Permit j
*ill . CITY OF F T I GI R D PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00391
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/27/2007
PARCEL: 25111 BA -06900
SITE ADDRESS: 09529 SW INEZ ST ZONING: R -4.5
SUBDIVISION: BUTLER TERRACE LOT: 003 JURISDICTION: TIG
PROJECT: PHOENIX REDEVELOPMENT
Project Description: Fixture replacement.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PHOENIX REDEVELOPMENT
516 SE MORRISON ST #700 Description Date Amount
PORTLAND, OR 97214 [PLUMB] Permit Fee 8/27/2007 $99.60
[TAX] 8% State Surcha 8/27/2007 $7.97
Phone : 503-238-0113 Total $107.57
Contractor:
REAMECH
30330 SW GRABEL RD.
HILLSBORO, OR 97124 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 969 -6252
FAX 503- 640 -9344
Reg #: LIC 148437
PLM 34 -389PB
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.
Issu d By: 1 . / // /i / ,� Permittee Signature:� /� .i!c:�� /4
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.
Plurmbing Permit Application
+ . FOR OFFICE USE ONLY
IN City of Tigard Received ^ 7 01 (�n Permit No.: rC 7 - y:O5 /
a 13125 SW Hall Blvd., Tigard, OR 97223 Date /By: / �,j+/, r
Phone: 503.639.4,171 Fax: 503.598.1960 Plan Review Other Permit No.:
Date/By:
Inspection Line: 503.639.4175 Date TIGARD Ready/By:
www.tigard or.gov Notified/Method 1. ® plemeutal
TYPE Of - WORK _ FEE *•SCHEDULE . '
❑ 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
�'- and 2- family 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=`S1ltE - INFORMATION AN D LOCATION
�� �9 . ,. Site utilities
Job site address: SvJ v■-2 Z Catch basin or area drain 16.60
City /State /Z1P: 71 c G ,� 0 't_ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: J 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.: ) 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.:
Absorption valve 16.60
' . DESCRIPTION OF WORK Backflow preventer Page 2
--- 1 --.)(s _. %re P iCa...P e :AA-- -- Backwater. valve 1'6.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER . ❑ r TENAN Dri fountain 16.60
Ejectors /sump 16.60
Name: 0 E, l x - prof JO Expansion tank 16:60
Address: `& Sir., D 4 ,,,,„) Sr - 1€ 760 Fixture /sewer cap 16.60
City /State /ZIP: pa ea- - # ? 7 4 Floor drain/floor sink/hub 16.60
Phone: ( 3 ) 93e- on ? Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
' - ❑ ,, APPLICANT; - ❑ CONTACT'yERSON
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: ( ) Fax: : ( )
(9k/basin/16;;;) (- $ A-1.- 3 16.60
Tub /shower /shower pan 16.60.
E -mail: Urinal 16.60
. ' .,CONTRACTOR Water closet 16.60
Business name: R_ e \ Q j rte_ Water heater
Address: 3 33 6' J v �-t l c4 Other: I
1 . Subtotal •
City /State /ZIP: ( .01 l k \ S ,.S O � �t - 7 12.- j
Minimum permit fee: $72.50 g9. 0
Phone: 6c17) I.6 - to Z Fax: (5-D ) (040 - `l3 Z/ 9 Residential backflow minimum permit fee: $36.25 , 7 1
CCB Lic.: ( e y 3 Plumbing Lic. no.3 Li - 3 8 ci p _ Plan review (25% of permit fee) �--
State surcharge (8% of permit fee) 7. ?7
Authorized signature: ..
TOTAL PERMIT FEE l0 7. S 7
Print name: •t v ` o Gi/ka■e_ ( 12-ec... Dater a b -o '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.\Building\Permits\PLM- PermitApp.doc 12/27/06 440- 4616T(I0 /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 Squar..e:Fo'otage: .. Pe rmitrFee:
Footing drain - 1s 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
Sewer 3,601 to 7,200 $220.00
ewer - 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 Vahlation:: 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 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
-Tub/Shower ❑ New exterior plumbing site utilities for any complex structure
Bath - hower
Tub /S as defined in OAR918- 780 - 0040. .
-Jacuzzi/Whirlpool
Car Wash Each Stall ❑ . Medical gas and vacuum systems for health care facilities.
Drive Stall ❑ . Any multipurpose.fire sprinkler system.
Cuspidor/Water Aspirator ❑ 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 Dia
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 *Note: If the fixture work under this permit results in an
- Bradley
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\PCM- PermitApp.doc 12/27/06
. _
CITY OF TIGARD • ....% . .
BUILDING DIVISION PERMIT #: PLIVI2007-00391
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/27/2007
Phone: (503) 639-4171 j iie
Inspection Requests (24 Hrs.): (503) 639-4175 .
INSPECTION WORKSHEET FOR DATE: 8/2812007 TIME: 7:00AM PAGE: 33
SITE ADDRESS: 09629 SW INEZ ST CLASS OF WORK:
• SUBDIVISION: BUTLER TERRACE LOT #: 003 TYPE OF USE:
PROJECT NAME: PHOENIX REDEVELOPMENT
DESCRIPTION: Fixture replacement.
OWNER: PHOENIX REDEVELOPMENT, PHONE #: 603-238-0113
CONTRACTOR: REAMECH PHONE #: 503-969-6252
Inspection Request Scheduled For: Date: 8/2812007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 054747-01 503-969-6252 Y
Corrections /Comments/ Instructions:
1 7.4.L - 'L-- . (--v4...i - ,h4J-e_ I 11 ° A iVleet...
-:;.- -
JR1 PASS 0 PARTIAL APPROVAL n CANCEL 0 NO ACCESS
0 FAIL I CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: CT314)--1_, 't 1, 1.---,_ Date: ?PM() —) Phone #: (503) 718-