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Permit (113) CITY OF TIGARD PLUMBING PERMIT I ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00302 Date Issued: 07/29/2019 A I.f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S103DC00805 Jurisdiction: Tigard Site address: 11415 SW FAIRHAVEN ST Project: Abel Subdivision: VIRGINIA ACRES Lot: 3 Project Description: Installing backflow preventer for landscape irrigation. Contractor: LANDSERVICES INC Owner: ABEL,JENNI M PO BOX 1777 11415 SW FAIRHAVEN ST NORTH PLAINS, OR 97133 TIGARD, OR 97223 PHONE: PHONE: 503-644-8575 FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/29/2019 $31.27 Specifics: 1 12%State Surcharge- 07/29/2019 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 07/29/2019 $41.23 Plumbing Class of Work: OTR Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 2.1987 1 ' 6.332.2344. Issued By: � Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures FOR OFFICE USE ONLY r4,77,::---: ,- Date/Bed ? _Z /. .. /%1 (�, sea City of Tigard " ' "' Fermi/tido/ay Ilhi . '� 13125 SW Hall Blvd.,Tigard,OR 97223 y � ;�;.i;� Plan Review Phone: 503.718.2439 Fax: 503.594. 0 Et t-.'-�1.. Date/By: Other Permit No.: TI GARD Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information 7%":%5,74 ,:: -OE., ,', ' x`�tk b,trl t 1$', - IF'�*'1, [TLE 0 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) T�URY OF CONSTRUCTION SFR(1)bath 312.70 �• `I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 i'Tar .10"13 SITE:„INFORMATION AND LOCATION a Site utilities: ' /S (,i Catch basin or area drain 18.76 Job site address: S re,I`A h�-C,", S - City/State/ZIP: '�" �� O� %7"� a3 Drywell,leach line,or trench drain 18.76 5 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: ii‘j.d S Q�.,r 0,-) Manufactured home utilities 50.03 Cross street/directions to job site: tcJ Manholes 18.76 '15 -- 0 .T-�r L'A aver Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 1 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 1.<,..Z7 i Backwater valve 12.51 �� =' �ESCRII'TIOtI�I C))F,WQRI{:", , Clothes washer 25.02 It/s+4, ,/ i h r 15k,-4 t`aN a a 01 le C lei.j 64tc 11 tilt"4, Dishwasher 25.02 111 02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER" 1 1.3-TENANT Expansion tank 12.51 Name: IT Hy laid t,Bet, Fixture/sewer cap 25.02 Address: )1 LI/s '11.A.) FA.tlt- 1' '-e,� 'SIJ , Floor drain/door sink/hub _ 25.02 Garbage disposal 25.02 City/State/ZIP: i 'I-J , d R Li -7 aa3 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 'fI,ICANT f" CONTACTP RSt1 Interceptor/grease trap I t 25.02 Business name: 44 N of5e_i-Vice e s', /NC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: 53.e tie f. it?iN9 Roof f Roof drain(commercial) 12.51 Address: .`0 . Ao i 1'7 7 7 Sink/basin/lavatory 25.02 City/State/ZIP: ot)el s T k f I,,1'pKct b142+ 9 7 /33 Solar units(potable water) 62.54 �t Phone:(5-0 Ip't et=. - Fax: :( ) 12.51 U E-mail: Stege, 1 5',e4,U'j o e (2 0- 0 01 , co--wl rina �. ' 1 2"02 ,:j.''.5. r -- tl ITIACTOR Water closet 25.02 . .•s,.. < ,: ...., Water heater 37.52 Business name: %4,,,,,1-5lyji ice S, j 1,./ Water piping/DWV 56.29 Address: P.0. 604 ! Other: 25.02 City/State/ZIP: 00---t Ii rct)VS wr �/ , 9 7 / 33 _ Subtotal 312 'j Phone:4'03) 0 414 1 JT' 5 Fax:( ) _ Minimum permit fee: $72.50 ipt Aar tCB Lie.: c)0$ L40 ,At4 Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: ,,e- & e TOTAL PERMIT FEE Print name: $+-ev 6,1 O /11�Q$' Date: 7.9-ko ii This permit application expires if a permit is not obtained within 180 days _ 1 after it has been accepted as complete *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: , tFee(e • Total s�' S><te.Ut><l>Gt►es: • � Footing drain-151 100' 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 Vluatdn P�rmil 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 ether Inspections or r ees Qty. Fee(ea) •• Total each 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*. Quantity by Fixture Type. Pia l Reyr<ew f©r Plumba�ng Installations Fixture Type for Replace Work Performed: Capped Added Relocate'- Plan review is required for any of the following. Baptistry/Font Please check all that 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 El 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 ❑ 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" • Car Wash Drain ispmetric or liser ,y,tag�riln, , Garbage Domestic-non-food CI 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\steve\Downloads\PLMF PermitApp.doc 2 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11415 SW FAIRHAVEN ST, TIGARD, OR, 97223 August 21 , 2019 at 10:31 :28 AM Record Type: Record ID: Residential - Plumbing PLM2019-00302 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: 1 " Febco irrigation backflow device model #H19667 model B500 located in front of house approved with test report. Violation Summary: Inspector Contractor