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Permit CITY OF TIGARD j PLUMBING PERMIT a COMMUNITY DEVELOPMENT t Permit#: PLM2014-00335 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ®� / Date Issued: 10/09/2014 Parcel: 2S 103AA01900 `+�� Jurisdiction: Tigard Site address: 10495 SW WALNUT ST Project: Haddock Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: PTS 1 & Project Description: Connect existing house to sewer service. Reimbursement District#14 expired 7/13/14. 10/5/14,reprinted to note: Septic tank must be pumped and filled or removed. Contractor: KERR CONTRACTORS OREGON INC Owner: HADDOCK,GLEN RICHARDS AND PO BOX 1060 KATHRYN RUTH TRUSTEES WOODBURN, OR 97071 10495 SW WALNUT ST TIGARD, OR 97223 PHONE: 971-216-0050 PHONE: FAX: FEES Quantity Description Date Amount 100 If Sewer Service 10/09/2014 $62.54 Specifics: 1 12%State Surcharge- 10/09/2014 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 10/09/2014 $9.96 Class of Work: ALT Plumbing 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 suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utilit ification 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 erect questions to OUNC calling 503.232.1987 or 1.800.332.2344. � Issued By: / / Permittee ''9nature: Call 503.639.4175 by 7:00 a.m.for the next available inspe •.n 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. y 4 CITY OF TIGARD PLUMBING PERMIT `"� t: COMMUNITY DEVELOPMENT Permit#: PLM2014-00335 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2014 Parcel: 2S 103AA01900 Jurisdiction: Tigard Site address: 10495 SW WALNUT ST Project: Haddock Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: PTS 1 & Project Description: Connect existing house to sewer service. Reimbursement District#14 expired 7/13/14. Contractor: KERR CONTRACTORS OREGON INC Owner: HADDOCK, GLEN RICHARDS AND PO BOX 1060 KATHRYN RUTH TRUSTEES WOODBURN, OR 97071 10495 SW WALNUT ST TIGARD, OR 97223 PHONE: 971-216-0050 PHONE: FAX: FEES Quantity Description Date Amount 100 If Sewer Service 10/09/2014 $62.54 Specifics: 1 12%State Surcharge- 10/09/2014 $8.70 Plumbing Type of Use SF 10 ea Minimum Fee Adjustment- 10/09/2014 $9.96 Plumbing Class of Work: ALT 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 adopt-, by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain • •opy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B Permittee Signature: , // eriP0,4 ■ 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. Plumbing Permit Application Building Fixtures IOIZ Ol l II I. I .I O\I RE(1EIVEE Received / City of Tigard Date/By: �� 14, Permit No.: ( )/ --60335-- • 13125 SW Hall Blvd.,Tigard,OR 97223 nc- 9 ZOj4 � 11111 . 96H Plan Review Other Permit No.: ,!�v� �f Phone: 503.718.2439 Fax: 503.598.1 Date/By: ,,T wj„d l I G;�I.I Inspection Line: 503.639.4175 CITY^C r��.s nD Date Ready/By: Jude• 63 See Page 2 for Internet: www.tigard-or.gov (Jf1�1 Notified/Method: Supplemental Information TYPE OF WOIRDm SVP' FEE* SCHEDULE El Demolition For special information use checklist IX-New constructionso.„ t�C oisiN Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 l-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ' ccessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder - ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: mite address: / 'J t.,- Catch basin or area drain 18.76 ` !C 7�5 'S W Aj'�� S r Drywell,leach line,or trench drain 18.76 City/State/ZIP: .-77,6 4e0 ooze,0jI f 97113 Footing drain(no.linear ft.: Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: HA-61)0C-141 18.76 S__1�/i�i`� i Rain drain connector 18.76 W Sanitary sewer(no.linear ft.:40) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: NtTax map/parcel no.: Backflow preventer 31.27 ...N. DESCRIPTION OF WORK Backwater valve 12.51 \\ n- �^ Clothes washer 25.02 I\� OF°(,G':'717,/Lc /L'i) st`iQ l7[.- ./n,V L C•L,✓i7/;�C.%r f Dishwasher 25.02 0)174 , Vtt/t.it. Drinking fountain 25.02 P _I Ejectors/sump 25.02 5 PROPERTY OWNER l ❑ TENANT Expansion tank 12.51 .. Name: 61�4O40nCX- Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 ( 4.Address: /O5j yc- Sw L,/i%,V t'i sr V� Garbage disposal 25.02 City/State/ZIP: 'To fi.o cc(_ y 71 23 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 w APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 4i Business name: Medical gas(value:$ ) Page 2 , � 0C'•rin l_-�C/t-� Primer 12.51 Contact name: ILA H fin-- Roof drain(commercial) 12.51 - `� Address: w yh�?X t 0 too Sink/basin/lavatory 25.02 City/State/ZIP: ("J cloy.-)10,,`iYLN 0,1., 9 7c7 I Solar units(potable water) 62.54 APhone: ii - C't 05-0 Fax: :(97/ ) Z/to._ 00 I 5 Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 '- Business name: i S/M 6 Q'VC: Water P�P� �1 in W V 56,29 ddress: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) I ) Minimum permit fee: $72.50 7,2.CC) CCB Lic.: /q�-6 a �'� PI A r ing Lic.no.: A.`7--e-bgpb Plan review (25%of permit fee) State surcharge(12%of permit fee) 70 Authorized signature: /�� TOTAL PERMIT FEE �/ •P{J Print name: Date: 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:�BuildingWermits�PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/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-la 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 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 Valuation: Permit Fee: Storm&Rain Drain-1st 100' 62.54 $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*. Plan Review for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font El Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuni/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR9I8-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram 4 ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor P WaterCloset-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 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 10495 SW WALNUT ST, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal FAIL PLM2014-00335 George Heimos 1. permit required, add to existing permit, septic tank de-commission #350. 103.4.1 2. Provide pump receipt, remove top of septic tank and backﬁll with approved material. 722.2/722.3 3. Recall inspection when corrections have been completed. Re-inspection required. 103.5.6.1 NOTE: ok to remove test and backﬁll 4" sanitary sewer pipe. Kasey Carter. kcarter@kerrcontractors.com Violation Summary: Inspector Contractor