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Permit
Ill w CITY OF TIGARD 7.- ° PLUMBING PERMIT 7 COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00339 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/31/2007 PARCEL: 2S 102DC - 00300 SITE ADDRESS: 09220 SW O'MARA ST ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT: 016 JURISDICTION: TIG PROJECT: MILLER Project Description: Relocate meter to correct parcel. 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: ft WATER CLOSETS: WATER LINE: 2 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES SHANE /MICH MILLER 9220 SW O'MARA Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 7/31/2007 $72.50 [TAX] 8% State Surcha 7/31/2007 $5.80 Phone : 503 - 372 -5413 Total $78.30 Contractor: RAYBORN'S PLUMBING INC 19990 SW CIPOLE RD. TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 692 -4139 FAX 503- 691 -2328 Reg #: LIC 87852 PLM 34 -166PB 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: (- ,kf /P ILeheLf rtle,,e1) 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 Applicati. 0 ,yam, . hi� ; :�? ;j to I'�C/ i : building Fixt � 1 ,�_ FOR OFFICE USE ONLY J U L 3 1 2007 Received City of Tigard DateBy:' $1 D ' 6 Permit ?)./.. 2 0,0m' I a 13125 SW Hall Blvd., Tigard, OR 97223.-.• : ''s i:z:^ s E� Plan Rev' w 0 Phone: 503.639.4171 Fax: 503.5 160 Other Permit No.: Inspection Line: 503.639.4175 B U°.15 I !- LAVINOI Date Bead /B rur; la See Page 2 for 1 I G n K D Internet: www.tigard or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ID Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addit ion /alteration/replacement %Other: 10C' r ( - New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (I) bath 249.20 Itl- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 1:1 Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: C ? 2_ 2 0 Ski f 9f)1 /gi$ Sr Catch basin or area drain 16.60 City /State /ZIP: 11 072 q 7 2_ Z- 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: - ©ykA.:(01,„ y\ p i i_ �( L Manholes 16.60 .. Wt q1 fh Le Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 r Subdivision: I Lot no.: Water service (no. linear ft.: Page 2 LTD � jl D z /J ( Fixture or it Tax map/parcel no.: bfl Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 `f�fl, L') - (.IS'f1, k/ p C i t erb Backwater valve 16.60 Clothes washer ' 16.60 . 1` q a /) ro Dishwasher 16.60 ,�, �C^, &A ry ° C , "i'� Drinking fountain 16.60 ❑ PROPERTY OWNER ❑ TENANT Ejectors /sump 16.60 Name: .fm-e_ 4'. MIciu4it M, (i.er Expansion tank 16.60 Address: 2.2.0 5 OY1fS Prrov 5t Fixture/sewer cap 16.60 City /State /ZIP;, J l 61A,4) , J of- ciaSleg � ZZ� Floor drain /floor sink/hub 16.60 1 J� • Phone: (5y) 37 a- 5`/ / Fax: ( ) Garbage disposal 16.60 vvv ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 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 Sink/basin/lavatory 16.60 Phone: ( ) Fax: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR - closet 16.60 Business name: TAI 1JS pL t , Water heater 16.60 Address: Other: City /State/Z1 P: r Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lie.: Plumbing Lic. no.: Plan review (25% of permit fee) � /f� 9 �� State surcharge (8% of permit fee) Authorized signature: L ►� 7 1'd) )1 '�wt0� TOTAL PERMIT FEE 'Z� i riot name: ; �hel L !n I I �� Date: / (� D) T his 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. 1:\Building\Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(t0 /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 - I" 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' A 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 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 - 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: INI L� � .Pcw � S4,J iABuilding \Permits\PLM- PermitApp.doc 12/27/06 a CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00339 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/31/2007 PARCEL: 2S 102DC - 00300 SITE ADDRESS: 09220 SW O'MARA ST ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT: 016 JURISDICTION: TIG PROJECT: MILLER Project Description: Relocate meter to correct parcel. • 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: ft WATER CLOSETS: WATER LINE: 2 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES SHANE /MICH MILLER 9220 SW O'MARA Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 7/31/2007 $72.50 [TAX] 8% State Surcha 7/31/2007 $5.80 Phone : 503- 372 -5413 Total $78.30 Contractor: RAYBORN'S PLUMBING INC • 19990 SW CIPOLE RD. TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS 0 Contact # : PRI 503- 692 -4139 FAX 503- 691 -2328 0 Reg w Re #: LIC 87852 EXPIRED �' � PLM 34 -166PB - : .?/4/ 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: ( . . .t, � ( / ✓ /It) 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 PLM2007 -00339 REQUIRED ON GREEN INSPECTION CARD. ✓ Code I Inspection Description I PASS Date I By ✓ Code 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 810 MFG - Structure set -up MEC - Mechanical Permit 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 I Fire damper 299 Final inspection 635 Smoke detector shutdown 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final I 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 X 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 X 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines _ SWR - Sewer Permit f 495 Misc. inspection: 505 Sanitary sewer _ � 498 Grading final _ 595 Misc. inspection: I _ 499 Final inspection 599 Final inspection i:\ Building \Dorms \InspCard AOP•Blankdoc 02/02/07