Permit •
CITY TIGARD PLUMBING PERMIT
Aek DEVELOPMENT SERVICES PERMIT #: PLM2005 -00593
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/21/2005
PARCEL: 2S 104AC - 10900
SITE ADDRESS: 13320 SW WALNUT ST ZONING:
SUBDIVISION: LOT: JURISDICTION:
Project Description: Sewer connection.
CLASS OF WORK: OTR 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: 100 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BARBARA ZECHMANN
13320 SW WALNUT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 10/21/200`. $72.50
[TAX] 8% State Surcha 10/21/200E $5.80
Phone : Total $78.30
Contractor:
KERR CONTRACTORS INC
PO BOX 1060
WOODBURN, OR 97071 REQUIRED ITEMS AND REPORTS
Phone : 971 - 216 -0050
Reg #: LIC 72599
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: c !� !� �� � Permittee Signature: c>iNtc
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.
Bui!dinfi Fixtures
Plumbing Permit Ap FOR OFFICE 11 SE ONLY
City of Tigard D By /1 e2/ VS-96Z- Permit No.: � ^'1� ) 9
13125 SW Hall Blvd., Tigard, OR 97223 ^+J
Phone: 503.639.4171 Fax: 503.598.1960 A., Plan Review Other Permit No.: \ `/
24 Hour Inspection Line: 503.639.4175 1 I Date/By. ��� (/�7
_., Date Ready/By El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPE OF WORK FEE* SCHEDULE -
construction ❑ Demolition . For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection)
' CATEGORY OF CONSTRUCTION SFR(1) 249.20
and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other: Fire sprinkler ( sq. ft.) Page 2
' JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: / 3 3 az, s,L 1.4,' /' t- Catch basin or area drain 16.60
City /State/ZIP: Drywell, leach line, or trench drain 16.60'
Suite/bldg. /apt. no.: 1 Project name: Footing drain (no. linear tt : ) 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
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 Back flow preventer Page 2
4 !A�/ii/4/l $5() 74- L/'i�C J./7 yit/ l,.ekit - Backwater valve 16.60
/ / Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
\ • Ejectors/sump 16.60
ir
Name: e . C V� -��/�% ,. , -. 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
Hose bib 16.60
❑ APPLICANT . ❑ CONTACT PERSON
,, Ice maker 16.60
Business name: ! `k /�� <7 Interceptor/grease trap /^ Interce tor/ ease tra 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: /pen) Llfr Primer 16.60
City /State/ZIP: 6 Roof drain (commercial) 16.60
Phone: (V/ ) x6, SU Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
. C ONTRACTOR Water closet 16.60
Business name: Water heater 16.60
Address: Other:
Subtotal
City / State/ZIP: Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Li 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 \Buildmg\Permits\PLMF- PeimutApp doc 06/05 440.4616T(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
•F 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
•
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 C Str . : -,
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 building.
Fixture Type: - • - . Replace ❑ Any new exterior plumbing site utilities.
Previous - Capped Added Existing . ❑ 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.
Dnnking Fountain ❑ Any NFPA 13 -D 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 this permit results in an
Water Extractor un 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\Permits\PLM- PenniApp doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200E -00593
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10121/2005
Phone: (503) 639 -4171 4M
Inspection Requests (24 Hrs.): (503) 639 -4175 7111
INSPECTION WORKSHEET FOR DATE: 12/6/2006 TIME: 7:02AM PAGE: 57
SITE ADDRESS:, 13320 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ZECHMANN
DESCRIPTION: ,Sevier connection.
OWNER: 7DCHMANN, BARBARA PHONE #:
CONTRACTOR: KERR CONTRACTORS INC PHONE #: 971 216
Inspection Request Scheduled For: Date: 12/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 022998 -01 971 -235 -5018 N
Corrections/Comments/Instructions:
4 /APO
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /Y / Date: ! Phone #: (503) 718-
•
CITY OF TIGARD • �.''
BUILDING DIVISION PERMIT #: PLM2005 -00593
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/21/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10127/2005 TIME: 7:16AM PAGE: 100
SITE ADDRESS: 13320 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ZECHMANN
DESCRIPTION: Sewer connection.
OWNER: ZECHMANN, BARBARA PHONE #:
CONTRACTOR: KERR CONTRACTORS INC PHONE #: 971 - 218.0050
Inspection Request Scheduled For: Date: 10/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 018483 -01 971 - 235-60113 Y
Corrections /Comments /Instructions:
•
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•
b )0+- vo.k e C `-c- 1 N- e-t^f Lei cJ ✓w,
•
IA PASS X PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: cT Date: 1 /2 - 71 o r; Phone #: (503) 718-