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Permit CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 -00015 ,,�� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/12/2006 PARCEL: 2S10100-01202 SITE ADDRESS: 07930 SW HUNZIKER RD ZONING: I -L SUBDIVISION: LOT: JURISDICTION: TIG Project Description: 80' ft. 1" water service, from ball valve in parking lot to bldg. crawl. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: F2 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: 80 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES COE MANUFACTURING COMPANY Description Date Amount PO BOX 520 PAINESVILLE, OH 44077 [PLUMB] Permit Fee 1/12/2006 $72.50 [TAX] 8% State Surcharl 1/12/2006 $5.80 Phone : 503 349 - 6175 Total $78.30 Contractor: ROTO ROOTER - WEST OFFICE 25599 SW 95TH B REQUIRED ITEMS AND REPORTS WILSONVILLE, OR 97223 Contact # : PRI 503- 227 -3330 FAX 503- 685 -9754 Reg #: LIC 13989 PLM 37 - 76PB 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 -6 99 or 1- 800 - 332 -2344. Issued By: Permittee Signature: C .S 7 44./ Call 503 - 639 -4175 by 7:00 a.m. for an inspection tha 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. , I Building Fixtures I Plumbing Perrii't ' &GEV E® FOR OFFICE USE ONLY City of Tigard Received „j� Permit No.: 1/ /yt ./ej�5" / /m�aAr 13125 SW Hall Blvd., Tigard, OR 97223j 12 2006 Date/By. / - /460-^- Dios /EJ L.I /� r v .. r Plan Review Phone: 503.639.4171 Fax: 503.598.1960 � I \ Date/By: Other Permit No.: 24 - Hour Inspection Line: 503.639.410ITY OF TIGARD a ,.II Internet: www.ci.tigard.or.us `• ; - Date Ready/By: S See Page 2 for BUILDING DIVISI Notified/Method: Supplemental Information TYPE OF WORK FEE* S DULE ❑ 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 Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ >Multi- family SFR (3) bath 399.00 ❑ Master builder Each additional bath/kitchen . 45.00 ❑ Other: Fire sprinkler ( sq. ft.) - Page 2 - _ JOB SITE INFORMATION AND LOCATION ' Site utilities Job site address: /' �GO4, 7 4 7 ' _‘,O,„7 793' S6.--) Catch basin or area drain 16.60 City /State /ZIP: /r‘,-//-1 2/ .7 7; a. -us l/ 97,-,01_3 Drywell, leach line, or trench drain 16.60 ✓ Suite/bldg. /apt. no.: + Project name: Footing drain (no. linear ft.: ) Page 2 Cross street /directions to job site: Manufactured home utilities 110.00 ���� , 5-...Z._ ` /44/..74,.1 O h Manholes 16.60 //a// S/ � 4 O , G /,# /6 // /-/71-- O 7 Rain drain connector 16.60 �7/L//7 Z/ ✓ .. /i/drf /S . /O ,- r- Z.../)„:),./ Sanitary sewer(no.linearft.: ) Page ���/// Storm sewer (no. linear ft.: ) Page 2 r097ii/J ra A Gs_ Subdivision: l Lot no.: Water service (no. linear WO ) Page 2 S3 -' O Fixture or item Tax map /parcel no.: Absorption valve 16.60 = , ' " , DESCRIPTION OF WORK - Backflow preventer Page 2 7 . Backwater valve 16.60 W yam / i � ��� Clothes washer 16.60 Dishwasher 16.60 /// � � � Drinking fountain 16.60 • ,PROPERTY OWNER I ❑ TENANT Ejectors/sump 16.60 • Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State /ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 Hose bib • 16.60 ❑ APPLICANT C ONTACT PERSON Ice maker 16.60 Business name: � /� Cr7 C /�e.'„/' /i,s Interceptor /grease trap 16.60 Contact name: tit,, / ✓ Medical gas (value: $ ) Page 2 Address: 79j O c.5" 7/.72/040 0 r c.-71-. Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 • Phone: (,6,3 J 9 '9 .. /� - Fax :: ( ) sink/basin/lavatory / f 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal - 16.60 CONTRACTOR Water closet 16.60 Business name: /49(07(5, i ��� .0 - '2 A jJ7 Q Water heater 16.60 Address: 2j ? 9 ....5-76.i„, 9 / ....)e,„4„..6_, Other: City /State /ZIP: %/. /5",x,9 �i ✓ h ©/ . O 70 7 O / � Minimum permit fee: : $72.50 $72.50 Phone: (! ®, � a - 9 7 9 4/ Fax: (. 3 l; es-- 973 Rsidential backflow minimum permit fee: $36.25 CCB Lic.: /c3 9 c9 Plumbing Lic. no.: '',84/4/ OC1 Plan review (25% of permit fee) 7 � I / State surcharge (8% of permit fee) Authorized signature: 7 10 TOTAL PERMIT FEE ' 3 Print name: ,' � ` ` �� Date: a 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 ' its\PLMF- PermitApp.doe 06/05 4404616T(I0 /09JCOM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site .Utilities : ' Qt-y.' 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 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 of 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 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. Fixture Type: ' 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 Diagi and 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 Washer - Clothes *Note: If the fixture work under this ermit results in an Water Extractor p Water Closet - Toilet , increase of sewer EDUs, a sewer permit will be issued and Urinal . . ' '�`' < 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 CITY OF TIGARD - = PLr- 106(0- boo r6 BUILDING DIVISIO V PERMIT #: 13125 SW Hail Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 ,1 h� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/ \ 7 i 6 Le TIME: PAGE: SITE ADDRESS: 1 C 0 OM k1; 1 \C -.,t0 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: I , OWNER: PHONE #: i CONTRACTOR: PHONE #: • Inspection Request Scheduled For: Date: Pour Time: Co de # Inspection Description Confirm # Contact # Message '-' a , wlle e)o -01 1,& , - Corrections /Comments /Instructions: .1 , y ' 'S ( 0 1 ' • 1 - I` f ASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS , I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ___r . . . Inspector: Date: A Phone #: (503) 718- /