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Permit c.: CITY OFTIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2005 -00602 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/25/2005 PARCEL: 2S103CA -00210 SITE ADDRESS: 13080 SW HOWARD DR ZONING: R -4.5 SUBDIVISION: WOODCREST NO.2 LOT: 026 JURISDICTION: TIG Project Description: Line work, water service and reversed plumbing. Septic system to be pumped and filled or removed. CLASS OF WORK: NEW 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: 30 ft WATER CLOSETS: WATER LINE: 35 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES DAN & YVONN VALENTINO Description Date Amount 13080 SW HOWARD DR. TIGARD, OR 97223 [PLUMB] Permit Fee 10/25/200f $172.50 [TAX] 8% State Surcharq 10/25/200: $13.80 Phone : 503 319 - 3397 Total $186.30 Contractor: SPIRIT PLUMBING 609 E. 5TH ST. REQUIRED ITEMS AND REPORTS NEWBERG, OR 97132 Phone : 503 475 - 9464 Reg #: LIC 162669 PLM 36 - 105PB 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: i �' - Permittee Signature: /4;;Ii/ Call 503 - 639 -4175 by 7:00 a.m. for an inspection hat busi ess day. This permit card shall be kept in a conspicuous place on the jo' site unt completion of the project. Approved plans are required on the job site at the ime of -ach inspection. lituild4ng Fixtures Ylumtiin Permit A PP li ca FOR OFFICE USE ONLY City of Tigard Received p ermit No. f 13125 SW Hall Blvd., Tigard, OR 97223 OCT ate/By: /0/A5�05 Bis r' A:12 -°Q �k4' � Phone: 503.639.4171 Fax: 503.598 I, / / , 1 Plan Review Other Permit N 4 f.t/Q�•05 - C453...? N'� �'7{ 1 ' , Date/By. 24 Hour Inspection Line: 503.639.4175 ,. I I Internet: www.ci.tigard.or.us Date Ready/By: t 9' ® See Page 2 for CITY OF 1 cam J Notified/Method: i Supplemental Informat . TYPE OF WOOING DIVISION FEE* S(EDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. I 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 ❑ 1- and 2- family dwelling 0 Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen 45.00 ❑ O ther: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND .LOCATION Site utilities Job site address: ) 3 61 u S W u / n Catch basin or area drain 16.60 City /State /ZIP: - 77 AyLD 0 0,(z- q )-Q-3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: J Project name: Footing drain (no. linear ft.: ) Page 2 Cross street /directions to job site: (� / , f-vN� • Manufactured home utilities 110.00 �) / // tW Manholes 16.60 � U T 4 & 4-04/2,-De Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 6 -- Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 S ' Tax map /parcel no.: Fixture or item Absorption valve 16.60 DESCRIPTION OF WORK Back flow preventer Page 2 1 5 j '0,o 2 'L�eingla'C- 4 //Jd i/A //t•J(s_ a.)4re _ C / am! /UE Backwater valve 16.60 (2-C vvte-h) 7-- Clothes washer 16.60 l G W0> 5.,u..,c e- Dishwasher 16.60 Drinking fountain 16.60 • � PROPERTY O R � ❑ TENANT Ejectors/sump 16.60 Name: \/vo N 1,..)e, V A -Le:IU Ti ' 00 '' II w, Expansion tank 16.60 Address: 9 &) 8o s u t"f0 IA) vi2D 't) - Fixture /sewer cap 16.60 City /State /ZIP: --1 m 9 k q72. 3 Floor drain/floor sink/hub 16.60 Phone: 62)7j) s -- 3 (q ) 7, Fax: ccb 3) 5 - q-55s--- Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT "PERSON • Hose bib 16.60 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: ( ) I Fax: ( ) Tub /shower /shower pan 16.60 E-mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: SO i2.7- PI,U tM B l n-x Water heater 16.60 Address: Z O'q 57"d,/ 5- Ot r: , e0c2. 5a City /State /ZIP: t, 9 q7/3; - _ /,�,t U � Subtotal Mi um permit fee: $72.50 Phone: (67)5 ) 1 a Ltip Fax: ( ) Residential backflow minimum permit fee: $36.25 l7a.SO g 3 f - �O� i3 Plan review (25% of permit fee) D CCB Lic.: 1 , Loa t Plumbin Lic. no. [� / State surcharge (8% of permit fee) / 3, go ' Authorized signature: / --I-0p' ?// O. 1 .3D TOTAL PERMIT FEE Print name: 4 7 1r t ' r UM 111Ji Date; • 0,5' 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. is \Building\Pe • ' . F- PermitApp doc 06/05 440-4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard �� Page 2 - Supplemental Information Fee Schedule: • Residential Fire Suppression Systems: • Site Utilities . " Q. 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 - Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit, Fee: - • - $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 Back flow 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 specially requested inspections - per hour 72.50 and including $50,000.00. 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: Plan Review for Complex Structures' • Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria accurately report fixtures could result in increased sewer fees*. Please check all that apply. Quantity, by (Fixture) Work Performed ❑ Any new commercial building. • FixtureType: , , ' Replace ❑ Any new exterior plumbing site utilities. Previous Capped Added Existing . ❑ A commercial building with installation, alteration or addition Baptistry /Font of nine (9) or more new or relocated plumbing fixtures.. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi/Whirlpool providing services to human beings. Car Wash -Each Stall ❑ Plumbing installations, alterations or additions to food service -Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor/Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system. Eye Wash Floor Drain /sink 2" • Submit 2 sets of plans with any of the above. • -3" -4" Car Wash Drain • Isometric or Riser Diagram' Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial • Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory . - Bradley , - Commercial - Service . Swimming Pool Filter Washe? - Clothes Water Extractor *Note: If the fixture work under this permit results in an Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. i:\ Building \Permits\PLM- PennitApp.doc 07/06/05 WALTER LAWSON - Active 11055 S.W. Clay • Sherwood, OR 97140 Telephone: (503) 682 -0233 1 Date — t 9 Service for - '. r °' f je Address ,t � 4 , City :'�" - 1� Phone (/ -- =7 For Cleaning Septic Tank For Cleaning Drain Line For Cleaning Grease Trap - For Extra Labor _ I I i V -- j f TO11AL/ 1r ■,1 � / Amount Paid Balance Due Due Date Signature Please make check out to present driver Three percent per month interest charged on bills If not paid in 30 days. Not responsible for septic tank, drain field, curbing or driveway damage. 2A 17 / 7)- 1-. LL& i f 0 i4 z , S to'v\ C INVOICE rt. t 7 .3 357390 SOLD TO SHIP TO V) 0)1 e- d Ocl al, I Ji ADDRES I ADDRESS / 3 0 -, z) 5.u Pa. . CI ATE, IP CITY, STATE, ZIP Gur:„Tor. kTR-crcpteR7Ne.. SO BY 11 &.a 35 9 ofFtpp3p,:, NPNITI Ogl ( ; I/L._ 9 6s cc, r-- 5840 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2005 -00602 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10125/2005 Phone: (503) 639 -4171 iI Inspection Requests (24 Hrs.): (503) 639 -4175 - ... !till . ? INSPECTION WORKSHEET FOR DATE: 6 TIME: r 7: •22 AM PAGE: 22 SITE ADDRESS: 13080 SW HOWARD DR CLASS OF WORK: SUBDIVISION: WOODCREST NO.2 LOT #: 026 TYPE OF USE: PROJECT NAME: VALENTINO DESCRIPTION: Line work, water service and reversed plumbing. Septic system to be pumped and filled or removed. OWNER: VALENTINO, DAN & YVONNE PHONE #: 503 - 319-3397 CONTRACTOR: SPIRIT PLUMBING T PHONE #: 503-475-%16,1 Inspection Request Scheduled For: Date: 6113/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 , Plumbing final 031649 -01 503 - 320 -5299 N Corrections/Comments/Instructions: A I 1 I I I lif r.../ ..4 ■K,..44e....4.44r, 7 Alle 4 ��� PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL _ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: / t Kg Date: 6 0/6f Phone #: (503) 718- g' PI CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM:;at > . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7 5&2006 Phone: (503) 639-4171 °'a "Jln�lll f�i Inspection Requests (24 Hrs.): (503) 639 -4175 ,„_1110- LL ._.. INSPECTION WORKSHEET FOR DATE: 4/19/2006 TIME: 7 :02AM PAGE: 3'1 SITE ADDRESS: 13080 SW HOWARD DR CLASS OF WORK: SUBDIVISION: WOODCREST NO.2 LOT #: 026 TYPE OF USE: PROJECT NAME: VALENTINO DESCRIPTION: Line work, water service and reversed plumbing. Septic e to be pumped and tilled or removed. OWNER: VALENTINO, DAN & YVONNE PHONE #: 5031•3397 CONTRACTOR: SPIRIT PLUMBING PHONE #: 503 -175 -9464 Inspection Request Scheduled For: Date: 4/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message $05 Sanitary sewer 028308 -01 E03- 31 3397 Y Corrections /Comments /Instructions: M 1.�5 ec o CIS © o S'7 • — ASS ❑ PARTIAL APPROVAL ❑ CANCEL H NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 4i" Phone #: (503) 718-?24523 CITY OF TIGARD BUILDING DIVISION . ‘A PERMIT #: PLIVI2005-00602 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10121;40006 Phone: (503) 639-4171 . Olt Inspection Requests (24 Hrs.): (503) 639-4175 ...„..,,. ---. INSPECTION WORKSHEET FOR DATE: 4/19/2006 TIME: 7:02AM PAGE: 18 SITE ADDRESS: 13080 SW HOWARD DR CLASS OF WORK: SUBDIVISION: WOODCREST NO.2 LOT #: 026 TYPE OF USE: PROJECT NAME: VALENTINO DESCRIPTION: Line work, water sewice and reversed plumbing. Septic system to be pumped and filled or removed. OWNER: VALENTINO, DAN & YVONNE PHONE #: 503-319-3397 CONTRACTOR: SPIRIT PLUMBING PHONE #: 503-476-9464 Inspection Request Scheduled For: Date: 4/19/2006 Pour Time: , Code # Inspection Description Confirm # Contact # Message 330 Water service 028311•01 503-319-3397 Y Corrections/Comments/Instructions: I 0 PARTIAL APPROVAL [1] CANCEL 0 NO ACCESS 1 I FAIL - CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED ■■• 4 / 1 11117.4. • Inspector: div■ ' V 1 Date: (C ? 6 Phone #: (503) 71824-a3