Permit g
C ITY ` OF TIGARD � PLUMBING PERMIT
PERMIT #: PLM2006 -00208
:2111 DEVELOPMENT SERVICES DATE ISSUED: 5/12/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S108BA - 01700
SITE ADDRESS: 15950 SW COLONY CT ZONING: R -7
SUBDIVISION: WEST COLONY PARK LOT: 008 JURISDICTION: URB
Project Description: Relocate (1) lay, (1) shower, (1) water closet. Add (1) tub.
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: 1 OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
JASON SCHALLOCK
15950 SW COLONY CT Description Date Amount
TIGARD, OR 97224 [UPLUMB] Permit Fee 5/12/2006 $72.50
[UTAX] 8% State Sure 5/12/2006 $5.80
Phone : 503- 880 -6339 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #:
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
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
//.
Issued By: __ _ ___ Permittee Signature:
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.
Building Fixtures
•
Plumbing Permit Application R E C E O V E 7
City of Tigard v�
MAY Permit No.: 1`I �P - 0 2,'1 � / a 13125 SW Hall Blvd., Tigard, OR 97223 IV! 14 2 ��06 �e/BY ����� Q��
7 C Plan Review Other Permit No.:
Phone: Fax: 503.598.1960 Date/By.
T I G A It I) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: S3 See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition' For special information use checklist
Description I Qty. I Ea. I Total
ist Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 249.20
fff I- 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: ( Sb .r t) c _ ` _ Catch basin or area drain • 16.60
City / State/ZIP: 1 1 .�.1 On • to 1 2-2. 2-2. - I qqq Drywell, leach line, or trench drain 16.60
(� Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: � ft_7tx� �M„
Manufactured home utilities 1 10.00
Cross street/directions to job site: �� J�/v 1
l lTt� . I M anholes 16.60
-1r, CO\ov -k
-4- 1 ti('. k --- C £ tot✓L1 C . 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
1 , 1 .51 '4n.a t^ 1 - T 1a- Backwater valve 16.60
i ti - t , �a - Clothes washer 16.60
J Dishwasher 16.60
fiit OWNER I ❑TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name:
SI
D- �'Jt/�. Expansion tank 16.60
Address: ` c 4 7 6 .c Cpl O l [ - L
C -. Fixture/sewer cap 16.60
City /State/ZIP:�( r.ra O C. C � Floor drain/floor sink/hub 16.60
•
Phone: (60 - ZS L G . Fax: ( ) Garbage disposal 16.60
n � `� \ Hose bib 16.60
g APPLICANT ❑ CONTACT PERSON
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 i 16.60
Tub /shower/shower pan 2 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet , 16.60
Business name: Water heater 16.60
Address: Other:
City /State/ZIP: Subtotal
Minimum permit fee: $72.50 '
Phone: ( ) Fax: ( ) Residential backflow minimum permit fcc: $36.25 t�•"
CCB Lic.: Plu • . i , .''ic. .. Plan review (25% of permit fee)
_
/ State surcharge (8% of permit fee) X.. yt)
Authorized signature: TOTAL PERMIT FEE l 7 >. 0
Print name: - 3 c,„6e,,,,,t 6 ' ..• I .. I Date: j/ Z //7f f _ 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\PLMF- PennitApp.doc 04/06/06 440-4616T( I0/02/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 u 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 - I st 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 Back flow 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: Plan Review for Complex Structures
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.
Drinking Fountain
❑ My NFPA I 3 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
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.
is\ Building \Pcunits\PLM- PemnitApp.doc 07106105
C
CITY ' OF TIGARD " • ... PLUMBING PERMIT
Ili DEVELOPMENT SERVICES PERMIT #: P -00208
"III DATE ISSUED: 5/12/20012/200 6
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S108BA -01700
SITE ADDRESS: 15950 SW COLONY CT ZONING: R -7
SUBDIVISION: WEST COLONY PARK LOT: 008 JURISDICTION: URB
Project Description: Relocate (1) lay, (1) shower, (1) water closet. Add (1) tub.
EXPIRED
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: 1 OTHER FIXTURES:
TUB /SHOWERS: 2 SEWER LINE: ft .
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
•
Owner: FEES
JASON SCHALLOCK
15950 SW COLONY CT Description Date Amount
TIGARD, OR 97224 [UPLUIVIB] Permit Fee 5/12/2006 $72.50
[UTAX] 8% State Surc 5/12/2006 $5.80
Phone : 503- 880 -6339 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
l' 2) '01 C
Reg #: EXPIRED
--
f A x x c c ; 146 To W& - co • O
O
I
O
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 copieyf
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. A • 7, j- ( Q
/ ,� �� / , rte' _`
•� P ermiftee Signature: / `�% ` %v%
Issued By: �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.
