Permit CITY TI G D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 -00017
4a-:24J1%._ DATE ISSUED: 1 /12/2006
. - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 28 ZONING: R -12
SUBDIVISION: MARCIENE 11 APARTMENTS LOT: JURISDICTION: TIG
Project Description: Repipe of 1st & 2nd floors. Apartments: 28,29,30,31.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
BOOTH - HEYDON LLC
PO BOX 1185 Description Date Amount
LAKE OSWEGO, OR 97035 [PLUMB] Permit Fee 1/12/2006 $72.50
[TAX] 8% State Surcha 1/12/2006 $5.80
Phone : Total $78.30
Contractor:
PLUMB CRAZY
52683 NE SHEENA PL
SCAPPOOSE, OR 97056 REQUIRED ITEMS AND REPORTS
Contact # : FAX 503 -543 -3920
PRI 503 - 544 -2160
Reg #: LIC 138864
PLM 3436 -PB
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.
, Permittee Si natu
Issued By: � �� f� 9 L
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.
Building Fixtures
Plumbing Permit Applicatioq ; C � r -0,l� _" .. *.
City of Tigard Received • _ Date/By U� �P /
/�( Permit Nq'\ \ � ( O J I
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /Lrinr ,. Other Permit No.:
I'�I D ate B y.
24- Hour Inspection Line: 503.639.4175 ''l l� Date Ready/By: Jun ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method � U - Supplemental Information
TYPE OF WORK . FEE* SCHEDULE .
❑ New construction ❑ Demolition For special information use checklist:
Description 1 Qty. 1 Ea. 1 Total
X Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
' CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building 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: / , S S �'i,/ , /`( j -) Catch basin or area drain 16.60
City /State /ZIP: u •i 7 2 Z Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 .
U � Manufactured home utilities 110.00
Cross street /directions to job site:
Manholes 16.60
I
0 d (AIL i a, 7 9 N 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 FORK Back flow preventer Page 2
G - r// / i_" Backwater valve 16.60
t / Clothes washer 16.60
14 Ut 0 q
Q Dishwasher 16.60
/ t Drinking fountain 16.60
❑ PROPERTY OWNER . l ❑ TENANT
/11,,{, Ejectors/sump 16.60
Name: M ( / ( 4 co Ge' 1 "'1 4 t^ Expansion tank 16.60
Address: + Ai L 1 • Fixture /sewer cap 16.60
City /State /ZIP: VI a c ,---1,..-0 Wa • q--65 1 Floor drain/floor sink/hub 16.60
Phone: ( , ) a - Fax ( ) Garbage disposal 16.60 •
[APPLICANT - ' ❑ CONTACT PERSON Hose bib 16.60
e ' - Ice maker 16.60
Business name: 4 /f7 • G,...,/, Interceptor /grease trap 16.60
Contact name: e , ,-r 4, Medical gas (value: $ ) Page 2
Address: 4 7( 2_ S - /, ,w � U0 u r- J, ,4 i7 5 J Primer 16.60
O N N ve r-6r A 9 7 Roof drain (commercial) 16.60
2 r b 3 Sink/basin/lavatory 16.60
O
Phone: ) - 7 - Fax: : ( )
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: P[ 4 on 6 Cr--- 0 ` Water heater 16.60
s`. 3 ,
Address: 5 J /C c�ti (C ok a PL Other.
City/State/ZIP: o (, a 7 O ' C Subtotal
V C 1 Minimum permit fee: $72.50
Phone: ( NA, . d'� ` Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: * i �� � Plumbing Lic. no.: _ />tl� Plan review (25% of permit fee)
Authorized si ature_ �" State surcharge (8% of permit fee) r
TOTAL PERMIT FEE ' , 4. (•�
Print name if e - a rrel_ Date:/ /2 -0 6"
7 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.
is \ Building \ Permits\ PLMF- PemritApp.doc 06/05 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities .Qt Fee (ea) - Total ..,
Square Footage: ,, . Permit Fee: _ = .
Footing drain - 1 100' 55.00 0 to 2,000 $115.00
Footing dram - 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 - Ist 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm &Rain Drain - 1st 100' 55.00 $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
` additional $100.00 or fraction thereof to and
Fixture or Item Qty' Fee (ea) Total
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
each additional $100.00 or fraction thereof; to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixture s could result in increased sewer fees *. Please check all that apply.
- • Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher -Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain ❑ Any NFPA 13 - D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isometric or,RiserDiagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture permit results in an
Water Extractor ure work under this P
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
i :\ Building \Permits\PLM- PermitApp.doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00017
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: •/1212006;
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
4114
INSPECTION WORKSHEET FOR DATE: 8127/2005 TIME: 7:07AM PAGE: 4
SITE ADDRESS: 14555 SW 761 AVE 28 CLASS OF WORK:
SUBDIVISION: MARCIENE I1 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE II APARTMENTS
DESCRIPTION: Repipe of 1st & 2nd floors. Apartments: 28,28,30,31.
OWNER: BOOTH - HEYDON LLC, PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503-5M-2160
Inspection Request Scheduled For: Date: 8/27/ 2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 037250 -02 503 - 267 -3668 N
Corrections /Comments /Instructions:
•
AW 69 % --- ..0
PASS U PARTIAL APPROVAL CANCEL _ NO ACCESS
FAIL I I CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: M 1/ Date: l . Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION •� • •- PERMIT #: PLM200(00017
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1212006
Phone: (503) 639 - 4171 °,..
Inspection Requests (24 Hrs.): (503) 639 -4175 ,� i ^�I
INSPECTION WORKSHEET FOR DATE: 0/16/2006 TIME: 7:05AM PAGE: 90
SITE ADDRESS: 14655 SW 76TH AVE 28 CLASS OF WORK:
SUBDIVISION: MARCIENE 11 APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE. 11 APARTMENTS
DESCRIPTION: Repipe of 1st & 2nd floors. Apartments: 28,28,30,31.
OWNER: BOOTH- HEYDON LLt1, �' PHONE #:
CONTRACTOR: PLUMB CRAZY PHONE #: 503 - 5.14 -2160
2,_cs C
Inspection Request Scheduled For: Date: 8/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 034997-01 503 -267- 3668 N
Corrections /Comments/ Instructions:
44111
/ `` i
PASS g._ PARTIAL APPROVAL n CANCEL n NO ACCESS
n FAIL ; CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r p �
Inspector: / `� Date: 0 / Phone #: (503) 718- '
Il
CITY OF TIGARD Pt_ni
BUILDING DIVISION •• PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: W �� ®� 7
Phone: (503) 639 - 4171 ° a ,, . , i1����
Inspection Requests (24 Hrs.): (503) 639 -4175 s
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / !j 76 " ± V CCASS OF WORK:
/
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: ' PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
PL
Corrections /Comments /Instruc ns: 6a °� / e`
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
[7 FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: a // " Phone #: (503) 718 -
i