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Permit CITY OF TIGARD PLUMBING PERMIT 111111 I - COMMUNITY DEVELOPMENT Permit#: PLM2015-00345 Date Issued: 10/08/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25104AA04100 Jurisdiction: Tigard Site address: 12670 SW KAREN ST Project: Arid LLC Subdivision: BELLWOOD Lot: 25 Project Description: Replace galvanized plumbing to copper or pex,and remodel existing bathroom. Contractor: OWNER Owner: ARID LLC-CHRIS STOCKS 4800 E HUMMINGBIRD LN PARADISE VALLEY, AZ 85253 PHONE 602-478-8888 E: FAX: FEES Quantity Description Date Amount 1 ea Tub/Shower/Shower Pan 10/08/2015 $12.51 Specifics: 1 ea Water Piping/DWV 10/08/2015 $56.29 1 ea Water Closet 10/08/2015 $25.02 Type of Use: SF 1 ea Water Heater 10/08/2015 $37.52 Class of Work: ALT 1 12%State Surcharge- 10/08/2015 $15.76 Type of Const: Plumbing Occupancy Grp: Stories: Total $147.10 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the,ales adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090/. Y,Q :y obtain a copy--.ot.he rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: / Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application RECEIVED Building Fixtures OCT 8 2015 FOR OFFICE USE ONE Received ry�p/i$ Z / ./ � l QO395 III City of Tigard `//1L Receive �� Of/ QG¢7 Permit No. J (/ • 13125 SW Hall Blvd.,Tigard,OR 97223 CI TV I O f iC Plan Review 0 Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit No.: Inspection Line: 503.639.4175 IILDIN�tii� Date Ready/By: fu la See Page 2 for TIGAKD Internet: www.ti ard-or. ov g g Notitied/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 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 Accessory building SFR(3)bath 500.32 ❑ ry g ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 12670 SW Karen Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97233 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site:Scholls Ferry Rd&SW 121'r Ave 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 change galvinized plumbing to copper or pex,remodel existing bathroom Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 x/21 Z. i Fixture/sewer cap 25.02 Name: /I Q L 7�/N ��P ��Pl✓�� LLB �/�12i) ��b:k5 Address: Cti2/S S �CK.S Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Su.014 014 e p ,41 /44de Hose bib 25.02 Phone:( till 1) `)/7 g gie ET Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: (} (, ivuz Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) I Fax: :( ) Tub/shower/shower pan 1 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet ! 25.02 Water heater 1 37.52 Business name: (7I.JNef. Water piping/DWV 1 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal ,Q-37/1I- Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: [ 1 TOTAL PERMIT FEE / t Aie/,9 C /(�//ci S J- - /0/5A,j This permit application expires if a permit is not obtained within 180 days Print name: // Date: J after it has been accepted as complete. / *Fee methodology set by Tri-County Building Industry Service Board. H7, /0 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: 9 n'V-i.{l::Y:. - a.c�.� ..L^.: 'R' ';i:i''YdSF:i1•-�.,..�.,v-1•`- _ ^�!;�a aw'Y•.•e;-'> :y-' '' - `?-_'.".,• �� . 3, - ..5.:x.5.. .,7' �_'�•., `Site`UtiLti'es• .-. . -..;- ;: ,- -_- - ._ - :..,- -- -. �... : ,_ -,. � ,,.: 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 3,60I 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 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 �,,_ g• ::,;,;; :ti= each additional$100.00 or fraction thereof,to lierIn ectots=or_Fees ,. ? KFee(ea>tz _Totiilr. p U��''� ��; � =�a .:��Y:=�� 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$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. - -Quantity by Fixture Type; ' p�llil1,b11IT )I1Stalla110l1s >,=b 7,r .� ,;Plan Reyaew for;' {r -Fixture Type for: -: _ _ ReP!� :• Plan review is required for any of the following. Work Performed: - Capped :Added: Retaato: Baptistry/Font Please check all that apply. Bath -Tub/Shower ❑ Any new commercial building with water service 2"and -Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" -4.. ,;�,.. --T$"y. ,,.k,s�s.••..•rL3� 2 ;r3z°`• ..._,. i' -�^t-i •=k.si ,y"�¢: Ty4r,'«.>IsometriczorRiserxDia - � Car Wash Drain �t am: s. cif 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./Refng.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: 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 12670 SW KAREN ST, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal FAIL PLM2015-00345 David Young Trap piping not allowed. Shall have smooth interior surface. Dishwasher hose to be secured to top of cabinet. 807.4 Add washer, dishwasher, sink and 2 lav to permit. 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 12670 SW KAREN ST, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00345 David Young Contractor on site ﬁnishing corrections for homeowner. 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 12670 SW KAREN ST, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00345 David Young Contractor on site ﬁnishing corrections for homeowner. Violation Summary: Inspector Contractor