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Permit CITY OF TIGARD IIPI PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00006 TIGARD: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/10/2007 PARCEL: 25111 AD -18000 SITE ADDRESS: 14840 SW JONAGOLD TERR ZONING: R -4.5 SUBDIVISION: LADY APPLE LOT: 004 JURISDICTION: TIG Project Description: Backflow preventer for irrigation. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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 BEACON HOMES NW, INC. 12703 SW 67TH AVE. Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 1/10/2007 $36.25 [TAX] 8% State Surcha 1/10/2007 $2.90 Phone : 503 -570 -8828 Total $39.15 Contractor: CONTOUR LANDSCAPING INC 12485 SW TOOZE RD SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 682 -1302 FAX na Reg #: LIC 5698 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 Permittee Signature : ( i' `l�"'� -A— 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. th 'gst E t /t �.� i v i a s 4 a . f +l p+ {_, +. 0 r ✓.. Plumbinz Permit Anplica� . t) : C IVE A + „ V , FOK ° O1 F ICE USE ONLY , , 4 s ' , , 1 t k .,.. L r■ , a 1 1Yd s City SW Tigard 9229 I ® 20 7 D BY ` .. G O � .,. Permit No o1.Q77 O , p ,. n 13125 SW Hall Blvd., Tigard, OR Plan Review C , i., Phone: 503.639.4171 Fax: 503.5 9 F TIGARp Date/By. Permit No.: '' Inspection Line: 503.639.4175 T: GSA K;17' ' DI VISION Date Ready/By. luris: See Page 2 for "zt „ . Internet: www.tigard- or.gov BUILD Notified/Method g Supplemental Information .'E''* a +rx` 7'�ar7y�:._ �''i%t'rd:�'�i�'y"�:i'�'�=• .,t�, „t�`.:-".v %� xw.xix.«.P ,.� �'.+u :�a�',�;'sa .' �;%g "`.ti ��rv'� T'd..�:tyv� Paz-•.., sar�:..u- :•a- �.i� - _ ""ice -^' s -.:r� : M a� ')s i . r. , , e V AY0.04 :0, ORK °� .,: • ...; s I 47,0 EDULE . i ll .%-''. � s; .ia� �°`�...+r .±o�ro.e+7���."�'•` P�"'� Aa;^a3,r,^.% _ e= u�z�"' S�<r.�^:.e _.,� . -� _ -.. .., , �n' 3' r�' aw .A��n,�iCn.,aiS��.'ta..r "»�m�: ErNew construction ❑ Demolition For s, ecial in ormaiion use checklist. Description I Qty. I Ea. I Total ❑ Addition /alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft for each utility t, N 1 2 family d 'ngs (in h tility connec �on) 249.20 '�. � ^ .: � >i�f�:� M{�r��'t; �°� rs`�k � v�, - .s� »�, ,. .... .uar�x a s. � .• � "fti" ;; ; ��_ + - FCATEGORY UF»yCONSTRUCTIUN �� '.;lS A t r SFR (1) bath ���(t .M. �«i!„c. .:;i �ks�k �xw�� . xa.�e ��. �.- ,.,rc.�r �n� .��a+r� 4��';.�'r�. � "�", �';.E Jf [a'1and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 El Accessory building ID Multi-family SFR (3) bath 399.00 1:1 Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ft. w;� _ w ,a ou._ +.n:- m.�a�+`4.4:.; a, vx w�,. _.. r r7e"+wih- y.•�:srt 1.3+ xz:1�� - P ( sq. ) Page 2 j' '*'`' ' 144 .ii B SITE INF81Iiial'ION AND IACATION? '"" , ±` # ^`s t aMw.� t� �<.- ,.,mra m±.ms.,w:�,.:.w s���.m+fm ca�•ae� .,�wr, . - � . =r:.r»��•."v.w••k .:�'�r..� - v� Site utilities Job site address: / L '� 0 V U S W J o N y'}i 0 Ln �"P... Catch basin or area drain 16.60 City /State/ZIP: 1( i a R Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: . Project name: 2-4 O1. / Pje Footing drain (no. linear ft.: ) Page 2 "Apple 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: I Lot no.: y Water service (no. linear ft.: _) Page 2 Tax map/parcel no.: Fixture or item t „ ,. _. Absorption valve 16.60 % dl 4 x�` � „DESCRIPTION WURK . - N y e r n `�` Back flow preventer / Page 2 �� (' n 6 ri Cam` Backwater valve 16.60 Clothes washer 16.60 • Dishwasher 16.60 ON: f- ln YROP 1r' ! UWNERt �" Xtlr lit ®yTENANT Drinking fountain 16.60 M. roe. t. a.�' , ' ,.. #+ inn Ejectors/sump 16.60 Name: - 8 - c.r/vJ f -( {• /U AA Expansion tank 16.60 Address: 45 W 6 12 -P V 2 Fixture /sewer cap 16.60 City /State/ZIP: - 111 (.0 n-(P'. 0 /L, Floor drain/floor sink/hub 16.60 Phone: (3 5 0 - ,gg S Fax: ( ) Garbage disposal 16.60 .;�S:Y�a,�'�;4akC •k,�,k:r,, 4,®, r ?wr....�. .�wt;N °�,. • - ;�."y, r��_.� �,�� ,.� ,��... ,�..�xr.»ar• ��- i � `.'s,"_+ "�.�„'are r� k�aE ,.a Hose bib 16.60 �t iCONTACT P.ER$ON' �k��;e°�„�;, %: .,. ?�A .�'�� »�sY yam i�ia rw�'M�:.�' �, +�e,"r,-;..p��u�•�' {, ... .' 3^.. xF 'Y��w= .�yn'itt"Fe�iM':.1.^+4� * �'4.: s'd+,: ,.iaiN:u 9dlEU.' .�iaY. ��^°^= SJt� "ea��M±' 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::( ) E -mail: Tub /shower /shower pan 16.60 _ Urinal 16.60 s�;.,, Vj', , ,1,...iltl ' ,.1,'�' - . G^�. k X • .T,... - ."FS1' . pa.r.�y.T tim: .. W .�w �a� '�'`RA'' V^ ��� � { {r. *�.j n".W�r.��' � ' • '; : ,: ;;2 + "* '' :`. . .. CO 1VT RA C T' OR 1 4' .1't' .t , u `' a .,, c"' ,, ; 1, .� �J.... +C.�aus. . -� - 3+'�t':' ,.°is,'�'4 --E' ., ('*"t.. , rx� . <, '., � , u _� >,�t v'4.+�. .� a; �C q;1:�.rs �1e +u �� �. g Water C IO y � ( Y. ���, F, � closet 16.60 t � Business name: C��1 (, S c l , _ Water heater 16.60 Address: ( L ( eJ t- S c ' I 0 0 '" &b Other: City / State/ZIP: s h-pNA -15-irri ( on_ ei- (y 6 Subtotal Minimum permit fee: $72.50 , - Phone: ( J -6 .3 ,s3. a - t 3 ©4- Fax: ( ) S Kwve Residential backflow minimum permit fee: $36.25 _g6. ( 2,.. CCB Lic.: Plan revi (25% permit fee � 6 q 8 Plumbing Lic. no.: ( P fee) ,� n State surcharge (8% of permit fee) a.Cj . 0 Authorized signature: ( �J TOTAL PERMIT FEE 3 I 4-. Print name: OA U L (`y GO WO olt...) Date: L (l 0 (0 G This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. l:\ Building \Permits\PLM- PermhApp.doc 06/26/06 440- 4616T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information .„,;• - , Fee Schedule: Residential Fire Suppression Systems: ,�,� .• � ,� a �• -t" ,$a ,a'6- �x,..Y',�x'��:, m� a.w..ie�,e � r.' tF ^r � '� �.� ' -�m7r. y m'�,." r 1 }SItC'Ut[II.tie3•' s ' i'' 9r 3? AEe (ea) Total St]Ua>I'e"FOUta�,C. °� , m � � b , . : ;� :�./666/A i I'ermi<tfArtf . .� . Footing drain - l 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 7201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service -each additional 100' 46.40 CYaluatiOn , 4 Z , w � ,. - ; Pe t'FCe ,$ '' x ;, », ' 4', Storm & Rain Drain - Ist 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 y Fazture" `* ` ° . " " ti' " 0 i ' k .] . Qty ; Fee:`(ea), . I'o'ta additional $100.00 or fraction thereof to and .. i . O reItelll '.°}frix# ;k .,ir ,,,. ,rote.'; . .r: s;..,�:. mu,;, 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 a 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 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof Fixture Work: > 'Maw, , �; ,' " -' . .., . fo...R1 mbiag lIitA.. , lation§ u , Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to . Please check all that apply. • accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and i;4 °.4 $ h i i puaotitY'by (Fixture) Wock .k greater, except systems designed and stamped by licensed r ♦ ', 5 f a s c, - - �Fixturr � ��; . ,''''V' � �' "���� �_ � ,� � ,� " Replac engineer. A, , 14? e; ?'r ' . _. ::_ , a . P, ii r dappe 'Aade T Exsdak s ❑ New exterior plumbing site utilities for any complex structure . Baptistry/Font as defined in OAR918- 780 -0040. Bath Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. • - Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system. .. Car Wash - Each Stall ❑ Any complex structure as defined in OAR918 780 - 0040. - Drive Thru Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic n.uv .�,e Drinking Fountain s , ,.«„ ,, lser ? � •, ? - Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -3" -4" Car Wash Drain Comments regarding fixture work: Garbage - Domestic Disposal - Commercial -Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang - Stall *Note: If the fixture work under this permit results in an Sink - Bar/Lavatocy increase of sewer EDUs, a sewer permit will be issued and - Bradley fees assessed for the sewer increase must be paid before the - Commercial - Service plumbing permit can be issued. Swimming Pool Filter . Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\ Building \Permita\PLM- PennitApp.doc 09/21X16 CITY OF TIGARD BUILDING DIVISION A PERMIT #: PLM2007-00006 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2007 - Phone: (503) 639-4171 . i rtlitit Inspection Requests (24 Hrs.): (503) 639-4175 ------tlir --"" INSPECTION WORKSHEET FOR DATE: 1/31/2007 TIME: 7:02AM PAGE: 26 SITE ADDRESS: 14840 SW JONAGOLD TERR CLASS OF WORK: SUBDIVISION: LADY APPLE LOT #: 004 TYPE OF USE: : PROJECT NAME: LADY APPLE DESCRIPTION: b'ackflow prevent er for irrigation. OWNER: BEACON HOMES NW, INC., PHONE #: 503-570-8828 ,. CONTRACTOR: CONTOUR LANDSCAPING INC PHONE #: 503-682-1302 Inspection Request Scheduled For: Date: 1/3 Pour Time: Code # Inspection Descr 'o Confirm # Contact # Message 395 Misc. inspection 042751-01 503-320-0183 N Corrections/Comments/Instructions: a-l LQ t1e-4 1--,,o - ( 0 0 PARTIAL APPROVAL fl CANCEL fl NO ACCESS FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED V; ( IL--- --- I nspector: Date: V A . 7 Phone #: (503) 718 - a - k12 - I f . ,