Permit !N • a CITY OF TIGARD PLUMBING PERMIT
`� 'COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00501
T,tGAKD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2007
PARCEL: 1 S135CD - 09500
SITE - ADDRESS: 09923 SW PIHAS CT ZONING: R -12
SUBDIVISION: JACOB COURT LOT: 003 JURISDICTION: TIG
PROJECT: ABRAMS
Project Description: Backflow preventer 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
JENNIFER ABRAMS
9923 SW PIHAS CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 11/9/2007 $36.25
[TAX] 8% State Surcha 11/9/2007 $2.90
Phone : 503- 705 -0074 Total $39.15
Contractor:
DENNIS' 7 DEES LANDSCAPING
7355 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 777 -7777
FAX 503- 777 -2399
Reg #: LIC 5009
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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:
Permiftee Signature:
ern 1Ca
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.
P . • .
07/532
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Plumbing_Peranit Ap. 'cation FOR OFFICE USE ONLY
City Tigard * "I ` () : Received /}�
131 SW Hall Blvd., Tigard, OR 97 ' 3 E � Re Date/By: ve , al Pr/ \% Permit No�/ Nn�O/J� ,n0�
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: vie Other Permit No.: ! (/
: 11�
24- Hour Inspection Line: 503.639.4175 09 r ' � Date Ready /By El See Page 2 for
Internet: www.ci.tigard.or.us NOV Ii tJ ^ Notified/Method: Supplemental Information • TI T C ( 1 9 r e 1 IUA� • FEE• SCHEDULE - • .
For special information use checklist.
❑ New construction RU r 1 \ r p I
RUM lti7l�f�J Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ® Other: LANDSCAPE 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 ❑ 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: 9993 81,J /' /N45 Gov air Catch basin or area drain 16.60
City /State/ZIP: c77619-12-49 c K2_ 920-g-3 Drywell, leach line, or trench drain . 16.60
Suite/bldg. /apt. no.: I Project name: /j�[�' 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.: ) I Page 2
Subdivision: 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 1 Page 2
INSTALL BACKFLOW DEVICE Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
" or PROPERTY OWNER I • ❑ TENANT
Name: U &n t 1 t� Q�{i2 4-6i2/(11445 Expansion tank I 16.60 I
"t • U Expansion tank 16.60
Address: 31A/4&t._ Al (k- Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16.60
Phone: ( 57) 70s -007 C! 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: ( )
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: DENNIS t SEVEN DEES LANDSCAPING, INC Water heater 16.60
Address: 7355 SE JOHNSON CREEK BOULEVARD Other:
City /State /ZIP: PORTLAND, OR 97206
Subtotal
Minimum permit fee: $72.50 to -�
Phone: ( 503 ) 777 - 7777 Fax: (503 ) 777 - 2399 Residential backflow minimum permit fee: $36.25 3
CCB Lic.: 5009 Plumbing Lic. no.: 05LIBDI Plan review (25 % of permit fee)
�y� 3 State surcharge (8% of permit fee) ?; " c
Authorized signature: 71 /P ' TOTAL PERMIT FEE . i S
Print name: DEAN SNODGRASS Date: /l�`J�t� 7 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.
is 1BuildingPermits 'PLM- PermilApp.doe 12/03 440- 1616T(10 /02 /COM/WEB)
r w 11119
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' 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 $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:
Are you capping, moving or replacing existing fixtures? If
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"yes ", please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * .
• . • Quantity -by (Fixture) Work Performed
Ype� _ Replace Fixture T New Moved Existing Capped Comments regarding fixture work:
Baptistry/Font
Bath - Tub /Shower
- Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher - Commercial
- Domestic
Drinking Fountain
Eye Wash
Floor Drain/sink - 2"
-3"
-4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial *Note: If the fixture work under this permit results in an
- Industrial increase of sewer EDUs, a sewer permit will be issued and
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the
Rec. Vehicle Dump Station plumbing permit can be issued.
Shower -Gang
-Stall
Sink - Bar/Lavatory Ouantitv Total
- Bradley Isometric or riser diagram is required if fixture quantity
- Commercial total is >9.
- Service
Swimming Pool Filter
Washer - Clothes
Water Extractor Plan Review
Water Closet - Toilet Plan review is required if fixture quantity total is >9.
Urinal
Other Fixtures:
CITY OF TIGARD
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BUILDING DIVISION PERMIT #: PLM2007-00501
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/9/2007
Phone: (503) 639 -4171
Al
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Inspection Requests (24 Hrs.): (503) 639 -4175 - -... - "_ ..
INSPECTION WORKSHEET FOR DATE: 11/13/2007 TIME: 7 :01AM PAGE: 71
SITE ADDRESS: 09923 SW PIHAS CT CLASS OF WORK:
SUBDIVISION: JACOB COURT LOT #: 003 TYPE OF USE:
PROJECT NAME: ABRAMS
DESCRIPTION: Backflow preventer for irrigation.
OWNER: ABRAMS, JENNIFER PHONE #: 503. 705.0074
CONTRACTOR: DENNIS' 7 DEES LANDSCAPING • PHONE #: 503-777 -7777
Inspection Request Scheduled For: Date: 11/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Misc. inspection 05849501 503 777 -7777 Y
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Corrections /Comments /Instructions:
D Q 1c e- .
Get rt C; k- , A.
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A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q \ jk,....L___ Date: 11 1 13 10 Phone #: (503) 718-