Permit CITY OF TIGARD PLUMBING PERMIT
'`1 s COMMUNITY DEVELOPMENT Permit#: PLM2014-00225
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2014
Parcel: 1 S125DC06100
Jurisdiction: Tigard
Site address: 9645 SW SHADY PL
Project: Ash Creek Gates,Lot 3 Subdivision: ASH CREEK GATES Lot: 3
Project Description: Installation of residential backflow preventer for irrigation.
Contractor: GREENWAY SCAPES LLC Owner: RIDGECREST CONSTRUCTION CO INC
5430 36TH AVE SE 13565 SW TUALATIN-SHERWOOD RD
SALEM, OR 97317 SHERWOOD,OR 97140
PHONE: 503-391-8029 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 07/14/2014 $31.27
Specifics: 1 12%State Surcharge- 07/14/2014 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 07/14/2014 $41.23
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 s ions o NC by calling 503.232.1987 or 1.800.332.2344.
155 d By: Permittee Signa re:
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.
RECEIVED
Plumbing Permit Application
Building Fixtures JUL 14 2014 l t 11; t It I It 1 t .1 ()N I , n, /� Nt
Received Lt tae) _W
City of Tigard Date/B 7 A Permit No: 2IZS
1111111
13125 SW Hall Blvd.,Tigard,OI I FTIGARD Plan Review ��r'^i3�O q?9
• Phone: 503.718.2439 Fax: t Date/By: Other Permit No.. I`v .l.J!
\' l Inspection Line: 503.639.4175 ,'D' G DIVISION Date Ready/By: tuns: ® s«Page 2 for
Internet: www.tigard-or_gov Notified/Method: 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 7. Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1- 2-family dwelling SFR(2)bath 437.78
y ng ❑CommerciaUmdustrial
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02
❑Master builder 'Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
/1 6Ll 5 6W G ka_I p I Catch basin or area drain 18.76
Job site address: `7 �.J (,1 1" _
Drywell,leach line,or trench drain 18.76
City/State/ZIP: �t a )) 01;2_ Z 3 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: 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.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
-1..v..54-0‘11 Nt./J bo►c,k cI otel d e J,Ce_ cc,r Dishwasher 25.02
SItC x •K 1rr Sys-tees-la Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
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
. APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Greg h w'„f .a ) L�4 Medical gas(value:S ) Page 2
Contact name: "`y D Primer 12.51
M te-1 pp-z_ Roof drain(commercial) 12.51
Address: -j L.1.-50 G-14, 7LJ e Sin k/basin/lavatory 25.02
City/State/ZIP: Ga - � , I I 3 ' Solar units(potable water) 62.54
Phone:(50 )- 3cr I _(at2Z40i Fax::(S(j3)---516- 9 Q y Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
r r Water heater 37.52
Business name: (a.r4:ev.Way Sc A • -5, L Lc_ Water piping/DWV 56.29
Address: .L • Other: 25.02
City/State/ZIP: Sa c>» 0 Q-- 4 3('3- Subtotal
Phone:(5j )----6C(I - -I 40 Fax:(503)- I b- '09 Minimum permit fee: $72.502•SO
CCB Lic.: PI .' o. Plan review (25%of permit fee)
• �� _ State surcharge(12 of permit fee) 4e.---4.0
Autho ..�slgnat� /1ST / , - TOTAL PERMIT FEE +al,-2_,.}
czi=ra, I ' L3[.r1/' Er..O I This permit application expires if a permit is not obtained within 180 days
,i after it baa been accepted as complete.
C� *Fee methodology set by Tn-County Building Industry Service Board.
I:I BuildingWermits WLMII-ParmitApp.doc 10/01/09 440-4616T(1W07JCOM/WFB)
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"' 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2.001 to 3.600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and including$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 charge-1/2 hour) and including$25,000.00.
Inspections outside 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 charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 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 first$50,000.00 and$1.20 for
(minimum charge-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 report fixtures could result in increased sewer fees*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following.
Work Performed: Capped Added Relocate �1 Y g•
Baptistry/Font Please check all that apply.
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 Thm ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isometric or Riser Diagram
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.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-Clothes
Water Extractor increase of sewer EDUs,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:
http://www.tigard-or.gov/city_hal l/depart ments/cd/docs/PLMF-PermitApedoc
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9645 SW SHADY PL, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
FAIL
PLM2014-00225
George Heimos
1. back flow device, provide minimum 12” clear space below device to ground 603.3.4
2. back flow device, provide a minimum depth of 24” backflow device from grade. 609.1
3. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
NOTE: received backflow device test results. 1" Wilkins, model 350, serial no. A374444
greenwayscapesllc@comcast.net
Violation Summary:
Inspector Contractor