Permit CITY TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00103
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/12/2008
PARCEL: 2S103DD-00403
SITE ADDRESS: 10645 SW FAIRHAVEN ST ZONING: R -3.5
SUBDIVISION: FAIRHAVEN COURT LOT: 003 JURISDICTION: TIG
PROJECT: SCHMIERER
Project Description: Install new shower pan and change -out wall mount toilets to floor mounts. Replace some
galvanized piping in exposed areas.
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:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MICHAEL & SCHMIERER
10645 SW FAIRHAVEN ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/12/2008 $72.50
[TAX] 12% State Surch 3/12/2008 $8.70
Phone : 503 -639 -8797 Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
•
Contact # : PRI
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.
Issue. By: _koto _rniLLt. J` Permittee Signature: i 2 Add,
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.
Plumbing Permit Application
-.7.
Building Fixtures , FOR OFFICE USE ONLY .
City of Tigard Received
Date/By: r d'' / Ci Permit No.: ill , A 3
R 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By:
h
Internet: www.tigard Notified/Method: : .........1-17. See Page 2 tar Inform
- TYPE OF WORK ' FEE* SCHEDULE..
0 New construction 0 Demolition For special information use checklist
Description Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
0 1- and 2-family dwelling El Commercial/industrial SFR (2) bath 350.00
0 Accessory building 0 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
- - JOB' SITE INFORMATION AND LOCATION Site utilities
Job site address: 1,0 (2113 51,0 Fairhcw-ensfr Catch basin or area drain 16.60
City/State/ZIP:
Ili 9 t q 7 223 Drywell, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt. no.: Project name:
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: 1 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
. . Backwater valve 16.60 .
Clothes washer 16.60
Dishwasher 16.60
0 PROPERTY OWNER
1 0 L TENANT Drinking fountain
Ejectors/sump 16.60
16.60
Name: M trkia.e( 4-- 136t1/tetAre2) 5c_kvnt I-Are-LI Expansion tank 16.60
Address: )0IP / 43 .1 d0 F-cutriNAA)f,v) 5f Fixture/sewer cap 16.60
City/State/ZIP: t actiVa_ OE -a ll 7 3 Floor drain/floor sink/hub 16.60
-
Phone: (N35 Aci_q-ieri Fax: ( ) Garbage disposal 16.60
. Hose bib , 16.60
0 APPLICANT 0 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: ( ) Fax:
Tub/shower/shower pan ! 16.60
E-mail:
, Urinal 16.60
- , CONTRACTOR Water closet
A 16.60
Business name: C 0 giL Water heater 16.60
Address: Other:
Subtotal
City/State/ZIP:
Minimum permit fee: $72.50 ..- 50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 t
CCB Lie.: Plumbing Lie, no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee) % .
Authorized signature: s i e (1 /
TOTAL PERMIT FEE . 2-0
Print name: T k )advai „v, g ere,r Date: ,..1 __JA_ce This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tr-County Building Industry Service Board.
I: \Building Wermits\PLMF-PermitApp.doc 12/27/06 440-4616T(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 - 1 100' 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
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: $50,001.00 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 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
QuautitY 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 or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3"
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
10/8/2008 _
Case Activity Listing
CEL Case #: P
11.25:01�AM,
1 �i►"� L 00103
°Assi' ned
;��.:
Date..l. Date.2 . °
Date 3 • °;Hold ' „� 1-a
PLM1010 Application received 3/12/2008 None RECD DEB 3/12/2008
BLD
PLM1020 Permit created 3/12/2008 None DONE DEB 3/12/2008
BLD
PLM1030 Check for parcel tags 3/12/2008 None DONE DEB 3/12/2008
BLD
PLM1260 PLM signature on 3/12/2008 None DONE DEB 3/12/2008
application BLD
PLM1280 Issue permit 3/12/2008 None DONE DEB 3/12/2008
BLD
PLM2320 Plumbing rough -in 4/13/2008 4/14/2008 4/14/2008 None PART JW 4/14/2008 068326 -01 — 503- 639 -8797 -- VM -
STI N —180
PLM2320 Plumbing rough -in 4/17/2008 4/18/2008 4/18/2008 None PART JW 4/18/2008 068611 - 01 — 503 - 639 - 8797 VM -
STI N — 180
PLM2320 Plumbing rough -in 4/20/2008 4/21/2008 4/21/2008 None PASS JW 4/21/2008 068678 -01 — 503 639 - 8797 -- VM -
STI N
PLM2322 Shower pan 5/22/2008 5/23/2008 5/23/2008 None PASS JW 5/23/2008 070307 -01 — 503- 639 -8797 — VM -
STI N
Page 1 of 1 CaseActivity..rpt
„. 40
CITY OF TIGARD
k .
