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Permit 7 CITY OF TIGARp, ' " ' PLUMBING PERMIT a COMMUNITY DEVELOPMENT PERMIT #: PLM2009 - 00005 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/7/2009 PARCEL: 2S102DB - 00500 SITE ADDRESS: 08815 SW O'MARA ST ZONING: CBD SUBDIVISION: FANNO CREEK PARK LOT: JURISDICTION: TIG PROJECT: TIGARD SENIOR CENTER GARDEN RM Project Description: Storm connection. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: 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: 100 ft Owner: FEES ' CITY OF TIGARD 13125 SW HALL Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 1/7/2009 $72.50 [TAX] 12% State Surch 1/7/2009 $8.70 Phone : 503- 639 -4171 Total $81.20 Contractor: CASCADE MECHANICAL SYSTEMS INC PO BOX 399 ES TACADA, OR 97023 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 630 -4492 FAX 503- 630 -5510 Reg #: LIC 127012 PLM 3 -324PB 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: Qov' \ 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. •i*iumbing Permit Application i � E CE MD Site Utilities .-. - FOR OFFICE USE ONLY g ^ Al 0 n n009 Received City of Tigard JAN I L -7 Permit No • 13125 SW Hall Blvd., Tigard, OR 97223 Plan 7. OQ �1 rflri ' �� Phone: 503.639.4171 Fax: 503.598 Plan Review Other Permit No.: LAY OF TIGARD Date/By: Inspection Line: 503.639.4175 D ate R ead B Juris: ® See Page 2 for T I G A It D Internet: wwtv.tigard or.gov BUILDING DIVIS Notifie \ ( C l Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction 0 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 (I) bath 249.20 ❑ 1- and 2- family dwelling AS 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 INFORMATION AND LOCATION Site utilities Job site address: g c 15 .S , IC) © e e, '',A-- Catch basin or area drain 16.60 City/State /ZIP: 10 c(1 Q'' Drywell, leach line, or trench drain 16.60 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: (� (,, fiY 44 �J1 K3C �"t��* Manufactured home utilities 110.00 Cross street/directions to job site: 6 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 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 7\c . t A-0 5 iA cam* `'AQQ Backwater valve 16.60 cN �1 ` �cx \,� (1,..k5 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State/ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) 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 Sink/basin/lavatory 16.60 Phone: ( ) I Fax: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 � , CONTRACTOR Water closet 16.60 Business name: �-y-,�_ ■n P06 Water heater 16.60 Address: 67th f - c( f Other: City/State /ZIP: Or Subtotal �� Minimum permit fee: $72.50 -7,1 1 � 7 Phone: (.0 ( < yyq Fax: (PP)) 3 ) (. C I T _ Residential backflow minimum permit fee: $36.25 CCB Lic.: 12"7 O/ 7.-- Plumbing Lic. no.3 -- 3 2-9196 Plan review (25% of permit fee) State surcharge (12% of permit fee) 70 Authorized signattue:� � TOTAL PERMIT FEE RI , Print name: 6 Q r) t_0,- le I Date: This permit application expires if a permit is not obtained within / 180 days after it has been accepted as complete. *Fee methodology set by Trr -County Building Industry Service Board. I:\ Building \Pertnits\PLMU- PermitApp.doc 12 /27/06 440- 4616T(l0 /02/COM/WEB) 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' 105 , 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 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. Commercial 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 Quantity 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. -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 - Bradley *Note: If the fixture work under this permit results in an - 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\PLMU- PermitApp.doc 2 I CITY OF TIGARD -- BUILDING DIVISION P ERMIT #: PL M2009-00005 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1l7f;1009 Phone: (503) 639 -4171 / a� , 7 g OV IIri\ Inspection Requests (24 Hrs.): (503) 639 -4175 4,�- I INSPECTION WORKSHEET FOR DATE: 11812009 TIME: 7:00AM PAGE: 9 SITE ADDRESS: 08815 SW O'MARA ST CLASS OF WORK: SUBDIVISION: FANNO CREEK PARK LOT #: TYPE OF USE: PROJECT NAME: TIGARD SENIOR CENTER GARDEN RM DESCRIPTION: Storm connection. OWNER: CITY OF TIGARD. PHONE #: 5 -4171 CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC P H ONE #: 503-630- Inspection Request Scheduled For: Date: \,, Pour Time: N p q 1/8/2009 U" Code # Inspection Description Confirm # Contact # Me ge dr LI � � 340 Storm (pain 079514-01 503. 332 -6458 Y 3 - 1..-v■-.41/4...1 EY „....„......---. Corrections /Comments/ Instructions: +74—e '� n sk) e s. • diff----' C O(12./ ✓1 .-7 v 3 •-( - .--1 ii jp V I, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Ins ector: " l/1 f_.._ : ` 6 q Pho #: 503 718p Date: ( )