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Permit CITY OF TIGARD PLUMBING PERMIT -- COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00173 TIGARD ' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/27/2007 ` PARCEL: 2S112BB -04800 SITE ADDRESS: 14137 SW FANNO CREEK DR ZONING: R -7 SUBDIVISION: COLONY CREEK ESTATES ES NO.2 LOT: 031 JURISDiC T ION: TIG PROJECT: HOFFMAN Project Description: Backflow preventer for irrigation,. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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 BEN HOFFMAN 14137 SW FANNO CREEK DR Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 4/27/2007 $36.25 [TAX] 8% State Surcha 4/27/2007 $2.90 Phone : 503- 869 -6806 Total $39.15 Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact #: { 9r,, Reg #: y `f�� , „ /j 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: I Permittee Signature. 14it ru/ 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. . " CITY OF TIGARD PLUMBING PERMIT ": COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00173 'TIGARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/27/2007 PARCEL: 2S112BB-04800 SITE ADDRESS: 14137 SW FANNO CREEK DR ZONING: R -7 SUBDIVISION: COLONY CREEK ESTATES NO.2 LOT: 031 JURISDICTION: TIG PROJECT: HOFFMAN Project Description: Backflow preventer for irrigation,. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 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 BEN HOFFMAN 14137 SW FANNO CREEK DR Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 4/27/2007 $36.25 [TAX] 8% State Surcha 4/27/2007 $2.90 Phone : 503- 869 -6806 Total $39.15 Contractor: OWNER REQUIRED ITEMS AND REPORTS Contact # : Reg #: 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: /L' Permittee Signature — uu/ 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 Fb ' `� _ 1 ' �a FOR1'`O IC E::USE Nli ' li R 3 : E. �9 •C. c -JET : !„. . it . �r F�§t • F ,'.` 'f �kta ,'!4 k A4:ti 41 ,0Ci i.' f r, y �+ Received / � . 4 ? x r ? i City O f T td�� t c'''' / �1 , Per ? ": V 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: a�J d "? `A 7� D� �� .. Phone: 503.639.4171 �SOt9o98. ��1 Plan Review / Date/By: Other Permit No.: " + 4 Inspection Line: 503.63f d"l i�'s r+ tT 1 411 D �� Date Ready /By: lu See Page 2 for • ±gayy�lgr; Internet: www.tigard or.gov uu�� Notified/Method: - I! Supplemental Information • . C E�+ OVANO . Y l 1 FEE* SCHEDULE X T . ❑ New construction f D emolition For special information use checklist "' Description 1 Qty. 1 Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) . - CATEGORY OF CONSTRUCTION - SFR (I) 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 JOBSITE INFORMATION AND LOCATION Site utilities Job site address: / 5(') / , t.o K CA Catch basin or area drain 16.60 City /State /ZIP: / l ( )li OA ? Zr Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 1 10.00 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: 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 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 , - O D. PROPERTY WNER ❑ TENANT Drinking fountain 16.60 / I Ejectors /sump 16.60 Name: X / ci Expansion tank 16.60 Address: Ny /3 7 V " S() giotO Crtek C/ • Fixture /sewer cap 16.60 City /State /ZIP: /� m 97224 Floor drain/floor sink/hub 16.60 Phone: (51)3) R( -6 eg Fax: ( ) Garbage disposal 16.60 ' • ❑ APPLICANT Hose bib 16.60 0 PERSON' maker 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 Sink/basin/lavatory 16.60 Phone: ( ) Fax::( ) . Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: &IA/X.1A-, Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 36, .D.6 CCB Lic.: Plu bing Lic. no.: Plan review (25% of permit fee) Authorized signature: ^ / /%% State surcharge (8% of permit fee) TOTAL PERMIT FEE 3-(. ISM Print name: t /,04, , ] 1 4 N Date: I 0 7 This permit application expires if a permit is not obtained within u `� 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. I: \ 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) ` Total Square 'Footage: Permit Fee: Footing drain - I 100' 55.00 0 to 2,000 $ 1 15.00 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 VA 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 and including $50,000.00. specially requested inspections - per hour 72.50 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 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 Fix Type: R 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 /S i/W hirlpool. as defined in OAR918- 780 -0040. Stall ❑ Medical gas and vacuum systems for health care facilities. Car Wash -Each Drive Stall El 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 . Isometrico D iagram.' . Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings that meet the qualifications above. -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 -Gang -Stall Sink - Bar/Lavatory *Note: If the fixture work under this ermit 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\PLD1- PermitApp.doc 12/27/06 CITY OF TIGARD atu (0- a) n3 BUILDING DIVISION- PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: L , (� tr ( S OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: WNER: �V S PHONE #: CONT PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 6 - 6k. al/t/N 1 Corrections /Comments /Instruotions: --. 5 -e- �Q - ?..1. , pc. Qs% w— 9't4/ 6 (i ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- .4 e.ti_:1,91ta ili 0:111:044t, 4 Qt50.4 4,:i,.. No ,,,, 2008 RESIDENTIAL BACKFLOW ASSEMBLY TESTER LIST W U 4 pdated February 5, 2008 Dear Water Customer: Foryour convenience, a list of certified backflow assembly testers working within Tigard Water Service Area is provided below. This list is not inclusive. Testers are private individuals or companies. Testing costs vary, so getting quotes from several companies is recommended COMPANY ADDRESS PHONE NUMBER A & A DRILLING PO BOX 585, CLACKAMAS (503)284 -3701 ACCURATE BACKFLOW 2715 HARVEST COURT, FOREST GROVE (503)357 -1444 AFP SYSTEMS 19435 SW 129TH, TUALATIN (503)692 -9284 ALL SEASONS BACKFLOW PO BOX 1811, BEAVERTON (503)644 -4913 ALOHA BACKFLOW TESTING 5074 NW STABLE CT, HILLSBORO (503)693 -1720 AMERICAN BACKFLOW SERVICES 5905 N INTERSTATE AVE, PORTLAND (503)289 -1745 AQUA -TECH BACKFLOW SERVICES 14655 NE RUSSELL CT, PORTLAND (503)251 -1683 BACKFLOW PREVENT. DEVICE TEST PO BOX 751, TUALATIN (503)692 -2885 BACKFLOW SERVICES PLUS 17675 SW FARMINGTON RD # 118, BEAVERTON (503)629 -8200 BASIC FIRE PROTECTION, INC 8135 NE MLK JR. BLVD, PORTLAND (503)285 -1855 BEAVERTON PLUMBING, INC 13980 SW TV HWY, BEAVERTON (503)643 -7619 BWE BACKFLOW TESTING 16923 KING RICHARD CT, SHERWOOD (503)625 -4083 CANBY PLUMBING INC. 805 NE 4TH AVE, CANBY (503)266 -2091 CLEARWATER BACKFLOW 717 E BURNSIDE, PORTLAND (503)703 -7821 COLUMBIA CROSS CONNECTION PO BOX 9217, PORTLAND (503)235 -6141 COOKMAN BACKFLOW 17895 NW TILLAMOOK, PORTLAND (503)645 -0296 DENNIS SEVEN DEES LANDSCAPING 7355 SE JOHNSON CREEK BLVD, PORTLAND (503)777 -7777 DON MARTIN PROPERTY MAINT. 2255 SE 73RD, HILLSBORO (971)570 -7630 DRAKE'S 7 DEES, INC. 16519 SW STARK, PORTLAND (503)256 -2224 FARR BETTER BACKFLOW TESTING PO BOX 389., BORING (503)475 -9080 FIRE EXTINGUISHER SERVICE CTR 3460 SW 209TH AVE, BEAVERTON (503)356 -9445 FITZERALD LANDSCAPING 10835 SW TIGARD ST, TIGARD (503)620 -4761 GARDENVIEW LANDSCAPE IRRIG. 