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Permit
C ITY OAF lI GARD PLUMBING PERMIT 4"1 DEVELOPMENT SERVICES PERMIT #: P -10049 DATE ISSUED: 3/27/20027/200 6 '` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2 S 105 D D -04400 SITE ADDRESS: 13550 SW SANDRIDGE DR ZONING: R -7 SUBDIVISION: PACIFIC CREST LOT: 020 JURISDICTION: TIG 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 MOHAMMAD & AMIRI 13550 SW SANDRIDGE DR . . Description. Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 4/6/2006 $36.25 [TAX] 8% State Surcha 4/6/2006 $2.90 Phone : 506 -524 -1133 Total $39.15 Contractor: ESEQUIEL ROBLES LANDSCAPING 7076 RIDGEMONT DR N KEIZER, OR 97303 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 997 -9874 • Reg #: PLM 7784 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: %15L Permittee Signature: S.c-e, \ 1 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. Dui/Ding Permit A �. I' VE® FOR oI l l(: t :SI: r);,"l.l • 1 W H B ,Tigard, OR 9722 3MAR 2 7 2000 Date/BY. 7 ,fl " v O - JX1 Permit No'I ` at ,o 2/q Phone: 503.639.4171 Fax 503.598.1960 d,,, „, i Date/By. `W Other Permit No.: 24- Hour Inspection Line: 503.639.4175 I DUILDING DMSION Y Internet: www.tigard-or.gov CI OF TIGARD !- �� : _,. Date Ready/By: ® Set Paget for Noti6ed/Metlwd 'r j(� Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For spedal information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement j 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 El 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: 1 k5 .e-) S Cl t. d t c -0 r Catch basin or area drain 16.60 City / State/ZIP: T.' 6 5. a r a 9, F , , Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: 1 Project 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 Tax map/parcel no.: Fixture or Item Absorption valve 16.60 p DESCRIPTION OF WORK _ Back flow preventer Page 2 S ,1 Y i ► (/ S /5 freP"T Backwater valve 16.60 134:34.c.„ 134:34.c.„ � oc r Y P, ci ?-1 7 Clothes washer 16.60 Dishwasher 16.60 ❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 � I Ejectors/sump 16.60 Name: /7 0 yy yt q Y 7 ' t e / , : y r ' Expansion tank 16.60 Address: 1 -5 9 sit" S a A d✓, g e p Fixture/sewer cap 16.60 City /State/ZIP: y' i e, (is ,,k O r 97 ..3 Floor drain/floor sink/hub 16.60 Phone: (St5 S a Li 11"3 Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: ES . e. L R , (� L 4 4 � - S C.4 f ; ri 5 Interceptor /grease trap 16.60 Contact name: e$ ei . c F e L .bid). 5 Medical gas (value: S ) Page 2 Address: - 7 0 -2 (o R i . 0 e, 7 br, ( v F., �f Primer 16.60 City / State/ZIP: - tce;zl?,- © C'r7 -3O Roofdrain(commercial) 16.60 Phone: (S C.::. ! r, ) y I Fax: : ( ) Sink/basin/lavatory 16.60 E-mail: Tub/shower /shower pan 16.60 Urinal 16,60 ,) CONTRACTOR Water closet 16.60 Business name: rS P. eru Fe ( ,b[e, ( m e C.cp.rx. Water heater 16.60 Address: 7o 7,b R , . _,e,. Yf'L a K! l7 . .t//` Other: 3z City /State/ZIP: )e 2e/ . .) f. ? �jO� Subtotal �one: Minimum permit fee: 572.50 1 Phone: (9b QQ7 Off 7 (J Fa x: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: i Plumbing Lic. no.: Plan review (25 %ofpermit fee) Authorized signature: State surcharge (8% of permit fee) TOTAL PERMIT FEE Print name: I Date: 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 \Pnmib\PLM- PerrnitApp.doe 12/30/05 440-4616T(10102/COM/WEB) Plumbing Permit Application - City of Tigard 4 Page 2 7 . Supplemental Information •t F Schedule: Residential Fire Suppression Systems: Site Utilities ' . . - - Qtr. 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 ' • additional $100.00 or fraction thereof to and Fixture or Item Qty. Fee (ea) Total • 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 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 - per hour 72.50 and including $50,000.00. 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 • 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 buildin _ Fixture Type: - .. R . ❑ Any new exterior plumbing site utilities. Previous Capped Added E>cb6ng ❑ 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 I 3 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 k d this permit results in an Water Extractor P 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 \Permiu\PLM- PennitApp.doc 07/06/05 CITY OF TIGARD • BUILDING DIVISION PERMIT #: PLM2006- 10049 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/: 7/200ti Phone: (503) 639 -4171 ,% _ it Inspection Requests (24 Hrs.): (503) 639 -4175 : � � `.. INSPECTION WORKSHEET FOR DATE: 5/1212006 TIME: 7:03AM PAGE: 69 SITE ADDRESS: 13660 SW SANDRIDCE DP. CLASS OF WORK: SUBDIVISION: PACIFIC CREST LOT #: 020 TYPE OF USE: PROJECT NAME: AMIRI DESCRIPTION: Backflow preventer for irrigation. OWNER: AMIRI, MOHAMMAD & TERRI PHONE #: 506.524.1133 CONTRACTOR: ESEQUIEI. ROBLES LANDSCAPING PHONE #: 503997 -9(374 Inspection Request Scheduled For: Date: 6/12/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 029739-01 603-997 -9874 N Corrections/Comments/Instr tions: L , .qc s"�Z� -t--.51.- r i l • ,/ i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ►' V' Date: 5/1 1// ( Phone #: (503) 718- 791 , (