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Permit
IA 4 CITY OF TIGARD PLUMBING PERMIT ' N 0 COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00538 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/6/2007 PARCEL: 1S136AD-06503 SITE ADDRESS: 10900 SW 68TH PKWY ZONING: C -G SUBDIVISION: WAY LEE LOT: 002 JURISDICTION: TIG PROJECT: AMERICAN'S TIRE Project Description: Prive storm and sewer line. (4) manholes CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 4 TUB /SHOWERS: SEWER LINE: 477 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: 475 ft Owner: FEES WAY W LEE GENERAL CONTRACTOR Description Date Amount 5210 SE 26TH [PLUMB] Permit Fee 12/6/2007 $454.80 PORTLAND, OR 97202 [TAX] 8% State Surcha 12/6/2007 $36.38 Phone : Total $491.18 Contractor: BAKER CONSTRUCTION & DEVEL. 2711 E. SPRAGE AVE SPOKEN, WA 99202 REQUIRED ITEMS AND REPORTS Contact # : PRI 509 -535 -3668 FAX 509 -535 -3720 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. .4410' Issued By: i l / 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 ' Site Utilities RECEIVED FOR OFFICE USE ONLY ' City of Tigard Received Permit N. a 13125 SW Hall Blvd., Tigard, OR 97223 t + p r C Phone: 503.639.4171 Fax: 503.598.19 � � 0 2001 Plan Review Other Permit No.: Inspection Line: 503.639.4175 Date/By: R e T I G A R D CITY OF TIGARU Date ReadyBy 9 c yr ® See Page 2 for Internet: www.tigard- or.gov ���� D ��� S �� Notified/Method: J Supplemental information TYPE OF WORK IVl7 FEE* SCHEDULE 'ew construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total, ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2- family dwelling 13 Commercial/industrial SFR (2) bath I 350.00 ❑ Accessory building 12 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: I©co O 5,0 9 a A V F Catch basin or area drain 16.60 City /State /ZIP: &, , •a. A., p (2_ , 91 221 Drywell, leach line, or trench drain 16.60 Suite/bldg./apt. no.: I Project name: 1 7-) 15e0 ,.) ,...7 I ,, 2� Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: -. Manholes 4 16.60 (A., ND / l 4 f 9 S Rain drain connector 16.60 llss�� S h P,�n,kt. J r Sanitary sewer (no. linear ft.: y2) y 77 Page 2 1 f. Le { Storm sewer (no. linear ft.: c25) 141. Page 2 16741, ZO Subdivision: I Lot ro.: Water service (no. linear ft.: ) I a•ve 2. . Fixture or item Tax map /parcel no.: 1 S 1 3 (o / t S o3 Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 N e.e.k►J RA V t4'�L Si-o ry-.. t s a w e„1..- /-1 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 V PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: LOA- t{ w/ L g G C- -)GiJ 6s(Watrt • C) LTOiI )tv (.. Expansion tank 16.60 Address: S 1 O se .- ?_10 Jb 1.4-4) Fixture /sewer cap 16.60 City/State /ZIP: * P o /t7.- I.PJ - O , (:)R- 9 720"7_ Floor drain/floor sink/hub 16.60 Phone: (5(;.) 234 - PAS' I Fax: ( ) Garbage disposal 16.60 g APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: T--) 5 C„,,., i NJT . 