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Permit (107) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00304 13125 SW Hall Blvd.,Ti Date Issued: 07/27/2017 T[ 1k and OR 97223 503.718.2439 9 Parcel: 2S111AA11900 Jurisdiction: Tigard Site address: 8961 SW INEZ ST Project: Greensward South,Lot 13 Subdivision: GREENSWARD SOUTH Lot: 13 Project Description: Installation of residential backflow preventer for irrigation Contractor: AUSTIN BROWN LANDSCAPE Owner: GP4 LLC PO BOX 14441 PO BOX 1577 PORTLAND, OR 97293 BEAVERTON, OR 97075 PHONE: 503-887-7795 PHONE: 503 720-7445 FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/27/2017 $31.27 Specifics: 1 12%State Surcharge- 07/27/2017 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 07/27/2017 $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 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 No' . ion - • er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma, obtain a copy of the rules or dir-• questions to OU by ling 503.232.1987 or 1.800.332.2344. Iss ed By: tj • Permittee Signature: 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 f th• .roject. Approved plans are required on the job site at the time of each inspection. Ilk Plumbin Permit A lic i n Building Fixtures EIVED Cityof Tigard c� 2 n 1 7 Received i permit No.: 17Cz4 g ( U / Date/By: III 'll 13125 SW Hall Blvd.,Tigard,OR Plan Review Other Permit No.: ISr t i.. i Phone: 503.718.2439 Fax: are.. p. A-, ,� � Date/By: Inspection Line: 503.639.4 f 'n✓t► DIVISION � t t yry g Date Ready/By: Juris: SupplementalSee Page2 for Information T l G A K D Internet: µ,µ,w tigard-or.gov-�v I LD I!V G D I V I S 1 O 1 y Notified/Method: TYPE OF WORK FEE* SCHEDULE N ew construction 0 Demolition For special information use checklist. Description Qty. I Ea. I Total rr 0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION a; SFR(1)bath 312.70 .�, _ SFR(2)bath 437.78 ❑ 1-and 2-family dwelling 0 Commercial/industrial 500.32 SFR(3)bath ❑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: Catch basin or area drain 18.76 Job site address: / ` , S I ,wn •A1" SiDrywell,leach line,or trench drain 18.76 City/State/ZIP: l Vim/ ( _ 7 7-7'Z LI Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: `jy Manufactured home utilities 50.03 Cross street/directions to job site: %itY U 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: I Lot no.: l3 Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 I � its- _ „� �, �' .,�. Backwater valve 12.51 - DESCRIPTION OF WORK gig. ''. A / Clothes washer 25.02 6.4()Y. 1-41/3' ' 0 \(' Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 : © PROPERTY OWNER ' = 0 TENANT Expansion tank 12.51 Li D Co��� cJt 1 .,r,. Fixture/sewercap 25.02 Name: U f� - Floor drain floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT 0 CONTACT PERSON''' ' Interceptor/grease trap 25.02 ; Medical gas(value:$ ) Page 2 Business name: Primer 12.51 Contact name: 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 Urinal 25.02 E-mail: Water closet 25.02 ; CONTRACTOR ter heater 37.52 Business name: 1k-��/0 �e�� .."A LA1/41� piping/DWV 56.29 Address: le b 3( IL-1.141-4,‘. Other: 25.02 City/State/ZIP: QO21 CJ14-0 6-\/C-- I Subtotal Minimum permit fee: $72.50 .� Phone:(C ) Fax:( ) - Plan review (25%of permit fee) �- CCB Lic.: eel 2 Plumbing Lic.no.: State surcharge(12%of permit fee) j-it--) Authorized signature: /_ / / / TOTAL PERMIT FEE %l.9.6This permit application expires if a permit is not obtained within 180 days Print name: �' ,� Date: '/ after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitA..doc 10/01/0/ 440-46I6T(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 +'ootage: Permit-Pee: ,. Footing drain-l'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' 3,601 to 7,200 $233.20 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 Stonn&Rain Drain-1st 100' Valuation.' ''. 'Permit Fee. 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 TIIspeetions or Fees F�(ea) Total 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/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*. u ` a` ' flan Re vliW fir Plumbing In at6ions Quantitw by Fixture Type , Plan review is required for any of the following. Fixture Type for Replace/ Please check all that a 1 Work Performed: Capped Added Relocate pp Y' Baptistry/Font 0 Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -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" IsoWtrile of Riser Diagram t _ 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 Water Extractor fees assessed for the sewer increase must be paid before the 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: 8961 SW INEZ ST, TIGARD, OR, 97224 Record Type: Record ID: Residential - Plumbing PLM2017-00304 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: 1 " backflow preventer Wilkins model 350 ser# A641448 approved with test report. Violation Summary: Inspector Contractor