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Permit
Al: CITY OF TIGARD PLUMBING PERMIT 1, DEVELOPMENT SERVICES PERMIT #: PLM2005 -00006 `'� .,�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/6/2005 SITE ADDRESS: 08260 SW HUNZIKER RD PARCEL: 2S1 01 BC 02100 SUBDIVISION: ZONING: I -P BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 2 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 2 URINALS: GREASE TRAPS: LAVATORIES: 3 OTHER FIXTURES: 3 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 3 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Completion of permit p1m2002 -00018 for rough and final. (3) hose bibs, (3) water closets, (3) lays, (2) sinks, (2) water heaters. FEES Owner: Description Date Amount ANNAND, JOHN D II + EDNA N 8260 SW HUNZIKER RD [PLUMB] Permit Fee 1/6/2005 - $215.80 TIGARD, OR 97223 [TAX] 8% State Surcharl 1/6/2005 $17.26 Total $233.06 Phone: Contractor: EARL WISDOM 3966 NE GARFIELD PORTLAND, OR 97212 REQUIRED INSPECTIONS Phone : 503 Rough -in Insp Final Inspection Reg #: LIC 122960 PLM 26 -620pb 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. • Issued By: i n /,t Permittee Signatur- 0 , •L 4.1 Call (503) 639 -4175 by 7:00 P.M. for an inspection need- : - e next business day f • I., Plumbiip Permit Appli FOR OFFICE USE ONLY City of T ^ 0�� Received ' �~ K. 7 _ y � L DateBy: /.,.... . (/� �/1 Permit No. \ � � G Q S �/U� _ _ _ 13125_SW Hall_B1vd., Tigard,.• a : S Q _ Plan Review Phone: 503.639.4171 Fax: 503. 9:.1960 ,� Q` f . ;NI 4 ��I � Date/By: Other Permit No.: 24- Hour Ins ection Line: 503.639.4175 �� el‘ ��\ ri' II � p a°: <'W Date Ready/By: Juns H See Page 2 for Internet: www.ci.tigard.or.us y � Notified/Method: 11V 1 Supplemental Information ;;"_'�s°,:Zr. -+ . ia. a , .,;, .,y e -.. : 11.4°w.:; ' .r. «?; ;�a:j: 5:I t i; .a , ,: �;: "f P T YPE 9 S , ? "''f ,. :: FEE* SCHED f . � � ". �..3 ,1 r.�� °��» .ry - te ._. , �.. � �.® ,.e� . �r�r �,. _.•, .. � . . _.. � ❑ New construction ❑ Demolition For special information use checklist Description Qty. Ea. Total ".Addition/alteration { eplacemen) ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) s ttr ' a RIO .a- lV ' ., y { i C TE ORY0 CON TRL TION , ; . 4 , SFR (1) bath 249.20 - ❑ 1- and 2- family dwelling ommercia industrial SFR (2) bath . 350.00 1:1 Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder ❑ Other: Each additional bath/kitchen • 45.00 "� " _ , Fire sprinkler ( sq. ft.) Page 2 " t;i ? , JOB SITE T„ NFO N AR LO A T1ION � ' 2 "` " . .: * n `' " Site utilities Job site address:82. Go €, Nov ., 'tH V N 'Z 1 it.../g_ T': Catch basin or area drain 16.60 City/ State/ZIP: "'r 1 e ,A, , C. l - �42:sPJ c , 223 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: l Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 S ''w' . H' - \.. L. r O • •s ." IA U t....)-Z i � 1 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: a C 1 i 1:2 � 1 (jcj �. § Absorption valve 16.60 a + ,' DESCRIP�TTON OR irvbi : '� �+o `- 4� =�.',. 4� to . s , ,,,,, , ., N.. , ,f:�,. � ... �, „ v : .. T..,.4'= Backflow preventer Page 2 CL c t--1 i> L. 1. T' i c, i GG '1Z C' E it_ 1 - l Backwater valve 16.60 n L M 2c�o2- C_ CDC-1 1 a "F s --c 4 'IA i� Clothes washer 16.60 4.To� _� i C> F e� u M �l rJ 1.2. Nr.1 �y Dishwasher 16.60 : 1 .. 7 ; r -� r " -°C„s D i fountain • 16.60 PRwP R "O ice? ate,.: . -, .�. s,, t.. �4 $ . . w � , �x � '' � T�E °` �,t�s t �s ump 16.60 ' "�"�"`� . ` - �"��"� '�� ° `� Ejec ors Name:J ej t.