Permit 4'
T., CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00114
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/22/2007
PARCEL: 2S 111 AC -00500
SITE ADDRESS: 14570 SW 91ST AVE ZONING: R -4.5
SUBDIVISION: PINEBROOK TERRACE LOT: 046 JURISDICTION: TIG
PROJECT: SILCOX
Project Description: Replace 60' of sewer.
CLASS OF WORK: OTR 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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
STEVE SILCOX
14570 SW 91ST AVE Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/22/2007 $72.50
[TAX] 8% State Surcha 3/22/2007 $5.80
Phone : 503- 639 -2251 Total $78.30
Contractor:
ABILITY PLUS DRAINAGE CO.
1813 SW MOSS ST
PORTLAND, OR 97219 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 246 -0474
FAX 503 -236 -9930
Reg #: LIC 106644
PLM 26 -785PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes _ .. all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work i not started wit •n 180 • .ys of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to f•, %w rules a' +opted by th /ire•on
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0 10. You m. obt. n co. es •
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. r
Issued By:� •Permittee Signatur:.
•
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.
lu Permit A pp >< 1><1 ca t i on its fi t . D . 1 r ° 1 -. ? ' :' OH ' O`FH,I C L °ilb ' o i\ I : �` � '
r
'. City of Tigard " j � M
7
0 1312 SW Hall Blvd., Tigard, OR, 97223': c, DateB /07 �� P ertn tt N o I t- I ' t wQ`�• 1
2001 Plan Review Other Permit No..
II Phone: 503.639.4171 Fax: 5di598.1966' Other
Inspection Line: 503.639.4175
T.I .G A'R' b Date Ready/By. inns. ® See Page 2 for
Internet: www.tigard- or.gov i k ) j,_' I.b.k.y Notified/Method
Supplemental Information
, . . � � ,., >� ��,.�,�.o-...��• .,.._.._ ���.• r §F _. +- .F. >a� „r #_ ;.' ,,, , , a-±1 ,.k.,.. �' ,.f F EE S "" ,._;�.k: `.� � � r �'` -.. '�'
. <, t•
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. , Ea. I Total
1{ Addition /alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection)
srrT+ .��;., '' 'CONTSRUICTON `''� . ,..; .�. :, ,,x,_.�. - -
.... � � "'�: GATE`GO`ItY F es;..,.. � �"`�`� " '� v '� SFR I bath
., ; O 24920
a1 - and 2 -family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
_
r4:;�'..;'g„ Ni , . >.. . 1Y tit.,--406-4.5,'. Flre sprinkler ( sq. ft.) Page 2
.)' _ ,L�JOB,`Ig:,tIIYFORTION . rAD'lF.00A1'IO�1V -, 1:'i4
. ` •. '.� ^ � ``. � -�." t ti. ., S - .ri • M � ... rru -. � ° es�e -c, - . a ;3kta,"- .t',�.n:�:•�d. Site u tiliti es
Job site address: 1 57/, 6 � l / S 4- g_ Catch basin or area drain 16.60
City /State/ZIP: l Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: f Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to jo tte: Manholes 16.60
Ck
�' 'G 0 ' "" Rain drain connector 16.60
. 0 3
, ( Td q l E +' N6 'ch., Sanitary sewer (no. linear ft.: 0)) 6,0 Page 2
Storm sewer (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map/parcel no.: -
a , ,;.0:,,, , 1,,,w-t='•.;- 4 7,1,..•4• , ..F.' , ; y ._ �,-,, << n t; _ - r _ . r tv Absorption valve 16.60
4 •- * ,,r,. iDESCR " u + " =,` / „ � " Backflowpreventer Page2
Ltr.itAl 5.2.1 -cc_ r �, t , v . e .„ Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
- - -. . + r�,� I ,d,,t �,;s',j'"a r [r y , . ® .� a...e, a .
tp+;cm�'i' «p:, .
Drinking fountain 16.60 .
�i:; � ` UPEItTY., . w �s - ,ti ''" ,.'..; ; ;119 TEIVANT::,�B;f 3 ,, f.
. x: ,, PR OVVIVER' W � ::., ...e , .:."^ , .. _r..
