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Permit (109)
CITY OF TIGARD PLUMBING PERMIT 11111 - S. COMMUNITY DEVELOPMENT Permit#: PLM2016-00005 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/17/2016 Parcel: 2S 111 AA07500 Jurisdiction: TIGARD Site address: 8915 SW INEZ ST Project: Greensward Park No.4,Lot 15 Subdivision: GREENSWARD PARK NO.2 Lot: D Project Description: 75 ft.of water service,75 ft.of storm sewer,and 75 ft.of sanitary sewer for lot 15. Contractor: D&T EXCAVATION INC Owner: GP4 LLC PO BOX 3767 PO BOX 1577 WILSONVILLE, OR 97070 BEAVERTON, OR 97075 PHONE: 503-263-2607 PHONE: FAX: 503-263-2648 FEES Quantity Description Date Amount 75 If Sanitary Sewer 02/17/2016 $62.54 Specifics: 75 If Storm Sewer 02/17/2016 $62.54 75 If Water Service 02/17/2016 $62.54 Type of Use: SF 1 12%State Surcharge- 02/17/2016 $22.51 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $210.13 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 foils the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009. 'u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80 Issued By: Permittee Signature: 40 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 ity ruIVEj Building Fixtures City Of Tigard 1+'NI 6 2016 Received i V C err-- Permit No.:fr��M/J,,� , 5 III U 13125 SW Hall Blvd.,Tigard,OR 97223 U U Date/By:v ! /,���c g Plan Review • Phone: 503.718.2439 Fax: 503.598.1960iy 11) Date/By: Other Permit No.: Inspection Line: 503.639.4175 I itv Date Ready/By: Juris: ® See Page 2 for _ l ��,,;l:l) �tlY �� A Internet: www.tigard-or.gov ' t ,i. . Silk. otified/Method: f Supplemental Information `,t .. , r 'az'T.:::!'„,,,',..,- :'1U4'./.01',' � 4....;„!,,,,,,,„,,,,,_.,_...,,,,-.-,-,,em ,.,,+ass . ;s, - �.j':.. .,-"J :1143c a ,.d, . ..�4" „ :.,,44 10- x 'at-,4, '4`,4_' r New construction 0 Demolition For special information use checklist. Description I Qty. I Ea. I Total 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) b g 7 zsize. .r_ SFR(1)bath 312.70 4 "M,i" .�J �v„ '`+x'ry w..'k+* , 44,405)-,-41.- ., -I d, S,M=1. .F.:, i t. r .Y'--' 1 i-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 SITE INFORMATION AND LOCATION " Site utilities: Job site address: �( �' Catch basin or area drain 18.76 v I y ,� �Z^ - Drywell,leach line,or trench drain 18.76 City/State/ZIP: ---73 /yip b fl--/ Footing drain(no.linear ft.:_) Page 2 t7 Suite/bldg./apt.no.: I Project name: ✓YGiiu+/f,,ti) P,4q'k- Manufactured home utilities 50.03 Cross street/directions to job site: No N Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: i 5 ) . Page 2 62_cif Storm sewer(no.linear ft.: 75 ) Page 2 6)+s-i( Water service(no.linear ft.:7-fl) Page 2 6,21 .5-11 Subdivision: Lot no.: f 5 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 111/rfr-i �X-+ei/.,-c- t Sun. ? L"&l`✓40'f, 5,444,, St-✓1.6k44 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 'OWNER 1 © • ,, . Expansion tank 12.51 Name: T Fixture/sewer cap 25.02 \r- (��C Floor drain/floor sink/hub 25.02 n Address: 0, pox. ,S7 / Garbage disposal 25.02 City/State/ZIP: FSei1c/c+hY• 0 R .17c)S� Hose bib 25.02 �T" Phone:( S ) -7 0 9 - 22 -7 Fax:( ) Ice maker 12.51 r 9, 7 ,;.;;• 41*. 3��.s = »t f'Co'A44iti,PE '-. Interceptor/grease trap 25.02 r Business name: ./r- T6-n4_,,,)>,,,.., T•ne Medical gas(value:$ ) Page 2 -t' Primer 12.51 i j) Contact name: pr,,,/c,k t)s)-4 Ls I,L� Roof drain(commercial) 12.51 Address: ?. 0. i < y? (,7 Sink/basin/lavatory 25.02 v City/State/ZIP: (,t/ . LS.. ,.. I I L OR. y?D.7 0 Solar units(potable water) 62.54 Phone:(S i)) (, I L- 5. e L( Fax::(53_3 ) 4/2 - `j 2 `d 7 Tub/shower/shower pan 12.51 E ' Urinal 25.02 , � mEail rce4✓rko., ,,„,,,,,,i,4- y--Lc,rcc-uaf,xc✓t. LJrN "Mr1 * xP -"'J' - Water closet 25.02 'e,-'*!:*'-',, .4 5 U, ''''' .+� a. "'' ::4 ''. .S'e ' t Water heater 37.52 Business name: / '7 � C ! ,ADA f '- Water piping/DWV 56.29� 1 Address: jU ^ ?7c-7 Other: 25.02 City/State/ZIP: tu, s an ti.. lc,. 04 '?O7(.) Subtotal Phone:(5�j) (j(2_ 92 g� Fax:(5 j ) 4/2 . 11 a Minimum permit fee: $72.50 j 7 0 Plan review (25%of permit fee) CCB Lic.: i S-164 9 -/ b Plumbing Lic.no.:36/-(-1,75-1)B / j State surcharge(12%of pent fee) 5/ Authorized signature: . 64_ 7! �( t TOTAL PERMIT FEE p? 0, y [ Dhis permit application expires if a permit is not obtained within 180 days Print name: �r'�C L/.5/ li,L Date://04/�d/S after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:Building Permits PI.MU-PermitApp.doc 10 01 09 440-4616T(10 02 COM WFB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: 1 1 t 1Fee:(t*). . o z t - � 'lilltit ECk Footing drain-I"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 y yy ;ti . 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 each additional$100.00 or fraction thereof,to Other nsp+ �►ns�r" a ". - � 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*. - 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 ❑ Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ 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.. x sometrl Or Riser Diagraiii 4 0 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 _ increase of sewer EDUs,a sewer permit will be issued and Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: 1:ABuilding\Permits\PLMF_PernitApp.doc 08/04/2011 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8915 SW INEZ ST, TIGARD, OR, 97224 November 7, 2018 at 9:07:51 AM Record Type: Record ID: Residential - Plumbing PLM2016-00005 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor