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Permit C ITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00370 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/12/2008 - PARCEL: 1S125DB-04500 SITE ADDRESS: 07180 SW TAYLORS FERRY RD ZONING: R -4.5 SUBDIVISION: SHADY DELL NO. 2 LOT: 019 JURISDICTION: TIG PROJECT: BURTON Project Description: Re- routing 138 ft. of storm sewer. 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: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: 1 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: / 3F ft Owner: FEES STEVEN & P BURTON Description Date Amount 7180 SW TAYLORS FERRY RD TIGARD, OR 97223 [PLUMB] Permit Fee 9/12/2008 $101.40 [TAX] 12% State Surch 9/12/2008 $12.17 Phone : 503- 244 -7925 Total $113.57 Contractor: BONES CONSTRUCTION CO INC 3508 SW 209TH AVE ALOHA, OR 97007 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 649 -5682 Reg #: LIC 734 PLM 34 -204pb 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 B / Permittee Signature: i i� 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. Plumbing Permit Application ' _ -�-'. -uikding Fixtures �`° FOROF U SE ,O NL Y c ? . Receive ^r City of Tigard Date/By. 9 p Permit No.: /d�al.0 0�� 76 i " � ,'• es 13125 SW Hall Blvd., Tigard, OR 972 ^' � `.,, TI n Review ` f 4 v ' Phone: 503.639.4171 Fax: 503.598.1 °. Q Other Permit No 1 eW . T C Inspection Line: 503.639.4175 \Q ING /By: J,r, ® See Page 2for M., ., Internet: www.tigard- or.gov a .cotfied /Method Supplemental Information TYPE OF WORK` FEE* SCHEDULE. ❑ New construction CI Demol it�rt�lv��x - For special information use checklist Description Qty. Ea. 1 Total ❑ Addition /alteration/replacement ❑ Other: `r7" New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 [2 and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 C1 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: 71 5i.,,2,, - .�,�y2 ors Fora ep Catch basin or area drain 16.60 City /State /ZIP: 7 ( -1�- O � ` /e904/ 97,Z1 3 Drywell, leach line, or trench drain 16.60 Saito, Bldg. /apt. no.: Project name: 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 1 , Storm sewer (no. linear ft. 4U) Page 2 /of, 1 O 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 ,e,e(7O'f / jl!-i flra l ii Backwater valve 16 60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ❑ PROPERTY OWNER . I' ❑ TENANT Ejectors /sump 16.60 Name: S t �D l / i o n j, ga,n jew Expansion tank 16.60 Address: 7 /go C • f .p erry 'D Fixture /sewer cap 16.60 City /State /ZIP: 17,6 l O n G 7:„v / ? Floor Floor drain /floor sink/hub 16.60 Phone: 7 (` J d3)"3�Jv - L 7 69 Fax: (5o3)64/ .- 17/7 Garbage disposal 16.60 . . ❑ APPEICANT " . ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 I I Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16 60 Sink/basin /lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 ' ` , C ONTRACTOR , Water closet 16 60 Business name: .3 e, iv e c coo S fr c •-) -jon CO • Water heater 16.60 Address: 3 5o) Sid U) q fL• Ave Other: City /State /ZIP: it lo k U ©R 9 7-o 0 7. Subtotal Minimum permit fee: $72.50 Phone: ( 9D� j) 6i L(q-- y( Fax: ( "Q3 ) (p I/ 4 - / L/ 7- Residential backflow minimum permit fee: $36.25 `U 'I• I t 0 CCB Lie.: q 4 Plumbing Lic. no.: 3L1- 209 Pa Plan review (25% of permit fee) State surcharge (12% of permit fee) /4( Authorized signature: c::;• �" (( , 7 TOTAL PERMIT FEE Print name: 5 it Off 0 