Permit CITY OF TIGARD PLUMBING PERMIT
01'- • COMMUNITY DEVELOPMENT Permit #: PLM2013 -00260
Date Issued: 07/30/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S101AC01100
Jurisdiction: Tigard
Site address: 7035 SW HAMPTON ST
Project: TED DURANT & ASSOCIATES Subdivision: BEVELAND NO.2 Lot: 17
Project Description: Replace 60 feet of water service.
Contractor: JACK HOWK PLUMBING /RESCUE ROOTER Owner: AFT - OREGON BUILDING TRUST INC
PO BOX 2830 7035 SW HAMPTON ST
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE:
PHONE: 503 - 850 -3100
FAX: 503 -491 -2932
FEES
Quantity Description Date Amount
60 If Water Service 07/30/2013 $62.54
Specifics: 1 12% State Surcharge - 07/30/2013 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment - 07/30/2013 $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: ' � / Permittee Signature: D/V/ 'e977v/
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.
JUL- 30 2013(TUE) 09: office staff (FAX)503 491 2932 P. 001 /003
RECE
Plumbing Permit Application
Building Fixtures JUL 3 0 2013
,•, FOR Off 1GE U ONLY ''....
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2 CITY OFTIGAR1_ 9 7 rmit N /I
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Phone: 503.639.4171 Vas: 5l13,598.1 CITY
DIVIS S frn gi "7ie
nklB purr Permit No.:
TICARD
Inspection I utc . 503 6 9.4175 Date R, d In
I nrcutct. www ugard- or.gov y y • Sec Page 2 I'm
r 1 Notified/meal's': L Supplemental lufunnution
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❑ New construction ❑ Demolition For special information use checklist.
Description . 1 Qty. ] Ea. - Total
[Addrilun/alleration /repiacemenl ❑ Other New 1- 2- family dwellings (includes 100 fl.•for. utility connection) •
•
I . 11T I r " 40 ��a'., � °t�, illiga n �1 11 rr,4F fl " G,7, ' + t tir"�� S F R ( 1 ) bath 312.70
❑ 1- and 2- family dwelling %: ommercial /industriul SFR (2) bath 437.78
-
El Accessory building SFR (3). bath 500.32
rY b ❑ Multi- family
❑ Master builder '-" Each additional bath/kitchen _a 25.02
❑ Other -
tt t ,, . r 1,, r *, , 1 + Fits sprinkler ( . ft.) Pa
Est v^+a x t . � 1 1 1 «• ��,m r, x c s� •) e 2
Page
Muir V , 7 J' 17 �, t; a ,�,(r `,���I ' a �s1,,��'' 'il 11+ + `- pp��
A
itkit a�i l�f , i Itt 1N t r i ., - , w'S_ t ''t tit Rra ,. , 27 ' Site utilities.
Job site address: # 71 • i f fE • iJ��. Sr Catch basin or area drain 186
City/State/ZIP: l--�� Drywell, leach line, or trench drain 18.76
44.1L-M i ' Footing drain (no. linear ft.: _) Pug: 2
M D -
Suirc/bldg. /apt. no.: Project name:
f/ A Manufactured home utilities 50.03
Cross street /directions to job site: 1 �� -
Manholm 18.76
Rain drui
4 n connector_ 18.76
Sanitary sewer (no. linear ft; ___,) Page 2
