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Permit CITY OF TIGARD PLUMBING PERMIT 11111 ', COMMUNITY DEVELOPMENT Permit#: PLM2015 00279 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/24/2015 Parcel: 1 S134CD05400 Jurisdiction: Tigard Site address: 11755 SW SUMMER CREST DR Project: Cook Subdivision: BURLWOOD NO.3 Lot: 14 Project Description: Replace 50'of water service. Note:electrical permit may be required if replacement piping effects house grounding. Contractor: COMMERCIAL PLUMBING SERVICE Owner: COOK, MARTIN B 21185 NW EVERGREEN PKWY SUITE 105 11755 SW SUMMERCREST DR HILLSBORO, OR 97124 TIGARD, OR 97223 PHONE: 503-439-9999 PHONE: 503 341-4004 FAX: 503-439-1999 FEES Quantity Description Date Amount 50 If Water Service 08/24/2015 $62.54 Specifics: 1 12%State Surcharge- 08/24/2015 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 08/24/2015 $9.96 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or dire • estions • OUN •• ailing 503.232.1987 or 1.800.332.2344. Issued By: / Permittee Signature: _40!ii Call 503.639.4175 by 7:00 a.m.for the next available insp ction date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Appli a u Building Fixtures l CEIVEP FOR OFFICE USE ONLY Received y: . // 3 01/4_,),b9 f'i/. /5 y - City of Tigard DateBy: Permit No.: �00�7 n 13125 SW Hall Blvd.,Tigard,( }18,72gd 2 n i5 Plan Review Phone: 503.718.2439 Fax: 0 8. 9 Date/By: Other Permit No.: TIGARD Inspection Line: 503.639.4]7$�v�� ,�, `A�'y Date Ready/By: orris: I See Page 2 for Internet: www.tigard-or.go (. A IJ Notified/Method: Supplemental Information TYPB G®IVISIOT' FEE* SCHEDULE ❑New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. I Total pErAddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 pl 1-and 2-family dwelling ID Commercial/industrial SFR(2)bath 437.78 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: Catch basin or area drain 18.76 Job site address: I(7 S5 Su, S(a_r nrYlcr ere-4- c)`,v Q Drywell,leach line,or trench drain 18.76 City/State/ZIP:�r� l�C'L I'7 293 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: V 1 Project naritC: \� CocX. Manufactured home utilities 50.03 Cross street/directions to job site: $( `y,�.tp f'`O,e Manholes 18.76 Y\`f1 , Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.:1-n ) 1 Page 2 W.y45- Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 ` Clothes washer 25.02 e�IrC e'2 56 Cc L 1�.�'T� 1,,rve Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 go PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 +� � a`r\ �CC_V Fixture/sewer cap 25.02 Name: 1 r IC {1` Address: ere drain/floor sink/hub 25.02 ��1 i- SCE 3 i_r 'm ( re n- D(''.o`e Garbage disposal 25.02 City/State/ZIP: --c7t��, l ( eC.-^j, `r�f�3 Hose bib 25.02 Phone:(563)3i ii_q�[_/ \w' Fax:( ) Ice maker 12.51 1'APPLICANT /7 ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: . Medical gas(value:$ ) Page 2 arnmec e',ct��'�W1\D 111 y,S'e c6'oe 5 Contact name: Primer 12.51 1 1s C'e CScp Roof drain(commercial) 12.51 Address: A( full) 60,rfy.eP1.\ t u,)y" S(..4�e 70J Sink/basin/lavatory 25.02 City/State/ZIP: a't I 1 R:), ()I f 7/V1 Solar units(potable water) 62.54 Phone:(.5. 3)e{3ef_ 99??7 Fax::(:3 ) /3�_/,9 y Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 e�t6 -k C� P p5 -. ro'.e e 5.b,7-- Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:Cbv^tvrne.c I y( 1s .C'e5 Water piping/DWV 56.29 Address:,21j il.�Le� �Ue_f'epf ee-n '�� Y , ,k /is Other: 25.02 City/State/ZIP: err(&.h0t-0 Or f,0 �"1( j l� l Subtotal LZ,<<S Phone:( ) / Fax:(SO3) �31_/�f�f 9 Minimum permit fee: $72.50 Sp CCB Lie.: 17(4,0 1.5-- tel 34,4, Plumbing Lic.no.:31_y'Z t P� Plan review (25%of permit fee) tZ_']� ///// / State surcharge(12%ofpermit fee) ell-9-- - Authorized signature: c�� TOTAL PERMIT FEE Print name: I4,,�+ F m,,_,- Date:gy,L1 fr _ This permit application expires if a permit is not obtained within 180 days rafter it has been accepted as complete. "Fee methodology set by Tri-County Building Industry Sece B d.n O I:\Building\Permits1PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) 6 O' 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-151 100' 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 I Minimum fee$72.50 Storm&Rain Drain-each additional 100' 37.5 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Qt. Fee(ea) I otal 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 Please check all that apply. Baptistry/Font 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 Thru ❑ 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,, Isometric or Riser Diagram Car Wash Drain ❑ Isometric diagram is required for new buildings Garbage -Domestic-non-food c or riser g ram s re q 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/L.av -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/document_centerBuilding/PLMF_PermitApp.dS 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 11755 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal FAIL PLM2015-00279 George Heimos 1. Provide water service approval. 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 11755 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00279 George Heimos NOTE: 2-ea electrical grounding rods located on right left side of house at garage. Violation Summary: Inspector Contractor