Permit 71 ^t ' CITY OF TIGARD PLUMBING PERMIT
°,; COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00085
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/1/2007
PARCEL: 2S 102C D -02607
SITE ADDRESS: 09760 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: TWALITY HILL LOT: 007 JURISDICTION: TIG
PROJECT: RAMAKRISHNAN
Project Description: Line work to connect sewer. Septic system to be pumped and filled or removed.
CLASS OF WORK: ALT 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: 66 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
NIRANJAN, RAMAKRISHNAN +
RAM, SHAILAJA Description Date Amount
9760 SW OMARA ST [PLUMB] Permit Fee 3/1/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 3/1/2007 $5.80
Phone : Total $78.30
Contractor:
NW SUNDOWN SERVICES
1701 BROADWAY
VANCOUVER, WA 98665 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 888 -2677
FAX NA
Reg #: LIC 163547 if
PLM PB264
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:, LAL,14440, 171
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 •
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City of Tigard 1 11: �4 i s - � X r ` _
q 13125 SW Hall Blvd., Tigard, OR 97223 DawB ,. / = ,,� _ . 1 11 2007 OCj°j
Phone: 503.639.4171 Fax 503.598.1d6R, 1 wDate/By. Other PermitNo..
•
Inspection Line: 503.639.4175
t '' " S - 2007 1�e+�07•
I I G A It I) Date Ready/By: Jima: El See Page 2 for
Internet: www.tigard or.gov ,/ NatifedMethod Supplemental Information
TYPE OF Wkd Y U./ 1l�Y15 FEE* SCHEDULE . .
r,r.To 1TITT(Tfl ,
❑ New construction Demolition ` - For spedal information use checklist
Description I Qty. I Ea. I Total
Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 24920
Kl- 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: ( 4 7 &a 4A) n lin' 01,4 Catch basin or area drain 16.60
City /State/ZIP: / oci Cl 7 -_ Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I name: Footing drain (no. linear ft.: _) 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 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 Badkflow preventer Page 2
gi.a.t_. L 1 14_ e.Owp.,r i Backwater valve 16.60 .
Clothes washer 16.60
Dishwasher 16.60
CI Drinking fountain 16.60
❑ PROPERTY OWNER '
K A M �4Kt?VSMIJMi J I 7611/4) Ejectors/sump 16.60
Nye Q I'rN Expansion tank 16.60
Address: "1 * () p S A) 0 MAO} 21 • Fixture/sewer cap 16.60
City/State lZlP: 7) '7 �' ^� BR 4223
` Phone: (503) 631- I D Floor drain/floor sink/hub 16.60
Z Fax: ( )
Garbage disposal 16.60
❑ APPLICANT I ❑ 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 F es:: ( ) Sink/basin/lavatory 16.60
Tub/shower /shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: L / ss �� /��-- ` �������j�_ - - s .--, Water heater 16.60
Address: ... ": „ .,T4, ���7�� -` Other: I -
City /State/ZIP: l/`y-':::? g- /
Subtotal
` �' � //0 Minimum permit fee: $72.50
Phone: ( . J Fax: ( ) r Residential backflow minimum permit fee: $36.25 7,� )
CCB Lic.:,e s' � f ?, /7 3/ 7/01 Plumbing Lic. no.: ��� Plan review (25% of permit fee)
State surcharge (8% of permit fee) 6.
Authorized signs TOTAL PERMIT FEE 7 g •30
Print name: j,� ' Date:� . ,,,, i, This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
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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 - 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
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 Back flow 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
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 $50,001.00 and up $742.00 for the first $50,000.00 and $120 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
Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: 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"
-4"
Car Wash Drain Comments regarding fixture work:
Garbage - Domestic
Disposal -Commercial
- Industrial
Ice MachfRefrig. 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
-Commercial
- service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
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CITY OF TIGARD
BUILDING DIVISION , PERMIT #: PLM2007- 00U8fi
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1 12007
Phone: (503) 639- 4171 ��` ,1l
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 3/8/2007 TIME: 7:01AM PAGE: 30
SITE ADDRESS: 09760 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: TWALITY HILL LOT #: 007 TYPE OF USE:
PROJECT NAME: RAMAKRISHNAN
DESCRIPTION: Line work to connect sewer. Septic system to be pumped and filled or removed.
OWNER: NIRANJAN, RAMAKRISHNAN +, PHONE #:
CONTRACTOR: NW SUNDOWN SERVICES PHONE #: 503.B68-2677
Inspection Request Scheduled For: Date: 3/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # • Message
399 Plumbing final 044513-01 503 888-2672 N
Corrections /Comments / Instructions:
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❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 ),•. w' I it 6-4. Date: 3/7/07 Phone #: (503) 718-