Storm sewer (no. linear ft: ) Page 2
•-" Water service (no. linear ft.: ) , fir - ' Page 2
""
Subdivision: 'Lot no.: Fixture or lure:
Tax map /parcel no.; Backilow preventer 31.27
,t hbr `,G�:?IC � `' I } i r � 7 iit pi p ' ',5 4 art .�f ' , r y m > g r b lur v , M I _
v ,J , 1r ` t , E "r ' f' 1 e �r� n11 I pt 1 � .+. « 4, � p�6 7�7 r • ?-L � I ' Ir .� hf Dnckwarervalve 12.51
r:!'r7.1.�.,W1 6 zz.;, -.,1 l , .4. . :;L`'r� w :'4J �i e'lo�" t rr � � 1 4V, �'�
� �+ " " "., a k ',a,h 1 " . Clothes washe
/. ✓ ffi % 4 i r . - �• 25 -02
Dishwasher. 25.02
* IPM � ' - ...'IL tJ Drinking fountain 25.02
• Ejectors/surnp 25
-Nr+ a IF.!A , -jolt 1 7 •'4 �>L { i ) ,:
, +� r rtl ,fr i(`"t Ir, r} i m « ir, h{ in , (1 ,4 � ∎ 1� i t« r 4� °t ansi0m tank
d'.. /-46, mn„ t,_41;f, '' ,x.441r,m w... ;2144.4f41, I Y u. r a.. ..!ta., J.,., , j11f?_ ° � 1 ..i � l:F: P 12.51 Name: �2�� / � , rw Fixture/sewercap 25.02 •
� � " Floor drain/floor 25.(72
Add rt¢s: u fir
Ciry /State/LTP; i � Garbage disposal 25.02
�� ', �� Hose bib 25.02 • Phone: ( ,7�, mg"- f ax ( ) Ice maker 12.5I
�r iYf, � t •�11" j (� �i11 1i } h ry n ti er n t � �"i),MONT. t � t. mie∎ • ,rtryM qt 1 Sll �t fir ,}r' y
.ii:xiwul.d, . ..n:..t, sue o.x. .,14M41 :i.1ie.t.).. `,.1::. M1. ..1..a t . :t; wgi. , i � ; lntcrccptor /�easetrap 25.02
Business name: ARS dba JACK HOWIURF.SCUE ROOTER Medical gm (value: $ ) Page 2
Contact name: JOYCE DENNIS Primer 12.51
• •
Roof drain (commercial) 12.51
Address: P.O. BOX 2830
Sink/basin/lavatory 25.02
City/State/Z11): CLACKAMAS, OR 97015 Solar units (potable water) 62.54
Phone: (503) 850-3100 Fax:: (503) 491 -2932 Tub /shower /shower pan 12,51
E -mail: JDENN1SQo ARS,COM Urinal • 25.02
° w ater i } pV; F, nl r7 t' r , S 5 ' r 25,02
"I' r 5`µ Ih' �;( �3''' � t ° ��^ t � 7 ' yrK �itir j a�,PEW,av °,. vrl"�iid 1i'r;lkrz' Water closet
,F,....c"!1 .ul lili': i..C'-.ta..Gr.l'..,�.•a..{, � iil.1�d..,l ." ir r ��a.rJ.1�C^1,..�'i` f L.:t.i;'d ,I.t' `'�'.L'k�lr,,,:.':)
13usiness name: ARS dba JACK HW
OK/RESCUE ROOTER 37.52
Water piping/DWV 56.29
Address: P.O. BOX 2830 Other, 25.02
City/State/ZIP: CLACKAMAS, OR 97015 Subtotal i� .6 4 ,
Phone: (503) 850 -3100 Fax (503) 491 -2932 Minimum permit fee: $72,50 „Sr, !, SI
CCD Lie.: 127325 PJatmbing Lie_ no.: 34 -168PB —
Plan review (25% of permit fee)
Authorized signature: / State surcharge (12% of permit fcc) ", •11) 1/
TOTAL PERMIT F tje
!, ,,.. : JOYCE DENNIS This permit Application ewpinp If a'plrmrt is not'obtalae wieh',/
>�Vr . .x• ::,, ;.,. y D attec : ilfhmbre e I3 ,.aPeAPttrJsom I,eIe,i,.,, .
Print name a 1/ �� f a
A
(� /� '" '�FC'e itiulhoiiolegy set by l`ri• oiinty Building lid uatry Service hoard.
