Permit CITY OF TIGARD PLUMBING PERMIT
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• COMMUNITY DEVELOPMENT Permit #: PLM2009-00286
TiGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 10/08/2009
Parcel: 2S 102 DD00812
Jurisdiction: Tigard
Site address: 13905 SW 87TH CT i
Subdivision: FILBERT PARK Lot: 5
Project: Curtis
Project Description: Connect existing house to sewer. 100' sanitary sewer.
Owner: FEES
CURTIS FAMILY TRUST Quantity Description Date Amount
15285 SW ALDERBROOK CT
TIGARD, OR 97224 100 If Sewer Service 10/08/2009 $62.54
PHONE: 1 12% State Surcharge - 10/08/2009 $8.70
Plumbing
10 ea Minimum Fee Adjustment - 10/08/2009 $9.96
Contractor: Plumbing
SAMMY LEE MUNSEY PLUMBING
11771 LONGSTANDING CT
OREGON CITY, OR 97045
PHONE: 503 - 333 -5499
FAX: 503 - 723 -4753
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. �\
Issued By: tiacLUO Permittee Signature: //11 /—� A
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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December 1, 2009
Constance G. Curtis
15285 SW Alderbrook Ct.
Tigard, OR 97224
Re: Sewer Connection Inspection Results for: 13905 SW 87 Ct., PLM2009 -00286
13935 SW 87 Ct., PLM2009 -00284
13960 SW 87 Ct., PLM2009 -00285
Dear Ms. Curtis,
Per your request, I have enclosed copies of the activity listing report for each of the above
referenced sewer connection permits which indicate that the final inspection for each of these
permits "passed ".
Please contact me at 503- 718 -2430 if you need further information regarding these permits.
Sincerely,
l ,/
Dianna Howse
Building Division Services Supervisor
Encs.
Phone: 503.639.4171 ® Fax: 503.684.7297 ® www.tigard or.gov ® TTY Relay: 503.684.2772
taR' ''''v:.' CITY OF TIGARD
-
12/1 /2009
��,ii 13125 SW Hall Blvd., Tigard OR 97223
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i��ntti� Activity Listing
Case #: PLM2009 -00286
Project Name: Curtis
Site Address: 13905 SW 87TH CT
; DATE DONE , ' 4 k
CODE ;DESCRIPTION D ISK. DONEBY>
NOTES t, ,;
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505 Sanitary sewer 10/22/2009 PART Gary Noble Waiting for pump (septic tank) certificate.
399 Plumbing final 10/23/2009 PASS No C of Gary Noble
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CaseActivityShortForm.rpt Page 1 of 1
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CITY OF TIGARD
12/1/2009
0 . 13125 SW Hall Blvd., Tigard OR 97223 11:00:52AM
' 503.639.4171
(Ax, Activity Listing
Case #: PLM2009 -00284
Project Name: Curtis
Site Address: 13935 SW 87TH CT
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C OD E D °> = r { a ` 4 r DISP -DON BY-' F r ; ,NOTES s. $..
,< , (Descendmg.Orderjs ,, s s,
505 Sanitary sewer 10/16/2009 FAIL Rick Bolen Tested- OK 4 -inch ABS
Septic Tank needs to be pumped & Filled. Submit
receipts l i l l
399 Plumbing final 10/23/2009 PASS - No C of Gary Noble
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CaseActivityShortForm.rpt Page 1 of 1
CITY OF TIGARD
12/1 /2009
13125 SW Hall Blvd., Tigard OR 97223 11:02:37AM
503.639.4171
t I nx �.a Activity Listing
Case #: PLM2009 -00285
Project Name: Curtis
Site Address: 13960 SW 87TH CT
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505 Sanitary sewer 10/22/2009 PART Gary Noble Waiting for pump (septic tank) certificate.