Ejectors/sump 16.60
Name: � �, Z ■ C. D x
Expansion tank • 16.60
Address: ,4/-4.- Fixture /sewer cap 16.60
City /State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) & -.7 / Fax: ( ) Garbage disposal 16.60
�' ;•., X xnt,R» a g t X Hose bib 16.60
? ::N . • `i i Y':a`, ',APE,:,LICAIVTx.i �7; it', �.^;,<i . '._ „F Z� " TPERSON. ;tf; ,
) J Ice maker 16.60
Business name: ' L1 , � . 1, �,� tn✓a -1,?, (. Interceptor /grease trap 16.60
Contact name: X
et1 Medical gas (value: $ ) Page 2
Address: 1 g j � ir% /40 S 5,- Prima 16.60
City /State/ZIP: .4-. c 2- F 7 z4, 9 Roof drain (commercial) 16.60
- Phone: (5 2`� , X41 Cr Fax: : ($63) 7,3(e, 1 3 Sink/basin/lavatory 16.60
E -mail: Tub /shower/shower pan 16.60
Urinal 16.60
• �_' '' A CTOR. , •r j•� „ • r ''; c ose • -�... ^�� �=CONTR
. • �" .. W a t t I 16.60
Business name: � .„ Water heater 16.60
Address: ! iJ Other:
f(/f _n.! _ 7 , Subtotal
City / State/ZIP: �r ►►►"`bbb `t7 v`P I 01 I D�
` Minimum permit fee: $72.50
\
Phone: ( ) (AV Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: �� �p (� �' if L PI bing ic. no.: - s- l�i� Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature: TOTAL PERMIT FEE 7 g 50
Print name: Gm tr 6 v _ 1 .,_ + , i ( Date: 3 _ <• This permit application expires if a permit is not obtained within
6� l J 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I: Building \ Perm it PLM- PermitApp.doc 06/26 440-46 16T( I CW02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
�'Site� � .rA r �� � . � i..�� te !8 TOtel 't ^ R" � aka `F a�7x� xu _• :'�`�. "� vY� �� � wm,. �;d-x�
Squace'Footage�Per <a,.
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' 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 r Fee. .a a � , f
Wal uati<on:yW , : P ,ermitr,� M .. ,, ,, .IM 1
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
�r• " $
Q ` Fee. ea Total additional $100.00 or fraction thereof to and
,.or ei n s �. C:) _
� -„ �: ,��.�a.,��.• a��- ;�,�r` „ x.4-zon 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 Back flow 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.
$50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
Fixture Work:
, ;. Plan��tey><ew for Plumbing1nstallations t4
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
greater, except systems designed and stamped by licensed
Fatu Type�N� QoaotitY by (Fixture) Work Performed engineer.
s a f f � at i '"° Rep
Sze, s ..0 - " A,zweat Previousi i t capped� �. nddedir :Eitt;ne,.,, ❑ 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 rr4 sw+ >r
Drinking Fountain ar m. t'ISOlne1I'1GQC.R1SeI':lagialIl n =;,cs
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 Comments regarding fixture work:
Garbage - Domestic
Disposal - Commercial
- Industrial •
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
- Stall *Note: If the fixture work under this permit results in an
Sink - Bar/Lavatory increase of sewer EDUs, a sewer permit will be issued and
- Bradley fees assessed for the sewer increase must be paid before the
- Commercial
Service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal -
Other Fixtures:
1:\ Building \Permits\PLM- PennitApp.doc 09/22/6
CITY OF TIGARD,. _\
BUILDING DIVISION PERMIT #: PLM2007- 00114
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639 -4171 /ays41n
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/29/2007 TIME: 7:00AM PAGE: - 8
SITE ADDRESS: 14570 SW 91ST AVE CLASS OF WORK:
SUBDIVISION: PINEBROOK TERRACE LOT #: 046 TYPE OF USE:
PROJECT NAME: SILCOX
DESCRIPTION: Replace 50' of sewer.
OWNER: SILCOX, STEVE PHONE #: 503 -639 -2251
CONTRACTOR: AI:3ILITY PLUS DRAINAGE CO. PHONE #: 503 -246 -0474
Inspection Request Scheduled For: Date: 3/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 045692.02 503 - 519.9893 N
Corrections /Comments /Instructions:
Carey e ra i4A-
[Nt PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 6 t1 A‘ - Date: 3 I <) 7 Phone #: (503) 718-
k
t
CITY OF TIGARDt¢. ) '
BUILDING DIVISION PERMIT #: PLM2007- 00114
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639 -4171 a_ ,e0 y14 40
Inspection Requests (24 Hrs.): (503) 639 -4175 1.L
INSPECTION WORKSHEET FOR DATE: 3/29/2007 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 14570 SW 91ST AVE CLASS OF WORK:
SUBDIVISION: PINEBROOK TERRACE LOT #: 046 TYPE OF USE:
PROJECT NAME: SILCOX
DESCRIPTION: Replace 60' of sewer.
OWNER: SILCOX, STEVE PHONE #: 503-639-2261
CONTRACTOR: ABILITY PLUS DRAINAGE CO. PHONE #: 503 - 246.0174
Inspection Request Scheduled For: Date: 3/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
606 SanitAry sewer 045692 -01 503 - 619.9093 Y
Corrections /Comments/ Instructions:
44 PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \14%."4 \ \d�^t- Date: 3 j 1 o') Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007- 00
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/10/2007
Phone: (503) 639 -4171 1I�I
Inspection Requests (24 Hrs.): (503) 639 -4175 �' !r -_L
INSPECTION WORKSHEET FOR DATE: 3/14/2008 TIME: 7:OOAM PAGE: 35
SITE ADDRESS: 09600 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 107 TYPE OF USE:
PROJECT NAME: WWIBERDING
DESCRIPTION: Add powder room.
OWNER: W1LBERDING, f3 J + MICHAEL J CO PHONE #: 503 -245-9768
CONTRACTOR: TEE TO GREEN, INC. PHONE #: 503.740-2S19
Inspection Request Scheduled For: Date: 3/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing fine! 066717 -02 603 -317 -8035 Y
Corrections /Comments /Instructions:
( re_ C6 L-4- 1 -g-k)t-- )
X PASS n PARTIAL APPROVAL ❑ CANCEL (l NO ACCESS
7 FAIL Ti CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: (77 �) \ `fix..__ Date: 3111 F Phone #: (503) 718-
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PL.M20()7 -00414
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9110/2007
Phone: (503) 639 -4171 tilt
Inspection Requests (24 Hrs.): (503) 639 -4175 �' `__..
INSPECTION WORKSHEET FOR DATE: 11 /1/2007 TIME: 7:02AM PAGE: 8
SITE ADDRESS: 0960() ,MA/ VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 107 TYPE OF USE:
PROJECT NAME: VVII.BERDING
DESCRIPTION: Add powder rootn.
OWNER: VV1l.BERDING, 13 J + MICHAEL J CO-T, PHONE #: 5503-245 -9768
CONTRACTOR: TEE 10 GREEN, INC. PHONE #: 503- 740 -2649
Inspection Request Scheduled For: Date: 11/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
32.0 Plumbing rough -in 058825-01 503 -317 -8035 Y
Corrections /Comments /Instructions:
X PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: CFO ''vNA-' ‘ ‘,--, Date: i J I 1 ) 0 - 1 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: CJI 004 i4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9:10/2007
Phone: (503) 639 -4171 '�I
Inspection Requests (24 Hrs.): (503) 639 -4175 �' p__...
INSPECTION WORKSHEET FOR DATE: g/2Fi2QQ7 TIME: 7 :01AM PAGE: 37
SITE ADDRESS: 0!..3600 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 107 TYPE OF USE:
PROJECT NAME: WILBERDING
DESCRIPTION: Add powder room.
OWNER: WILBERDING, 13 J + MICHAEL J CO - PHONE #: 503 - 97GB
CONTRACTOR: TEE TO GREEN, INC. PHONE #: 503. 740 - 2519
Inspection Request Scheduled For: Date: 3!2&2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
I' t'iTi' 0 G 7t; 01
503-317-80.).., Y
3 IS eoc -A-A_ € IAA
Corrections /Comments /Instructions:
X PASS PARTIAL APPROVAL ❑ CANCEL 1 1 NO ACCESS
FAIL n CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: Cib Irl . ; I ko-"- Date: q 12C ICY'? Phone #: (503) 718 -