Permit v CITY OF TIGARD PLUMBING PERMIT
! °' • COMMUNITY DEVELOPMENT Permit #: PLM2011 -00004
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/07/2011
Parcel: 2S112DB00200
Jurisdiction: TIGARD
Site address: 15255 SW 72ND AVE
Project: Pittman & Brooks Subdivision: FANNO CREEK ACRE TRACTS Lot: 45
Project Description: Install sump pump.
Contractor: POWER PLUMBING CO Owner: BROOKS & PITTMAN RENTALS
PO BOX 19418 15255 SW 72ND AVE
PORTLAND, OR 97280 PORTLAND, OR 97224
PHONE: 503 - 244 -1900 PHONE:
FAX: 503 - 244 -8825
FEES
Quantity Description Date Amount
73 Plumbing Permit 01/07/2011 $72.50
Specifics: g 12% State Surcharge - 01/07/2011 $8.70
Plumbing
Type of Use: COM
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 ' • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. cation Cen = . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dire questions to OUN • . ' g •3.232.1987 or 1.800.332.2344.
!sew • By: Perm itteeSig lure: / Zary
Call 503.639.4175 by 7:00 a.m. for the next available inspec ion date.
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.
JAN /06 /2011 /THU 12:10 PM POWER PLUMBING FAX No, 503 244 8825 P.
Plulnbin Permit A - c APO/ /?,O60 5
'building Fixtures E I1/FD FOR OFFICE USE ONLY
City of Tigard c 2011 Received : / ffir / / "iGC/ ,�/� t.t/ A
u 1312e 550 Hall Blvd., Tigard, 4K147223 6 zz3 Plan n Review 451/0�OI 3
Phone: 503.639.417) Fax: x: 503595.1960 Other Permit No.
DoteBy:
TIGARD Inspection Line: 503.639.4 O F TIGARD Date Ready/By: @ See Page 2 for
Internet_ www.Iigard -or. :o Nutfied/Metlwd: Supplemental Information
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0 New construction - 0 Demolition For special information we checklist
Descri•tion .8 . Ea. Total
ddition/alteration/replacement • [] Other: New 1 - 2- family dweltin: s (includes 100 ft, for each utility connection)
I FirrtCSt( a� ,.., Wil , p ��� . d � 1 e �y{ � u.�a aaiwa ('j§r`nl�r "+tlp� ,2'4514 if SFR (1) bath 312.70
,. ri,' � �,r r4� ?i'•,1�2r� (iY��' I1d e � ' hYu'tV��ni��e��",.l�.t�•t r '' �,���� ° ,hF'ri�� w�' ���d�:
0 1- and 2 family dwelling ► arnmercialfindustr"ial SFR (2) bath 437,78
0 Accessory building 0 Multi family SFR (3) bath ■ 500.32
- . Each additional bath/kitchen 25.02
- 0 Master builder 0 Other: Fire sprinkler ( sq. fl.) EMI Page 2
� S:ISI ,r � w r i +L me -�� �' NOM ?
r r l n u t , 1ioaa ..i1R , l ll n w "- ry � r �t ,: Sire utilities til 1 :glz ,. , ).$'nf.�� . .'1+. wr r'h , Ialm... a' .. e r@dlNv �,k5W L : 1 :fl rE.
Job site address: 15 9_6 Su) 1 i lug Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State/ZIP:
.A. . e y ' 1 a Footing drain (no, linear ft.; ) Page 2
$uite/bldg. /apL no.: Proj name: 44- .n 1 .. VA Manufactured home utilities 50.03
Cross street/directions to job site: _ .Manholes 18.76
Rain drain conne ■ 18_7
Sanitary sewer (no.o.' linear ft.: ) Page 2 2
- Storm sewer (no. linear fl-.: ___) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: • J Lot no.: Fixture or item: _
' Tax map/parcel no.: • - 00 _ Backflow preventer 3127
�' i , * _ ; t s^� 'la% "? gz .1t l r9 S' .1 47 , ''' '' 7'' .' Backwater valve I2.51
x t ails +!1 yr �. 0 P /" '�'' ( w' '-
I Clothes washer 25.02
4J_ - ��1�..r4-J % ` - /A ., Dishwasher 25.02
_ - -�� •`!____ , Drinking fountain 25.02
WIN A A .. P.,,,, Pi ` , A iwa. ,lectors /sump • MINI 25.02 d".-
i1 , t iii Ir ' '' L ° -v A F, 5 i °� '�k " tank 12,51
� . �.'(' . (�f e ' a nE�e � rpa 9: � �.�� ;Fw� � �
. o � « •,. t ,. ? y'5:�.:. L „r .� "�
Fixture/sewer cap MN 25.02 MI
Name. Cloor drai floor sink/hub CM 25.02 R
Address: Garbage disposal mii 25.02
City /State/ZIP: Hose bib 25.02 MN
Phone: ( ) Fax: ( ryg ) Ice maker NM
fi . a:'t(b 1 ,M1kt,v' t .iNUS M1 1.---- t w ' w"La OrN �:" ,' (q - J•M N ' - x I 3: "', " r at 0 I + Interceptor /grease tra 25.02
' 4.-..w .. �ww.. k�iNa�7 m dw aa�6 t.�l'� - ' m:r. �.. y JS'�F6^Jh!.
Business name: 17 al y /_ Medical gas (value: $ ) Page 2
' __.14_./ , Primer 12.51
Contact name: AL_J At !! j
Roof drain (commercial) EMI 12.51
Address: / Z) i q S( *� /� Sink/basin /lavatory - 25.02
� 0 City/State/ZIP: 0 0 91,A . U Solar units (potable water) 6234
Phone:. b3i „, Y 07) Fax: : V6) - _ Tub /shower /shower pan 12.51
Urinal 25.02
E Water closet ■ 25.02
''A"' ." 1 :: , ,na �i�'�. ii f ''n a Sail r "t13131104 r �! ara 318 6 y a i„ , I �il` l
F_ Sti .e_. n m a•2. e.._c. ; I '. _ sciu7?liq , e wh',, y Water heater 37.52 r
�usiness...iLt j : __. -- P . ! - - - _ _.yii.atet:.piping./D9,'1r - -__ EM�_._._
- - Address: Other
25.02
City /State/ZIP: ' W Subtotal + a lm
Phone: ( ) Fax: ( ) Minimum permit fee: $72:50 50
ISEEMBISMIEM Plumbing Lic. no.: 31 -1 soh!) Plan review (25% of permit fee)
State surcharge (12% of permit fee) ! D
Authorized signature: • ‹. Q,dl .1 TOTAL PERMIT FEE • 7 y
Dat 1 This permit application expires ifs permit is not obtained within 180 days 0!'
Print name: A i t f alter It has been accepted as complete.
"Fee methodology set by Tri- County Building Industry Service Board.
t:VButldinevennit LMU.PtrmitApp.dn: 10/01/09 445-46! 6T(IO /O ICOM/WEB)
•
JAN /06 /2011 /THU 12:11 PM POWER PLUMBING FAX N. 503 244 8825 P. 002
Plumbing Permit Application) — City of Tigard -
Page 2 - Supplemental Information
Fee Schedule: .Residential Fire Su h ression Systems:
E7w h e;• r i.
r ; y " rr ' y �r F 1 p :' i� "1�10191�a . µa L1 �r e•" i^t ` l� , „ , , , Y., - , f ir
N °a�r v m *' wv »rs to - �4,. , , . aeF�h E+. �1Sn s d3WWM1; - .. , r ,^ r, n r
Footing drain - Ia 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37,52 - 001 to 3,600 $ 169.69
3,601 to 7,200
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 S stems:
Water Service -each additional 100' 37.52 r 14 r t i3 i i& � i y r ds u tµ,^ ,' - AI " ;#1 r
Storm &Rain Drain 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50
Storm K Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 fbr the first $5,000.00 and $1.52 for
l' (Iii. l. n u r :1,0? '6 i ' i "r*' 1 . ... ,' fi - 9 �, 7 '' + , y '"",.. each additional $100.00 or fraction thereoL to
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 550.000.00 $379.50 for the first $25,000.00 and 51.45 for
hours minimum eh: .e -2 hours) each additional $100.00 or fraction thereof, to
• Reinspection Fees 90.00 /hr and including $50 000.00.
$50,001.00 and up $74100 for the first 550,000.00 and $1.20 for
Additional plan review for revisions 00,00/hr each additional $100.00 or fraction thereof.
(minimum charge -1 /2 hour) _ i_---
Subtotal:
•
• Fixture Work:
Commercial
adding or replacing fixtures If "yes", - �` ..
� Are you capping, g P g IY r �� , .... s y
_..w. ,, ...� ��R�' �,� .. .....: ^-._.ace �,. ,
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.
, st 4 + S n a t lal ti ;(,Err2ttrr' '°Vl4Gr`3c7P.erformed t ] Any new commercial building with water service 2" and
t _ R „ rr� � . � ; � , a e greater, except systems designed and stamped by licensed
- .... +x: " r . s , t . . engineer,
Barns. /Font Mill ❑ New exterior plumbing site utilities for any complex structure
Bath - Tub/Shower 111111 as defined in OA1t918 - 780 - 0040.
- lacuzzi/Whirl root • ❑ Medical gas and vacuum systems for health care facilities.
Car Wash - Each Stall 11i111 ❑ My multipurpose fire sprinkler system.
-Drive Thru • Q Any complex structure as defined in OAR918 -780 -0040.
Cu , idor/Water As • irator •
Dishwasher - Commercial Submit 2 sets of plans with any of the above.
- Domestic
Drinkin. Fountain w "rrrr wf WrM+u rgmy�� ' a mrr. Ae seeamn
E e Wash a ,. E.: 1: `6 5p Lu ivAA3 t+ d .b ?.. tt ,o-ga
Floor Drain/sink - 2" NM= El Isometric or riser diagram is required for new buildings
. • 3 r that me the qualifications above.
Car Wash Drain
Garbage - Domestic ME
Disposal - Commercial NMI Comments regarding fixture work:
- Industrial
Ice Mach./Refri :. Drains
Oil S • .arator Gas Station 101111 ,
Rec. Vehicle Dum. station
Shower -Gang .
-Stall MEI
- ---- -fit - - /Lavatory - -- - IM= -- --
- 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 plumbing permit can be issued.
Water Extractor
water Closet - Toilet
Urinal •
Other Fixtures: 411 1 1 Th r allMillMilliM
han://www.tiaard-or.gov/city hall/departments/cd/d ocs/PLIsF- PermitApQdoc