Permit A' CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00168
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' 13125 DEVELOPMENT HO BMEN9 Tigard, SERVICES DATE ISSUED: 5/1/2006
PARCEL: 2S 102DC -00502
SITE ADDRESS: 09130 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT: 013 JURISDICTION: TIG
Project Description: Install 150 feet of sanitary sewer service and 50 feet of storm service
CLASS OF WORK: NEW 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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 150 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 50 ft
Owner: FEES
• DANIEL & D FRANCO Description Date Amount
9130 SW OMARA ST
TIGARD, OR 97223 [PLUMB] Permit Fee 5/1/2006 $156.40
[TAX] 8% State Surcharl 5/1/2006 $12.51
Phone : Total $168.91
Contractor:
TCJ CONSTRUCTION
19750 SW PAGE CT. REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97007
Contact # : PRI 503- 320 -7831
FAX 503- 259 -2432
•
Reg #: LIC 67499
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 -0s 1 hrough OAR 952 -0001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 5 t - 246 -6.' ' o • 1 00- 332 -2344.
Issued y: / l � 10 u _I , [ ; Permittee Signature: r A l ida\ A •
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business d
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.
Building Fixtures
Plumbing Permit Application FOR OFFICE: USE ONi
City of Tigard D eI dip /I/) Permit No.: IL j/1M QQ��j Q
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 �'� Ow v
0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By. • Other Permit No.: -ego
T I G A It D Inspection Line: 503.639.4175 Date Ready/By. Jun ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method /1O' Supplemental informat
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration/replacemettt _Other: New 1 dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) 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
❑ Other: Fire sprinkler ( sq. ft.) Page 2 .
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address / 3l, � ,..,, O\' -' , . 63 Catch basin or area drain 16.60
City /State/ZIP: "-7C\ (,.7j) l .(,Q 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.: 4 Page 2 /0/, 4
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Storm sewer (no. linear ft.: . Page 2 5 DC)
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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 Back flow preventer Page 2 .
L CO 4C ))\--1/ ) T ?(L` ��
1 � /C Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: • 161.__. if i 0 1.6)N-A) 4 ) • 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: 1 (3' - t tt&_ Interceptor /grease trap 16.60
Contact name: `T(L Uy J GL✓Ea(--, Medical gas (value: $ ) Page 2
Address: 1 c -/s 5, pp, � 5 c. Primer 16.60 .
City /State/ZIP: D (Z1( A ( c42, 99 �5r7 Roof drain (commercial) 16.60
Phone: (�) 5Z0' r 3 ) 1 I Fax: : (5e.>3) z -+z 95Z- Sink/basin/lavatory 16.60
Tub /shower/shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: („, 7s" ( - if -pop-, Water heater • 16.60
Address: ( ! 73 5,.. ( ffei 111 � &•-- ( T Other:
T G n/ / �
City /State/ZIP:. t4 q /r-(/ 1 Subtotal •
1 1 Minimum permit fee: $72.50 /
Phone: (563 ) (,(t C -571/O. Fax: ) / - Residential backflow minimum permit fee: $36.25 '�5 (0 f VC
CCB Lic.: (, I y G Plumbing Lic. no(/,L../ Plan review (25% of permit fee)
- State surcharge (8% of permit fee) 9..
Authorized signature: /) n C
�� TOTAL PERMIT FEE 1P 7 r
Print name: -T/z. ! --r- _AA-, I Date: -/ -.� � This permit application expires if a permit is not obtained wi thin
180 days after it has been accepted as complete.
• *Fee methodology set by Tri -County Building Industry Service Board.
1 :y r wi 07' q dhyt /odo6 44046 r6T(ra/a)JCOMAVEB) .. 0629 / 3 ; BUD c �t P'GIX� o
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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 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
L� 3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40 Gf(� • yp
Water Service - I st 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
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: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for •
each additional $100.00 or fraction thereof
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Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
• Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic • dwelling units.
Drinking Fountain
- ❑ Any NFPA 13 - D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above. •
-3"
-4"
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal -Commercial three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
-Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and •
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: _ plumbing permit can be issued. -
i: Building \Pennits\PI.M- PertnitApp.doe 07/06/05 •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: pLivu0UE' ( :) ifil3
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: ?`i/iD0 Iia
Phone: (503) 639 -4171 �4, � i II
Inspection Requests (24 Hrs.): (503) 639 -4175 �� ' la- ''
INSPECTION WORKSHEET FOR DATE: 5/2r2QUt. TIME: 7:01AM PAGE: 10
SITE ADDRESS: ( 13() SW O'MARA :III CLASS OF WORK:
SUBDIVISION: f:DOI _WOOL) LOT #: 01.E TYPE OF USE:
PROJECT NAME: FRANCO
DESCRIPTION: Install 1' 10 feet of sanitary eewer service and `j() feet of a:torni e.ervke for fut,ure bit.
OWNER: FRANCO, DANIEL & DIANNA PHONE #:
CONTRACTOR: TCJ CONSTRUCTION PHONE #: !f0:1' "►0 /;311
Inspection Request Scheduled For: Date: 5/a1?017& Pour Time:
Code # Inspection Description Confirm # Contact # Message
?:ti'; Sanitary sewer 029173 01 503 -320 103 i N
Corrections /Comments /Instructions:
�;r •
0" .
L- ' I
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: .M2006 -00168
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/
Phone: (503) 639 -4171 l) :���
Inspection Requests (24 Hrs.): (503) 639 -4175 °"
INSPECTION WORKSHEET FOR DATE: 5/2/2006 TIME: 7:01AM PAGE: 9
SITE ADDRESS: 09130 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: EDC3EWOOD LOT #: 013 TYPE OF USE:
PROJECT NAME: f RANCO
DESCRIPTION: lns`i.aii 150 feet of sanitary sewer service and 50 feet of storm service for future lot.
OWNER: F RANCO, DANIEL & DIANNA PHONE #:
CONTRACTOR: TCJ CONSrRUC11ON PHONE #: 503-320-7031
Inspection Request Scheduled For: Date: 5/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 0291 -02 603. 320.7831 Y
Corrections /Comments /Instructions:
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-