Permit n CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00139
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 05/06/2013
Parcel: 2S114AB10900
Jurisdiction: Tigard
Site address: 16142 SW 93RD AVE
Project: LaFontaine Subdivision: KNEELAND ESTATES NO.2 Lot: 138
Project Description: 60 ft water service
Contractor: POWER PLUMBING CO Owner: LAFONTAINE, TROY MICHAEL
PO BOX 19418 16142 SW 93RD AVE
PORTLAND, OR 97280 TIGARD, OR 97224
PHONE 503- 244 -1900 PHONE.
FAX. 503 - 244 -8825
FEES
Quantity Description Date Amount
60 If Water Service 05/06/2013 $62 54
Specifics: 1 12% State Surcharge - 05/06/2013 $8 70
Plumbing'
Type of Use SF 1 0 ea Minimum Fee Adjustment - 05/06/2013 $9 96
Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232 1987 or 1.800.332 2344
Issued By: VL IA JV � Permittee Signature: D ' I A n n C 4 (A_
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
MAY /06/2013/MON 08:00 AM POWER PLUMBING FAX No,503 244 8825 P. 001
Plumbing Permit Application
Building Fixtures RECEIVED FoR OFEICr 119E ONLI
IN e l 3 25 w I T Ial 1g l a a l v d .,T;gara,oR 97224 . �p( 0 6 2013 e r 6..-/to l Si Paa1;tNo: ()Lill ao/3 - X39
Plan Review
Phone: 503.7182439 Fax: 503.598.19t0 Other Permit No -:
Inspection Line: 503.639.4175 Do a -_
T I G A R D Internet: www.tigard•or.gov CITY OF TIG ARD Date Ready/By: )aria See Page I I of � -
• ► N 11 l0 SppphmentalInformation
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I' -... _, +_ ?� :.eSY, ... . .. �+ t rtes %. u� � r f ' F�I "IG ndr` • .1 . 1 . . r �_
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121 New construction I=1 Demolition Foraprrialitljormmton use checklist
Description ( Qty, F Ea. I Total
Ip I. ddition/alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
1 •, ^ r ',1 r `,Uarl�'p�,,h�al I� iiii'liIiffi e rn'T;i�1's 43 t ,. a s SFR (1) bath 312.70
1 ^ ,_ • ;• '-. - ... = ,_ x.. yam• - _.r'.a!_ 'r;..
- and 2- family dwelling 0 Commercial/industriM
SFR (2) bath 437.78
El Accessory building SFR (3) bath 500.32
[] Multi - family
Each additional bath/kitehen 25.02
❑ Master builder �� ❑ Other: Fire sprinkler (_ sq. ft.) Page 2
•
( C) 1 , 111 1[ U �� ° [ \11 - V i U , i' lT J:, j 1
I .1 t al , J, t Y.,- ) ft .. av ', d ,?. Sift utilities:
i s wet x �;.s:�v -.�.
T 2- SU) g 3-r7 &OI Catch basin or area drain 18.76
Job site address: 1
City/State/ZIP: 1 t .� 4 Y I "ID-. Footing drain line, or trench drain Page 2
- r"" " • Focting drain (no. linear ft.: __i p� 2
Suite/bldgJapt. no.: Project name: I P Manufactured home utilities 50,03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft: Page 2
Storm sewer (no. linear ft.: _) Page 2
•
Water service (no. linear ft: IM Page 2 _
Subdivision: Lot no.: , Fixture or item:
Tax rxtap /parcel no.: Bacicflow preventer 31.27
77 S :.:f4 �r Backwater valve
r - I I r. , i li)G ?1Ua J •U1i [.(U).Tr;hq/,U � 'l i ; r 'S 12.51
" - r • "� - ""` J `�`�" Clothes washer • 25.02
�-:E / n -+ / rl � Dishwasher - 25.02
wa I 1.C..4 Drinking fountain 25.02
Ejectors /sump 25.02
f r ` ,t -1 :,-,� �•• n �u E� ,r ..3," r` � -r; +�µrtig j Ii ; v- l'„s'a It h 2` Ml Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
-
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25,02
City/State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
r a ST, aCIF` 1 ii';' - .'1 . � �( IT . ' , I.nterce tor/ ese
I ' 7 ' LL ! it i, l; tl . I r
{G-F--- -, 4 I (o l '` � D l trap 25.02
�`�_n 1J.1 4 r..?"... kmL ' .,./NOC r2yr ,- ,,,,,n ', -- +l
Business name: ' P J . 1 y J J �1 j= Medical gas (value: $ ) Page 2
Contact name:
.1 Ail V) 11 -C . Roof 12.51
`i Roof drain (commercial) 12.51
Address: / /q'4j k Sink/basin/lavatory 25.02
City/State/ZIP: p 0--y- j 7 d) Solar units (potable water) 6154 .