_ * .
BUILDING DIVISION
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13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: N PI1V1 2/ 2 Zr "1"3
Phone: (503) 639-4171 iNilltiit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/18/2008 TIME: 7:01AM PAGE: 6
SITE ADDRESS: 10645 SW FAIRHAVEN ST CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: SCHMIERER
DESCRIPTION: Install new shower pan and change-out wall mount toilets to floor mounts. Replace some galvanized
piping in exposed areas.
OWNER: SCHMIERER, MICHAEL & BARBARA PHONE #: 603639.,8797
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 078194-01 603-639-8797 N
Corrections/Co ents/Instructions: , V
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PASS n PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
0 FAIL CALL FOR INSPECTION fl ADDITIONAL FEES.A ESSED
_
Inspector: Date: 1 \ i \ S)/ t 1 Phone #: (503) 718-
I,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200B-00103
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1212008
Phone: (503) 639-4171 A M O oRtIllt
Inspection Requests (24 Hrs.): (503) 639-4175 ,4111.
INSPECTION WORKSHEET FOR DATE: 5/23/2008 TIME: 7:00AM PAGE: 23
SITE ADDRESS: 10645 SW FAIRHAVEN ST CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: SCHMIERER
DESCRIPTION: Install new shower pan and change-out wall mount toilete to floor mounts. Replace some galvanized •
piping in exposed areas.
OWNER: SCHMIERER, MICHAEL & BARBARA PHONE #: 50'3-639-8797
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/2312008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 Shower pan 070307-01 503.639-8797
Corrections/Comments/Instructions:
•
*ASS PARTIAL APPROVAL LI CANCEL NO ACCESS
fl FAIL fl CALL FOR INSPECTION L1 ADDITIONAL FEES ASSESSED
Inspector: CTIrv Date: a221 Phone #: (503) 718-
' • .
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CITY OF TIGARD � � ,
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BUILDING DKVUSUON PERM|T PLM2008-00103
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2008
Phone: (503 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A- ^�i!.,
INSPECTION WORKSHEET FOR DATE: 4121/2008 TIME: 7:00AM PAGE: 2
SITE ADDRESS: 10645SyV F/NRHAYEM ST CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: E
DESCRIPTION: InsIaII new shower pan and chngeout wall mount toilets to floor mounts. Replace umnw galvanized
piping in exposed areas.
OWNER: SCMkNERER. MICHAEL & BARBARA PHONE #: 503-639-8797
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4K21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 068670-01 503-639-8797 N
Corrections/Comments/Instructions:
.
x PA88 III PARTIAL APPROVAL n CANCEL ri NO ACCESS
III FAIL I | CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
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Inspector: ��h�~��W�~~~~~^/ Date: � � Phone #: (503) 718-
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CITY OF TIGARD ip
- A BUILDING DIVISION PERMIT #: PLIVI2008-00103
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2009
Phone: (503) 639-4171
hp, 0114,
Inspection Requests (24 Hrs.): (503) 639-4175 i
INSPECTION WORKSHEET FOR DATE: 4/18/2008 TIME: 7:01AM PAGE: 7
SITE ADDRESS: 10646 SW FAIRHAVEN ST CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: SCHMIERER
DESCRIPTION: Install new shower pan and change-out wall mount toilets to floor mounts. Replace some galvanized
piping in exposed areas.
OWNER: SCHMIERER, MICHAEL tit BARBARA PHONE #: 503-639-8797
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 068611-01 603-639-8797
Corrections/Comments/Instructions:
PazAi A Cok41,-'73A.
El PASS PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
I FAIL fl CALL FOR INSPECTION . ADDITIONAL FEES ASSESSED
Inspector: 0 Date: 171/3?) Phone #: (503) 718-
_ •
CITY OF TIC'AR.D
BUILDING DIVISION PERMIT #: I'I.M 00S 0 103
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/12/2008
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �' °__..
INSPECTION WORKSHEET FOR DATE: 4/14/2008 TIME: 7:00AM PAGE: 6
SITE ADDRESS: '10645 SW FAIRHAVEN ST CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: SCHMIERER
DESCRIPTION: Install, new shower pars and.chartge-outwall mount toilets to floor. mounts, Replace some galvanized
piping in exposed areas,
OWNER: SCHMIERER, MICHAEL & BARBARA PHONE #: 503- 639.0797
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/1412000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 068326 -01 603-639-8797 N
Corrections /Comments /Instructions:
:2 ',' (t,A - ry
fa LA ✓c_A (bo,:
❑ PASS `j PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL 7 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gbv M\Yo-^•2--' Date:'Lf311-13O Phone #: (503) 718-