Permit CITY OF TIGARD PLUMBING PERMIT
o COMMUNITY DEVELOPMENT Permit #: PLM2010 00298 •
T 1 G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/14/2010
Parcel: 1S133CA07800
Jurisdiction: TIGARD
Site address: 13568 SW ROSEMARY LN
Subdivision: VILLAGE AT SUMMER CREEK Lot: 1
Project: Village at Summer Creek
Project Description: Storm drainage improvements for townhouse project, Lots 1 - 88.
Owner: FEES
INTEGRITY DEVELOPMENT GROUP INC Quantity Description Date Amount
16280 NW BETHANY CT
BEAVERTON, OR 97006 21 ea Catch Basin or Area Drain 09/14/2010 $393.96
PHONE: 12 ea Drywell, Leach Line or 09/14/2010 $225.12
Trench Drain
725 If Storm and Rain Drain 09/14/2010 $325.18
Contractor: 1 12% State Surcharge - 09/14/2010 $113.31
BONES CONSTRUCTION CO Plumbing
3508 S 209TH AVE
ALOHA, OR 97007
PHONE: 503 - 649 -5682
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $1,057.57
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 que • UNC by calling 503.246.6699 or 1.800.332.2344.
Issued /jf Permittee Signature: ow
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 I OR OFFICI•. USE ONLY
City of Tigard RECEIVED Received 0 9
/
Date/B : O �G gm Permit No.: 14 /�ID -00 0
1111 n 13125 SW HaII Blvd., Tigard, OR 972
C Phone: 503.639.4171 Fax: 503.5981916T 1 0 2010 Plan Review
Date/By: Other Permit No.:
I . � c . ` 1 . 1 � Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF 'IDING DIVISION FEE* SCHEDULE
XNew 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 312.70
•
El 1- and 2- family dwelling 1:1 Commercial/industrial SFR (2) bath I 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: Catch basin or area drain 1 1 I 18.76 3 f 3 Y�
Drywell, leach line, or trench drain rii ! 18.76 P-25i I
City /State /ZIP: 16SO Pg_ op 12_3
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: f/j(-(,j¢- Manufactured home utilities 50.03
Cross street/directions to job site: .135 - X�0[.-tt� Manholes 18.76 .
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: i Page 2 , �g
Storm sewer (no. linear 11.:72,5 Page 2 li,../4.6-..ccr..-
Water service (no. linear ft.: ) I Page 2
Subdivision: vi! (f # 6�' � 00,604/Lot no.: 1 �,r Fixture or item:
Tax map /parcel no.: ••r Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
v
Clothes washer r - 25.02
!.� Y ` <0 l! i 44/ _ Dishwasher 25.02
f� 7ix,ov J'Ibi1ic / /-&T ` - Drinking fountain 25.02
/ Ejectors /sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
• Name: CkAirkiK fr /(44v 6Q Fixture /sewer cap 25.02
� ry/ _ ,' `f � Floor drain floor sink/hub 25.02
Address: 1Z L q v / �-� S '� / �'v
. �� _ y Garbage disposal 25.02
Cit y /State / ZIP: eD gzeppAg.
✓y M Ho se bib 25.02 ok
Phone: (3 ) O- l l(`Jl / Fax: ) ? ( � Q V L 7 3061 Ice maker 12.51
❑ APPLICANT ; CONTACT PERSON Interceptor /grease trap 25.02
Business name:F1�1;, Ea/j/ ` Medical gas (value: $ ) Page 2
^/ j^ CA
Primer 12.51
U
Contact name: C �
Roof drain (commercial) 12.51
Address: 1040,9 6 , erro / e Sink/basin/lavatory 25.02
City /State /ZIP:` TM44M " / 1706F....-- (7,F....-- Solar units (potable water) 62.54
Phone: (a6),_5/5 7 g Fax: : ( ) '/2-7 -pip y Tub /shower /shower pan 12.51
E -mail: 0100G, pct (P, ap-iL ay j . /1., Urinal 25.02
CONTRACTOR Water closet 25.02
1 n ' �- -- - - -- -- - '- a Water heater 37.52
Business name: F A1/ j- 69 1/ >' i 4�L7icpti _ . S Water piping/DWV 56.29
Address: j l+v 7 /I;- Other: 25.02
City /State /ZIP: tga- it ` c ' 7 7 Subtotal e i
Phone: ) �° Fax: t7 /��j - 7 Minimum permit fee: $72.50 • `-
'7 / n Plan review (25% of permit fee) �� ,'�
CCB Lic.: 7 3 Plumbing Lic. no.: �!�' �O P8 State surcharge (12% of permit fee) ''
Authorized signature: ‘ TOTAL PERMIT FEE f
Print name: Date:O 1 �y l'6 This permit application expires if a permit is not obtained within I 0 days
t'_ ✓� 4 t - 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(I0 /01KOM/WEB) 14 04-7'
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 - 1S 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 7,201 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 ' 62 Valuation: Permit Fee:
Storm &Rain Drain - 1st 100' 62.54 t4 3 _ $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 ec
Ins tions or Fees ty. Fee (ea) otal yy ( each additional $100.00 or fraction thereof, to
Inspections �Od�' 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: L7 '3c L
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
Bath - Tub /Shower CI New exterior plumbing site utilities for any complex structure
-Tub/Shower as defined in OAR918- 780 -0040.
CI Car Wash Each Stall Medical gas and vacuum systems for health care facilities.
Drive Stall ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ID 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
that meet the qualifications above.
-4 "
Car Wash Dram
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 aid before the
Washer - Clothes p
Water Extractor • plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
I:\ Building \Permits\PLMF - PermitApp.doc 2 •
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13568 SW ROSEMARY LN, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
2013-12-17 00:00:00
PLM2010-00298
PASS - No C of O
Contractor to locate one buried catch basin between buildings #7 and #8. All else ok
Violation Summary:
Inspector Contractor