Permit CITY OF TIGAR®
M ' PLUMBING PERMIT
4 ° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00224
r DATE ISSUED: 5/30/2007
T ! 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102AC -00400
SITE ADDRESS: 09230 SW BURNHAM ST ZONING: CBD
SUBDIVISION: BURNHAM TRACTS LOT: 001 JURISDICTION: TIG
PROJECT: DOLAN
Project Description: Repipe and replace fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
DOLAN + CO LLC
BY FLORENCE T DOLAN Description Date Amount
4025 SE BROOKLYN [PLUMB] Permit Fee 5/30/2007 $83.00
PORTLAND, OR 97202 [TAX] 8% State Surcha 5/30/2007 $6.64
Phone : 503- 225 -9009 Total $89.64
Contractor:
JOE PETRO PLUMBING
PO BOX 98
WILSONVILLE, OR 97070 -0098 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -913 -1221
FAX 503- 625 -6307
Reg #: LIC 91524
PLM 3 -469PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signatur .
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.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
r,, R ,Pr�>a (i , , }P . ry - � . r '•' � 'F �+ . , 4' r O F r U Y t , _` „ `` r ,
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City of Tig ard l�� t� Receive P it : _ _ ,, as !
n 13125 SW Hall Blvd., Tigard, OR 97223 Date/By? 3o /p "j^�;.J�/� 4J 40
1 M AY ®2007
Plan Revi w J
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
+ iGA s Inspection Line: 503.639.4175 1� = 1a � �.tRU Ready/By: " r� Date Read /B ® See Pa t; e 2 for
TIGARD; C t +
;i,.,r r.1 Internet: www.tigard or.gov p a p aE1d �t,;;� p Notified/Method: Supplemental Information
' .. TYPE O F WORK • FEE* SCIIEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 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 249.20
�J I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
/ ❑Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND-LOCATION. Site utilities
Job site address: YZ $ ( 6 u {n h ,,,t Rof Catch basin or area drain 16.60
City /State /ZIP: li� (712 2 77.2. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture, or item
Tax map /parcel no.:. Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
j � p, 91 M 1-- ' �' 401/4 Backwater: valve 16.60
l j Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I 0 TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: DUB 1.2.2160‘X _ Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16.60
Phone: (573) 62 ? 4/9 5-O Fax: ( ) Garbage disposal 16.60
Hose bib 16.60
la APPLICANT' ❑ CONTACT PERS
l / Ice maker 16.60
Business.name: Du vi t Q. I (---,,,7_,,,- r 1'1 -- Siiv (911 S -� , Interceptor /grease trap 16.60
Contact name: 726 \ Medical gas (value: $ ) Page 2
Address: loo i3 9X 2 ,3 4 -0 Primer 16.60 l
City /State /ZIP: „,, c, ` -�-u 9 ) 9 ,,
,7/_ Roof drain (commercial) / 16.60
J Sink/basin/lavatory / / /2 16.60 cli Phone: (s3) J r Z� 7�, Fax: : ( ) Tub /shower/ hoover pan 1 16.60
E -mail: Urinal 16.60
' CONTRACTOR. y Water closet 7 16.60
• Business name: r , cj - r c) Y/ 0 , b� C Water heater 16.60
Address: r L) Other: /� , r
Subtotal
City /State /ZIP:
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 3, 07)
CCB Lic.: V( 6 41 Plumbing Lic. no.: .....e f .. p A Plan review (25% of permit fee)
State surcharge (8% of permit fee) (p .6/4/
Authorized signature: 67(-4-/ TOTAL PERMIT FEE .'is , q
Print name: pe, ` - 7 4 G�, .7 .. \ - -S ( N Date: 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.
1.\ Building \ Permits\PLM- PermitApp.doc 12/27/06 440- 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) Tot Square Footage: Permit Fee:
Footing drain - I st 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 ,
Storm &Rain Drain - 1st 100' 55.00 Valnattlont `Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture Or Item :"qty. ' Fee (ea). Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, adding or replacing fixtures? If "yes", Plan Review •for 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
-Tub/Shower as defined in OAR918- 780 -0040.
Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Each tall ❑ 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
a „
Eye Wash - or Riser" °1Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory *Note: If the fixture work under this permit results in an
- Bradley p
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i:\ Building \Permits\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: i,I_M2007.0023A
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/30/20Q7
Phone: (503) 639 -4171 ihre °'r, „G,II
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/19/2007 TIME: 7:01AM PAGE: 25
SITE ADDRESS: 09230 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: BURNHAM TRACTS LOT #: 001 TYPE OF USE:
PROJECT NAME: [)OLAN
DESCRIPTION: Repipe and replace fixtures.
OWNER: [)OLAN + CO LILC, PHONE #: 603.225-9009
CONTRACTOR: PE RO PLUMBING, JOE PHONE #: 503.913 -1221
Inspection Request Scheduled For: Date: 10/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
389 Plumbing final 057953-01 503 -522 -9376 Y
Corrections /Comments /Instructions:
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Inspector: '►'A^--” 1) 11 - Date: i a r 19/0"? Phone #: (503) 718-
CITY OF TIGARD p ili
BUILDING DIVISION _ _ PERMIT #: o? —l»O�a L /
Allk 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: T
Phone: (503) 639 -4171 „ 4: 1 1 1 At
Inspection Requests (24 Hrs.): (503) 639 -4175'
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: q a 3 O CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
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CONTRACTOR: PHONE #:
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Code # Inspection Description Confirm # Contact # Message
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P C !TY OF TIGARILY
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BUILDING DIVISION v A _ , ■ PERMIT #: 607 rlo...,,,), 4 7
13125 $W Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 A,
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Inspection'Requests (24 Hrs.): (503) 639-4175 ,.. )
INSPECTION WORKSHEET FOR DATE: TIME: , PAGE:
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SUBDIVISION: LOT #: TYPE OF USE:
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Code # Inspection Description -_,..--
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00224
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2007
Phone: (503) 639- 4171��p
Inspection Requests (24 Hrs.): (503) 639 -4175 �-!�i
INSPECTION WORKSHEET FOR DATE: 6/11/ 2007 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 09230 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: BURNHAM TRACTS LOT #: 001 TYPE OF USE:
PROJECT NAME: DOLAN
DESCRIPTION: 12ttpipe and replace fixtures.
OWNER: DOLAN + CO LLC, PHONE #: 503-225.9009
CONTRACTOR: PETRO PLUMBING, JOE PHONE #: 503. 313.1221
Inspection Request Scheduled For: Date: 6/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 049975-01 503- 522 -9376 Y
Corrections /Comments /Instructions:
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PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 11- 1) Date: / � // Phone #: (503) 718- 4 r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2i007- 00224
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/30/2007 •
Phone: (503) 639 -4171 � ��� � pi A ,
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7:01AM PAGE:
SITE ADDRESS: 09230 SW BURNHAM ST CLASS OF WORK:
SUBDIVISION: BURNHAM TRACTS LOT #: 001 TYPE OF USE:
PROJECT NAME: DOLAN
DESCRIPTION: Repipe and replace fixtures.
OWNER: DOLAN + CO LL.C, PHONE #: 503 - 225.9009
CONTRACTOR: PETRO PLUMBING, JOE PHONE #: 503913
Inspection Request Scheduled For: Date: 6/4 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 049530 -01 503. 522.9376 N
Corrections /Comments /Instructions:
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Inspector. 1 1 Date: / Phone #: (503) 718 - GP 41-31