Permit I CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00098
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/8/2007
PARCEL: 1 S133CD -05000
SITE ADDRESS: 13645 SW FEIRING LN ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS LOT: 048 JURISDICTION: TIG
PROJECT: WARNER
Project Description: Bath remodel.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
HAROLD & B WARNER
13645 SW FIERING LN Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/8/2007 $83.00
[TAX] 8% State Surcha 3/8/2007 $6.64
Phone : 503 -524 -5710 Total $89.64
Contractor:
KODIAK PLUMBING
12030 SE MT SCOTT BLVD
PORTLAND, OR 97266 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 740 -9159
Reg #: LIC 72465
PLM 26 -419pb
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. Y.. - . , obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
, L' r , e v 1111
Issued By:�� , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business : •y.
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 ���� �® ' ..q,.,):--.:, „ , 1 . :Oi H Cl i,.:!'..'-','•:
s � . N L v �' ). °�.'
City of Tigard M 0 D Received ^79 3 _ �i / J ' Permit \ 10......A0 /
a 13125 SW Hall Blvd., Tigard OR 97223 20
:, 1 ;: Phone: 503.639.4171 Fax: 503.598.1960 Other Permit No.:
Date/By.
;' Inspection Line: 503.639.4175 CITY Date B .Iw El Se Page 2 for
fiGi,Kt7 OF Ready /BY: ng
Internet: www or.gov BU Notified/Method: Su
_ �(IJ(� DWI _ pplementallnformation
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TYPE ;OF WORK z'' :'r` y ,, t ;;; n i, N FEE!.. HEDULE
�.+' `'- - -- . ... r_ g. �� o�� .. .z -�,...:,. • .•�.��: • -• .. - +,`,:% plc,. , .�x'a�'•; .�a ;��� ^ � - ; .x;~. . . ..Y m.,:;r,•,r'��'t( aa"..,.�d �.. , • : a ,nlrf�f =�t'��- ..�_`r,�.
❑ New construction ❑ Demolition For special information use checklist
�,� Descri rtion So S. Ea. Total
I� Addition /alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection)
. - -'�_ `` s - ` CATEGO RY �OF ;CONSTRUC'T1:0N ! t v g e ; . ; •, . SFR (1) bath 24920
[ I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
1,3 Accessory building ❑ Multi - family SFR (3) bath 399.00
ID Master builder Each additional bath/kitchen 45.00
❑ Other:
s Fire sprinkler ( sq. ft.) Page 2
°�:: F``% . . F ,,4; ;?:,JOB' SITE' 4INFO , ' , 4-,:
=NrX. � 7 "'�E:; ;. _ emu,. .....Rte �� .:. w. .. IS .. `t -,. ., n �.xus ��, d+ �`:�s:.aY�._ �:`�;. si utiliti
Job site address: I 3 t 4 S i.r/ f-id7 f`i /a- r- 'L Catch basin or area drain 16.60
City /State/ZIP: `rI 5 ..?,i t, , o 2 q -7 a- )--3 Drywell, leach line, or trench drain 16.60
t
Suite/bldg. /apt. no.: l Project name: (J o f vx-?_L Footing drain (no. linear ft.: ) Page 2 -
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
S i i 3 S &/U Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: l Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.:
„ ^ � ,' ; ;,� . - :: .. t p , , .�. • ,, -t.. ,.' Absorption valve 16.60
RIPTI N F y
u, :DES C O O ;WORK r t .•. , fit` . " " Back flow preventer Page 2
'�t.- ,a71-0t)if Backwater valve 16.60
Clothes washer / 16.60 /6, 6 a
Dishwasher 16.60
;�, 1 ° ' Drinking fountain 16.60
i - %,: , rl .sP - -TY €O WP I ER p,' °, ,!. " = � "t �:'. , T q .- a .., ;rt. , .,.. , 1 . x ,
TENAIY, �
- . - ,., w .. Ejectors sump 16,60
Name: /4a-rzsi D ,< /3 e•ZT,e / r J a-r'rt ,e .2
Expansion tank 16.60
Address: /364_5- Sv 7i--/ eg,-- � I Fixture /sewer cap - 16.60
City /State/ZIP: `-- i 2 t' D, 1 Q e (2 7,)'a' 3 Floor drain/floor sink/hub 16.60
Phone: (co 3) - -5 / 0 Fax: ( ) Garbage disposal 16.60
' . ,.` •.�-';w::a'n` "z .> Hose bib / 16.60 / 6. GO
y7 °:1:, .- r APPLICANi:42) `� :; .: ",( 15s ,.•.,V .
