Permit . r. q.
iiiii q -ViTY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00012
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/14/2008
PARCEL: 2S 111 AD - 15200
SITE ADDRESS: 09059 SW REILING ST ZONING: R -4.5
SUBDIVISION: MALLARD LAKES LOT: 018 JURISDICTION: TIG
PROJECT: BURR
Project Description: Remodel bathroom.
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: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
NORMAN BURR
9059 SW REILING Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 1/14/2008 $83.00
[TAX] 12% State Surch 1/14/2008 $9.96
Phone : 503- 620 -4538 Total $92.96
Contractor:
BURFITT PLUMBING
6223 NE HASSALO ST
PORTLAND, OR 97213 REQUIRED ITEMS AND REPORTS
•
Contact # : PRI 503- 287 -1267
FAX 503 - 331 -3933
Reg #: LIC 1076
PLM 26- I 1 PB
•
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: P ermittee Signature: ' ir _ / w „„„,,,.„.,„,__ ` �_A
Call 503.639.4175 by 7:00 a.m. for an inspection that bu mess 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.
w
Plumbing; Permit Application
Building Fixtures RECEIVE() FOR OFFICE USE ONLY
Ali Received P ermit No.:
City of Tigard 1 1 4 LUUJ ii 7Z• /�LeoZOpS - QddV.2
n 13125 SW Hall Blvd., Tigard, OR 4 2d
Date/By: a ii
C Plan Revi
Inspection Line: 503.639.4175Phone: 503.639.4171 Fax: 50 Other Permit No.:
�!� ��((��n�(r///.�� f Q 1oN Datee eady
Date/By:
T I G n K D Internet: www.ti ard -or. ov D Notified/Method:
eo ns R By:
luri S S Page f
g g fied/Method: Zp 2 or lnformation
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ 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 (1) bath 249.20
,-. 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
Accessory building SFR (3) bath 399.00
❑ ry g ❑ Multi - family
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: CQ7 Stt) Qe/4' _ Catch basin or area drain 16.60
City /State /ZIP: • n`�� /` Drywell, leach line, or trench drain 16.60
IT'S �`�-+ Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: g
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.: ) 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 Page 2
t✓� ZO.,grC /gy 4 9 Backwater valve 16.60
///�"�'" ___ "'°°° S. Clothes washer 16.60
Dishwasher 16.60
PROPERTY OWNER
❑ TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: A ifr / Q ti Expansion tank 16.60
-
Address: 9&59 $j ��Z.//t/C- S7 Fixture /sewer cap 16.60
City /State /ZIP: 77 oR �2 ' Floor drain/floor sink/hub 16.60
+
Phone: r�t7 � '. v 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: ( ) p er:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan a 16.60 0 70
E -mail: Urinal 16.60
CONTRACTOR Water closet / 16.60 A `0
Business name: 1:?,..,, ✓� Water heater 16.60
Address: �j�1, �C 1 4 .. rt Other:
City /State /ZIP:
,€)E- G• Subtotal e3"�
�� � + �
�'"�-' Mi nimum permit fee: $72.50 p
Phone: ) 0p � ' 7 Fax: ( ) Residential backflow minimum permit fee: $36.25_ O - '
CCB Lic.: /D Plumbing Lic. no.: - ..24.- f/ Plan review (25% of permit fee)
9 State surcharge (12% of permit fee) 7 , 9'4
! TOTAL PERMIT FEE 9a , 9
Authorized signature:
Print name: /4 Date: f.4 V. de 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.
I: \Building\Permits\PLMF- PermitApp.doc 12/27/06 440.4616T(10/02/COM/WEB)
te
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
•
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 includinp $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
specially requested inspections - and including $50,000.00.
_ pe y e9 p 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: 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 Thry
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\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Pi .M2008,00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1412001i
Phone: (503) 639 -4171 Ate
Inspection Requests (24 Hrs.): (503) 639 -4175 P_
•
INSPECTION WORKSHEET FOR DATE: 3/3/2008 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 09059 SW REILING ST CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 018 TYPE OF USE:
PROJECT NAME: BURR
DESCRIPTION: Remodel bathroom.
OWNER: BURR, NORMAN PHONE #: 503- 620 -4538
CONTRACTOR: BURFITT PLUMBING PHONE #: 503 -287 -1267
Inspection Request Scheduled For: Date: 3/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 065998 -01 503-888-9953 Y
Corrections /Comments /Instructions:
ro, .64
Iii -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 31 31 b Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FILM 20 0O612_
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 'i
INSPECTION WORKSHEET FOR DATE: 2 1 q 1 07i TIME: PAGE:
SITE ADDRESS: a5 R 221 1 1 n3 SI CLASS OF WORK:
SUBDIVISION: Mo. 1161,,-61 C.o ti. LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: p
OWNER: SW Ij0°/ " " PHONE #:
CONTRACTOR: sL4r, / re 16 PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
2 2a b � y 43 o I
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: __Cra Date: 2 j 4 th> Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: RI_M2003 -00012
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/14/2008
Phone: (503) 639 -4171 . '►�'4�q q r1\
Inspection Requests (24 Hrs.): (503) 639 -4175 J 1 L
INSPECTION WORKSHEET FOR DATE: 2/1/2008 TIME: 7 :02AM PAGE: 79
SITE ADDRESS: 09059 SW REILING ST CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 018 TYPE OF USE:
PROJECT NAME: BURR
DESCRIPTION: Remodel bathroom.
OWNER: BURR, NORMAN PHONE #: 503 - 620-4538
CONTRACTOR: BURT ITT PLUMBING PHONE #: 503287 -1267
Inspection Request Scheduled For: Date: 2/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 Shower pan 0(4325M1 503 889 -99613 Y
Corrections /Comments / Instructions:
%PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ». Date: Phone #: (503) 718- _
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM700R -00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/14/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 °1 L
INSPECTION WORKSHEET FOR DATE: 1/16/200 TIME: 7 :00AM PAGE: 13
SITE ADDRESS: 09059 SW REILING ST CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 018 TYPE OF USE:
PROJECT NAME: BURR
DESCRIPTION: Remodel bathroom.
OWNER: BURR, NORMAN PHONE #: 503.620 -4538
CONTRACTOR: BURFITT PLUMBING PHONE #: 603.207 -1267
Inspection Request Scheduled For: Date: 1/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 063329 -01 503-888-9953 1f
Corrections /Comments / Instructions:
U Uol.e✓ r I 0 o✓ PI (AL-A. N
Cam. \ ed ✓ o■49 L fi t, -SL- Co t.. -y LA-a.
•
•
❑ PASS [X1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _KT Date: j 1 14,1;0 � Phone #: (503) 718-