Permit CITY TIGARD PLUMBING PERMIT
I A, DEVELOPMENT SERVICES PERMIT #: PLM2006 -10055
�• l! . DATE ISSUED: 3/30/2006
'` - - -- 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 2S 112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 11 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT: JURISDICTION: TIG
Project Description: REPIPE 1ST FLOOR WATER ONLY UNITS 5, 6.
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MICHAEL O'GROMANI
302 ASHLEY DR. Description Date Amount
UNDERWOOD, WA 98651 [PLUMB] Permit Fee 4/6/2006 $72.50
[TAX] 8% State Surcha 4/6/2006 $5.80
Phone : 503- 386 -1980 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.
Issued By: Permittee Signature: ___2: ay 4
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.
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PI .a g Permit jrs
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CityofTigard I _ ,OG 6 Permit No o�5
13125 SW Hall Blvd., Tigard, OR 97223 oo � I
3 0 2006 .� Date/By. Review
Phone: 503.639.4171 Fax: 503.59 ^ � Other Permit No.:
24- Hour Inspection Line: 503.639.417
Internet: www.tigard or.gov - Date Ready/By. t ' • ® See Page 2 for
CITY OF TIGARC Notified/Method �a�-+A Supplemental Information
IMI ltilealliSIO? FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
�'I Addition /alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ I- and 2-family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building Multi - family
SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address 114.6 5 ( ' L / 7g L- / s, 6, Catch basin or area drain 16.60
City /State/ZIP: / i �,..' 0/ t 7 2 L 3 Drywell, (each line, or trench drain 16.60
Suite/bldg. /apt. no.: j '/ 1 Project name: " ry Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street /directions to job site:
Manholes 16.60
�J �✓, 0bt f 1 y Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: ( Lot no.: Water service (no. linear R: ) Page 2
Tax map /parcel no.:
Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Back flow preventer Page 2
_ / r ( / / 1 Backwater valve 16.60
• + t , ACA/ , `� /� Clothes washer 16.60
w Dishwasher 16.60
In PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
( Ejectors/sump 16.60
Name:
/chet.4_ o // Gv v � Expansion tank 16.60 Address: `? (7Z J Fixture/sewer cap 16.60
City / State/ZIP: f � A p o p 4 7Cf6 S Floor drain/floor sink/hub 16.60
Phone: ( ) I Fax: ( ) Garbage disposal 16.60
❑ APPLICANT 1 ❑ CONTACT PERSON Hose bib 16.60
• Ice maker 16.60
Business name: . /
i 5 •/ �/'� Interceptor /grease trap 16.60
Contact name: l/ e ,t ( 8( /` a "N Medical (value: $ ) Page 2
g
Address: / G -7 J. Aw A / Primer 16.60
City / State/ZIP: l P 4 r v Gr e,e- Te.„ / 9 7 t/ e ct Roof drain (commercial) 16.60
X03 ) �Z A / � Sink/basin/lavatory 16.60
Phone: ` 3 66,(/ Fax: : ( )
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: it ivi 6 r z Water heater 16.60
Address: s � 9 L p 3 / {/ f ( pL Other:
City / State/ZIP: S wee 0 JA / Oa_ q 7V d �^ G Subtotal
Minimum permit fee: $72.50
P hone: 103 ) S5 21 h 0 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: /3,,r ( G f Plumbing Lic. no.: 3 934 - RI Plan review (25% of permit fee)
r State surcharge (8% of permit fee) 17.dj
Authorized sign. , t6'
TOTAL PERMIT FEE
Print name: r / _ Date: ,3/0) 6 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
t/, *Fee methodology set by Tri -County Building Industry Service Board.
1 : \Building\Pemro\PLM- PemiWpp.doc 12/30/05 440 -4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) - Total Square Footage: Permit Fee:
Footing drain - I 100' 55.00 0 to 2,000 5115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 5220.00
Sewer - 1st 100' 55.00 7,201 and greater _ 5309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 Valuation: Permit Fee:
Storm &Rain Drain - 1st 100' 55.00
51.00 to 55,000.00 Minimum fee 572.50
Storm & Rain Drain - each additional 100' 46.40 55,001.00 to $10,000.00 572.50 for the first 55,000.00 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 525,000.00 5148.50 for the first 510,000.00 and $1.54 for
Residential Back flow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee 536.25) 27.55 and including 525,000.00.
Rain Drain, single family dwelling 65.25 525,001.00 to 550,000.00 5379.50 for the first 525,000.00 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 550,000.00.
550,001.00 and up 5742.00 for the first 550,000.00 and 51.20 for
Subtotal: each additional 5100.00 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 fixtures could result in increased sewer fees *. Please check all that apply. •
Quantity by (Future) 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
Eye Wash ❑ Any NFPA 13 -D multipurpose fire sprinkler system.
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
-4
Car Wash Drain Isometric or Riser Diagram
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 -
Water Extractors *Note: If the fixture work under this permit results in an
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.
\ Building \Permits\PLM- PennitApp doc 07/06/05
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 100 6 •
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 3 /30/2006
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 r °_.
. INSPECTION WORKSHEET FOR DATE: - i0/5/2006 TIME: 7:00AM PAGE: 1
SITE ADDRESS: 1465,5 SW 76TH AVE 11 CLASS OF WORK:
SUBDIVISION: MARCIENF II APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE APT;
DESCRIPTION: REPIPE 1ST FLOOR WATER ONLY UNITS 5, 6.
OWNER: MICHAEL O'GROMANI, PHONE #: 5Q3- 343 &198()
CONTRACTOR: PLUMB CRA7Y PHONE #: 603.5442160
Inspection Request Scheduled For: Date: 10/5!2006 Pour Time:
Code # Inspection Description Confirm # , Contact # Message
393 Plumbing final 037766 - 01503 - 267 -3668 Y
Corrections /Comments / Instructions:
/
(/
• ' -g i l
PASS I I PARTIAL APPROVAL I I CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� 2 G //
Inspector: �/ Date: e D' Phone #: (503) 718
clf
CITY OF TIGARD .4, , ebb-f
BUILDING DIVISION � PERMIT #.
13125 SW Hall Blvd., Tigard, OR 97223 � DATE ISSUED:
Phone: (503) 639 -4171 +�
Inspection Requests (24 Hrs.): (503) 639 -4175 ^'II
INSPECTION WORKSHEET FOR DATE: 3/ 3 \/( , TIME: PAGE:
SITE ADDRESS: ( f 4 S S (D -- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: , / PHONE #:
CONTRACTOR: k/Ak PHONE #: 24 7 . 76 / e
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
3/-6 e NQ„„(A,____
Corrections /Comments / Instructions:
"PASS ❑ PARTIAL APPROVAL
•
El CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /) "- Date: 7/ 4 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM:%i ?i r,100!.;6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30/200(:;
Phone: (503) 639 -4171 '�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4 /iW200G TIME: 7:06AM PAGE: 3
SITE ADDRESS: 14(6f SPIV TCTF AVE. 11 CLASS OF WORK:
SUBDIVISION: MARCIENE II APARTMEN TS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE APDS
DESCRIPTION: REPIPE 1ST FLOOR WATER ONLY UNITS a 6, 6_
OWNER: MICHAEL_ O' ROIVIANI, PHONE #: d:.03 MG - (?
CONTRACTOR: f LUIVIB CRAZY PHONE #: 503
Inspection Request Scheduled For: Date: 4 /'lMO% Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 02025a-02 503-267-366B
Corrections /Comments /Instructions:
1:7 1-7
•
•
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .v Date: 4 Phone #: (503) 718 - 0 " G/