Permit q n
CITY TIGARD. PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00043
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/8/2007
PARCEL: 2 S 114 BA -14700
SITE ADDRESS: 09500 SW MARTHA ST ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 4 LOT: 112 JURISDICTION: TIG
Project Description: Bathroom conversion.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BARBARA BROWN
9500 SW MARTHA ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 2/8/2007 $72.50
[TAX] 8% State Surcha 2/8/2007 $5.80
Phone : 503- 624 -9448 Total $78.30
Contractor:
ALL METRO PLUMBING LLC
2835 SE 25TH
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 317 -0131
Reg #: LIC 150700
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: -- ErZi Permittee Signature: ,j D Tel
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.
Plumbing Permit Applica r ob , t ., 4 ra , 11 11 . •=smom
City q 13125 SW of a ll Blvd., Tigard, OR 97223 "`W
gdl d r^ 0 8 2 DawBY 6 7 Permit No�1M 7/3'17 it q i
SW Hall
Phone: 503.639.4171 Fax: 503.598.196 L Nan eW Other Permit No.:
inspection Line: 503.639.4175 y p
T I C �� R f) ` � a 1 v �i �,/ o f I. l j Ready/By. tints: s: See Page 2 for
Internet: www.tigard or.gov � � 6ed/Me Supplemental Information
TYPE OF �11rN s I 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(l)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
❑� Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 9 5-00 S L \\S?1,4 pv Catch basin or area drain - 16.60
City/State/ZIP: Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft : _) Page 2
Cross street/directions to job site: ci iv-) -IN-/ / i Manufactured home utilities 110.00
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.: Water service (no. linear ft.: _) Page 2
Future or item
Tax map/parcel no.: -
Absorption valve 16.60
DESCRIPTION OF WORK
Back flow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
3 PROPERTY OWNER ' I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: D 4.(-00 i / � 6 a fti Expansion tank 16.60 -
Address: 7 '/ 7 OA 0t r Fixture/sewer cap 16.60
City/State/ZIP: GJ 1 > , Z 4 Floor drain/floor sink/hub 16.60
Phone: ( ) 62. 7 ' 4) (/ (, t "I Fax: ( ) Garbage disposal 16.60
• - ❑ APPLICANT CI CONTACT PERSON Hose bib 16.60
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: ( ) I Fax: : ( ) Sink/basin/lavatory U 16.60
Tub/shower/shower pan 16.60
E-mail:
Urinal 16.60
CONTRACTOR Water closet J 16.60
Business name: , , jz ,P . �, c r `� (L I Water heater / 16.60
Address: - 2 ^1 ?At / ..24 Other:
Other:
City /State/ZIP: T V D Z Subtotal
- Minimum permit fee: $72.50
Phone: ( r, � j 1.1 01 �y I Fax: ( &0) , (../c6 2C(, Residential backflow minimum permit fee: $36.25
CCB Lic.: (t / 7 � / Plumbing Lic. no..j, 'Z 2.8,I Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:
/Ir TOTAL PERMIT FEE ,y O
I Print name: b 0 1( H IS� I Date: 2_7y 0 7 This permit applkation expires If a permit is not obtained within
I80 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I: \BuiIdmg\Pamits\PLM- PamitApp.doe 06/26/06 440.4616T(I0/02/COM/W®)
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 - 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 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
specially requested inspections - per hour 72.50 and including $50,000.00.
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: Plan Review for Plumbing Installations
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
OnantltY by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ 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
Drinking Fountain Isometric or Riser Diagram
Eye Wash • ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
- 3"
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/Lavatory increase of sewer EDU
- Bradley s, a sewer permit will be issued and
Commercial fees assessed for the sewer increase must be paid before the
-Service plumbing permit can be issued.
Swimming Pool Fitter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i\&nldingwumit \PUM- PamitApp.a« 09n2ro6
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00043
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/8/2007
Phone: (503) 639 -4171 :, to
Inspection Requests (24 Hrs.): (503) 639 -4175 � h:_..
INSPECTION WORKSHEET FOR DATE: 2/9/2007 TIME: 7:04AM PAGE: 25
SITE ADDRESS: 09500 SW MARTHA ST CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Bathroom convcrt ion.
OWNER: BROWN, BARBARA PHONE #: 503624 941B
CONTRACTOR: ALL METRO PLUMBING LLC PHONE #: 503 - 317 - 0131
Inspection Request Scheduled For: Date: 2/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 043197 -01 503 - 201 -9665 N
Corrections /Comments /Instructions: -
DO(
t
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e--/M Date: Z-AM Phone #: (503) 718- Z 7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00043
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/8/2007
Phone: (503) 639 -4171 /, a�N4jyI�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/23/2007 TIME: 7:01AM PAGE: 8
SITE ADDRESS: Q95Q0 SW MARTHA ST CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Bathroom conversion.
OWNER: BROWN, BARBARA PHONE #: 503 - 624.9449
CONTRACTOR: ALL METRO PLUMBING LLC PHONE #: 503 317 - 0131
Inspection Request Scheduled For: Date: 2/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 043810.03 503 -201 -9665 N
Corrections/Comments/Instructions:
in PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cIIjf Date: Z z. 3 67 Phone #: (503) 718 7.