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Permit
• CITY OFI1GARD PLUMBING PERMIT ,.�I DEVELOPMENT SERVICES PERMIT #: PLM2006 -10030 1I DATE ISSUED: 3/15/2006 13125 SW Hail Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134AB - 00100 SITE ADDRESS: 10980 SW SPRINGWOOD DR ZONING: R -12 SUBDIVISION: ENGLEWOOD TERRACE APARTMENTS LOT: 090 JURISDICTION: TIG Project Description: INSTALL 3" PRESSURE REDUCING VALVE IN METER VAULT. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R1 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 HARRINGTON, THOMAS E 105 FREMONT AVE, STE B Description Date Amount LOS ALTOS, CA 94022 [PLUMB] Permit Fee 4/4/2006 $72.50 [TAX] 8% State Surcha 4/4/2006 $5.80 Phone : Total $78.30 Contractor: - MECHANICAL SERVICES INT. LLC 21185 NW EVERGREEN PKWY STE. 106 REQUIRED ITEMS AND REPORTS HILLSBORO, OR 970124 Contact # : PRI 503- 439 -9999 Reg #: LIC 126015 PLM 37-421PB 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: �J • 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. 4 1d ng Fixtures ( o sr t z t 6 d Plumbing Permit Ap I fir,. rye/ 7 FOR OFFICE USE ONLY • • , t`: %:: I i E R/F Re ceived � Q M Cit of Tigard Date/By: a I S ! 0(4 - 6 a Permit No.: t IM .. / Vo) 3 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review t 1 r�ww Phone: 503.639.4171 Fax: 503.598.1960 Mr R 1 5 21 � 'kohl' oh 1, Date/By: Other Permit No.: 24 Hour Inspection Line: 503.639.4175 a,✓ � . e` W Date Ready/By: At y a .. 7° See Internet: www.ci.tigard.or.us Notified/Method: /4 Supplemental Page 2 Information 1:*TIII11 4 � � +,�►. FEE* SCHEDULE ... ❑New construction W e ' i � " Dem " I`\ For spec 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) 4 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 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: ' pc `6b 510 s p; Nsi jn (V. Catch basin or area drain 16.60 City/State/ZIP: ` art e ©r . ¶' 7 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 = wg,Ir..�� Te �rar.�_ Ap-� 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: I 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 ka 514 t ( 3 r / n P�, -re.- et /),,,i Backwater valve 16.60 A I' v Clothes washer I6.60 t IV IIIr...TW` (1 1T Dishwasher 16.60 Drinking fountain 16.60 ❑ PROPERTY OWNER ,I ❑ TENANT Ejectors /sump 16.60 Name: Expansion tank 16.60 Address: Fixture/sewer cap 16.60 City/ State/ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax ( ) Garbage disposal 16.60 ❑ APPLICANT 0 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 Fax: : ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: in e.ac t yv i ca. ( •der✓► ce s I r■T . LL C Water heater 16.60 Address: Other: Prea.Sure Red (lade i J Jo A6�s Subtotal a , go p City/State/ZIP :1k `1 s h oIP d d , ` 2 t 2. L Minimum permit fee: $72.50 72 • fa Phone: (spa )937, 9' 9 7 Fax: (5 ) q 39,./ 9 9 9 Residential backflow minimum permit fee: $36.25 CCBLic.: / O a (,D I S go,3 ,p( PlumbingLic.no.: -4411/ IV Plan review (25 %ofpetTnit fee) I _ l -6'6' State surcharge (8% of permit fee) 5 $C Authorized signature: b-idlEtr -7 I TOTAL PERMIT FEE 7c$ 4-� Print name: �B.yvL 19 G I I e1T' Date:3 /i3 / /pa This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Q; *Fee methodology set by Tri -County Building Industry Servi oar i:\ Building 'Permits\P[drff- PermitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) 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 • Storm & Rain Drain - 1st 100' 55.00 Valuation: Permit Fee:, $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 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 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: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Quantity by (Fixture) Work Performed • Fixture Type: Replace 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 Quantity Total - Bradley Isometric or riser diagram is required if fixture quantity - Commercial - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total >9. Urinal Other Fixtures: i:\ Building \Permits\PLM- PertnitApp.doc 3/03 CITY OF TIGARD Pc_4"1 BUILDING DIVISION PERMIT #:2,06 ( — /00 3o 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 I �.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / d 960 � J Lo O e LASS OF WORK: SUBDIVISION: J LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 — o q -- Pour Time: Code # Inspection Description„ Confirm # Contact # Message 397 iW y3 -�g�9 Corrections /Comments /Instructions: 33 dory. p, k BASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 1\< Inspector: VI' Date: ) 1. 'hone #: (503) 718 -