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Permit (55) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00082 Date Issued: 03/14/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S 14/201 6400 Jurisdiction: Tigard Site address: 13309 SW PUMPKIN VALLEY TER Project: River Terrace Northwest,Lot 64 Subdivision: RIVER TERRACE NORTHWEST Lot: 64 Project Description: Irrigation backflow. Contractor: CASCADIAN LANDSCAPERS, INC. Owner: ADLV LAND HOLDINGS LLC 21510 NW FARM PARK DR BY FORSUM, MICHAEL HILLSBORO, OR 97124 7600 E DOUBLETREE RANCH RD STE 1 SCOTTSDALE,AZ 85258 PHONE: PHONE: 503-647-9933 FAX: 503-647-9922 FEES Quantity Description Date Amount 1 ea Backflow Preventer 03/14/2017 $31.27 Specifics: 1 12%State Surcharge- 03/14/2017 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 03/14/2017 $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 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 tto�}OUNC by calling 503.232.1987 or 1.800.332.2344. ` Issued By: /� ,/` /��_ Permittee Signature: 2,Aj ,pGy �/` 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 Applica ' n. ,,,,-,1 `(. lis) BuildingFixtures ?, >> FOR OFFICE l SF O\I.1 City of Tigard MAR 13 2017 Received 14 . ,is 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Rev /y�7 Ferxrrit No.�c.tA ©f 2 ,I;0D Cs Phone: 503.718.2439 Fax 5 '.99.8 96C� ; , Plan Review tl l• e 1 - ") Date/By: Other Permit)10757.- j 7.4i�� T l( \R I-) Inspection Line: 503.639.417,54 1 a ,4 x a Date Ready/By: Internet www.tigard-or.gov 1-1" 1 'a ;m.," ; ' Juris: Supplemental See Page 2nr ,y' -:,.7;»,. ..7,!; 1. = » �, .- NO �M Information Notified/Method:re ethod r ®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) _ G Y 7 W c `(': SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accesso SFR(3)bath 500.32 rY buildin g ❑Multi-family ❑Master builderEach additional bath/kitchen 25.02 0 Other: .*� Fire sprinkler( sq.ft.) Page 2 O S � ) T - Site utilities: Job site address: 13309 SW Pumpkin Valley Terrace Catch basin or area drain 18.76 City/State/ZIP: Tigard OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: River Terrace NC/L7J L<-ST- Manufactured home utilities 50.03 Cross street/directions to job site: SW Roy Rogers Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Stone sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: 64 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 - a.f "' , O' Backwater valve 12.51 Clothes washer 25.02 Backflow Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® ' R E f. ?:. „1/4..„.„,,,,, Expansion tank 12.51 Name: Polygon Northwest Co Fixture/sewer cap 25.02 Address: 109 E 13th Stret Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Vancouver WA 98660 Hose bib 25.02 Phone:(360 )695-7700 Fax:( ) Ice maker 12.51 - . _ _. _ .. 25.02 Business name: Cascadian Landscapers Medical gas(value:$ ) Page 2 Contact name: Art Meisner Primer 12.51 Roof drain(commercial) 12.51 Address: 21510 NW Farm Park Dr Sink/basin/lavatory 25.02 City/State/ZIP: Hillsboro OR 97124 Solar units(potable water) 62.54 Phone:(503 ) 647-9933 Fax::(503 ) 647-9922 Tub/shower/shower pan 12.51 E-mail: art@cascadianlandscapers.com Urinal 25.02 0. " "# `" Water closet 25.02 "' f . ; , '' Water heater 37.52 Business name: Cascadian Landscapers Water piping/DWV 56.29 Address: 21510 NW Farm Park Dr Other: 25.02 City/State/ZIP: Hillsboro OR 97124 Subtotal Phone:(503 )647-9933 Fax:(503 )647-9922 Minimum permit fee: $72.50 72.50 CCB Lic.: 51443 LCB#:5185 Plumbing Lic.no.: PB 124 7//// Plan review (25%of permit fee) � /� �/ //` State surcharge(12%of permit fee) nre. /- - 8.70 Authorized TOTAL PERMIT FEE 81.20 Print name: Art Meisner Date: 3-9-2017 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-PemsitApp,doe 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Res► entla Fire Su ression S stems: ift '41713 Footing drain-is 100' 50.03 0 to 2 000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 7,201 and a eater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 t i' 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 Iddil IL: 4' ,�K.-I v �w� 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 char•e-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 char_•e-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 each additional$100.00 or fraction thereof. (minimum char_e-1/2 hour 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*.ate . ,vx Quantity by FixturesType� a ��_�° n - .._stnllatioAs` .y Fixture Type for e f Replace/ Plan review is required for any of the following. Relocate Work P�rfortned ' Capped AddePlease check all that apply. Baptistry/Font ❑ Any new commercial building with water service 2"and Bath -Tub/Showergreater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool Car Wash -Each Stallengineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. Dishwasher i Cuspidor/Water Coirator Dshwashherer -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinlder 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„ -4„ W.aglaIllie'jiiC1016Rigai 0441,0 Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food 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: D:\Users\Patty\Downloads\PLMF_PermitApp(2).doc 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13309 SW PUMPKIN VALLEY TER, August 21 , 2017 at 11 :12:12 BEAVERTON, OR, 97007 AM Record Type: Record ID: Residential - Plumbing PLM2017-00082 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: 1 " Wilkins backflow device model 350 ser#A563138 located right of front porch approved with test report Violation Summary: Inspector Contractor