Permit CITY 'TIGARD PLUMBING PERMIT
`
• COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00402
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/13/2008
PARCEL: 2S103CD -01300
SITE ADDRESS: 13705 SW FAIRVIEW CT ZONING: R -4.5
SUBDIVISION: HOLLYTREE • LOT: 019 JURISDICTION: TIG
PROJECT: SPANG
Project Description: Replacing 50 ft. of water service.
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: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ADAM SPANG
13705 SW FAIRVIEW CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/13/200E $72.50
[TAX] 12% State Surch 10/13/200E $8.70
Phone : 503- 684 -7813 Total $81.20
Contractor:
WATER BOY PLUMBING & DRAIN
1600 NE 137TH AVE
PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -260 -0561
FAX 503 -253 -3269
Reg #: PLM 179226
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 obtai copies of
these rules or direct questions to PUNIC by callin. ! _ • 6.6699 or 1.800.332.2344.
Issued B.: ■ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection th. business day.
This permit card shall be kept in a conspicuous place on the job to until completion of the project.
Approved plans are required on the job site at the f e of each inspection.
Plumbing Permit Application
•
Building Fixtures FOR' OFFICE USE ONLY
City of Tigard NO R eceived
1 Date /By: . : � " lI/ U cog())
"
q 13125 SW Hall Blvd., Tigard 'c L }' rt 't: Plan Review / �� 0 ! • �� elltllt No _[
a Phone: 503.639.4171 Fax: 1 ' 960 lCV �� `® or ® Date/By: Other Permit No..
Inspection Line: 503.639.4175
TIGARD (�C� � DateReady /By: ris: See Page 2 for
Internet: www.tigard- or.gov v ��� Notified/Method: � , Supplemental Information
TYPE.OF WO IC _�(�,�Q FEE* SCHEDULE _ CI New construction ❑ P u \n For special information use checklist
Description I Qty. I Ea. I Total
eAddition/alteration /replacement ❑ ther: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
. . - . .- • . C OF CON_ STRUCTION. .: . • SFR (l) bath 249.20
0 and 2- family dwelling El Commercial /industrial SFR (2) bath 350.00
El 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: / 37e2 S S(,,1 1- 4 /e.... i t„.) Catch basin or area drain 16.60
City /State /ZIP: d' 69(L- Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: r7 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.: ) Page 2
Storm sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: J Page 2
Subdivision: Lot no.: r
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
- DESCRIPTION OF. WORK, : ' , Backflow preventer Page 2
JJ CA" U At - se. c ,Qr - Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
- _0` OWNER I • ' ❑ TENANT
Ejectors /sump 16.60
Name: A la4A4 .5,4"..,/,
_ Expansion tank 16.60
Address: /37oS .`✓G✓ h de&deu.s., C>� Fixture /sewer cap 16.60
City /State /ZIP: c-7 ,0 o it . Floor drain/floor sink/hub 16.60
Phone: (j3) 6 79 13 Fax: ( ) Garbage disposal r 16.60
- - ,APPLICANT CONTACT PERSON Hose bib 16.60
Business name: ,� L Q nit r Ice maker 16.60
�4 - Qy V �d �j �t Interceptor /grease trap 16.60
Contact name: , f ,, `B / . / Medical gas (value: $ ) Page 2
Address: /4 ,,U6 f 3 7/-Z..... ,4-4/+z Primer 16.60
City /State /ZIP: ;,u., 7 62«- y 72_ 30 Roof drain (commercial) 16.60
Phone: (59 3 ) Zh 6)5 / Fax: : (9,3 ) z 3Z6,
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: .E6 cheTEL. C l S .4/15,0 . co e----
Urinal 16.60
CONTRACTOR. : Water closet 16.60
Business name: 1I. 61_ � vY ea..% 4`"`5 d i,-J Water heater 16.60
Address: /C06) fig- i .3774-6_ Other:
Subtotal
City/State /ZIP: R y,vh 5- L 72
Minimum permit fee: $72.50
Phone: (5 ) z) O / Fax: (2j3) 253 326-5 Residential backflow minimum permit fee: $36.25 7A-'51) CCB Lic.: P- 2 Z 6 / y'lt bing Lic. no.: 7,5 9 77 Plan review (25% of permit fee)
Authorized signature: State surcharge (12% of permit fee) k.,----70 l - TOTAL PERMIT FEE i,11)
Print name: ,40,3 _ GH Q( Date: �A9 This permit application expires if a permit is not obtained within
j'j 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I \Building \Permits \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' ` F e° a T otal w <F
, � e o (e > Square.Footage Perini`t•Fee ,_ '•�;.:�
Footing drain - 1' 100' 55.00 O 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:: PCrthit
$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
.
q::, additional $100.00 or fraction thereof, to and
EixtUi-e ItCffi Qty' "` ` Total;
Fee_( ea) - 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.
Commercial Fixture Work: . ' Pl Review for Plu>rnbing, Installatnons,
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*. El Any new commercial building with water service 2" and
"- - Quantity by (Fixture) -Work Rerfor'uted ' greater, except systems designed and stamped by licensed
�Fisttre Type: `' Replace. engineer.
P revious ':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 ' Isometiic od' R1SCr'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 _ . _
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/2008
Phone: (503) 639-4171 4491 t
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/14/2008 7:00AM 24
SITE ADDRESS: CLASS OF WORK:
13705 SW FAIRVIEW CT
SUBDIVISION: LOT #: TYPE OF USE:
FIOLLYTREE 019
PROJECT NAME: SPANG V
DESCRIPTION:
Replacing 50 ft. of water service.
OWNER: PHONE #:
SPANG, ADAM 503
CONTRACTOR: PHONE #:
' WATER BOY PLUMBING & DRAIN 503.260-0661
Inspection Request Scheduled For: Date: Pour Time:
10114/2008
Code # Inspection Description Confirm # Contact # Message
330 Water service 076658.01 503,260-0561 N
Corrections/Comments/Instructions:
Cot
C 6 3 v LAA---A. e-o 61 it" i ..:-.../ I
X PASS n PARTIAL APPROVAL n CANCEL 0 NO ACCESS
0 FAIL I I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: (11 \.\ 14---a. Date: )0 i IL4 I OZ Phone #: (503) 718-
.. ,