Permit 11n CITY OF TIGARD PLUMBING PERMIT
111 I�- COMMUNITY DEVELOPMENT Permit#: PLM2015 00137
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/05/2015
I
Parcel: 25111 CA00600
Jurisdiction: Tigard
Site address: 9884 SW SATTLER ST
Project: Sather,Lot 1 Subdivision: ALDERBROOK FARM Lot: 10
Project Description: Installation of 80'of private sewer lateral and 220'of private water line.
Contractor: RYCHART EXCAVATION INC Owner: SAGE BUILT HOMES LLC
2790 SE 73RD AVE 1815 NW 169TH PL,SUITE 1040
HILLSBORO, OR 97123 BEAVERTON, OR 97006
PHONE: 503-848-8819 PHONE: 503-502-6623
FAX:
FEES
Quantity Description Date Amount
80 If Sanitary Sewer 05/05/2015 $62.54
Specifics: 220 If Water Service 05/05/2015 $137.58
1 12%State Surcharge- 05/05/2015 $24.01
Type of Use: SF Plumbing
Class of Work: NEW
Type of Const:
Occupancy Grp:
Stories:
Total $224.13
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 direc •- •-• to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issu d By: Permittee Signature:
• r • -.../iii "t "I
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 • •fect.
Approved plans are required on the job site at the time of each inspecti•
Plumbing Permit Application
Site Utilities RECEIVED FOR OFFICE USE ON I l
Received
City of Tigard Y 5 2015 Date/By: -/ S / PermitNo.: PL��/5��137
13125 SW Hall Blvd.,Tigard,OR 9.14W Review
' = Phone: 503.718.2439 Fax: 50/14.4.20960 Other Permit No.: /nC...r�/ �10aS'
f Ti�ARD DateBy:
Inspection Line: 503.639.4175
TIGARD Date Read B Y Juris: H See Page e 2 for
Internet: www.tigard-or.gov ?i III l; (` ,; r " V)
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
)a-New construction ❑Demolition �For ecial information use checklist
_---
Description r Qty. I Ea. Total
❑ Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
3 CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial industrial SFR(2)bath 437.78
SFR(3)bath 500.32
"--1 ❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
a JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: g g�Y � SA toe 5 Catch basin or area drain 18.76
City/State/ZIP: TI(7A� 0 4/7 ZZ3 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: 5,,ohIp- 'CO e_f- Manufactured home utilities 50.03
Cross street'directions to job site: Ste) c' 9 i'" A t� Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: Page 2 &‘9.,,5Y
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:JZQ) Page 2 / 7,�$
Subdivision: Lot no.: Fixture or item:
Tax map parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
I , , _ / Clothes washer 25.02
Pr1V� - (fie - /Gt+e,rA I -t-hs4.ai( f Dishwasher 25.02
'er y\/cA k Gt../CA-d-te- I l rl L. .. .../e7 461,(. Drinking fountain 25.02
4 Ejectors/sump 25.02
PROPERTY OWNER
� /� I ❑ TENANT Expansion tank 12.51
Name: e 3u 1 t�5 i' 1 c2tY1 e,s i �L C-
Fixture/sewer cap 25.02
Floor drain/floor sink,hub 25.02
Address: 4.C-iv( ) /6'7 /�bte-,_��`e.* /oq 0 Garbage disposal 25.02
1 City/State/ZIP: 3617[v 'CJ I 1L 1/` F7006. Hose bib 25.02
Phone:($O 3) 5-3 3 - 3-/‘--7 Fax:( 1 Ice maker 12.51
) ZAPPLICANT ❑ CONTACT PERSON Interceptor trap 25.02
43 Business name: 5i4�� (3ti Yh.e� GC (✓ Medical gas(value:$ ) Page 2
• (,� >' Primer 12.51
Contact name: ()O N�y
j Roof drain(commercial) 12.51
Address: SAfvte_ ,Q s /J40V-e- Sink/basin/lavatory 25.02
4 City/State/ZIP: Solar units(potable water) 62.54
Phone:(93 ) 7lp y�,:>Z Icy 1, Fax: :( ) Tub/shower/shower pan 12.51
E-mail:�,a£)Sa jeb tot`lTko(A,�e.IiCC t Cc.`Vt Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: gYG A /-1- ZI=>CCa(.C-t-it -t.) Water P�i m�WV 56.29
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Address: a 7 7a) 7, 0 Ave- Other: 25.02
City/State/ZIP: Hitt‘b.y r() / Q g 9'7/.4 77 Subtotal .2 c.<A
Phone:(j0;) J(/$ g)/ 7 Fax:( ) Minimum permit fee: $72.50
^ Plan review (25%of permit fee)
17 1 CCB Lie.: /0 q 30 6 Plumbing Lic.no.:3 yL eIR
State surcharge(12%of permit fee) c5c4,a/
Authorized signature: 2Z/ TOTAL PERMIT FEE eA9.1.1.13
7l ? This permit application expires if a permit is not obtained within 180 days
Print name: C L 6, `�
Date: 3/
G J7 / after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.Building Permits,PLMti-PermitApp.doc 10,01,09 440-4616Ttl0/02,COM/WEB)
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
9884 SW SATTLER ST, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
FAIL
PLM2015-00137
George Heimos
1. Water service, leave trench open to check 24" depth below meter from grade. Ok to
cover rest. 103.5.1.3/103.5.1.4
2. Recall when ready. All else ok
Violation Summary:
Inspector Contractor