1095 NE CORNELL RD, HILLSBORO (503)693 -6823 GREEN DAY LANDSCAPE, LLC PO BOX 2613, CLACKAMAS (503)658 -2685 HEATH BACKFLOW TESTING PO BOX 1565, SHERWOOD (503)625 -8553 JACK HOWK PLUMBING PO BOX 20698, PORTLAND (503)235 -8784 JANE GANSER & CO. 8960 SW DOLPH ST, PORTLAND (503)247 -9562 KENNEDY PLUMBING, INC 13985 SW FARMINGTON RD, BEAVERTON (503)643 -5535 LANDSCAPE EAST & WEST 8850 SE 76TH DR, PORTLAND (503)256 -5302 LANDSCAPE ENTERPRISE PO BOX 436, WILSONVILLE (503)682 -3343 LANDSCAPE SERVICES CO PO BOX 1623, CLACKAMAS (503)656 -6890 METRO SAFETY & FIRE INC 14324 SE STARK, PORTLAND (503)231 -2999 MP PLUMBING PO BOX 393, CLACKAMAS (503)655 -9161 NW BACKFLOW INSPECTION & TEST PO BOX 1536, HILLSBORO (503)695 -3286 OREGON BACKFLOW TESTING 212 SE 3RD ST, TROUTDALE (503)491 -9402 OREGON IRRIGATION 15916 S AMES ST, OREGON CITY (503)656 -9826 PM BACKFLOW PO BOX 981, WILSONVILLE (503)830 -0171 PROGRASS, INC 29895 SW KINSMAN RD, WILSONVILLE (800)776 -4727 ROTO ROOTER 25599 SW 95TH AVE STE B, WILSONVILLE (503)682 -9774 Approved Residenuai Backflow Tester Listing Updated. Page 1 of 2 2/5/2008 3 - 01 pm COMPANY ADDRESS PHONE NUMBER SUNRISE LANDSCAPE PO BOX 665, BORING (503)658 -1828 T &R BUILDING SERVICES 6880 ROGUE LN, WILSONVILLE (503)318 -6313 TIMBER VALLEY PLUMBING PO BOX 34, CANBY (503)266 -4300 TOM HEMPEL TESTING 82696 WILSONVILLE RD # 184, WILSONVILLE (503)579 -0923 WATER METRICS 16120 SW 72ND AVE, TIGARD (503)603 -9988 WESTERN STATES FIRE PROTECTION 13896 FIR ST, SUITE B, OREGON CITY (503)657 -5155 WOMACK WATER WORKS, INC PO BOX 608, BEAVERTON (503)643 -0466 A current public list of DHS- Certified Backflow Testers is available at: http: / /oregon.gov/ DHS/ ph /crossconnection /publiclist.shtml Approved Residential Backflow Tester Listing Updated' Page 2 of 2 2/5/2008 3.01 pm INSPECTOR'S SIGNATURES ARE NOT Inspections Required for PLM2007 -00173 REQUIRED ON GREEN INSPECTION CARD. ✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground /slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG-Structure grading /footing 125 Wall cover 210 Foundation walls 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post/beam structural 150 Hot tub /spa /pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors 199 Electrical final 240 Exterior sheathing 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG- Structure set -up MEC - Mechanical Permit 280 Insulation 605 Post /beam mechanical 285 Drywall nailing 610 Gas line 287 Suspended ceiling 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG- Structure final 625 Duct work 498 Grading final 630 Fire damper 299 Final inspection 635 Smoke detector shutdown 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor/slab PLM - Plumbing Permit 910 Sprinkler rough -in 915 Fire alarm rough -in 305 Plumbing underslab 920 Suppression trip test 310 Crawl drain 995 Misc. inspection: 315 Post/beam plumbing 998 Alarm final 320 Plumbing rough -in 999 Sprinlder final 322 Shower pan 330 Water service 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 405 Excavation 345 Culvert/catch basin 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: 205 Footing X 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I: \Building \Forms \InspCard- AOP- Blankdoc 02/02/07 CITY OF TIGARD Li stc,e( ?e-goel:7ks BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 A � . Inspection Requests (24 Hrs.): (503) 639 -4175 4 " L INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: 1..04 S ¥. k Ai - 4 , QCS . CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: QWNE "1 5 5r", frL L=1> W/ 0 ��ti5? PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 3,4A 4 -d" , --- 6%4 c)o-L3c_e_ -,_,;,,,,..,q Corrections /Comments /Instructions: 14 V 1 c- vn v CL-e-- V . ( ( a7 - 00 1)3) S4 ( . 4 . . ✓ s — T E S 1 ° . - O g CI• ® 1 G t . - e 1 k d i r Kr L 4 0 • ( P ()I- -t 7.4 d) - oC 4 ZA , ',571NJ si-xduk A...4 Lion" ..... re S "1'4. .. o f _A S*% C ?L 7Aa a O 3g l .114 Sins-AA ik.if — T S 4 C - 4-A- — 0 CS 0 Li se A-c to, -P-v.r-ci, 9r, C 2 L-H. -- 2-463 - 7- Oa - 2- 5 4 4 ) s1-&Au (..*. - 1^2- s 47e_ c - 1 S63a L . . (Po—c S P Zoo , — . ) t..v1✓, -- Te_ s .Ic—z I - t1 Q17.-- ( -1 ': , A5Nfrt C 2 cr7- ode -q $bL - stas 3-- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718-