Permit (23) CITY OF TIGARD j� �, PLUMBING PERMIT
2. ' COMMUNITY DEVELOPMENT Permit#: PLM2017-00022
duiffai
T1GAR ) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2017
Parcel: 1 S125DCO2000
Jurisdiction: Tigard
Site address: 7045 SW VENTURA DR
Project: PETERS Subdivision: WASHINGTON SQUARE ESTATES Lot: 10
Project Description: Adding(1)laundry sink,replacing(1)tub in hall bathroom,and replacing(1)tub and adding(1)shower in master
bathroom. 4/3/17:REPRINTED permit to include(3)sinks.
Contractor: OWNER Owner: PETERS, MICHAEL DWAYNE
MICHAEL PETERS 7045 SW VENTURA DR
7045 SW VENTURA DR TIGARD, OR 97223
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
4 ea Sink 04/26/2017 $100.08
Specifics: 3 ea Tub/Shower/Shower Pan 01/23/2017 $37.53
1 12%State Surcharge- 04/26/2017 $16.51
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $154.12 1
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 direct stions to UNC by calling 503.232.1987 or 1.800.332.2344.
_
Issu d By: ^ (7", _ , / Permittee Signat re: AA
_,,,,e /r--- a------/
Call 503.639.4175 by 7:00 a.m.for the next available inspec ion 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 '°�,
F Received i /�
City of Tigard \,' Date/By: I l3 i4.77.....- Permit No.: /,/ t' 7_,o
INII13125 SW Hall Blvd.,Tigard,OR 97@'`' '. „ /
Plan Review
S Phone: 503.7182439 Fax: 50 eck1Q\' Date/By: Other Permit No.:
T i t i\ltD Inspection Line: 503.639.4175 q -Q;,j Date Ready/By: ..Suns::r 0 See Page 2 for
Internet: www.tigard-or.gov
P" ,4--.1.Y"M % � Notified/Method: Ina. Supplemental Information
�t
TYPE OF WORK Ok FEE* SCHEDULE ;
I ❑New construction El Crit.,P\io 9C:")'
For special information use checklist
KAdditton/altera
Description Qty. I Ea. I Total
tion/replacement ElNew 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY MJF CONSTRUCTION SFR(1)bath 312.70
1-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
JOB SITE INFORMATION AND-.00ATION i Site utilities:
Job site address:' 0 c- U n� atch basin or area drain 18.76
] 4 ,.„) Nrt1 V)(,Jr.•JlDrywell,leach line,or trench drain 18.76
City/State/ZIP: ; rw 1 Z Z3 4
c�fr� C� f/n�a Footing drain(no.linear ft.:i) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: YY Manholes 18.76
"V r A . Rain drain connector 18.76
* /3/), / y`�) Sanitary sewer(no.linear ft.: ) Page 2
l�+ CVVe� 1 t`y I-lc- t tZ/"'2k4�m Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: �jr1S tY'5 ii.1 Sti4t,rt L 4,e�Mc5 I Lot no.: 10 ' Fixture or item:
d' Backflow preventer 31.27
map/parcel no.:
1� ,` DESCRIPTION :,.-i,WORK F`� -: Backwater valve 12.51 •
Tax
pJ ,.,. , �-;; Clothes washer 25.02
t ACk4 4uvka(y £,\11\/. Dishwasher 25.02
P INk b Ck`". \\rA bevt\A ((qta l t 'k ui' k\ktt.,05) rDDrinkiinggs nfountain 25.02
25.02
MD41I tYlCtSitr )a,1411 ({ 'Ate Sltiair c'‘,1-kwe'? adol `(b)
EjecPROPERTY OWNERk "+ i 4yT Expansion tank 12.51
I �w Name: 1� g i d 7,-NGS Fixture/sewer cap 25.02
�G\\l�Z� �Ptt15 �/ Floor drain/floor sink/hub 25.02
Address: 70 L S 5 V) J ev t u/C{ 01,4e Garbage disposal 25.02
� City/State/ZIP: T‘v)r r 4( ll , oti z,,7,.'y Hose bib 25.02
Phone:(S V 7) 8.5 3 Z g S Fax:( ) Ice maker 12.51
1 `,.'7'::itt APPL NT ^ 0 CONTA `PERSON 'l" Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory A---'''..4 25.02 Z5.0 Z
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( )
Tub/shower/shower pan3 12.51 73'5
Urinal 25.02
E-mail:
7r Water closet 25.02
,.,,,,-4,:,.--,. CONTRA f Water heater 37.52
Business name: 0Q4) -r- Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal ((,Z.cc l
Minimum permit fee: $72.50 '77-S 0
Phone:( ) Fax:( ) Plan review (25%of permit fee) h/et
CCB Lic.: Plumbing Lic.no.: u
State surcharge(12%of permit fee) 5.-71.;
Authorized signature: 4 7 TOTAL PERMIT FEE I,Z1 I
�A l This permit application expires if a permit is not obtained within 180 days
Print name:
r\�(.W,,ex cK.tQ f> Date: t,'7� ,, u17 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:\Building\Pamits\PI.MU-PetmitApp.doc 10/01/09 440-4t16T(10/02/COM/WEB) 7 Ci
Tb l,jhow 1-t MA5 Cohccrhi
tease. Find -flee encivsPd check egy mewl Fvr -line CtvkSiovt to
? Imyrib'r9 Qer M' Q LMtol 7 - ObcZ.Z. a .5 Meir
9 vAiled Q 2( rY1�
emaits w\tti ?randcn Ta9g art .
RECEIVED 1 *)-
APR 2 4 2017 Michael Qetus
CITY
vsi110-s z1 13 ®rG aoN
A
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00022
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2017
f'G" f° 9 Parcel: 1 S125DCO2000
Jurisdiction: Tigard
Site address: 7045 SW VENTURA DR
Project: PETERS Subdivision: WASHINGTON SQUARE ESTATES Lot: 10
Project Description: Adding(1)laundry sink,replacing(1)tub in hall bathroom,and replacing(1)tub and adding(1)shower in master
bathroom.
Contractor: OWNER Owner: PETERS, MICHAEL DWAYNE
MICHAEL PETERS 7045 SW VENTURA DR
7045 SW VENTURA DR TIGARD, OR 97223
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 01/23/2017 $25.02
Specifics: 3 ea Tub/Shower/Shower Pan 01/23/2017 $37.53
1 12%State Surcharge- 01/23/2017 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 10 ea Minimum Fee Adjustment- 01/23/2017 $9.95
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
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 direct questions to OUNC by calling 503.232.1987 . .::! 32.2344.
Issued By: /L.,........?„, -rmittee Signature: —7�-
✓Oit-cer✓1 t
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
Building Fixtures
J Received / ///��� ,�y��
City of Tigard a' Date/By: i�-3 /Y Permit No.: p f .,,,h
• 13125 SW Hall Blvd.,Tigard,OR 972 '
y` Plan Review
. O Phone: 503.718.2439 Fax: 50 ,\%\k Date/By: Other Permit No.:
Inspection Line: 503.639.4175 �-y?''a Date Read /B Jur s: ® See Page 2 for
TIUARD X`°" Ready/By: S
Internet: www.tigard-or.gov
PC� il;,1.off(°'t,".lotified/Method: Supplemental Information
TYPE OF WORK 0���� �� FEE* SCHEDULE
0 New construction ❑EeN0' ' For special information use checklist
Description Qty. Ea. Total
AAddition/alteration/replacement 0 ts' : New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY-OF CONSTRUCTION SFR(1)bath 312.70
X 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
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 1 Catch basin or area drain 18.76
]b4c 5�.t) .)lY\-kNrt� tssir.
Drywell,leach line,or trench drain 18.76
City/State/ZIP: n t ?„7,3
'C�+{� G" c` � n Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: j/c {.� Manufactured home utilities 50.03
Cross street/directions to job site: // '-+ 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: �Jgshx\Askp:l SrC,4ft L'S'c e5 1 Lot no.: (L Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF.WOT ' 1•1;',)1 Backwater valve 12.51
Clothes washer 25.02
AAA lt(uvtat,,, r,1t1\'. Dishwasher 25.02
t,4\(-s- \\.q\k \p 1 ({/(uCe. -t4 .'\f`RklQ5) Drinking fountain 25.02
E' 25.02
�`GA\fJnuSitr )3.1411 (R1(41e 61vcatr ,4-t,k,r6 444- ectors/su�,-tb)y I
PROPERTY OWNER fl TEN" Expansion tank 12.51
`� Fixture/sewer cap 25.02
Name: G�In2` 4c2P @f5 Floor drain/floor sink/hub 25.02
Address: 70 tA5 5\,) 'v evvt ut;, 0 i'-ie Garbage disposal 25.02
City/State/ZIP: \\3r t 4 t 6 K1 5 Hose bib 25.02
Phone:( V 7) 3 7j .2,1.g c Fax:( ) Ice maker 12.51
❑ APPLtNT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory j 25.02 L .()t
City/State/Z1P: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 3 12.51 3 73-3
3
E-mail: Urinal 25.02
„ ' x Water closet 25.02
CONTRA R Water heater 37.52
Business name:
Oki/VC-4r- Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal (4,Z..5c'
Phone:( ) Fax:( ) Minimum permit fee: $72.50 77_c()
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) h/A
State surcharge(12%of permit fee) 5,71
Authorized signature: //7 �-1v TOTAL PERMIT FEE ?3 i,z) 1
Print name: M t 1 Date: L. )_ This permit application expires if a permit is not obtained within 180 days
,6VR2� ge-Vet> (Ari l4 1 7 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440 1616T(10/02/COM/WEB)
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
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 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 " Fee(ea) each additional$100.00 or fraction thereof,to
o .= 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*. Flan 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 _ 0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall
0 New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 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" Isometric or Riser Diagram
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:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7045 SW VENTURA DR, TIGARD, OR, 97223 February 5, 2018 at
10:40:05 AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00022
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Calk WC in master.
Provide listing for laundry tray DWV piping.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7045 SW VENTURA DR, TIGARD, OR, 97223 February 7, 2018 at
7:12:21 AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00022
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Correction complete, trap material listed and approved.
Violation Summary:
Inspector Contractor