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Permit
CITY ' OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00218 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/24/2007 PARCEL: 2S 102CC -01900 SITE ADDRESS: 10225 SW HILL VIEW ST ZONING: R -3.5 SUBDIVISION: FRELEON HEIGHTS NO.2 LOT: 022 JURISDICTION: TIG PROJECT: UPHOFF Project Description: 92ft. line work to connect sewer lateral. 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: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES RICHARD & UPHOFF 10225 SW HILL VIEW ST Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 5/24/2007 $72.50 [TAX] 8% State Surcha 5/24/2007 $5.80 Phone : 503 -639 -5755 Total $78.30 Contractor: CANTRELL & SONS CONTRACTING 6860 SW NORSE HALL RD TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 638 -0800 Reg #: LIC 97005 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: a ,.. . ,� Permittee Signature: /31 � ,, 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. Plu „y - .'ermit Application t. OR OFFICE USE ONLY { r F r RECEIVE * Received : City of Tigard e Date/By: 051/o 7 $ B Permit No?�,n'),7_ 0C�1 . il - u 13125 SW Hall Blvd., Tigard, ORM > 3 y 4 2007 Plan Review Phone: 503.639.4171 Fax: 50 Date/By: Other Permit No.: Inspection Line: 503.639.4175 CITY OF TIGARD Date Read /B .11" ..------ '' // la See Page 2 for TIGAIiD Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information 'TYPE OF WORK FEE* SCHEDULE ' For special information use checklist New construction ❑ ❑ D emolition Description Qty. Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 IS 1- and 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: fine.c W `/ ` Catch basin or area drain 16.60 City /State /ZIP:. Q � 1 5 ,9 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I/ 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. >,%I • 9 1 Page 2 Storm sewer (no. linear ft.: �) / t/ 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 Backflow preventer Page 2 4 ryLejtee L o A k OINke i CiatearMitelefyl Backwater valve 16.60 o' o- Ta , ij t Clothes washer 16.60 Dishwasher 16.60 [- PROPERTY OWNER I ❑TENANT Drinking fountain L �'� fry � � Ejectors/sump 16.60 sump 16.60 Name: a Expansion tank 16.60 Address: / /') '� l N fu ;p Fixture /sewer cap 16.60 City /State /ZIP: ,p, 6 te 9Va 1 Floor drain/floor sink/hub 16.60 Phone: 0 3) b 3 q _ y '�7� � f Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT Hose bib 16.60 ❑ 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 Phone: Sink/basin/lavatory 16.60 ( ) Fax: ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 • CONTRACTOR' Water closet 16.60 Business name: cez o y 4_ l / n i r Water heater 16.60 Other: Address: .� 7 ♦ l • / • A /.r /' ,k / / , / i a 1&� f41 (Q1ri{ , 9 /7d�� Subtotal City /State /ZIP: GG�r66�e' �e�"''`` �� 4i ! ` Minimum permit fee: $72.50 Phone: ( .-5 Fax: ( ) _ Residential backflow minimum permit fee: $36.25 70. 5 CCB Lic.: Q� Plumbing Lic. no.: Plan review (25% of permit fee) ` State surcharge (8% of permit fee) 7i DU Authorized signature: 3D / TOTAL PERMIT FEE TeX Print name: a 4' d itivI �[, ? z. ` / Date: q ©' This permit application expires if a permit is not obtained within �-sC l �) ( f e 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1\ Building \Permits \PLM- PermitApp doc 12/27/06 440- 4616T(t0 /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 - ls' 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to 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. Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", Plan. Review for Plumbing'Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. • Quantity by. (Fixture) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: ,Replace greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font Bath - Tub /Shower El New exterior plumbing site utilities for any complex structure _ as defined in OAR918- 780 -0040. -Jacuzzi/Whirlpool Car Wash -Each Stall U Medical gas and vacuum systems for health care facilities. Drive Thru El Any multipurpose fire sprinkler system. Cuspidor /Water Aspirator 111 Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or,Riser Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. 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 ;�. � JOB INVOICE _ O V L L T I , VER'T SEPTIC dv On. yy �� ^^ pp'� P.O. BOX c5,49 ® EcS rL.1� Wants before noon 1'\�1901V CITY, 06�ECa0� :J "5 CUSTOMERS ORDER NO. DATE ORDERED (503) 656 -3326 5-28-07 ORDER TAKEN BY DATE PROMISED ❑ A M grace 5 -29 ❑ P.M. BILL TO PHONE Gene Cantrel 312 -1363 ADDRESS MECHANIC CITY HELgER_� JOB NAME View AND LOCATION �w p� � }� (gip ❑ DAY WORK y X n27 SF I'll i .ni ew / off �` Mo Hona1d ❑ CONTRACT DESCRIPTION OF WORK ❑ EXTRA OUANT. DESCRIPTION OF MATERI USED PRICE AMOUNT Tank p ping Pel 11 HOURS LABOR AMOUNT TOTAL MECHANICS MATERIALS HELPERS TOTAL LABOR I hereby acknowledge the satisfactory TOTAL LABOR TAX completion of the above described work. SIGNATURE DATE COMPLETED TOTAL r t (.77 1 -t'. j �- 1 j 1 4 i ' 0r `G % -- i I I 4 t I J • j E; 4 j a 1 ± —fi —+ — —r— 4, ; 1- -� e S) _f T ---L -; , � i 1 t —�- ! i 1 i C% ' }- - - -- -,.-- ( - -- v ; r , - -- +- --- -- - - - pry . ' i /1 5 ..____ _ __I __t__ _ _,,., _ __..., ,.■ ____4__ _ ,_ . _ ,,._ ___„...._ _ ,- _- ,-_ - _ - ___.‘fri -.4____ _ _ -4-,.- -4 ; ; _ +._ - l._ 1 .. 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CI) ".6.......i_ * ; A z..., - 7 4_ - _ 1___ .___ 4 ,3„,,,,, v d9 — • f j -F -- -�- --+- -- -- - r - -F } - - - - ------ - - - - 1- --+ 1 I ! , E I • i — - -r- -- I- •- . - - I. -i- - -L-- -- -+- ? t - - - -- - ; - t ----- i - i - ' -'-- _ - --- -' _ _ ti- - - - � - 1 ! _ -_ n r _ ,_____...1 j I -- 1. - n r _ Y 1' — _ _ _ 'I - _ r _ — _ , i _ ,_ -i- t f i - - -( \ ' j am -- - %1 - - 1 � — t j - — 1 --� - - � - - ' • - Y i 1 ,i {- j a - ' i 1 -- 1. - --- , --- - t -- t- -• . - .-!__-_ 1 -: ---- , ---4--- E --- 4 -- 1 f 7 1 t_ • ' -L I -� ± 1 • . - r - -- - 1 --- - r L -'� - 1-- 1-- -- - ; ' I CITY OF TIGARD BUILDING DIVISION* PERMIT #: PLM2007- 00218 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/24/2007 Phone: (503) 639- 4171µ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/29/2007 TIME: 7:02Aivi PAGE: 29 SITE ADDRESS: 10225 SW HILL VIEW ST CLASS OF WORK: SUBDIVISION: FRELEON HEIGHTS NO.2 LOT #: 022 TYPE OF USE: PROJECT NAME: UPHOFF DESCRIPTION: 92tt. line work to connect sewer lateral. Septic system to be pumped and tilled or removed. OWNER: UPHOFF, RICHARD & ELNOR PHONE #: 503 - 639 -5755 CONTRACTOR: CANTRELL & SONS CONTRACTING PHONE #: 503 - 638 -0800 Inspection Request Scheduled For: Date: 5/29/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sani:ta), sewer 049181 -01 503-638-0800 N Corrections/Comments/Instructions: • \\ \ 9 PASS n PARTIAL APPROVAL ❑ CANCEL pi NO ACCESS ❑ \ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: N / Phone #: (503) 718 -