' " -� , .. "' .... .- . ,.,.� :�:: :..•,. � � ;r� , "c -r N TAT°I' «PERSON t s<.
Ice maker 16.60
Business name: 0 bes,r....1 ,L`u- d(�`'..\ Interceptor /grease trap 16.60
Contact name: $? t i-ne - b i a - Medical gas (value: $ ) Page 2
Address: o 2 ' h ( ' S Primer 16.60
City /State/ZIP: (�� &31, c n 1( 2-.63 Roof drain (commercial) 16.60
Phone: (9)!) 6 7s-__ 7 -2 / Fax: : (S-O Sink /basin/lavatory f' 16.60 1 �,� 6,b 75 _ - Q Tub /shower /shower pan ./ 16.60
E- mail. b Zr‘ 0 C) S LJ e-ei-fl D (' S h t Urinal 16.60
:, �- :, _ ,, : y CONTRACTOR,: ". - •;'.: .'' . !'!!;-'� ' `,1 Water closet 16.60
Business name: •,,--- p/ cit / P/ u / 1� o t Water heater 16.60
Address: /. »4
t4- Q 3 n Sg hi r, .SC,-77 Bi�z Other:
City/State/ZIP: 90 (- -i /� 4 ' ? -1-e 4
Subtotal
Y - Minimum permit fee: $72.50
\ Phone: (5 3) 7 4() 9 i 9 Fax: ( ) Residential backflow minimum permit fee: $36.25 _Y.�,
r ;; . CCB Lic.: 7 a 7 6 s Plumbing Lic. no.:: - ¢i9 p13 Plan review (25% of permit fee)
f t State surcharge (8% of permit fee) ,
Authorized signature: � `7
J
TOTAL PERMIT FEE `�
Print name: J r- le iv.A, �_ Date; 3 lid 6 7 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.
I:\ BuildingPermits \PLM- PermitApp.doc 0W2W06 440.4616T(I0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
m • F dw'•d' . „... -• ^R <. 3�+c
°S1te tdlltlCS, " . � ee (eat s =, S ll±' . C , 1a , t1Cl I)llt
guar Dote
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 ? Va1 cation ; Pci'1llllt FCC , r,. , ,.' , � " ,417
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
4FllCtlll'CO'Item r" additional $100.00 or fraction thereof to and
: : ,, i 0 e r QtY: F ee (i a) : Totiil'
s �._ .,� :;�,.: �c����wa�� , �� °� .;r , ° .r1:s 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 6525 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof to
specially requested inspections - per hour 72.50 and including $50,000.00.
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. ....:;
��x. �Plrl<n ;for, _,.tumbin ,_Instal_lahonsr., ;�h-,�
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
greater, except systems designed and stamped by licensed
r')r'1><tUl';T a J'�§ Y' r" » =, ss � .. ' a engineer.
1 ' ' _.At » * � cw t Eevious Cippee ded #i'i xi iie •' ❑ 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 p s F
Drinking Fountain s *I3UI11CttI Q vRLSer D a i`2 miN„ k ,��
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 Comments regarding fixture work:
Garbage - Domestic
Disposal • - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
- Stall *Note: If the fixture work under this permit results in an
Sink - Bar/Lavatory increase of sewer EDUs, a sewer permit will be issued and
- Bradley fees assessed for the sewer increase must be paid before the
-Commercial
-Service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal •
Other Fixtures:
i: \ Building \Pennia\PLM- PermitApp.doc 09/22/06
j
'CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 00098
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/8/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/20/2007 TIME: 7 :00AM PAGE: 42
SITE ADDRESS: 13645 SW FEIRING LN CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Bath remodel.
OWNER: WARNER, HAROLD & BEI I E PHONE #: 503 -524- 5710
CONTRACTOR: KODIAK PLUMBING PHONE #: 603 740 - 9159
Inspection Request Scheduled For: Date: 4/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 046883 -01 503 - 675.0771 -- Y
5 g"a LI 3 2s 8
Corrections /Comments /Instructions: 361 D'ZoZ
1Vb O
C - g.A,At t t Co
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Si FAIL [X CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: cTZ Date: Lf (2) Phone #: (503) 718-
CITY- OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 000.98
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 318/2007
Phone: (503) 639- 4171 i ill
Inspection Requests (24 Hrs.): (503) 639 -4175 „' �"�l� r_..
INSPECTION WORKSHEET FOR DATE: 3/14/2007 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 1364f SW FEIRING LN CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Bath remodel.
