Permit CITY OF TIGARD PLUMBING PERMIT
°'- - COMMUNITY DEVELOPMENT Permit #: PLM2009 -00096
T[GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/23/2009
Parcel: 2S102DD00400
Jurisdiction: Tigard
Site address: 13816 SW Fanno Creek DR, OFC# Rec
Subdivision: Lot: 0
Project: Fanno Creek Village
r Project Description: Replace water heater in office.
Owner: FEES
SOLARES HOMES L L C Quantity Description Date Amount
BY NORRIS BEGGS & SIMPSON, LOAN SVC 1 ea Water Heater 04/23/2009 $16.60
DEPT, 121 SW MORRISON #200 1 12% State Surcharge - 04/23/2009 $8.70
PHONE:
Plumbing
56 ea Minimum Fee Adjustment 04/23/2009 $55.90
Contractor: - Plumbing
EAGLE PLUMBING ENTERPRISES INC
13801 S FORSYTHE RD
OREGON CITY, OR 97045
PHONE: 503 - 650 -8703
FAX: 503- 650 -8720
Type of Use: COM
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
is u n r if work i e nded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. .: - rules -re set forth in OAR 952 - 001 -0010 through OAR 952 - 00-0100. • - - obtain a copy of the rules
5s \ By: Permittpe Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection • . . siness 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.
Apr 14 09 08:49a 503 -650 -8720 p.1
- Plumbing Permit Applicati 1 i
a
Building Fixtures FOR OFFICE LSE ONLY'
City of Tigard APR 1 4 2009 Received
' � I //--
q 13125 SW Hall Blvd_, Tigard, 1 0 OR 97223 Date/ Penult No.:' I NA AIR - �d W
IN C Phone: 503.639.4171 Fax: 503.598 OF TIGARD Plan Review
® Da[eBy Other Permit No.:
Ti GAR Inspection Line: 503 639.4175 BUILDING DIVISION Date Ready /By: : turfs B See Page 2 for
Internet: www.tigard- or.gov
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist !
Description I Qty. ! Ea. l Total
® Addition/alteration/replacement ❑Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I) bath 249.20
❑ I- and 2- family dwelling ® Commercial /industrial SFR (2) bath 350.00
- El Accessory building El 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: 13816 SW Fanno Creek Rd 6' Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg./apt. no.: Project name: Fanno Creek Village Footing draw (no. linear 11.: ) Page 2
Cross street/directions to job site:
Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear It.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: ) I Page 2
Fixture or item
Tax map /parcel no.:
Absorption val'c 16.60
DESCRIPTION OF WORK Backftow preventer Page 2
Replace Water Heater Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
❑ PROPERTY OWNER ❑ TENANT
Ejectors /sump 16.60
Name:
Expansion tank 16.60
Address: Fixture/sewer cap 16.60
City/State /Z1P: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) - Garbage disposal 1 16.60
El APPLICANT 13 CONTACT PERSON Hose bib 1 6.60
Business name: lee maker 16.60
Interceptor /grease trap 16.60
Contact name: Medical gas (value: S ) u Page 2
Address: Primer 16.60
City / State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) f Fax: : ( )
Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
-
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: Eagle Plumbing Enterprises, Inv Water heater 1 16.60 16.60
Address: 13801 S Forsythe Rd Other:
City /State/ZIP: Oregon City, OR 9'7045 Subtotal
Minimum permit foe: 572.50
72.50
Phone: (503) 650-8703 Fax: (503 -) 650- l t `� Residential backflow minimum permi fee 536_ _
CCB Lie.: 47914 Plumbing Lic. no.: 3 -154PB I. Plan review (25% of permit fee) ?0
State surcharge (12% of permit fee) '6 >0. 0
Authorized signature:
TOTAL, PERMIT FEE 7 , 0
Print name: Carl Cross, President Date: 4/14/09 I This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodoloey set by Tri- County Buildine Industry Service Board.
Apr 14 09 08:50a 503 - 650 -8720 p.3
'
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 - I" 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 5309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 -
Valuation: I 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 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: cacti additional $100.00 or fraction thereof.
Commercial 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 OAR91 8-780-0040.
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 Thnr
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'
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
lee 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: