Loading...
Permit CITY TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00474 T; ►GA[D: 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/22/2007 PARCEL: 1 S133DA -05500 SITE ADDRESS: 12880 SW GLACIER LILY CIR ZONING: R -7 SUBDIVISION: AMART SUMMERLAKE LOT: 077 JURISDICTION: TIG PROJECT: LUTZ Project Description: Install new ice maker line. 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: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES LUTZ, ARTHUR A + CAROL ANN 12880 SW GLACIER LILY CIRCLE Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 10/22/2007 $72.50 [TAX] 8% State Surcha 10/22/2007 $5.80 Phone : Total $78.30 Contractor: KRAFTSMAN PLUMBING LLC 2606 A ST. FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 793 -4338 FAX 503- 357 -0407 Reg #: LIC 176302 PLM PB352 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. / Issu By: �� /��� / Permittee Signature ( tol:j oy • 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. Plu,mbin'* Permit A 1 s fig: ,'..e. Building Fixtures "..11S - `rte ry`- ., :; ` R S °N w i ' +? City of Tigard Received Permit No nn a 13125 SW Hall Blvd., Tigard, OR ' Y 2007 Date /By: ki/2 - S PZ / Vel 0 _ . ;;- Phone: 503.639.4171 Fax: 503.598.1960 flan Review Other Permit No.: e y Date /By: l I GnR D. Inspection Y Y Page 2 for Internet: www.tigard or . � �y 4 7� Notified/Method: //� Supplemental Information r : e � 1y r , i . 0 1 t/TS FEET SCHEDULE ❑ New construction ❑ Demolition For special information use check list Description 1 Qty. Ea. 1 Total WI Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) it . CATEGORY OF CONSTRUCTION . SFR (1) bath 249.20 AI- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 1=1 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: ' 211 0 r S .; • OaCie,if l i LY V„ Catch basin or area drain 16.60 City /State /ZIP: - r , o A - 12.. 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: _) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 6 l o C h' r 1. a L so' 0 112 n 5 , 7/lme 1 kit' e ,9 �'� 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 /3t�t J T c e ol A e v j, Y► t_'- Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 VI PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors /sump 16.60 Name: r FA .t,0 I I n 4 L, 0 Ds- Expansion tank 16.60 Address: j z34o 5 t,.J 6 len ) e- 1.. L.y 40 g Fixture /sewer cap 16.60 City /State /ZIP: ) 91-2-V7 Floor drain /floor sink/hub 16.60 ! <�t" Yr' �` Garbage disposal 16.60 Phone: ( 503) 1 o q - 6 - 4 Fax: ( ) 0. APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker i 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 -- • Phone: ( ) ( ) Sink/basin/lavatory 16.60 Fax:: Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: 1,4 & AT . /yt, A t T Lom t1 m �+ iJ h c 1 L ( j Water heater 16.60 Address: ^1 , 606 � A I 5 -- 1 Other: / City /State /ZIP: � ^l �, / V e , n v 93,f6 Subtotal Q {P� o Minimum permit fee: $72.50 Phone: (563 ) 9 ._ z/3 <3 g I Fax: ( e""�- - O t 0-7- _ Residential backflow minimum permit fee: $36.25 CCB Lic.: / 163, '1 C j / Z s /69 Plumbing Lic. no 7 . / T/� / q- Plan review (25% of permit fee) o'er ff i State surcharge (8% of permit fee) Authorized si urn TOTAL PERMIT FEE �l �1rU �c� -ar Print name: Date: 1 �' I '�- This permit application expires if a permit is not obtained within r�1tC.� C�� /urn - / O 180 days afte it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. 1: Buildin \ Permits \PLMF - PermitApp.doc 12/27/06 440- 46t6T(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard =; x Page 2 - Supplemental Information .fit': • Fee Schedule: Residential'F Systems: Site Utilities • Qty. Fee (ea) Total Square Footage:, ; -;. .Permit Fee: Footing drain - Is' 100' 55.00 • _A4t6'40001 a. - " ' 1115.00 2,00)5to 3;600 .' " ,; ' ' ?� , ' $160.00 Footing drain - each additional 100' 46.40 t 43' ,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 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 • 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: Plan.Review'for Plumbing Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed engineer. Fixture Type: Replace g Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic Drinking Fountain Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. -3" - 4•' 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 -Gana -Stall Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results in an -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: is\ Building \Permits\PLA1- PermitApp. doc 12/27/06 • CITY OF TIGARD ' BUILDING DIVISION PERMIT #: piN2007-00474 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: itV22/2007 Phone: (503) 639-4171 Akb Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/23/2007 TIME: 7 PAGE: 35 SITE ADDRESS: 12880 SW GLACIER LILY CIR CLASS OF WORK: SUBDIVISION: AMART SUMMERLAKE LOT #: 077 TYPE OF USE: PROJECT NAME: LUTZ DESCRIPTION: install new ice maker line. OWNER: LUTZ, ARTHUR A + CAROL ANN, PHONE #: CONTRACTOR: KRAFTSMAN PLUMBING LLC PHONE #: 503_793.4333 Inspection Request Scheduled For: Date: 10/23/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough-in 068136-01 503-793-4338 Corrections/Comments/Instructions: • k PASS El PARTIAL APPROVAL CANCEL 0 NO ACCESS n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED V bArv)NA, .-- Inspector: d Date: /'O 1 ag i Phone #: (503) 718- 1 8/0 2008 CCEL Case Activity Listing A - CC �8 :43:44AM G Case #: PLM2007-00474 Assigned Done Updated Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes PLM1010 Application received 10/22/2007 None RECD SLN 10/22/2007 BLD PLM1020 Permit created 10/22/2007 None DONE SLN 10/22/2007 BLD PLM1030 Check for parcel tags 10/22/2007 None DONE SLN 10/22/2007 BLD PLM 1260 PLM signature on 10/22/2007 None DONE SLN 10/22/2007 application BLD PLM1280 Issue permit 10/22/2007 None DONE SLN 10/22/2007 BLD r , PLM2320 Plumbing rough -in 10/22/2007 10/23/2007 10/23/2007 None PASS JW 10/23/2007 058135 - 01 — 503 793 - 4338 — VM - r STI N 4/ 7,7/0 r //A;( NQ 1 �� GG,S t: Ti ' de_ Girl w✓ Page 1 of 1 CaseActivity..rpt