Permit 1111 /t V CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00404
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/5/2007
PARCEL: 2S102DC -01302
SITE ADDRESS: 08895 SW MCDONALD ST ZONING: R-4.5
SUBDIVISION: EDGEWOOD LOT: 010 JURISDICTION: TIG
PROJECT: HAESS
Project Description: Replace water pipes to lavatory and kitchen fixtures, (2) hose bibs (see other).
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: 2 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 2
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
ROBERT & T HAESS
8895 SW MCDONALD ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/5/2007 $182.60
[TAX] 8% State Surcha 9/5/2007 • $14.61
Phone : 503- 848 -5793 Total $197.21
•
Contractor:
THE PLUMBING WORKS
HILL S B O RO, T OR 97124 REQUIRED ITEMS AND REPORTS
HILLBRO, OR
Contact # : PRI 503- 936 -9551
Reg #: LIC 169592
PLM PB 103
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 :op 'ill / Permittee Signature: I `�` •�
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.
4219 bins Permit Application
FOR OFFICE USE ONLY
pEcE City of Tigard 1. / ' , b. ed �' �� ,� Permit No.:. "j - �o�
IIII
V 13125 SW Hall Blvd., Tigard, OR 97223
C _ Plan Review
P hone: 503.639.4171 Fax: 503.598.196( , Date/By: Other Permit No.:
Inspection Line: 503.639.4175 ..),:i 0 2UU� D ate Ready/By: luri ® see Pa e 2 f
TIGARD B
r r _ G , o ttfied /Method: �Supplementallnformation or
Internet: www.tigard- or.gov
TYPE OF 1 ti-IF 1 ` ice' i( FEE* SCHEDULE
❑ New construction B ZErta ' i.) 4)1310I\ For special information use checklist
Description I Qty. I Ea. I Total
dAddition/alterati replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
[j1 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 SITE O INFORMATION AND LOCATION Site utilities
Job site address: 9' S co J 1,\/- i t, 0 , no/i f Catch basin or area drain 16.60
City /State /ZIP: 7 G J 0 p� a r 9 7 2 2.y Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: -
pp / - n / Manholes 16.60
x 1e 1/ / 4 4 SA 0 ✓ ) 7'VN Arn,17 Rain drain connector 16.60
d /4 rL3 49' 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
Acp 4 ei /w 011 0 1--
w01 O `F WO 1 ."' Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
14 Ejectors /sump 16.60
Q °
Name: L7,rr 1 a e if Expansion tank 16.60
Address: es 9I 3' Pi. e, /Jp1'! e+f Fixture /sewer cap 16.60
City/State/ZIP: ''J*ai Ot rf O r 9 7 22' Floor drain/floor sink/hub 16.60
Phone: (¢p3) 3 .10 - r , 93 Fax: ( ) Garbage disposal 16.60
Er APPLICANT ❑ CONTACT PERSON Hose bib 2., 16.60 `�,
- y � Ice maker 16.60
y
Business name: 1 1K /' fv.,„ 4 t - 04j Interceptor /grease trap 16.60
Contact name: C) n S A, z kr k J .ro Medical gas (value: $ ) Page 2
Address: 10 by ,v P' ,4rri t, 4., rd Primer 16.60
City/State/ZIP: l r A Y a 7/2 Roof drain (commercial) 16.60
Phone: (5-e3 ) 93 6 _ CJf / Fax: : ( ) Sink/basin/lavatory y 16.60 (Q (p ,
Tub /shower /shower pan
D. 16.60 3 3 • 'LO
E -mail:
Urinal 16.60
CONTRACTOR Water closet .2 16.60 33.70
Business name: -11,„ pf„ ,,, 4,.. l�� vAi Water heater / 16.60 ( . (QO
Address: J 0 6 y NE- Ayr ✓ r d Other: F
JJ 1 1 )12 k Subtotal
City /State /ZIP:
r � v p ` Minimum permit fee: $72.50 Q� / r 1
Phone: 47J3) 93 6 •• 9j" / Fax: ( ) Residential backflow minimum permit fee: $36.25 (p2• Cob
CCB Lic.: 1 6 yr 9 2 L/' ill o8' Plumbing Lic. no.: /" 4 f 11 Plan review (25% of permit fee)
�/ i O
/ d State surcharge (8% of permit fee) .
�
Authorized signature: 6/ 1/
TOTAL PERMIT FEE 1 1
2
Print name: l dh s' a e t M ✓0/ Date: 9 .. - Y.-2 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:\ BuildingWermits \PLM- PermitApp.doc 12/27/06 4404616T(10/02/COM/WEB) Y r 1
*
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: 'Residential Fire Suppression Systems: .
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I n 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 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 futures? 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 /S 1. El New exterior plumbing site utilities for any complex structure
Bath - hower • Tub /S owerrlpool as defined in OAR918- 780 -0040. • , -
Car Wash -Each Stall 1:1 Medical gas and vacuum systems for health care facilities.
Drive tall ❑ Any multipurpose fire sprinkler system. •
Cuspidor/Water Aspirator El 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 Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
3 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 A. *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 i . fees assessed for the sewer increase must be, paid before the
Swimming Pool Filter r . , plumbing permit can be issued. • • , ,
Washer - Clothes
Water Extractor •
Water Closet - Toilet 1
Urinal ,
Other Fixtures:
i:' Building \Permits\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD ..
BUILDING DIVISION* PERMIT #: PLM2007 -00104
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/5/2007
Phone: (503) 639 -4171 AO
Inspection Requests (24 Hrs.): (503) 639 -4175 F...
INSPECTION WORKSHEET FOR DATE: 9/11/2007 TIME: 7 :00AM PAGE: 22.
SITE ADDRESS: 08895 SW MCDONALD ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: 010 TYPE OF USE:
PROJECT NAME: HAESS
DESCRIPTION: Replace water pipes to lavatory and kitchen fixtures, (2) hose bibs (see other).
OWNER: HAESS, ROBERT & TERI PHONE #: 503 - 818-5793
CONTRACTOR: THE PLUMBING WORKS PHONE #: 503-936.9551
Inspection Request Scheduled For: Date: 9/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 05548 6-01 503-936-9561 Y
Corrections /Comments /Instructions:
c� oe. � �, (�,,J
jXI PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �J ��^�'`� Datelj f 11, D 7 Phone #: (503) 718-