780 - 0040. Drinking Fountain Eye Wash _ Submit 2 sets of plans with any of the above. Floor Drain/sink • 2" - 3„ Isometric or Riser Diagram Car Wash Drain L I Isometric or riser diagram is required for new buildings Garbage - Domestic - food that meet the qualifications above. _ Disposal - Domestic -food related - Commercial -food related • Industrial•food related Ice Mach./Refrig Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -- - S tall - Sink/Lav -Non -food related • - Bradley - Commercial -food related _ ] - -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter p Washer - Clothes _ increase of sewer EDUs, a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet - Toilet plumbing permit can be issued. Urinal Other Fixtures