Permit (102) p CITY OF TIGARD PLUMBING PERMIT
`E'! £: - COMMUNITY DEVELOPMENT Permit#: PLM2016-00091
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/24/2016
TIGARD Parcel: 2S111CA00200
Jurisdiction: Tigard
Site address: 9650 SW SATTLER ST
Project: Spanu Subdivision: ALDERBROOK FARM Lot: 12
Project Description: Installation of residential backflow preventer for irrigation.
Contractor: OWNER Owner: SPANU, MICHELLE& RICHARD
9650 SW SATTLER ST
TIGARD, OR 97224
PHONE: 503-317-7057
PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/24/2016 $31.27
Specifics: 1 12%State Surcharge- 02/24/2016 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 02/24/2016 $41.23
Plumbing
Class of Work: OTR
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 ... All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
iss - ce, or if wo is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ility Notification Cen : . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
.r direct questions to OUNk by - n. •3.232.1987 or 1.800.332.2344.
ssued By: / Permittee Signature: •
Call 503.639.4175 by 7:00 a.m.for the next available inspectio 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 RECEIVEP
Cl Of Tl d Received
`, ganDale/By: A 4 Pennit No.: 4„hA0le.c p/
III NI 13125 SW Hall Blvd.,Tigard,ORc9E2333 4 2 n16 Plan Review
Phone: 503.718.2439 Fax: 503.1-548.-19 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Read /B orris: El See Page 2 for
i I t \1t 1> Internet: www.ti and-or. ov r`/ I yp Ready/By:
g g �,�1 I �l' l�l�l\I) Notified/Method: Supplemental Information
':SrM /.
0 New construction 0 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)
t# " f l * ".y{ € "-i,",. 511.
SFR(1)bath 312.70
;
i -and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑ Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOR SITE INFORMATION AND LOCATION Site utilities:
Job site address: I G �D S. 14/ �!z)�-(t/ )-
Catch basin or area drain 18.76
� S Drywell,leach line,or trench drain 18.76
City/State/ZIP: -r G ct i tl 0 Q e cJ, ei -t, -7 Gf / 2 2 y Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: J I Project name: 5 p q/ G( Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
9 g 744) 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backtlow preventer >4 31.27
DES(#.IPTION-- WURK Backwater valve 12.51
(/ /� L Clothes washer 25.02
'� �4 j C �4® = 0 C J e e\`^�( �-e' Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
... .R9pEtiTy OWNER.' I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: $ C ) S, 4 I-I tc_
Address: 9,S--Q S, LI/ _ S 4 4_4-1-e✓ f•*- Floor drain/floor sink hub 25.02
Garbage disposal 25.02
City/State/ZIP: '1-"( 4, 4-d Off-
7 •Z e y Hose bib 25.02
Phone:( )32J , '
-. )7-70,S-7 Fax:( ) Ice maker 12.51 ���
PLICANT i. =0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:
Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
O
Water closet 25.02
IC , OR
/^ -�x Gv✓ • Water heater 37.52
Business name: r)(�r vlt�.I Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50 11/.4)
Plan review (25%of permit fee) ----
CCB Lie.: Plumbing Lic.no.:
State surcharge(12%of permit fee) alba
Authorized signature: v
TOTAL PERMIT FEE 8a(.�•
Print nad`0 k spy Date:2_2y-/,6 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:Building,Permits\PLMU-PermitApp.doc 1001/09 440-4616T(10'02-COMWEB)
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-1" 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
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' 37.52V ,
Storm&Rain Drain-1st 100' 62.54 �� &(� •�' rii ;'Fee;'
$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 Qtr• 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/hrand including$50,000.00.
Additional plan review for revisions 90.00/hr 550,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 orf action 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 111Any new commercial building with water service 2"and
Bath: Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
1:1Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive as defined in OAR915-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
Domestic 0 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 Isq�c or Riser Diagram
4
El 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
Washer-clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
1:\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
9650 SW SATTLER ST, TIGARD, OR, 97224
Residential - Plumbing
312 Backwater valve
FAIL
July 22, 2016 at 11:39:53 AM
PLM2016-00091
David Young
Provide approved Backflow test report for final inspection.
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
9650 SW SATTLER ST, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00091
David Young
1" Watts model LF007M1 serial # 037260 left side of house.
Violation Summary:
Inspector Contractor