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Permit !� CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00245 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/14/2007 PARCEL: 1S133DB-04900 SITE ADDRESS: 13145 SW WINTERLAKE CT ZONING: R -12 SUBDIVISION: BRITTANY SQUARE NO. 4 LOT: 077 JURISDICTION: TIG PROJECT: ELLIOTT Project Description: Install backflow device for irriagation. 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 LEHNOW, JOSEPH E /LESLIE J 13145 SW WINTERLAKE CT Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 6/14/2007 $36.25 [TAX] 8% State Surcha 6/14/2007 $2.90 Phone : Total $39.15 Contractor: LANDSCAPE EAST & WEST INC PO BOX 30883 PORTLAND, OR 97294 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 256 -5302 FAX 503- 297 -6993 Reg #: LIC 167024 PLM 81 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. Issue= : /f / /// ��; / v` J Permittee Signature: l � ca f, _ep 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. F y, r Plumbing Permit Apph a ig � _ _ u I_ FOR OFFICE USE ONLY City of Tigard JUN Il 4 2007 ReceiDateved JBy: 14 i Permit No.: p R _ vv2 5 13125 SW Hall Blvd., Tigard, OR 97223 � Plan Review Phone: 503.639.4171 Fax: 503 598.1960 ©WV OF U Ur`,75 n ' s i s l• Date/By: Other Permit No. 24- Hour Inspection Line: 503 639.4175 B uppnxe, (� �G__ . e• ' II! Date Ready/By Jan' H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: "r Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑Demolition For special information use checklist Description I Qty. I Ea- I Total ❑ Addition/alteration/replacement TS Other. i:0f1C.}' Wl.l New 1 - 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249 20 Cg 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 El Accessory building ❑ Multi - family SFR (3) bath 399.00 ID 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! L/5 5 L I,J 1 N Tile L Ak Cco2T Catch basin or area drain 16.60 City/State/ZIP: 176,Al2.0 ) og 4 ?au 3 Drywell, leach line, or trench drain 16.60 Footing drain (no. linear ft.: Page 2 Suite/bldgJapt. no.: I Project name: J 0/ 707 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 - rriCorrliA5 C,01 DI (55 A3 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 3Cp , ./5 - e r,r 4 5 ALL OA C-lcicL -Or.) DE.vecL F15 1gial Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16 60 PROPERTY OWNER I ❑ TENANT Drinking fountain 16 60 Ejectors/sump 16.60 - Name: 5 u LL l _ Expansion tank 16.60 l La-i, �,` /� �� � Address: / 3 / I/5 5 1-I � L �T' ER_ , � UP--) Fixture/sewer cap 16.60 City /State /ZIP: bAgD �/j , 7)a 3 Floor drain/floor sink/hub 16 60 ( 3 Phone: (5D3) 590 - 7 j 93 Fax: ( ) Garbage disposal 16 60 El APPLICANT ( ❑CONTACT PERSON Ice make Ar 16.6 16 6 Ice maker Business name: t . Interceptor /grease trap 16.60 Contact name: Medical gas (value' $ ) Page 2 Address: /27 Primer 16 60 City/ State/ZIP: Roof dram (commercial) 16.60 1 Sink/basin/lavatory 16.60 Phone: Fax: : ( ) - - Tub/shower/shower pan 16.60 E - mail: :i,, V 1 ,i! y / S ! Pig 'r . ■ S , ali. Urinal 16 60 CONTRACT I • , _ Water closet 16.60 Business name: ba N E_ EA -4. 1--r,51 I`r.l\-C. Water heater 16.60 Address: 8750 5 /1 be Other City / State/ZIP: p fl 9 ? v ) (1b Subtotal n i Minimum permit fee. $72.50 Phone: (5 ) &S( C30.,) Fax: (503) , (pgg Residential backflow minimum permit fee: $3625 GC' -c° CCB Lic.:4 / 67 a; (p/ /� - Plumbing Lic. no.: pe, 31 Plan review (25% of permit fee) �y State surcharge (8% of permit fee) ) • I 0 Authorized signature: , ti I iler t 1 ��U TOTAL PERMIT FEE 3g. / 5 Print name: DAV t p FELZIZOY1 U \ Date: 5 I 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\Permits\PLM- PennitApp doe 06/05 440- 4616T(10 /02/COM/WEB) r Plumbing Permit Application - City of Tigard - " Page 2 - Supplemental Information . Fee Schedule: Residential Fire Suppression System s: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - l 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 Dram - 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 22�� each additional $100.00 or fraction thereof to (minimum permit fee $36.25) l 27.55 3( •' 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 each additional $100 00 or fraction thereof to P g P g or and including $50,000 00. specially requested inspections - per hour 72 50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: 3(0.°15 each additional $100.00 or fraction thereof. Fixture Work: Plan Review for Complex Structures Are you capping, adding or replacing futures? If "yes ", A "complex structure" is defined as an installation of a plumbing please indicate work performed by future. Failure to system that meets any of the following criteria. accurately report futures could result in increased sewer fees *. Please check all that apply. Quantity by (Fixture) Work Performed El 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. Drinking 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 MachiRefrig. 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 Water Extractor *Note: If the fixture work under this permit results in an 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 •\Butlding\Permits\PLM- PermitApp doc 07/06/05 CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2007 -00245 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 s' "'I L. INSPECTION WORKSHEET FOR DATE: 7/18/2007 TIME: 7:01AM PAGE: 74 SITE ADDRESS: 13145 SW WNTERLAKE CT CLASS OF WORK: SUBDIVISION: BRITTANY SQUARE NO. 4 LOT #: 077 TYPE OF USE: PROJECT NAME: ELLIOTT DESCRIPTION: Install backflow device for irriagation. OWNER: LEHNOW, JOSEPH E/LESLIE J, PHONE #: CONTRACTOR: LANDSCAPE EAST & WEST INC PHONE it: 503 - 256-5302 Inspection Request Scheduled For: Date: 7/18/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 395 Misc. inspection 052167 -01 503 - 256-5302 Y Corrections /Comments /Instructions: S Q -e- A. - re 1—r Vac ✓-r Do K l t � C �. t- U tut. SL r Care, ft L/ PL-61\, • ` tA PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4—?I�7) ( ) � Date: I� ► ✓w ` t t '""'�' � Phone #: 503 718- CITY OF TIGARD . - . BUILDING DIVISION PERMIT #: PLM2007 -00245 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 �' ":_.. INSPECTION WORKSHEET FOR DATE: 7/12/2007 . TIME: 7:04AM PAGE: 79 SITE ADDRESS: 13145 SW WINTERLAKE CT CLASS OF WORK: SUBDIVISION: BRITTANY SQUARE NO. 4 LOT #: 077 TYPE OF USE: PROJECT NAME: ELLIOTT DESCRIPTION: Install bacldlow device for irriagation. OWNER: LEHNOW, JOSEPH E/LESLIE J, PHONE #: CONTRACTOR: LANDSCAPE EAST & WEST INC PHONE #: 503-256-5302 1 Inspection Request Scheduled For: Date: 7/12/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 395 Misc. inspection 051771 -01 503.2565302 Y Corrections /Comments /Instructions: D 5 j r t _../ /_ . fib ,_ ..- we A 2_e_1- ,„,.4 .4-r--,- — %.-'--- �_�i �� — G A r ,,- 411111Flappliglir Apr ' (1 0 / V, ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ )1(114-4: "er,- Date2 / 6 ? Phone #: (503) 718- 2 G