at AA-- Date: ei lit log This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tn- County Building Industry Service Board. I \Building \Permits \PLMF- PermitApp.doe 12/27/06 440- 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: • Footine drain - ls' 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 &Ram Drain - 1st 100' ( 55.00 55,60 $1.00 to $5,000.00 Minimum fee $72 50 Storm & Rain Drain - each additional 100' 46 40 /fin .q0 $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 0.00. specially requested inspections - per hour 72.50 Subtotal: `��i $50,001.00 and up $742.00 for the e first $50,000.00 and $1 20 for " each additional $100 00 or fraction thereof Commercial 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 Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial -Domestic _ _ Drinking Fountain Isometric oraiser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -3" 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: is \Building \Permits\PLM- PennitApp doe 12/27/06 Z Xn — `� _ .,>,..... S � F` ��� ;.. % , =» `, y ky" # KK '* •,;,- a '� , , �. ,Z'1„ avxt`' y '9 rJ .; - �.: �',7^.;5;. Yr�� ii "'}S.x: -,, .� .: `;i. :-:? ,•: W a 4 s T"F S, n " F% ,�., .a_ T?i�y ., r ms % 0 "' :aa, ° : sz %' r,: : fl.., . «1 4 7, ,i 9 0 5° � , . Y T rtb. . # '''' i V is '• - < ='' • ' ' ' ''` ', ', V Y 0 ' '4.16 ' . `` � "'`,. ; .:ii:? - is #;••;�.,.:., v- as:.,:�5' „.'ui+' "3. ` •x`(! ` . J #;a •. `� ,�'.; Y' °,:k :;, r,te:, , # - , `f' ` ,:z: '': ,``'v, .r ?«.' 'j3:'.' .„' -4. : : '�,3<e, 5 ..,�:; va'"«,"C.� ;` r, . 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BUILDING DIVISION : PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DA TE PLM200800370 TE ISSUED: 9/12/2008 Phone: (503) 639-4171 himisolt Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/1/2008 TIME: 7:02AM PAGE: 25 SITE ADDRESS: CLASS OF WORK: 07180 SW TAYLORS FERRY RD SUBDIVISION: LOT #: TYPE OF USE: SHADY DELL NO. 2 019 PROJECT NAME: BURTON DESCRIPTION: Re-routing 138 ft. of storm sewer. OWNER: BURTON, STEVEN & PATRICIA PHONE #: 503-2447926 CONTRACTOR BONES CONSTRUCTION CO INC PHONE #: 503-649-5682 Inspection Request Scheduled For: Date 10/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 076145-01 503-380-0769 N Corrections/Comments/Instructions: PASS 0 PARTIAL APPROVAL pi CANCEL 7 NO ACCESS n FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: G\'.-&_i\\ \r'-'.--_ Date: Jo I I 1 f) Phone #: (503) 718- . . CITY �����7N�������� _- ��om m ��n nw����nn�� , ��UUUU ��U0��� ��U��U��U��0� ' � | ~"~""~~~~""~~= ~~^~^~°^~~"~ � PLM2008-00370 | 13125SVV Hall 8�d,T�a�.ORQ7223 DATE|SSUED: 9/12120013 Phono (503) 639-4171 • PERMIT Requea��4Hmj: (503) 039~4175 ~. "� INSPECTION DATE: TIME: PAGE: ' � 18/1/2008 � 7:02AM � 30 SITE ADDRESS: CLAGSOFVVORK� � 07180 SW SUBDIVISION: � � LOT TYPE � GMADYD�LLNO�2 � 019 � PROJECT NAME: � BURT0M DESCRIPTION: Ro'noudng 138 ft. of ttonm xetwmr. OWNER: PHONE #: � BURTON, CONTRACTOR: � 503-244-7925 � PHONE � �0M�� ��N8TRUC T l�N CO INC #: S0D~[,4%,50D2 Inspection Request Scheduled For' Date: ' Pour Time: � � 10/1/2088 Code # Inspection Description Confirm # Contact # Message 340 Storm drain 076117-01 5O3800.0709 Y Corrections/Comments/Instructions: lk PASS ri PARTIAL APPROVAL pi CANCEL ri NO ACCESS �� �� �� / / FAIL / / CALL INSPECTION / / ADDITIONAL FEES ASSESSED `� |napectoc�| r\n��~^�~ Date: >r»/(<[)�� Phone #: (503) 718- � ''