•{ N 4 ti? t > r ' J,e, / ■ t r / r -. L Expansion tank 16.60 Address: G° 2 C. C. , `.....3 , %4 U , i .yam V_- +, Fixture /sewer cap 16.60 City/State/ZIP: `- i W i t....i Q i d : r ,_ ig..A Q , q 7 2 2 i Floor drain /floor sink/hub 16.60 Phone: (55) 4020 - .E (a io e Fax: ( ) Garbage disposal 16.60 ,' API'LIt� w . ¢, a _ r , 4 a., „n-, " , Hose bib '5 16.60 i./' %, ) 9 ; ��. � 1 ,_,., ..._ ,,' ..,,.. � , CON .T . C 4 1 PERSQN Ice maker 16.60 Business name: vv S- a...._ 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: ( ) Fax: : ( ) Sink/basin /lavatory 5 16.60 is (/I) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 r `.;' . , �� ",:" t . _ AfpONTRACTO . 1< F = c ; ;T? ..... , x , . . � � , H Water closet 3 16.60 q , d" V Business name: ...-_,41,01.... L vv 1 S fl0 II k L v ( .... A 1x., i r,) A Water heater ' Z 16.60 33• Z Q Address: 3q C Cc> N 6, ., F 1 (y l.- Other: Subtotal City/State /ZIP: ' s 2„,_• T - k__ cp /_'_ .� "'f Minimum permit fee: $72.50 ^ �. ,t1 Phone: (S ci3) 3 8 p ..._ C.4 $ so Fax: ( ) Residential backflow minimum permit fee: $36.25 -L/ ) • s7 '° CCB Lie.: Plumbi Lic. no.: Plan review (25% of permit fee) _ i •22.y�� g z� - (02o State surcharge (8% of permit fee) / 1. Z.6 Authorized signature:`s 9 TOTAL PERMIT FEE , ,Z': A Print. name:, 1- -.& 'p.. ANN.) ft\JE) . j' Date: j i [p / © 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:\ Building \Permits\PLM- PermitApp.doc 12/03 440- 4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: 't' u S Site [T;f l t es .4 c 5 S,qua3re, ° . ' rmit fFee:< 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 ~k _ ,. y al am an : ; ` e`Permity Fee:. , as:> .::.,..; 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 E>iiture `Ifelll Qty =Fee (ea ' Tot Y''. additional $100.00 or fraction thereof, to and gi 4;a ';..: 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 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: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate. work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. � � �r i �Quantit'"y li (F►xture) Work;Perfei n 1 r ! Re t ,,Fi �� t � p A� N M • 4 4movi'd%OkOldiovVotdai Comments regarding fixture work: Baptistry/Font • Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive . Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" - 4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial • increase of sewer EDUs, a sewer permit will be issued and Ice Mach. /Refrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory B radley Quantity Total • - Commercial Isometric or riser diagram is required if fixture quantity • - Service - total is >.9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: is \Building'Pemtits\PLM- PeratitApp doc 3/03 • r CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM200S -00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/6/2005 Phone: (503) 639 -4171 A ltj�hl� — T_ Inspection Requests (24 Hrs.): (503) 639 -4175 •_I_.. INSPECTION WORKSHEET FOR DATE: 4/1/2006 TIME: 7:10AM PAGE: 82 SITE ADDRESS: 08260 SW HUNZIKER RD CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: ANNAND DESCRIPTION: Completion of permit pini2002 -00018 for rough and final. (3) hose bibs, (3) water closets, (3) lays, (2) sinks, (2) water heaters. OWNER: ANNAND, JOHN D II + EDNA N, PHONE #': CONTRACTOR: WISDOM, EARL PHONE #: 503 -528 -9551 Inspection Request Scheduled For: Date: 4/1/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 003491 -01 603 -380 -9860 N Corrections /Comments / Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: L v 1 Phone #: (503) 718-