•
' INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for. REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By I Code I Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR- Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing MEC - Mechanical Permit
810 MFG-Structure set -up
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final 322 Shower pan
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\ Building \Fonts \InspCard- AOP- Blankdoc 02/02/07
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 -00208
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 5/17J2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/22/2006 TIME: 7 :03AM PAGE: 22
SITE ADDRESS: 15950 SW COLONY CT CLASS OF WORK:
SUBDIVISION: WEST COLONY PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: SCHALLOCK
DESCRIPTION: Relocate (1) lav, (1) shower, (1) water closet. Add (1) tub.
OWNER: SCHALLOCK, JASON PHONE #: 503880 -6339
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/22/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 035385 -01 503-784 -9519 N
Corrections /Comments /Instructions:
0 r�li " L w �.,,� , _ V e B-e. Pcl r&4— S 44
C� Tit O TO 41 ro 2.a ✓ -�1 �
FILE
COPY!
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 - - v-A—A ` V`�-- Date: 71 ZZI 0 6 Phone #: (503) 718
CITY OF TIGARD ,
BUILDING DIVISION PEIMIT #. PLM2006 -00208
13125 SW Hall Blvd., Tigard, OR 97223 '' ' DATE ISSUED: 5/12/1006
Phone: (503) 639 -4171 4 i
Inspection Requests (24 Hrs.): (503) 639 -4175 •
�_
INSPECTION WORKSHEET FOR DATE: 7/1112006 TIME: 7 :00AM PAGE: 29
SITE ADDRESS: 15950 SW COLONY CT CLASS OF WORK:
SUBDIVISION: WEST COLONY PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: SCHALLOCK
DESCRIPTION: Relocate (1) lav, (1) shower, (1) water closet. Add (1) tub.
OWNER: SCHALLOCK, JASON PHONE #: 503-880-6339
CONTRACTOR: OWNER PHONE #:
I
1
Inspection Request Scheduled For: Date: 7/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 ' Plumbing rough -in 032913 -02 503. 880.6339 Y
Corrections /Comments /Instructions: FIL Copy
,." IJf) _ ‘ l . OW __. _-
/ j e,e/A .
I .// i !ay i Arian t - �� '
",,/ , s ,,,
5' , , '
0 d/ ,.. • ._ , 1 ,,,.. ,
if - i /
/
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
//j FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ill ��c‘. Date: I Phone #: (503) 718
2. //3/
■
4
TRANSMISSION VERIFICATION REPORT
TIME : 07/20/2007 14:10
NAME : TIGARD BUILDING DEPT
FAX : 5036243681
TEL .
SER.# : BROD4J479592
DATE,TIME 07/20 14:10
FAX NO. /NAME 5038466797
DURATION 00:00:24
PAGE(S) 02
RESULT OK
MODE STANDARD
ECM
FILE COPY
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: PI-M
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/11/2006
Phone: (503) 639 - 4171 - .y= 4: is
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 711 112006 TIME: 7.NAM PAGE:
SITE ADDRESS: 159 SO SW COLONY CT CLASS OF WORK:
SUBDIVISION: WF_ ST COLONY R. LOT #: 008 TYPE OF USE:
PROJECT NAME: St %HALL.t. ?CK
DESCRIPTION: Relocate (1) lav, (1) shower, (1) water closet. Add (1) tub.
OWNER: SCHALLOCK, JASON PHONE #: 50 ? Bt30 G:i:!St
CONTRACTOR: OWNER
PHONE #:
Inspection Request Scheduled For: Date: 7/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 032913 - 02 SW Y
Corrections /Comments /Instructions:
Age
C✓
/ /-
•
• 6/21 /2007
� Case Activity Listing
•
- CCEL% 2:43:45PM
• Y Case #: PLM2006 -00208
j 1f !, Assigned Done • Updated • Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
PLM1010 Application received. 5/12/2006 • None • RECD DER 5/12/2006
DER
PLM1020 Permit created 5/12/2006 None. DONE .DER 5 /12/2006
DER
PLM1030 Check for parcel tags 5/12/2006 None DONE.' DER 5/12/2006
• DER
•
PLM1280. Issue permit 5/12/2006 None DONE DER 5/12/2006
DER
PLM2320 Plumbing rough -in 7/10/2006 7/11/2006 7/11/2006 None FAIL MRS 7/12/2006 032913 -02 — 503- 880 -6339 VM
MRS Y
PLM2320 Plumbing rough -in 8/21/2006 8/22/2006 8/22/2006 None FAIL JW 8/22/2006 035385 -01 —.503-784-9519 —
STI N —180 • ..
•
PLM1530 Permit expired by 3/9/2007 None DONE JMT 3/9/2007. . , •
limitation JMT
•
•
Page 1 of 1 CaseActivity..rpt
•
•