Permit 1 / If ''
C ITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00511
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/20/2007
PARCEL: 25101 DA -01900
SITE ADDRESS: 07000 SW VARNS ST ZONING: C -P
SUBDIVISION: NELSON VIAL OFFICE LOT: 003 JURISDICTION: TIG
PROJECT: NELSON VIAL
Project Description: Line work to connect sewer into existing sewer line. Reverse plumbing.
Septic system to be pumped and filled or removed.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B 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: 40 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PRAM
7145 S W VARNS ST Description Date Amount
7145 SW
TIGARD, OR 97223
[PLUMB] Permit Fee 11/20/2007 $117.50
[TAX] 8% State Surcha 11/20/2007 $9.40
Phone : 503 -597 -2425 Total $126.90
Contractor:
PRO DRAIN & ROOTER SERVICE, INC
PORTLAND, OR R 972 22 9 REQUIRED ITEMS AND REPORTS
OR 979
Contact # : PRI 503 -533 -0430
FAX 503 -715 -4989
Reg #: LIC 108504
PLM 26 -776PB
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: ' 4 401r , 42________
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 . OS I o 1 _ A- 9 va
Building Fixtures R EcE\JED FOR OFFICE USE ONLY
City of Tigard 6 i)O1 Date/By: Received I ( I I (v (l) Permit N 1 c 9.40 7_0057/
13125 SW Hall Blvd , Tigard, OR 972214(.0i Plan Review ^ r`
: II Phone: 503 639.4171 Fax: 503.598. l e i l Y 0 4, CIGD Date/By. Other Permit �0 r9•? _ ,,b '�
Inspection Line: 503 639.4175 1 N Date Read B tn ® s ee or
P a e 2 f �-
TI G n It D Internet. www.tigard- or.gov BDILDIN6DIVI Ready /By. us
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
RAddition/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 Vommercial/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: /7ODe S (-3 ‘10..r P.-Ok. Catch basin or area drain 16 60
City/ State/ZIP: -1-k` r . rc i c) en Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: N Lc, K \) , , °,, Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16 60
Z kick r''t S Rain drain connector 16 60
Sanitary sewer (no. linear ft • ya f Page 2 Ob
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
e-4^+'e -r • kri-vt r s C.- C o K A. -- I.-. 4-11A-1 Backwater valve 16.60 .
Sewet �2 co •M
■ S S I con s.-PO (k.. n k
Clothes washer 16.60
Ii • I Dishwasher 16 60
J14.� r^i>u Drinking fountain / 16 60
❑ PROPERTY OWNER ❑ TEN
Ejectors/sump 16.60
Name: V I VA-L-- C 1
Expansion tank 16.60
Address: ''1 ( q 5 Fixture/sewer cap 16 60
City/ State/ZIP: ^-- k 9 ) C/A Floor drain/floor sink/hub 16 60
Phone: (l l % 5 ( - J t1l. 5 Fax: ( ) Garbage disposal 16.60
aff APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: PIC f) r nt t v\ Interceptor /grease trap 16 60
Contact name: � ( � t- Medical gas (value $ )' Page 2
Address: op 4.1 (g s`T"A *213
Primer 16.60
City/ State/ZIP: P6 ,i k. 0 k 9 2 1 Roof drain (commercial) 16.60
Phone: ) S 3"3 - p.A e lp I Fax: : (g')3) 1 t S /41 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: vC. %{ Dr± e X5 .1 co^-v -
Urinal 16.60
CONTRACTOR Water closet # y( 16.60
a
Business name: (7793- 9q -7 1 '19 Water heater + I 16
I C
Address: Other: A A) 4 .A- TILL 1 �j.R-5
City/State/ZIP: i
Subtotal
Minimum permit fee. $72.50
Phone: ( ) /0 r -•otf Fax: ( ) Residential backflow minimum permit fee: $36.25 / /7, 5
CCB Lic.: Plumbing Lic. no.: Ek, 77 6 P$ Plan review (25% of permit fee)
State surcharge (8% of permit fee) C7 .440
Authorized signatrue: , - TOTAL PERMIT FEE PA to I/0
Print name: IF6 r Date: -/6,- 67 This permit application expires if a permit Is not obtained within illirnPt
180 days after it has been accepted as complete.
I *Fee methodology set by Tri-County Building Industry Service Board.
I \ Budding \Permits\PLMF- PermitApp doe 12/27/06 440-4616T(10/02/r 1 M/WEB) '
Plumbing Permit Application - City of Tigard 1, .
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 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
and including $50,000 00.
specially requested inspections - per hour 72.50
Subtotal: $50 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 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 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
- Industnal
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 \Buiiding\Permits\PLM- PermttApp doc 12/27/06
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PLM2007 -00511
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2.0/2007
Phone: (503) 639 -4171 i d l e
Inspection Requests (24 Hrs.): (503) 639 -4175 " _ ..
INSPECTION WORKSHEET FOR DATE: 11/28/2007 TIME: 7 :00AM PAGE: 43
SITE ADDRESS: 07000 SW YARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL
DESCRIPTION: aa-work-tainect erintb existing sewer Line/ Reverse plumbing.
epti� o be pam( proved.
OWNER: VIAL & PI -IAM, PHONE #: 503 -597 -2425
CONTRACTOR: , PRO DRAIN & ROOTER SERVICE, INC PHONE #: 503533 -0430
Inspection Request Scheduled For: Date: 11128/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 060324 -01 503209.7779 Y
Corrections /Comments /Instructions:
See +1, C, la n
I< Cu- u---e-A--pt .t- R (L Ste e.n.. -N V c.[teti
G Ot r4- C ve.,4,A 9t*
j ;g1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (76w1•A...)■\ — Date: I 1 I �(' Phone #: (503) 718-
x,
To. Julie Page 2 of 2 2007 -11 -28 18:58 27 (GMT) 15037154989 From Greg Fort
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09/24/2007 19:02 5036488246 NOBLE SANITARY PAGE 01/01
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CITY OF TIGARD •
BUILDING DIVISION PERMIT #: pLM2007 -00611
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 11/20/2007
Phone: (503) 639 -4171 Att,
ll I Inspection Requests (24 Hrs.): (503) 639 -4175 I 11
INSPECTION WORKSHEET FOR DATE: 11/28/2007 TIME: 7 :00AM PAGE: 41
SITE ADDRESS: 07000 SW VARNS ST CLASS OF WORK:
SUBDIVISION: NELSON VIAL OFFICE LOT #: 003 TYPE OF USE:
PROJECT NAME: NELSON VIAL
DESCRIPTION: Line work to connect sewer into existing sewer line. (evp�umbing.
Septic system to he pumped and filled or removed.
OWNER: VIAL & PHAM, PHONE #: 503- 597 -2425
CONTRACTOR: PRO DRAIN & ROOTER SERVICE, INC PHONE #: 503 - 533 04 30
Inspection Request Scheduled For: Date: 11/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
350 Septic tank 060324 -03 503 - 209.7779 N
Corrections /Comments /Instructions:
S e < Pte►.•■V 2C. i z P �►-c
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q h+ W ( 1 Date: I I i2.-V(,) 7 Phone #: (503) 718-