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Permit • CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2012 -00124 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2012 Parcel: 2S110BB03200 Jurisdiction: Tigard Site address: 12448 SW CHANDLER DR Project: Overby Subdivision: ARLINGTON RIDGE Lot: 9 Project Description: Remodel - house Contractor: POWER PLUMBING CO Owner: OVERBY, JOHN & PO BOX 19418 OVERBY, INA RAE PORTLAND, OR 97280 12448 SW CHANDLER DR TIGARD, OR 97224 PHONE: 503 - 244 -1900 PHONE: FAX: 503 - 244 -8825 FEES Quantity Description Date Amount 1 ea Lavatories 05/16/2012 $25.02 Specifics: 1 ea Tub /Shower /Shower Pan 05/16/2012 $12.51 1 ea Water Closet 05/16/2012 $25.02 Type of Use: SF 1 12% State Surcharge - 05/16/2012 $8.70 Class of Work: ALT Plumbing Type of Const: 10 ea Minimum Fee Adjustment - 05/16/2012 $9.95 Occupancy Grp: Plumbing Stories: Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC byy &LW calling 503.22.1987 or 1.800.332.2344. nQ A Cis \: Issued By: i 44(,iJj1 A Permittee Signature: old APPQ .L7� 0/ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. • MAY /15 /2012 /TUE 02:39 PM POWER PLUMBING FAX No.503 244 8825 P.001 Plumbing Permit Application REcEJVE I Building Fixtures roe. orr7CE USE. ONLY III City of Tigard MAY 15 2012 Received 1Per mitr t oi p L/�.�Or .. ool 13125 SW Hall Blvd., Tigard, OR 97223 1)ata/By 5///o/ /2- Si t ®ITY O F TIGARD � Phone: 503.639.4171 Fax: 503.598.19 ` �1 Review Other P&mitNo.: TIGARL� Intemeton wwwtigard�r 9 75 BUILDING DI` ISIO � 6ed /M ahoo d : Supplemental Page lnforaiailoa ' 4, 1'rt = 4 1 � t t c�- -r 1 `n.°".:i x=P' v- ( " v -, , r 7 ^ yF 7 s a'r �-' _ X .l 4 , r J ,� A l 1� . '' 4 5 `Rf� tl t 1[r _7:4. __ -. F. � _� - '� .r te _, y. .. .. . _ ? � �Y � , _)1 � +� , L 2 -'-! ' y .. _ _ � -_ ].. _uy ... ! 4.vr, -r , Y' \Cr �" ' �' � 1. ��f �� : � .Z �r. '�Gk` r. � f ❑ New construction © Demolition For special information use checklist Descri .tion I Sty. 1 Es. I Total k►, • ddrtion/alteralron/replacement ❑ Other New 1.2- family dwellings (includes 100 ft. for each utility connection) I �' .1:4` _,mac r L i `r 0 ∎,' . (') I'� ? } SIL�)�,, v ..' :777.7..77.7.7-7717771M. r ` .: SFR(1)bath 312.70 Lr: - and 2- family dwelling ❑ Commercialhndust ial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi- family additional bnth/kitchen 25.02 Each ❑ Master builder ❑ Other Fires rinkler q ft) - p (` s . fk Page 2 "..-,- r o . : tl if _ - L *1FI( j 4 • ; r �- t4srs9 Siteatillties: Job site address: Catch basin or area drain 18.76 � . City/State/ZIP: , 4, Q' "' D.3- 1 �1 e S-W . � � /� DTywetl, leach line, or trench drain 18.76 Footing drain (no. linear ft: ) ■ Page 2 Suite/bldg./apt- no.: Project name: V i I Manufactured home utilities 50.03 Cross streettdir'ections to job site: Manholes 18.76 Rain drain connector ■ 18.76 Sanitary sewer (no. linear ft.: ,�,_) Page 2 Storm sewer (no. linear ft: ___J Page 2 Water service (no. liner ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: - Tax map/parcel no.: Backflow preventer 31.27 r .,=.. 2_, x , I Yc 1 i t rt)r `F t i,, r.0 is_. ; . �...;,. .1 Backwater valve 12.51 .. r_ __ _._11., .. -ti . ._, ' dl-', w } � .' • - , t: ° 1 ' ' -;_ • Clothes washer 25.02 I lD h /w Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 1* 2,-5P.."-;-:,:;',I'A'.. 't , r ,- .7 F .J . xv i z JT' 'S- / 1 �, Expansion tank ' F - i _.,..__ (1. __z:: : . _ " E„ ` ,-. : � . l a•.• `i. " � =: xPe 12.51 Name: Fixture/sewer cap 25.02 - Address. Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City /State/Z1:P: Hose bib 25.02 Phone: ( ) • Fax: ( ) Ice maker 12.51 �} < <� I i i v ' l e r '- i. e • ' "-^ , Interce trap 25.02 Business name: l s)A 1 / Medical Bas (value: $ ) page 2 Contact dame: ;� Primer 12.51 Contact 1 J 1 i I Roof drain (commercial) 12.51 Address: f 0 • c u Sink/basi / aveto - 25.02 5 OL- •City /State/ZI,P :. . '04? / q'72V Solarunits (potable water) . . . ..62.54 i ° I - /shower an _ . ............. 1 -51- ._ - • -- • - -... I E-mail: / Urinal 25.02 it #V i - _Audi [ s=-7,1:-..:-', r r ti� r I is ` --7t Water closet • 25.02 25 0") 1 J r ( � f i t i .;.. - 7', ,F �. ..1 [ f...t' k S A -....!. _._ _.� r ,.L s,$ . �,_, .... - Water heater • Business name: „r ' Q� 37.52 1 Water piping/DWV 56.29 Address: `�� „ _ / Other 25.02 City /State/ZIP: Subtotal 102.5' Phone: ( ) Fax: ( ) Minimum permit fee: $72.50 1 Z 5v Lic.: 62,37v ■ r ' lambing Lie- no :3 24_'r j 7) p9 Plan review (25% of permit fee) State surcharge (12% of permit fee) O Authorized signature: • 110 . TOTAL PERMIT FEE 21 2-W ,- Print name: /el../ „ 5-• -�,h Date: 5 4 5 � his perms[ apptlader It expires a ie a ccepts is not complete_ middy 1811 Jaya accepted as eompteta "Fee methodology set by Tri- County Building Industry Service Board. 1:16ul1d PamitslPLMt1- PermitApp.doe 10/01/09 440-40167110107/COM/W®) MAY /15 /2012 /TUE 02:40 PM POWER PLUMBING FAX No. 503 244 8825 P. 002 • Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: _ ' ( Residential Fire Sur • ression S stems: > 1. • L'11j71:1 :1:1: y4 ` -,. ,. T; r• .0., ( l r � }'C[Il I( '� : -.�. � ri. ..iD ' [ .f[Z I! ) 4, r.. -� } ?:ce.. ;. �__ = Footing drain - 1" 100' . 50.03 0 to m 0 6 $1 Footing drain each additional 100' 37.52 3 601 to 7 00 $23320 . Sewer - 1st 100' 62.54 7,201 and , eater 327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' IIIIIIIIIZill Medical Gas S stems: • Water Service - each additional 100' 37.52 hi , ' � p t r �_ �,- y _ ` , Storm & Rain Drain -1st 100' 62.54 $1.00 to $5,010.60 Minimum fee 572-50 Stone & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for "�� re I �rl ttl ' » rt[ } }r ( � c�' h' r [ p' � r"'r- each additional $100.00 or fraction thereof, to i . - I , - s I -3r , ,:„• and includm_$10000.00. Inspection of twisting plumbing or for ■ ■ $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof; to minimum ch -1/2 hoar and inclu''.: $25 000.00. Inspections outside of normal business 90,00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum eh '• _e -2 hours each additional $100.00 or fraction thereof; to Reinspection Fees 90.00/hr and includ ■ : $50 000.00. Additional plan review for revisions S 90.00/hr - $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum ch • • -• 1f2 hour each additional $100.00 or fraction thereof Subtotal: . Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees'`. . 4 " •'6' ; �, y ',,-r� . e-. 1 B _._� ' .,.: -t Le fik[, l;yr^'.:-Z , . Ct 1�t7r irt[[4i nil : rf,f16tl :l ;M EE' . - • ,, :2L- , ' - ' 5 ' I r ' C } -, n `J '� A , �'.� , t : ' { : Plan review is required for any of the following. Please check all that apply. Baptistry/Font - Tab/Shower ❑ My new commercial building with water service 2" and Bath Jaeurxilvdhirlpool greater, except systems designed and stamped by licensed Cal Wash - Each Stall engineer. - eve . ❑ New exterior plumbing site utilities for any complex structure Cuspidor/WaterAspirator as de red in OAIi9l8- 78x0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic _ ❑ Any • multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918 780 Eye Wash Floor Drain/sink - 2" / Submit a sets of plans with any of the above. -3" � t . :4" [:c al{ s' G4 1v �iir=[rrl.i 1 c ? i4 l r 1 - . Car Wash Drain _ Garbage - Domestic- non -food - ❑ Isometric or riser diagram is required for new buildings Disposal - Domestio related V that meet the • ualifications above. - Commercial -food related _- --...- ...._._._. _..._....-. _......._._._.............._... ...... ... Ice Mach./Refria Drains i Oil Senor (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang _ -Stall S' I at Non -food related - . - Bradley . - Commercial -food related - Service Swimming Pool Filter . *Note: lithe fixture work under this permit results in an washer - Clothes Water Extractor increase of sewer EDUs, a sewer permit will be Issued and water Closet - Toilet l fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: ■ . http://www.tigard hall/ departrments /cd/docs/PL1v1F- PermitApedoe