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Permit • CITY TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00152 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/19/2007 PARCEL: 1 S134CB -13500 SITE ADDRESS: 12398 SW MILLVIEW CT ZONING: R - 4.5 SUBDIVISION: MILLVIEW LOT: 035 JURISDICTION: TIG PROJECT: SMITH Project Description: Kitchen remodel. • • CLASS OF WORK: ALT GARBAGE DISPOSALS: 1 MOBILE HOME SPACES: TYPE OF USE: SF • WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: SR3.3 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: WATER LINE: ft • DISHWASHERS: 1 RAIN DRAIN: ft Owner: FEES SMITH, ALAN C + DEBORAH B Description Date Amount 12398 MILL VIEW CT TIGARD, OR 97223 [PLUMB] Permit Fee 4/19/2007 $72.50 [TAX] 8% State Surcha 4/19/2007 $5.80 Phone : Total $78.30 Contractor: ROBERTSON PLUMBING INC PO BOX 1329 BORING, OR 97009 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 658 -5818 FAX 503- 658 -7106 Reg #: LIC 88717 • PLM 3 -184PB 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: 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. Flaw, bi.� Perm Applicat pL,, rt5t Rk T , -. -' - (y Fe 503 - & 5S -7 to G ,I,' L, RECEIVE E FOR OFFICE USE ONLY City of Tigard Received ;� g APR 1 Date/By: Permit No.: FLIT 200- 00152 a 13125 SW Hall Blvd., Tigard OR 9 7223 j 2007 Pl Review e Phone: 503.639.4171 Fax: • -503.598.1960 Date/By: Other Permit No.: T 1 G n 1t D Inspection Line: 503.639.4175 CITY OF FIGARD Date Ready/By: Juris: 'El See Page 2 for Internet: www.tigard- or.gov Rt ',WING DlvlsiO ,Notified/Method: Supplemental Information TYPE OF WORK � FEE* SCHEDULE ❑ New construction v Demolition For special information use checklist Description I Qty. I Ea. I Total XAddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath • 249.20 ( l- 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 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job.site address: 1.4.--51s, 5 V \ ; \j l� s ,, W c -71 Catch basin or area drain 16.60. . City/State/ZIP: "–\-' ■ G p\---g J) c � 7 2-2-3 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: 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 i Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 • e; C? C Ii Z Ai R y D 7, ( Backwater valve 16.60 Clothes washer 16.60 WC) • Dishwasher r 16:60 1Ij Drinking•fountain 16.60 r • Ejectors/sump 16.60 Name: p /15 5 7 i „j i Expansion tank 16.60, Address: - " ` I Fixture /sewer cap 16.60 City/State /ZIP: I Floor drain/floor sink/hub' 16.60 ( ) ( ) Garbage disposal 1 16.60 . 1 G � Phone: Fax:: � p Hose bib 16.60 ❑ APPLICANT ❑ CONTACT PERSON - 64 - Ice maker • (( 16.60 I t r Business name: Interceptor /grease trap 16.60 • Contact name: Medical gas (value: $ ) Page 2 . Address: i Primer 16.60 .City/State /ZIP: Roof drain (commercial) 16.60 Phone: ( ) Fax:: ( ) Sink/basin/lavatory ( 16.60 I � p — Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 A CONTRACTOR Water closet 16.60 i n Business name: RE (�4.•I( r saki z,Cfc� Water heater 16.60 S Address: 9 e O, g o X I ? � Other: City/State /ZIP: P p. 1 � O :► I q eDo Subtotal ( - �.f Minimum permit fee: $72.50 Y° uu Phone: (503) _ S � i � Fax: (5p GS 0 —'7 f jr) G Residential backflow minimum permit fee: $36.25 72. S� . 1=11111 ��� Plumbing Lic. no.: „ . i `r Plan review (25% of permit fee) 5, g0 Authorized signature: p State surcharge (8% of permit fee) IC `+ rAl..5, ow 7 TOTAL PERMIT FEE 1-g; 30 Print name: n et NIsJ; S R 6, R e� Date: ii .-/ &� �j This permit application expires if a permit is not :obtained within t 1' 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(10 /02/COM/WEB) • • . ' : . } Plumbing Permit Application - City of Tigard • ,Page ; Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: 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 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 Q ty. Fee (ea) Total additional $100.00 or fraction thereof, to and Fixture or Item 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 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. Quandti 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 Bath - Tub /Shower • ❑ New exterior plumbing site utilities for any complex structure • as defined in OAR918- 780 -0040. - Jacuzzi/Whirlpool Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities. -Drive tall ❑ 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 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 *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\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2 007 -00152 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007 Phone: (503) 639 - 4171 °,62 . . Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 6/21 /2007 TIME: 7:03AM PAGE: 25 SITE ADDRESS: 12396 SW MILLVIEW CT CLASS OF WORK: SUBDIVISION: MILLVIEW LOT #: 035 TYPE OF USE: PROJECT NAME: SMITH DESCRIPTION: Kitchen remodel. OWNER: SMITH, ALAN C + DEBORAH B, PHONE #: CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503 -65B -58113 Inspection Request Scheduled For: Date: 6/21 /2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 050666 -01 503.360.2129 Y Corrections /Comments /Instructions: P ' 114 6911/ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ) )/ 09) Date: - IA Phone #: (503) 718- CITY OF TIGARD , BUILDING DIVISION PERMIT #: PLM2007 -00152 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007 Phone: (503) 639 -4171 ' II I Inspection Requests (24 Hrs.): (503) 639 -4175 V F:_.. c INSPECTION WORKSHEET FOR DATE: 6119/2007 TIME: 7:01AM PAGE: 83 SITE ADDRESS: 12398 SW MILLVIEW CT CLASS OF WORK: SUBDIVISION: MILLVIEW LOT #: 035 TYPE OF USE: PROJECT NAME: SMITH DESCRIPTION: Kitchen remodel. ■ OWNER: SMITH, ALAN C + DEBORAH B, PHONE #: CONTRACTOR: ROBERTSON PLUMBING INC PHONE #: 503 -65 &5818 Inspection Request Scheduled For: Date: 6/19/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 050429 -01 503.380.2129 N Corrections/Comments/Instructions: Ai Z e 7 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0\( ` j/ Date: / Phone #: (503) 718- 2 '13)