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Permit (41) CITY OF TIGARD PLUMBING PERMIT ,1111 COMMUNITY DEVELOPMENT Permit#: PLM2017-00011 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/18/2017 T[ t"a3�'L g Parcel: 2S115AA09000 Jurisdiction: Tigard Site address: 10727 SW TITAN LN Project: Speedie Subdivision: BERKLEY ESTATES Lot: 22 Project Description: Install residential backflow preventer for irrigation system. Contractor: WINTERBLOOM INC. Owner: MACDONALD, MARILYN C 14780 SW 98TH SPEEDIE,WILLIAM JOSEPH TIGARD, OR 97224 10727 SW TITAN LN TIGARD, OR 97224 PHONE: 503-598-0219 PHONE: 503-941-9132 FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 01/18/2017 $31.27 Specifics: 1 12%State Surcharge- 01/18/2017 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 01/18/2017 $41.23 Class of Work: OTR Plumbing 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 issua • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon 'iy Notification Cente Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma obtain a copy of the rules or direct questions to OUNC • • •3.232.1987 or 1.800.332.2344. -40211111111M411.tA001" Issued By: 1110/ � I ' Permittee Signature: am- _- e._ Call 503.639.4175 by 7:00 a.m.for the next available inspecti•- 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 AppliC 'q�I Site Utilities E E4D FOR OFFICE l SE 0N1.) City of Tigard Ti and Received Permit No.: lil liq13125 SW Hall Blvd.,Tigard,OR1 8O = Phone: 503.718.2439 Fax: 503.598.1960 Date/By: /1/7 /� Yn �/ / Plan Review Inspection Line: 503.639.41751TYOF,TIGARD Date/By: Other Permit No.: TIGARD Internet: www.tigard-or.govt Date Ready/By: Ions: El See Page 2 for DIN D I j LNotified/M,. ethod. Supplemental Information ,- ❑New construction 0 Demolition C .. . , y >SCIIC •. ,‘,1„,-...,-;• ®Addition/alteration/replacement ❑Other: For special information use checklist l CA t• R")r 1 f,,,1*TS VC.,i \� New 1-2-family dwellings(includes 100 ft.for eachtility connection) ® 1-and 2-family dwelling ❑Commercial/industrial SFR(1)bath 312.70 buildingSFR(2)bath 437.78 ❑Accessory ❑Multi-family SFR(3)bath 500.32 ❑Master builder ❑Other: Each additional bath/kitchen 25.02 ,IO INXi RMATION 4 i Zt �% :\ .��.. ' � �'� +� SCAT ,i ,,. ... Fire sprinkler(_sq.ft.) Page 2 Job site address:10727 SW Titan Ln. Site utilities: Catch basin or area drain 18.76 City/State/ZIP:Tigard,Oregon 97224 Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name:Bill Speedie Footing drain(no.linear ft.: ) Page 2 Cross street/directions to job site:Durham Rd. Manufactured home utilities 50.03 Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 Subdivision: i Lot no.: Water service(no.linear ft.:_) Page 2 Tax map/parcel no.: Fixture or item: .. ,:' i 41,.. - Backflow preventer 1 31.27 31.27 PIIiF W©Rt - ; " Backwater valve 12.51 Installaion of new backflow device for irrigation system Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 F.. . � ;� ❑ `I'�t�ANC�`. \.� Ejectors/sump 25.02 Name:Bill Speedie Expansion tank 12.51 Fixture/sewer cap 25.02 Address:10727 SW Titan Ln. Floor drain/floor sink/hub 25.02 City/State/ZIP:Tigard,Oregon 97224 Garbage disposal 25.02 Phone:(503)941-9132 Fax:( ) Hose bib 25.02 Arp 4 ❑❑ COIF 1A Ice maker 12.51 Business name:Winterbloom Landscaping Inc. Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Contact name:Eric Bock Primer 12.51 Address:14780 SW 98th Ave Roof drain(commercial) 12.51 City/State/ZIP:Tigard,OR 97224 Sink/basin/lavatory 25.02 Phone:(503)598-0219 Fax::( ) Solar units(potable water) 62.54 E-mail:eric.bock@winterbloominc.com Tub/shower/shower pan 12.51 y, Urinal 25.02 Water closet 25.02 Business name:Same as above Water heater 37.52 Address: Water piping/DWV 56.29 City/State/ZIP: Other: 25.02 Phone:( ) Fax:( ) Subtotal 31.27 CCB Lic.:6111 Plumbing Lic.no.: Minimum permit fee: $72.50 �a�O Plan review (25%of permit fee) Authorized signature State surcharge(12%of permit fee) 9.70 Print name:Eric B tP j Date:1/18/17 TOTAL PERMIT FEE g!,a`e) I:\Building\Permits\PLMU-Permit•.p.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Aitl ea} `otal e � 4 e arl r i stag . rmlt:, e y • 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 3,601 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 S stems: Water Service-each additional 100' 37.52 Storm&Rain Drain-1st 100' 62.54 1111 r I'f t F °' $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 j -IA,44 Q, Fee(r al each additional$100.00 or fraction thereof,toGt30 " 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 a .e ` 1111 �11gallations Fixture Type for Rep(ase Plan review is required for anyof the following. Work Performed Capped - Added Relprate'` that Baptistry/Font Please check all 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 0 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" �� , )tlil+l . o Set', Rg d Car Wash Drain Garbage -Domestic-non-food 0 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./Refrig.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: C:\Users\Admin\AppData\Local\Microsoft\Windows\INetCache\Content.gutlook\3XJ8UQOM\PLMU PermitApp.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10727 SW TITAN LN, TIGARD, OR, 97224 Record Type: Record ID: Residential - Plumbing PLM2017-00011 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 .1 " Wilkins DC model 350, serial # A600719 for irrigation, located by water meter - ok with test Violation Summary: Inspector Contractor