Permit o CITY OF TIGARD PLUMBING PERMIT
;`1 = COMMUNITY DEVELOPMENT Permit#: PLM2015-00138
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/05/2015
Parcel: 2S111 CA00500
Jurisdiction: Tigard
Site address: 9888 SW SATTLER ST
Project: Sattler,Lot 2 Subdivision: ALDERBROOK FARM Lot: 10
Project Description: Installation of 220'of private water line.
Contractor: RYCHART EXCAVATION INC Owner: PHOENIX REDEVELOPMENT INC
2790 SE 73RD AVE 516 SE MORRISON ST, STE 700
HILLSBORO, OR 97123 PORTLAND, OR 97214
PHONE: 503-848-8819 PHONE:
FAX:
FEES
Quantity Description Date Amount
220 If Water Service 05/05/2015 $137.58
Specifics: 1 12%State Surcharge- 05/05/2015 $16.51
Plumbing
Type of Use: SF
Class of Work: NEW
Type of Const:
Occupancy Grp:
Stories:
Total $154.09
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 Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o erect questions to O1)NC b i 503.232.1987 or 1.800.332.2344.
Issued By: t Permittee Signature: l '
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 th• . oject.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLY
City of Tigard RECEIVED Received .../
`, g DateBy: 9e/`• �y_4% Permit No.: /Gr j6/S-C)U/ 3 R
14 = • 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.5BSQ1960 DateBy: Other Permit No.: H Gjt (906.waiiy
Inspection Line: 503.639.4175 M 1 5 2015 T I G A R D Date Read /B lurk 63 See Page e 2 for
Internet: www.tigard-or.gov Notified/Method:
Supplemental Information
Ci F TIGARb FEE* SCHEDULE
TYPE �(,jEgNew construction ❑Demolition For special information use checklist
Description I Qty. 1 Ea. J Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(l)bath 312.70
ja-1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
����) 3A ` �` Catch basin or area drain 18.76
Job site address: d \ J
t� °f Drywell,leach line,or trench drain 18.76
City/State/ZIP: �'}�� ` Q 1 7 ZZ 3 Footing drain(no.linear ft.:_) Page 2
CI Suite/bldg./apt.no.: Project name:5p 1,4/ S{- S ew-er L) 1. Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
9 i-1 A y Rain drain connector 18.76
/ v 1� Sanitary sewer(no.linear ft.: ) Page 2
1 Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.:ZZ q Page 2 / .g g
Subdivision: I Lot no: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
`- DESCRIPTION OF WORK Backwater valve 12.51
a Clothes washer 25.02
Pt' GoA I1 9e- . 'a 1 l Dishwasher 25.02
Drinking fountain 25.02
:4 Ejectors/sump 25.02
eji PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: SA 7 8(..)f rt-- / es G e C Fixture/sewer cap 25.02
/ Floor drain/floor sink/hub 25.02
‘4? Address: /sots- Ay() /G y-i-tt f(4,ce so,If loco Garbage disposal 25.02
v) +3 City/State/ZIP: r%e4-.. g.,� l 0 q 702/0 C, Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
.APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: 5,46 C Go j i.1-- lfprn-es ec Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: C_Ot t't41�N
`(/
Address: CjAMc AS v Roof drain(commercial)
Sink/basin/lavatory 12.51
25.02
.�
City/State/ZIP: Solar units(potable water) 62.54
Phone:(9,3) 96 ^ gZ g 8 Fax::( ) Tub/shower/shower pan 12.51
/! Urinal 25.02
C
E-mail: a_.. 515 dou i tlfbom e511 e,e0�r
�J CONTRACTOR Water closet 25.02
_ / Water heater 37.52
Business name: R�/Gl ct"Y G 7cG l/,��yl(9 v7 bN Water piping/DWV 56.29
`--- Address: a7'0 S5 73 ' /`tie Other: 25.02
ICity/State/ZIP: f- )/5b0r)` (9 e 7 7-�'� 3 Subtotal /57,ss
Phone:(9 j1) Se/8 gg 1 i Fax:( ) •j/I t)- Minimum permit fee: $72.50
Lo CCB Lic.: 1f,y 30 (9 L/q(1' Plumbing Lic.no.:31 ?�7 T' Plan review (25°/a of permit fee)
State surcharge(12%of permit fee) 1,�I.rj 1
Authorized signature: �� TOTAL PERMIT FEE l 67`7•C el
t11 Print name: CL� 6 &X. Date: S/�j// 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.
C`Building`Permits\PLMU-PermitApp.doe I0/01/09 440-4616Tt I0/021COM/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
9888 SW SATTLER ST, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
FAIL
PLM2015-00138
George Heimos
1. Water service, leave trench open to check 24" depth below meter from grade.
103.5.1.3/103.5.1.4
2. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
All else ok
Violation Summary:
Inspector Contractor
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
9888 SW SATTLER ST, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00138
David Young
Lines under working pressure.
Violation Summary:
Inspector Contractor