OWNER: WARNER, HAROLD & BE I 1 E PHONE #: 503 -624 -5710
CONTRACTOR: KODIAK PLUMBING PHONE #: 5+03 - 740 - 9159
Inspection Request Scheduled For: Date: 3/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 044800 -01 503- 307 -0702 N
Corrections /Comments /Instructions: / c'(.'�
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•
PA p - A 'TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ICI 1' L FOR INSPECTION n ADDITIONAL FEES ASSESSED '
Inspector. Dat ,Z Phone #: (503) 718 - 7,
CITY- OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00088
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 318/2007
Phone: (503) 639 -4171 �wm���� `f!
. II�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_' ..
INSPECTION WORKSHEET FOR DATE: 3/13/2007 TIME: 7:02AM PAGE: 21
SITE ADDRESS: 13645 SW FEIRING LIB! CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Bath remodel.
OWNER: WARNER, HAROLD & BEI E PHONE #: 503-524 -5710
CONTRACTOR: KODIAK PLUMBING PHONE #: 503-740 -8158
Inspection Request Scheduled For: Date: 3/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 044739-01 503-307-0702 N
Corrections /Comments/ Instructions:
. L r! / - O. — r Z 11 /I
/ ' r 41 0 / •
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- 0 .'a dA/ - Il - 1_ QV F
I I PASS • "ARTIAL APPROVAL n CANCEL I I NO ACCESS
Ti T FAIL . - . FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: _ — ■_-�— Date: J I_ , 0 Phone #: (503) 718- Z-- ,7 ,
.. CITY OF TIGARD
,., BUILDING DIVISION PERMIT #: PLM2007 -00098
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/8/2007
Phone: (503) 639 -4171
1
.
-� - `
Inspection Requests (24 Hrs.): (503) 639 - 4175 _! 1 f !' 3�'
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INSPECTION WORKSHEET FOR DATE: 4/30/2007 TIME: 7:00AM PAGE: 35
SITE ADDRESS: 13646 SW FEIRING LN CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Bath remodel.
OWNER: WARNER, HAROLD & BEI I E PHONE #: 503 -524 -5710
CONTRACTOR: KODIAK PLUMBING PHONE #: 503 -710 -9159
Inspection Request Scheduled For: Date: 4/30/2007 Pour Time:
Code # Anspection Description Confirm # Contact # Me- :ge` iv
399 Plumbing final 047306-01 503 -307 -0702 N i--Q
Corrections /Comments /Instructions:
i"
❑ PASS n PARTIAL APPROVAL ❑ CANCEL h_l NO ACCESS
X FAIL ,'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ll} U 1% Date: ii ii 910 0 Phone #: (503) 718 - a7L(
CfTY OF TIGARD
• BUILDING DIVISION PERMIT #: P
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 Opoik
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/7/2007 TIME: 7:01AM PAGE: 60
SITE ADDRESS: 13645 SW FEIRINU LN CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Bath remodel.
OWNER: WARNER, HAROLD & BETTE PHONE #: 603 - 524 - 5710
CONTRACTOR: KODIAK PLUMBING PHONE #: 503 -740 -9159
Inspection Request Scheduled For: Date: 5/212007 Pour Time:
Code # Inspection Description Confirm # Contact # Me :.. -
399 . Plumbing final 047497 -01 503- 675-0771
Corrections /Com e s /Instructions:
.'i / d Q 144/C > Z . / S l►o
I I PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
rikt n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: - Date: 5/2 /6 7 Phone #: (503) 718- �T 2 y
•
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CITY OF TIGARD
BUILDING DIVISION r '_rw PERMIT #: PLM2007- 00098
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/8/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/10/2007 TIME: 7:02AM PAGE: 68
SITE ADDRESS: 13645 SW FEIRING LN CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 048 TYPE OF USE:
PROJECT NAME: WARNER
DESCRIPTION: Bath remodel.
OWNER: WARNER, HAROLD & BE I I E PHONE #: 503 - 524 -5710
CONTRACTOR: KODIAK PLUMBING PHONE #: 503 - 740 -91559
Inspection Request Scheduled For: Date: 5/10/2007 Pour Time:
Code # Inspection Description Confirm # • - Message
399 Plumbing final 047894 -01 503.675.0771 Y
Corrections /Comments /Instructions: •
‘1/7 h
•
•
i
1X 1pASS n PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
/vl ( 503
Ins ector: "V Date: 3 / Phone #: 718 -
p (503)