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Permit (101) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00460 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/08/2017 T f Parcel: 2S108DB06000 Jurisdiction: Tigard Site address: 15369 SW SEINE DR Project: SPEER Subdivision: POLYGON AT BULL MOUNTAIN Lot: 58 Project Description: Backflow preventer for irrigation. Contractor: DENNIS'SEVEN DEES LANDSCAPING INC Owner: SPEER, MICHAEL D 7355 SE JOHNSON CK BLVD 15369 SW SEINE DR PORTLAND, OR 97206-9329 TIGARD, OR 97224 PHONE: 503-777-7777 PHONE: FAX: 503-777-2399 FEES Quantity Description Date Amount 1 ea Backflow Preventer 11/08/2017 $31.27 Specifics: 1 12%State Surcharge- 11/08/2017 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 11/08/2017 $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 to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 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 of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application ,rte/ Building Fixtures FOR OFFICE USE ONLY City of Tigard RE ,.,t i::-.i ., Received p Date/By: 11/7/i // / 7 Permit No.: I '°�� }1 /«-( ( 1 13125 SW Hall Blvd.,Tigard,OR 97223Pl /ll 6ry ' Phone: 503.718.2439 Fax: 503.598.196R,O v 7 ZQ'�7 an Review '1`r� Date/By: _ Other Permit No.: Inspection Line: 503 639 4175 T I GARD - Date Ready/By: Jnru B See Page 2 for www.tigard-or.gov t'� � I�� c"tNotfi ed/Method ,,Supplemental Inf ormation\ 0 New construction 0 Demolition For special information use checklist. Description Qty. Ea. I Total ❑Addition/alteration/replacement 11e•they L6 At nl) New 1-2-family dwellings(includes 100 ft.for each utility connection) ' - - - � A ` GORY IF . .,,�`� SFR(1)bath 312.70 g1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accesso buildin SFR(3)bath 500.32 t1 g ❑Multi-family El Master builderEach additional bath/kitchen 25.02 0 Other k it _ `�1 Fire sprinkler( sq.ft.) Page 2 r C L��' I b 'IO LUQ T �4 _. .: .�. 'A Site utilities: Job site address: / 3- Z� 5‘,/,_,) .5 e?/,,e Ori v Catch basin or area drain 18.76 City/State/ZIP: (l G Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suiteibldg.iapt.no.: Project name: S -- - �, 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer / 31.27 T L1ESC* TIO F it 4 ,g Backwater valve 12.51 //�✓ \ /; _.. if) � /y. 7 ���. �' - Clothes washer 25.02 l " 1c) ""'u 106-C, © ") p e. ✓ 614.J -e4 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ®''PI PEI 'TY W R i ;<„.. ✓ L] I E ►N €y 0 0 Expansion tank 12.51 Name: /r/l/G ., Sr �/ Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 IPI CA 1I ❑ or& p 0 Interceptor/grease trap 25.02 Business name: 0.e../01,.., Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 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 E-mail: Urinal 25.02 ' 4i' I ?NTitciille A v" Water closet 25.02 Water heater 37.52 Business name: Dennis'Seven Dees Landscaping, Inc. Water piping/DWV 56.29 Address: 7355 SE Johnson Creek Boulevard Other: 25.02 City/State/ZIP: Portland, OR 97206 Subtotal 503.777.7777/503.777.2399 Phone:( ) tiffanyb@dennis7dees.com Minimum permit fee: $72.50 .2).,. .5) CCB Lie.: (( 3L�f/T Icb: 5009 plumb lic:05LIBDI Metro: 1478 Plan review (25%of pennit fee) -- State surcharge(12%of pennit fee) '.7r�c) Authorized signature: �, 4� /. ) (/ Print name: TOTAL PERMIT FEE . <Tl' i Y6 S Date: /6/7/t? 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:ABuilding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) /67// Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: S><tLtl�t es ` .. tiot . ., Fee(eat Tta7 Square outage P�ruut Fee, .. .�. . Footing drain-le 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 , l PElCmitvEee 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 Fee lea} Total each additional$100.00 or fraction thereof,to ©cher�nspectivnS ox els , . ", „ 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. $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/11r each additional$100.00 or fraction thereof. (minimum charge-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*. Quantity by Fixture Type , PPt211g Ilsallatioris, Fixture Type for s xepiacel Plan review is required for any of the following. Work Performed Capped :'_ Added �.. Relocate Please check all that apply. Baptistry/Font Bath -Tub/Shower ❑ Any new commercial building with water service 2"and Tub/Sowergreater,except systems designed and stamped by licensed 1pool Car Wash -Each Stall engineer. -Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 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" ham. .. 4" Isome-00 tric or Kiser:D agram ., Car Wash Drain ❑ 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 increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: http://www.tigard-or.gov/document_center/Building/PLMF_PennitApp.db� City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15369 SW SEINE DR, TIGARD, OR, 97224 December 14, 2017 at 9:40:25 AM Record Type: Record ID: Residential - Plumbing PLM2017-00460 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor