Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT f Permit#: PLM2009-00364
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/30/2009
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Parcel: 2S111CB01748
Jurisdiction: Tigard
Site address: 10335 SW HOODVIEW DR
Project: Wong Subdivision: HOOD VIEW NO.2 Lot: 44
Project Description: Install 100 feet or less of sanitary sewer line to connect existing home to sewer.5/11/15:Changed permit status
from expired to issued in order to complete the plumbing final inspection to close the permit.
Contractor: CANBY EXCAVATING Owner: WONG, M MOOYUN
PO BOX 848 10335 SW HOODVIEW DR
CANBY, OR 97013 TIGARD, OR 97224
PHONE: 503-572-0515 PHONE:
FAX: 503-266-2791
FEES
Quantity Description Date Amount
100 If Sewer Service 12/30/2009 $62.54
Specifics: 1 12%State Surcharge- 12/30/2009 $8.70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment- 12/30/2009 $9.96
Plumbing
Class of Work: ALT
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, Sta • of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expi'- if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require. yo to follow the rules adopted .y the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9 '-00 -0090. You may obtain a opy 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 p .j= t.
Approved plans are required on the job site at the time of each inspection.
r.- t, CITY OF TIGARD PLUMBING PERMIT
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m ' COMMUNITY DEVELOPMENT Permit #: PLM2009 00364
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/30/2009
Parcel: 25111 CB01748
Jurisdiction: Tigard
Site address: 10335 SW HOODVIEW DR
Subdivision: HOOD VIEW NO. 2 Lot: 44
Project: Wong
Project Description: Install 100 feet or less of sanitary sewer line to connect existing home to sewer.
Owner: FEES
WONG, M MOOYUN Quantity Description Date Amount
10335 SW HOODVIEW DR
TIGARD, OR 97224 100 If Sewer Service 12/30/2009 $62.54
PHONE: 1 12% State Surcharge - 12/30/2009 $8.70
Plumbing
10 ea Minimum Fee Adjustment - 12/30/2009 $9.96
Contractor: Plumbing
CANBY EXCAVATING
PO BOX 848
CANBY, OR 97013
PHONE: 503 - 572 -0515
FAX: 503 - 266 -2791
Type of Use: SF
Class of Work: ALT 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' odes . d all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not'started )thin 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules a• •pted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may 0• ain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By:
ya 0C,► aiki9A; Permittee Signature:
J n n �(. Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project. I
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application RECEIVED
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Building Fixtures _ �, ,. ,, ;
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Received , ^
City of Tigard \1 /t� Permit No.: am2cO9, co 3(dL
a 13125 SW Hall Blvd., Tigard, OR 97223 DateBy: w `-'W �r
Phone 503.639.4171 Fax: 503.598.1960 CITY OF TIGAR ► Plan Review ��2
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� 4 Other Permit No.: �►1'LJ `• l Jl 1''LC
i 1 1 a ; R I Inspection Line: 503.639.4175 BUILDING DIVISIi' .ate Rea telly:
d
'u is: See Page 2 for
Internet: www.tigard- or.gov Notified/Method: 1 )s Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
•
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: ( b 33 5� 7.
v� V�o Q Drywell, leach line, or trench drain 18.76
City /State /ZIP: l ( GA-62-0 or / -a tf Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.:)(X) ) I Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
fax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
• PROPERTY OWNER ' I ❑ TENANT Expansion tank 12.51
Name: �(�- /�(0 4) (JD Fixture /sewer cap 25.02
Address: ( O3) c 5 1w V ( DAZ Floor ge disposal sink/hub 25.02
Garbage disposal 25.02
City /State /ZIP: II Y 6 7 D-3 Hose bib 25.02
Phone: (59 ) 7 0d__ 30 Fax: ( ) Ice maker 12.51
❑ APPLICANT " ❑ 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 25.02
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
CONTRACTOR Water closet 25.02
' � G -� Water heater 37.52
Business name: - Water piping/DWV 56.29
Address: 1" 6 , 60)4 `' , S Other: 25.02
City /State /ZIP: (r 1 4 1 N3 Subtotal
Phone: (503) S7a , o (S9 Fax: ( ) Minimum permit fee: $72.50 `7 a •50
CCB Lic.: Plum : ; lC no.: Plan review (25% of permit fee)
1 ,��/,
Authorized signature: State surcharge (12% of permit fee) 8 ") U
TOTAL PERMIT FEE 8 ( . 20
Print name: \_..-- Date: This permit application expires it 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- 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:
Site Utilities Qty. ' Fee (ea) . Total " Square Footage: . Permit Fee:
Footing drain - 1s` 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
Storm &Rain Drain - 1st 100' 62.54 Valuation: Permit Fee:
$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 Qty. Fee.(ea) Total each additional $100.00 or fraction thereof, to
p 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 ", Plan Review for Plumbing Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
• Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
Fixture Type: • ,Replace greater, except systems designed and stamped by licensed
Previous Capped .Added Existing engineer.
Baptistry/Font
Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
Jacuzzi /Whirlpool as defined in OAR918- 780 -0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive Thru ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash Isometric or Riser Diagram.
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
3 that meet the qualifications above.
- 4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink -Bar/Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit.will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
[:\Building \Permits \PLMF - PermitApp.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10335 SW HOODVIEW DR, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2009-00364
George Heimos
Video provided from Steve Bailey, Apex Home Inspection dated 04/25/15 to verify pipe is
in good condition, also provided is documentation from contractor Canby Excavating that
"Demo septic tank, included. Filling with sand or CDF as needed."
Violation Summary:
Inspector Contractor