I: IiiuildirgtPemrlIl U- Pe rmitApp.d to U 11N7� - 44p 16T(1 /D2 oM/ a -a
JUL- 30- 2013(TUE) 09:05 office staff (FAX)503 491 2932' P. 002/003
Plurnbiug Permit Application •- City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su • ression S stems:
r 1 , f iFfRi f preri 1- ytj on, 41 w 1 �e�y cir t , e • 7 „ �['" ?', \. -a . a - "ieT +y(�r.��tt� �;q,"' 1 'lr� �:. �}, „, -, ,, �n �, n r,z w
m ..t :1.:a.1 E i ci, ,,,,tukr1: � I rt: i 1,, ,.. ∎: { � ! �.1 t�∎k it• t� it J 4,, , , . ":,.x41'1 t , y : ,, ,L ;,/ *t 0 n, ,
Footing drain - 1” 1 0U 50.03 r ww r' t� lr.; 4 m " ti� ill(' rlt ~ l "
0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 _ $169,69
Sewer - I sl 100' 62.54 7,601 and 7.200 '- $27.5
7,201 and pleat�r $327.54
Sewer - each additional IOU' IIIIII 37.52
•
Water Service, -,1st 100:... . , .•62.54. .. i
Watcr Service - each additional 100' ' Cf�l�ar Gay •S • stems: 1
Storm &Rain Drain - 1st 100' G2 54 EMI
$1:00
6 to$O 1 1 0 : 1 .Ts ..., ` "'�„ io`7` 4044 ,r,';. ;1 Lt `, ? 4 t.ih, •, Ts .� r i :11 :..,nr
5000,00 Mtntmum fee $72.50
Storm & Rain Drain each additional 100' $5,001.00 to $10,000.00 S72.50 for the first $5,000.00 and $1.52 for
a , r}�y 1 , fe�,•"r•"!,.'n,yj �A 1.r , Yi r r! r , d
Rtl r r . tr 8$f ` M�l l y'�� r+ cl� i kt;in1 19' P °' 7i, r w i �C ,? I; ,1 ' x ` each additional $100.00 or fraction thereof, to
�• O w. „.., r, .n_ z, w, ;,,, F AV AR" .. ' W r 4 , 4 . i. u_,� and including $10,000.00.
inspection of existing plumbing or for $10,001.00 to $25,000.00 - $148.50 for the fist $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 char_ e- 1/2 hour and including, $25,000,00.
Inspections outside of normal business 90.00/1ir $25,001.00 to $50,000.00 $379.50 fbr the first $25,000.00 and $1.45 for
hours minimum char e- 2liours each additional $100.00 or fraction thereof, to
Reinspection Foes 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the fast $50,000,00 and $1.20 for
minimum char a -1/2 hour) each additional $100.00 or fraction thereof.
Subtotal: �r .�A
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", `` .. 1` j l„ i rr;i i • ,• r I 'r^ I t , } tT a \' t
t', t . - t 111 : : " R J ;L J - � ,�Od � 7 � tl (�t/ d Al i. ' I t 7 .rsa l- t r � i i ∎ i ,7 4 ;
please indicate work performed by fixture. Failure to
Plan review is =Linked for any of the•following.
accurately report fixtures could result in increased k
c a
,� pyza � � a rM,• 1 #� ,,,, , ,i eASC(l server lees Plctlsc•check all that apply.
„
;+ ' ' Nr, , 1 •;, 1�1 4 tiit '' a iar4,tNi�ZLIirl`fi.L tk El An new commercial
ii r4 4 1 9 "'i �i " 1;, tF'Fa} I
i 0 rr rt EP,, n rm t f, rr t , y . , Y I building with water service 2" and
1lrt , "c1' � t . r ,�^rfe lht F r t� 0 y 1 ! "l � a�� ggreater, except systems signedandstampedbylicensed
a ih.;ll.;u y�:w »,r t�....o u. a� .:ix ll1!` ut t ] �. .11iT'w
Baptistry /Font engineer.
Bath - Tub /Shower El New exterior plumbing site utilities for any complex structure
ub/
yi/W irlpool as defined in OAR918 -780 -0040. '
'Car Wash -Each Stall - ❑ Medical gas and vacuum systems for health care facilities.
• -Drive Thin ❑ Any multipurpose fire sprinkler system.
Cuspidor /Water Aspirator ❑ Any complex structure as defined in OAR918- 780-0040.
Oiskwashcr - Commercial - •
-Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain •
_ Eye Wash - e1r` t h r ` t u ' n 1 S a � ra ea }:1
Floor Drain/sink 2" s> I}•MV 1 t..:i44..,:lib71!&:1i i? A ..;41.` _.,10 ' r,i:: ` .:•• ;1`;'
_ 3^ ❑ Isometric or riser diagram is required for new buildings
4 that meet the .ualifications above.
Car Wash Drain
•
Garbage - Domestic
Disposal - Commercial
- Industrial - Comments regarding fixture work:
Ice Mach.Rcfrig. Drains
- Oil Separato1Gas'Station) - •
Rec. Vehicle Pump Station
Shower -Gang r
-Stall
Sink - Bar/Lavatory —
- Bradley
-Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, p
Swimming Fool Filer , a sewer permit will be issued and
Washer - clothe fees assessed for the sewer increase must be paid before the
Water Extractor _ ' • plumbing permit can be issued.
Water Closet - Toilet
Urinal .
Other Fixtures: ... .
http://www,tigard-or.gov/eity hulI/departmcnts /cd /docs/PLMF- PennitAplQdoc