174, Interceptor /grease trap 16.60 Contact name: 71:::),A,.. \J-)p h) ti.)P -iG 44r Medical gas (value: $ ) Page 2 Address: O ZZ S N Se 'S ALA 1 72 0 Primer 16.60 City/State /ZIP: S 0 - r- rS�A -t. / e 9 1 5 JT Roof drain (commercial) 16.60 ,�/ t-/5? Sink/basin/lavatory 16.60 Phone: ( $p) G 0 e -S-25 S Fax: : t7O S) 604" - o Tub /shower /shower pan 16.60 E -mail: DAN), W O. 1 A) e-► 141 6 06 (00,.,1 TIRE- (O.Cof• Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: 3A k[� C Ov...) 0 - DE v t OPor►Eiti, Water heater 16.60 Address: 771 F S? R i ct , . AV Other: City /State /ZIP: 5 Po ic. ,,,, / ,,,4. l g Z 0 2- Subtotal y 54. Minimum permit fee: $72.50 Phone: ( 7) 5 _367 Fax: 601) 5 3 5 37 2 Residential backflow minimum permit fee: $36.25 J '_ t Plan review (25% of permit fee) _ 3 (o CCB Lic.: t� � l 03 /a �06 Plumbing Lic. no.: State surcharge (8% of permit fee) ,3 9 Authorized signature: 1 -8li TOTAL PERMIT FEE Print name: 02,41, & iglu Date:1 Z/4 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 12/27/06 4404616T(10/02/COM/WEB) ►y/ / , 111 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information ,l • Fee Schedule: • Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square ; Footage: Permit Fee: Footing drain - 1 100' 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' 1 pp .55.00 55,00 b 7,201 and greater $309.00 Sewer - each additional 100' 3.?? 46.40 1.7A , Za Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 1 O0 55.00 55, oo $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 3? s 46.40 1 3 6 1 , 2 6 $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 Fixture Type: Replace engineer. 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 -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: • - is\ Building \Permits\PLM- PermitApp.doc 12)27/06 CITY OF TIGARD w • BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i2i6.00Cli Phone: (503) 639 -4171 P e:I11f Inspection Requests (24 Hrs.): (503) 639 -4175 s INSPECTION WORKSHEET FOR DATE: 7/2212.00e TIME: 7:0 i AM PAGE: SITE ADDRESS: CLASS OF WORK: SUBDIVISION: WAY i. Er. LOT #: 002 TYPE OF USE: PROJECT NAME: iii; �i::'3;li: •i (:.' .i iPIV\P( DESCRIPTION: Priv. ((1) OWNER: WAY VV i_i::i:= GENT . AL, PHONE #: CONTRACTOR: f;r KE.I ;t_i{ f; : J(.: ! , OF ! L)E V L. PHONE #: Inspection Request Scheduled For: Date: . /.': ??i.:; u! Pour Time: Code # Inspection Description Confirm # Contact # Message fir);-.0 072P Corrections/Comments/Instructions: r L ` y� -s�= �4 , a✓ C �r ✓, J o.. ; - - `J 7 — St t✓ }� ° H a ���.�1 1 o P � w . L ; 0.(` ✓w.\1 PLh^ 2001-° tD(3 -1 LA I; DJr-ef (v Cafes E+ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS U FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: c11 Date: 7122_ IQ?. Phone #: (503) 718- 7/22/20 c CCE J Information Summary 2:24:04P Case #: PLM2007 -00538 Activity Hold Updated Activity Description Date 1 Date 2 Date 3 Disp Level By Date PLM1010 Application received 12/6/2007 RECD None BLD 12/6/2007 PLM 1020 Permit created 12/6/2007 DONE None BLD 12/6/2007 PLM 1030 Check for parcel tags 12/6/2007 DONE None BLD 12/6/2007 PLM 1260 PLM signature on application 12/6/2007 DONE None BLD 12/6/2007 PLM 1280 Issue permit 12/6/2007 DONE None BLD 12/6/2007 PLM2399 Plumbing final 7/21/2008 7/22/2008 7/22/2008 PASS None STI 7/22/2008 PLM1740 Case finaled 7/22/2008 DONE None JW 7/22/2008 Fees Create Created Fee Type Description Trans Revenue Account No. Date By Amt. Di Code PRMT [PLUMB] Permit Fee 245- 0000 - 431000 12/6/2007 BLD $454.8C 5PCT [TAX] 8% State Surcharge 100 - 0000 - 207020 12/6/2007 BLD $36.38 Name Case People Listing Role Type Address Company Name Hold Primary OWN WAY W LEE GENERAL None Y CONTRACTOR PORTLAND, OR 97202 PLM BAKER CONSTRUCTION & DEVEL. None N 2711 E. SPRAGE AVE SPOKEN, WA 99202 1 of 1 InfoSummary .