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Permit
• r. a CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00124 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/28/2007 PARCEL: 2 S 110 D D -04 30 0 SITE ADDRESS: 15665 SW OLD ORCHARD PL ZONING: R - SUBDIVISION: SUMMERFIELD NO.3 LOT: 145 JURISDICTION: TIG PROJECT: GREATHOUSE Project Description: Install residential backflow 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 MARK GREATHOUSE • 15665 SW OLD ORCHARD PL Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 3/28/2007 $36.25 [TAX] 8% State Surcha 3/28/2007 $2.90 Phone : • Total $39.15 • Contractor: LANDSERVICES, INC. 30033 NW EVERGREEN RD. HILLSBORO, OR 97124 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 644 -8575 • Reg #: PLM 5108 • 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 By: k if . L Permittee Signature: . • Call 503.639.4175 by 7:00 a.m. for an inspection that business da 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 Application /� p rolt 01:11( t :si t.) 1..1' III City of Tigard Date/B ateBy. ,1. 01 O d /.% Permit No.: / H /OK 5f7 - Op//' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review B ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.: T I G n 1: l� Inspedron Line: 503.639.4175 Date Ready/By r ^ 63 See Page 2 for Internet: www.tigard-or.gov Notified/Method /C A Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For spedal information ase 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 24910 ❑ 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 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: /5 51AJ O 1. 0 Rc -II D Ph. Catch basin or area drain 16.60 City /State/ZIP: 774) ©/e. 9 7223 Drywell, leach line, or trench drain 16.60 Suite/bldg /apt. no.: f Project name: (r -- 4 TI/0 USE Footing drain (no. linear ft.: _J Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 • Sanitary sewer (no. linear R: __J Page 2 Storm sewer (no. linear ft: , ) Page 2 Subdivision: l Lot no.: Water service (no. linear ft : _) Page 2 Tax map/parcel no.: Fixture or item Absorption valve 16.60 // DESCRIPTION OF WORK Back flow prevents Page 2 R, cI i J& GV !/V S 7'r4 L.L,A D/V Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 iii �( 6 4 Ejectors/sump 16.60 Name: /„4 '' ` �� T 4ouS � Expansion tank 16.60 Address: /3 6$ SW 0 c, 2 02C1>zff2D AL , Fixture/sewer cap 16.60 City /State/ZIP:7 0 g C? 7 2 3 Floor drain/floor sink/hub 16.60 Phone: (�0?) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ 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: Sink/basin/lavatory 16.60 ( ) Fax: ) E-mail: Tub/shower/shower pan 16.60 Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: L/9IV2) 5 RtJ /( 5 INC. Water heater 16.60 Address: P D, g fj K /777 Other: City /State/ZIP: jr NO(H /2 pt 4//v5 O!� 9 7/.?3 Subtotal Phone: // ! /c Minimum permit fee: $72.50 2/ ;s' (5-0. 6 7 T -F5 75" Fax: ( ) Residential backflow minimum permit fee: $36.25 -'‘e CCB Lic.: 5708 Plumbing Lic. no.: Plan review (25% of permit fee) State surcharge (8% of permit fee) A • ?61 Authorized signature: TOTAL PERMIT FEE 9 , f 5 I Print name: ,� I Date: 3 -z8 -O T his permit applieadon expires If permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. t:\ Build ng\PermitsWlld- PamitApp.doc 06/26/06 4404616T(10'02/COM/Wm) Plumbing Permit Application, - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) To1A1 Square Footage: Permit Fee: Footing drain - I 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 6525 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing each additional $100.00 or fraction thereof; to r on g p g 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: 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 QuaotitY by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type: Rep1 engineer. Previous Capped added Etdsting ❑ 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/Wata 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" - 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/Lavatory increase of sewer EDUs, a sewer permit will be issued and - Bradley fees assessed for the sewer increase must be paid before the - Servi l -Service plumbing permit can be issued. Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal - Other Fixtures: ialritding\Permiu\PLM.PennitApp.doc 09,2V06 CITY OF TIGARD - - BUILDING DIVISION PERMIT #: PLM2007 -00124 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28/2007 Phone: (503) 639 -4171 � Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/11/2007 TIME: 7 :00AM PAGE: 33 SITE ADDRESS: 15665 SW OLD ORCHARD PL CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.3 LOT #: 145 TYPE OF USE: PROJECT NAME: GREATHOUSE DESCRIPTION: Install residential backflow for irrigation. OWNER: GREATHOUSE, MARK PHONE #: CONTRACTOR: LANDSERVICES, INC. PHONE #: 503 6448575 Inspection Request Scheduled For: Date: 4/11/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 046292 -01 503-523-8455 N Corrections /Comments /Instructions: g own 0 Pi--A e-c - rye- -C4<_ A + ,L � PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: crbv'i` - r 11 ►J Date: `MM / /ta 7 Phone #: (503) 718-