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Permit
CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00403 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/14/2008 PARCEL: 2 S 110 C B -07600 SITE ADDRESS: 14998 SW AUGUSTA TER ZONING: R -7 SUBDIVISION: MOUNTAIN VIEW ESTATES LOT: 001 JURISDICTION: TIG PROJECT: MOUNTAIN VIEW ESTATES Project Description: Install 300' each of sanitary and storm for service for future residence. CLASS OF WORK: NEW 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: TUB /SHOWERS: SEWER LINE: 300 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: 300 ft Owner: FEES ACCENT HOMES 18676 SW BOONES FERRY RD Description Date Amount TUALATIN, OR 97062 [PLUMB] Permit Fee 10/14/200€ $295.60 [TAX] 12% State Surch 10/14/200f $35.47 Phone : Total $331.07 Contractor: DON BURKE EXCAVATION & CONSTRUCTION RUBY DR MILW AU KIE, OR 9 7267 REQUIRED ITEMS AND REPORTS MILWAUKIE, 97267 Contact # : PRI 503 -652 -0175 Reg #: LIC 150901 PLM PB41 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 95 -ell -1I You may obt.'n copies of these rul irectquestions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issu d By: k Permittee Signature • 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 Building Fixtures FOR OFFICE USE ONLY / City of Tigard Received / Date /By: t0 /y Q g Permit No.. //,./ ji g M� e Illq - v 13125 SW Hall Blvd., Tigard, OR 97223 /� Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date /By: Other Permit No.: T LG A R D Inspection Line. 503.639.4175 Date Ready /By: 1 ® See Page 2 for Internet: www.tigard- or.gov Notified /Method: 1 ti. Supplemental Information TYPE OF`WORK • • . . ' FEE* SCIIEDULE ❑ New construction ❑ Demolition For special information use checklist Description Qty. Ea. 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 ❑ Master builder ❑ Other: Each additional bath/kitchen 45.00 _ Fire sprinkler ( sq. ft.) Page 2 _ JOB SITE INFORMATION AND LOCATION' Site utilities Job site address: / t-/ 4 F SW A u G G s 7, Catch basin or area drain 16.60 City /State /ZIP: 7 0/2. `} 72 2 y Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft ) Page 2 /if 7' 0 Storm sewer (no. linear ft.Rreo) Page 2 o /L17 n Subdivision: /j. Lot no.: t Water service (no. linear ft.. ) Page 2 ` a V OVNTA,.J Visa/ E57A9Y S i1 Fixture or n Tax map /parcel no.:Art Absorption valve 16.60 • .. 'DESCRIPTION. OF WORK 5 8 - w a A/o /1 S7 2i '..,4 -7. Backwater valve 16.60 Clothes .1 Dishwasher ..1 - ❑, PROPERTY OWNER ❑ 'TENANT Drinkin 16.60 . '/ • r • .1 Name: d G C.75A., A.4"`7 S Expansion tank 16.60 Address: 1 674 I �A 16.60 City /State /ZIPi -7 , e)2 7V IP 2-. Floor drain /floor sink/hub 16.60 1 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ' ❑.A APPLICANT / . Hose bib ..1 . ❑ CONTACT Ice maker 16.60 Business name: � ii•N �� • - � 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: ( ) I Fax::( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 . " . CONTRACTOR ' Water closet 16.60 Business name: 4 V 2 j.c: ( \ i. t v,47 6 (04, 57/1t.�e_ _ ater heater 16.60 Address: / 5 G5 t-1 5e- 2, i3Y N )".4 , Other: City /State /ZIP: i ,, L Lo ,,, kr a d2 c h 7 4...`? Subtotal y Minimum permit fee: $72.50 1 Phone: (5 ) Co S 2 _ ©l 7 Fax: ( ) Residential backflow minimum permit fee: $36.25 ir CCB Lic.: /5 c 5 0 / Plumbing Lic. no.: Ra en Plan review (25% of permit fee) ! State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE 77 4b (`�� Print name: ,,, 0 , 21 ,-- Date: in//y/0b 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. I.\Buildmg\Permits\PLMF- PermitApp doc 12/27/06 440- 4616T(I0 /02 /COM/WEB) Plumbing Permit Application - City of Tigard , Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: a Q F,ee ea Total a. • s,. Site`�Jtilities� �'. °- - ty�' > , Square,Fo Pet-hiiit',Fee „ Footing drain - l' 100' 55.00 0 to 2,000 $115.00 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 $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 Qty. ., Fee`(ea) ' TOW:, additional $100.00 or fraction thereof, to and - ,Flxtu)r'COrItenl ".a _ - To 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 Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Commercial 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'(Fixtnre) Work Performed' greater, except systems designed and stamped by licensed Flxtur¢ ^Types • � ^ � � :Replace engineer. _ PreviousG, '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 Isometr Or Riser D 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 -Gang -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: i \Butding\Permits\PLM- PermtApp doc 12/27/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: RW2000-00403 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1412008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 10/15/2008 TIME 15 SITE ADDRESS: CLASS OF WORK: 14998 SW AUGUSTA TER SUBDIVISION: LOT #: TYPE OF USE: iY1OUNTAIN VIEW ESTATES 001 PROJECT NAME: MOUNTAIN VIEW ESTATE:S DESCRIPTION: Ind all 300' each of sanitary and storm for seryice for future residence. NO PLM FINAL UNTIL EASEMENT RECORDED OWNER: ACCENT HOMES, PHONE #: CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE it: 50.3 Inspection Request Scheduled For: Date: Pour Time: 10/15/2008 Code # Inspection Description Confirm # Contact # Message 340 Storni drain 076747-01 503-407-1102 Corrections/Comments/Instructions: c 9./ A &or-kit./ Ovq-e-V- C o S IA) Pro 0k (o )/J4K v -A3A.41 3 PASS $1, PARTIAL APPROVAL CANCEL 111 NO ACCESS FAIL Ej CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: Date: ) 611 Phone #: (503) 718- CITY OF TIGARD • BUILDING DIVISION PERMIT #: Pl_M2009- 00/403 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/'41/:2008 Phone: (503) 639 -4171 A fl etk Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/15/20Q8 TIME: 7:QOAM PAGE: 14 SITE ADDRESS: 14998 SW /'�l1Gl AUGUSTA TER CLASS OF WORK: SUBDIVISION: P1fioUN'1 AIN VIE ESTATES LOT #: 00 TYPE OF USE: PROJECT NAME: MOUNTAIN ViEw ESTATES DESCRIPTION: Install 300' each of sanitary and storm for service for future residence. FINAL. UNTIL. EASEMENT RECORDED' OWNER: CONTRACTOR: ACCENT HOMES PHONE #: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 503-652-01'75 Inspection Request Scheduled For: Date: i0/15/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 076747 -02 503 - 407 -1102 N Corrections /Comments/ Instructions: y '' 4 4- , Q t „LA v sv— S -��. � - r'� �w ��. P,� �.�, 1 w I t1 „ 1 L t c,t ° 1 vykuv V 6 P —) &t •o C,_7 f-axe c -dt h rn a; P /d A t Co P �.J ✓ c�v-44., S ep . - i — ��e vG✓ L J L.r2 / • ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: (JLv,.ti.,i �'�\j .._. Date: L i\ ) c l k Phone #: (503) 718-