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Permit
r to CIT OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PE DEVELOPMENT PLM2006 -00246 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/1/2006 PARCEL: 2S 103DD -00403 SITE ADDRESS: 10645 SW FAIRHAVEN ST ZONING: R -3.5 SUBDIVISION: FAIRHAVEN COURT LOT: 003 JURISDICTION: TIG Project Description: Line work to connect to sewer. Septic system to be pumped and filled or removed. CLASS OF WORK: OTR 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: 120 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES SCHMIERER, MICHAEL J AND BARBARA L Description Date Amount 10645 SW FAIRHAVEN ST [PLUMB] Permit Fee 6/1/2006 $101.40 TIGARD, OR 97223 [TAX] 8% State Surcha 6/1/2006 $8.11 Phone : 503- 639 -8797 Total $109.51 Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact # : Reg #: 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: 4 �� 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 ill Plumbing Permit A op}1 b>lfin - E - - FOR OFF ICE. USE ONLY City of Tigard Permit No.: Received (7 06 .813 R. p� 13125 SW Hall Blvd., Tigard, OR 9722UN 2006 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 / /H' - s \ Date/By Other Permit t L D0,, _oo 03 .4 24- Hour Inspection Line: 503.63 7 ' P wi�l . �/ tom' Internet: www.ti and -or. ov Y 014 f l i =" _ Date Ready/By: Ty El See Page 2 for g g at a- �Q� �'�`ppB�T�T�l�v I at R Notified/Method: Supplemental Information E 0 WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. • Description I Qty. I Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 511- 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: 4)645 46) / j �, y J S"-- , Catch basin or area drain 16.60 City/State /ZIP: ) )6 A-ILD Q ,L 9 7 'Z-7"3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I 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.: ) / 2.6 Page 2 Storm sewer (no. linear ft.: ) Page 2 • Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve • 16.60 DESCRIPTION OF WORK Back flow preventer Page 2 1 9 ilk 41 � A i A I _ _ A ,_, I . Backwater valve 16.60 . Clothes washer 16.60 • • Dishwasher 16.60 ❑ PROPERTY OWNER 0 TENANT Drinking fountain 16.60 I Ejectors/sump 16.60 Name: //// C H r9- EL c/ L5 4 ✓1'» I �2C1 Expansion tank 16.60 Address: / a 7"S SGe2 ,4,t,/ (/� $7 , Fixture /sewer cap 16.60 ' City /State /ZIP: 7 G 4-/2- © 9 '72- Z Floor drain /floor sink/hub 16.60 Phone: (6) 3 h 37 2' 7 9 ./ Fax: ( ) Garbage disposal 16.60 0, APPLICANT ` Hose bib • 16.60 0 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 Phone: ( ) Fax: ( ) Sink/basin/lavatory 16.60 • Tub /shower /shower pan 16.60 • E -mail: Urinal 16.60 • • • CONTRACTOR Water closet 16.60 Business name: /4 , t � 0 k, Water heater 16.60 Address: `� Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 / 0 I. YO . CCB Lic.: �/mbing Lic. no.: Plan review (25% of permit fee) (L...zzi)..... / State surcharge (8% of permit fee) q, 1 I Authorized signature: i i TOTAL PERMIT FEE ^ /o%. �l Print name: L /4 i n E--/2_ ��. Date: 6 r- - 6,V 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. 1:\ Buiiding \Permits■PLMF- PermitApp.doc 12/30/05 440 -4616T( 1 0 /02/COM/WEB) '(3c . V' Plumbing Permit Application - City of Tigard -- _. , Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site'Utitit•ies � a ,Qt 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 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 '��'j Medical Gas Systems: . Water Service - each additional 100' 46.40 We. ` 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 F ee (ea) T otal 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: $50,001.00 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 for Complex Structures 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. • Previous 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 ❑ Any NFPA 13 -D multipurpose fire sprinkler system. • Eye Wash 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 ID 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 permit results in an • Water Extractor 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. • i:\ Building \Permits\PLM- PetmitApp.doc 07/06/05 Lil' Stinky 4'7.6 Environmental Service COMPLElt SEPTIC SERVICE y DATE 19631 S. Kolar Dr. b 7 & Oregon City, OR 97045 V NUMBER e\... Molalla: (503) 829-8458 • Oregon City: (503) 658-0518 — 7717 Fax: (503) 722-7186 jo qt, fia.4.Ap I (,)(,) S teirio.0-) bfkCA TERMS: Net 10 Days. A service charge of 1 1/2% (18% per annum), $2.00 minimum will be applied to past due accounts. 270 PLEASE DETACH AND RETURN WITH YOUR REMITTANCE DATE CHARGES AND CREDITS BALANCE BALANCE FORWARD 10 rf.• ,D00 CAL n(-To c pump 270 r-O(IL Oij,k • (11 y 2 2 -cri 270 . ThankYou PAY LAST AMOUNT IN THIS COLUMN CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006-00246 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &1/2006 Phone: (503) 639 -4171 4 44i�p "( Inspection Requests (24 Hrs.): (503) 639 -4175 �'� VII INSPECTION WORKSHEET FOR DATE: 6/6/2006 TIME: 7:03AM PAGE: 110 SITE ADDRESS: 10045 SW FAIRHAVEN ST CLASS OF WORK: SUBDIVISION: FAIRHAVEN COURT LOT #: 003 TYPE OF USE: PROJECT NAME: SCHMIERER DESCRIPTION: Line work to connect to sewer. Septic system to he pumped and filled or removed. OWNER: SCHMIERER, MICHAEL J AND, PHONE #: 503-63943797 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/8/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 350 Septic tank 031269-01 503-490 -7727 N Corrections /Comments/ Instructions: _ T ■ • Are 4110 i - n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � � Da te: ! 6 .‘ . Phone #: (503) 718 4" --- 3(