Phone: ( ) y4 - / Ibb I Fax: : ( ) qq -- N2fD Tub /shower /shower -pan
Urinal - 12.51
E-mail:
25.02
cr ,°r a1 �,: n a k ,� u t _ y ��t Water closet 25.02
�, -: y - ,� � Y .3175 {t•�_nilipl cfr Ul; �f �• r� t o
r _: 5 1_- :•4 "rtz 1..1 - tin t ._ 'r,r 4. r+ �' 5, Vii? Water heater
le i .. 56.29
Business name l ... /L/1 a i piping/DWV
56.29
Address: R l i 4 .J W Other: 25.02 City/State/ZIP: / I] pa 4.71 su (
btotal �
Minimum permit fee: $7250
Phone: ( ) i g D U EMMIIIM 1747M9 plan review (25% of permit fee)
CCB Lie.: 5.2-3.7¥ Plumbing Lie. no.: 34 -I 5 ' ,
State surcharge (12% ofpermit f V 1 e>
Authorized signature; TOTAL PERMIT PEE - 7 1 29
Date: This permit application expires ire permit is not obtained within 180 days
6
Print name: ���`��� / j/� 13 after it has Inzn accepted as complete.
"Fee methodology set by Tti -County Building Industry Service Board.
I r:\ 8ui 1dRAPortltslPLMt1-PamlliApp.daa 10/01/09 4C0�616T(I Wa?l(:'OM/We5) �- a
MAY /06/2013/MON 08:00 AM POWER PLUMBING FAX No, 503 244 8825 P. 002
Plumb Pe rmit A Aplication - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su a r ression S stems:
, iII I' :l jiiiz 0 itllfsli I i ', _ aft1 '61 Er ,1tl U� "Il0, .01[YI 1tik-)plli A " 1 i17.^ y �i� a�` I '1 L r� I;t: r, ^�1 A
, r �: : 3 [?' _•_Y�13' _._. ��Ti ti, t JZ 4 } ` 4' = c.. f..asf:! r _._z 1
Footing drain -1" 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 11.11111 2, to 3,600 $149.69
Sewer 1st 100' 3,601 to 7,20 $233.20
7.201 and :. eater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' N' 62.54 rim
Medical Gas S stems:
Water Service - each additional 100' mei 37,52 r M rl i , F •t r r rr i .
�� YJ 1�i1iid�rVr; r r }Ji {',rlotVHy lii l �� I s `� li fiY .
Sturm & Rain Drain -1st 100' 62.54 * r $1.00 to $5.000.00 Minimum fee , b ._...> - y,
e $7 _50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $ I0.000.00 $72.50 for the first $5,000.00 and $1.52 for
.0 - 5 " ;; ■roi' 1a _lea r.0.4 )1j,I 1i) s f,5; J ;4, :3Yr f i end ach incl itiudin: $10 00.00or�rectionthereof to
- i and incln: $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof to
minimum ch. _e-12 hour and including $25,000.00.