399 Plumbing final 10/23/2009 PASS - No C of Gary Noble
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CaseActivityShortForm.rpt Page 1 of 1
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RECEIVED
November 20, 2009 DEC 0.12009
CITY OF TIGARD
BUILDING DIVISION
City of Tigard Community Development
13125 S.W. Hall Blvd.
Tigard, OR 97223
Re: Sewer Hook -ups for 13905 S.W. 87 Court
13935 S.W. 87 Court
13960 S.W. 87 Court
Sewer connections, septic tank fills and inspections have been completed at
the above properties, however I do not have anything in writing from you to
confirm this. I was told when I asked for a confirmation that it was "in the
computer" however when inspector Chip Barnett came to the property for
what was supposed to be an inspection of the water service, he stated that the
sewer connections were not approved according to his computer. He made a
phone call and determined that it was done.
This makes it necessary for me to obtain something in writing from you.
Your earliest attention to this matter would be appreciated.
Sincerely,
4 1144xei /,/ 2/A4Z, dit'ru/L.
Constance G. Curtis
15285 S.W. Alderbrook Court
Tigard, OR 97224
Plumbing Permit Application A r E C F V E L'6%5 �
. - � �� I � '1��'%ki� h� N ai �:,' v t o f ii i x " ry,
Building Fixtures ° °'� ° , '° a � I , , ,, 1 �
ld il', .. : i �� u I OR OI I ICH - US[ O I �A' g ° s
1 OCT 08 7009
�1.ei 'ew iS":Ir� wi �3 ,. +. ! L F .. h $ &S ar � I:�� w r k
i ' + ` ,. Received �QQ
� ) ry � City Of Tigard 13 � J Permit No.: PLu�l2C� �
n •
13125 SW Hall Blvd., Tigard, OR 97223 rr Plan Review
a Phone: 503.639.4171 Fax: 503.598.196 Inspection OF TIGARD Date /By: Other Permit Noi /2 /,61. • ._ r,
r p BUILDING DIVISION Ready /By: 10 See Page 2 for
^� y � �w�„ Ins ection Line: 503.639.4175 Date Read B Jun
TIC nKU
4mo.+ ,w4 ,t r. Internet: www.tigard - or.gov Notified/Method: 1 Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. I Ea. I Total
IR Addition/alteration/replacement ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
N. 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
.JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 13 .1 c.) 5 Q "i - sr" lr� `\ , Catch basin or area drain 18.76
City /State /ZIP: t� Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: e U v L3 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.:I ) 1 Page 2 ( .5q.
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Coo n n ee A teV( Sk(0.) r t,, l o u___-e AG Dishwasher 25.02
S ,Q s', Drinking fountain 25.02
Ejectors /sump 25.02
R.PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: (A Ak S �` " VUL V Fixture /sewer cap 25.02
Address: l / - ,2 g 5 S. W. / _e r )j ro d /� Co u j-'t Floor drain floor sink/hub 25.02
./ Garbage disposal 25.02
City /State /ZIP: �' d d , O/M ?7 z`t' Hose bib 25.02
Phone: (503) Lf,4 3 g'2 5 Fax: ( ) Ice maker 12.51
❑ .APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
. Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: rn I L - ,Q._ t t e� (AA IM 0)0(1 Water piping/DWV 56.29
Address: t ` -� `1 1 I___ � ( Cl( lfj - Other: 25.02
City /State /ZIP: Q (e 0 i k- i O O `'L.� R7O Subtotal (02 sit
Phone:(5()3)33 1 4gCi Fax: ( 503)23 - -53 Minimum permit fee: $72.50 72,5p
Plan review (25% of permit fee)
CCB Lic.: ''(0 l Plumbing Lic. no.:
State surcharge (12% of permit fee) a , z
Authorized signature: TOTAL PERMIT FEE I�\ ..7_ 0
Print name: 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\PLMU- PermitApp.doc 10 /01/09 440- 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 - 1' 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54
7201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Valuation: Permit Fee:
Storm &Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $ 1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
p and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial 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
Fixture Type: Replace greater, except systems designed and stamped by licensed
Previous Capped Added Existing engineer.
Baptistry/Font
Tub /Sowr ❑ New exterior plumbing site utilities for any complex structure
Bath - hower
Tub /S erlpool as defined in OAR918- 780 -0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive 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
Eye Wash Isometric or Riser Diagram .
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
3 that meet the qualifications above.
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
I:\ Building \Permits\PLMF - PermitApp.doc 2