Inspections outsi Y e of normal business - 90.00/hr - $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum cif. 'e -2 hours each additional $100.00 or fraction thereof to
Reinspection Fees 90.00/hr and includin, $50,000.00.
Additional plan review for revisions 90.00/hr - $50,001.00 and up $742,00 for the first $50,000.00 and $1.20 for
(minimum char:e -1/2 hour each additional $100.00 or fraction thereof.
Subtotal:
•
Commercial Fixture Work: ,
Are you capping, adding or replacing fixtures? If "yes ", ,
please indicate work performed by fixture. -Failure to
accurately re ort fixtures could result in increased sewer fees * .
'!`W, '�t w d
t � �7Y ky� �� � , y. '1 '1 r � ���,e u � l '�'r'a^'�{�r �- ,,. ` � ,� ..:.' t =.� 1 ^ �
m f a�k i - q ?.. 9 'N+. 4 '6'.;iti %n - r ,�..J, 7111E : X'Y G C 1 b�11t11�11A J' fi IL. I� 7 : 1 , r7
- I tl� =. l y w ' 9. : tfi rY ,
�ie6SA,1 d ,�cj`�'ir `ti � 1't ^' t, a �'J�. �y ` n .,� .......:: A. ��'� ^ .._ .� Y �' ! �=,.: � :. ., ?
r , t< x l ..•f „ y t 7, F b " p..*.'-' x k Plan review is required for any of the following.
!nr... -D , i . , + n•,7 W. _ A:- . 4 . ! it _ 0 ... k ^ Please check all that
Baptistry/Font
check a PPIy
Bath Tub /shower Any new commercial building with water service 2" and
-Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/WaterAspirator as defined in OAR918 -780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinlder system_
Drinking Fountain ❑ . My complex structure as .defined in QAR918- 780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
_
-4 h.,' 1�U -all li'nia �,y 1 yTC • h -1- � JET M-7 o- � , .lr y r
.. >Xt,_ 7.: 1�t+�.,S S �9(aI ,A,I[ TA F`(1i�r051 i _l5,l •"l�Jd t'� .
Car Wash Drain • Isometric or riser diagram '� -,..'71';',71
Garbage - Domestic -non -food gram is required for new buildings
' Disposal - Domestic - food related that meet the . ualiflcatious above.
- Commercial -food related
- Industrial- food'relkted .
Ice MachfRefiig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang _
-Stall • -
Sink/Lav -Non -food related
- Bradley -
- Commercial -food related _ _
- Service
swimming Pool Filter *Note: If the fixture work under this permit results in an
washer-ant= Water
increase of sewer EDT's, a sewer permit will be issued and
" Water Closet - Toilet - fees assessed for the sewer increase must be paid before the
Urinal • plumbing permit can be issued.
Other Fixtures:
. - - - .... _•_, ,..- . _, - - - -- - - -- - - p} -.- • - --- -_._ , , . , . , , . . . _ _ „ . . . „ , „ . . . - ,... . ... .•
http: //www.tlg ic ii,gov /city halUdepar< tnents /cd/docs/PLMi:- PermitAfgdoc - "
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16142 SW 93RD AVE, TIGARD, OR, 97224
Residential - Plumbing
330 Water service
05/13/2013 00:00
PLM2013-00139
PASS
.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16142 SW 93RD AVE, TIGARD, OR, 97224
Residential - Plumbing
330 Water service
05/08/2013 00:00
PLM2013-00139
FAIL
1. Remove pressure reducing valve from meter location, and install above grade as per
code section 608.2 OPSC 2011
2. Recall inspection when completed.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16142 SW 93RD AVE, TIGARD, OR, 97224
Residential - Plumbing
330 Water service
05/13/2013 00:00
PLM2013-00139
FAIL
1. Please provide access for inspection.
2. No inspection made OPSC 103.5.1
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16142 SW 93RD AVE, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
05/13/2013 11:43
PLM2013-00139
PASS - No C of O
Violation Summary:
Inspector Contractor