Permit pr i, .. ? cITY OI 11c A RD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00116
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/23/2007
PARCEL: 25111 BD -00508
SITE ADDRESS: 14780 SW 98TH AVE ZONING: R -3.5
SUBDIVISION: DARMEL LOT: 001 JURISDICTION: TIG
PROJECT: THORNBURG
Project Description: Line work for sewer connection. Septic system to be pumped and filled or removed.
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: 75 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
PHILLIP THORNBURG
14780 SW 98TH AVE. Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 3/23/2007 $72.50
[TAX] 8% State Surcha 3/23/2007 $5.80
Phone : 503- 639 -9379 Total $78.30
Contractor:
CANTRELL & SONS CONTRACTING
6860 SW NORSE HALL RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 638 -0800
Reg #: LIC 97005
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Code- and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if� is not sta id within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires yoyr to follow rule - 'opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -001-010. You obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
r7.791 / Issued By: � � 1 Z � Permittee Signatur_�f�` k / ! /
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. ir
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit APDlicati i' f y p Ti oiz €o' I IcN4 i s6/ �E 'I I , } -`
U k. � Received , , •_ .� _ ,
74 `* City of Tigard Date/By D 3 D - 7 3 B Pernnt No.
n 13125 SW Hall Blvd., Tigard, OR 9) 2007 plan Review 2497-earl,
I ; Phone: 503.639.4171 Fax: 503.598.1960 1 D��g Other Per No SU RA901 75
Inspection Line: 503.639.4175 CITY OF l (LAB®
T I G A K D Date Ready/By: Ju ® See page 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified/Method Supplemental Information
rs*"` syK. e.h - €ei; aw:x.: .^r.., � �"zw.:c�.. .,t :'S?•^^._• 4 �e , , ,r,.. °S „�� 4-&-4117--,1-45 _ •rs.s x �,�'' >��, . ��..F'� ='ice. •r� _ _ �YS,- '�+ ��.� a "'_a,. '�v'r. ?
h -r U' '4 ` y F, �l , ^!giro: p s - a
' s, Wiiiiie mo b , ;a • n � ' t;•,
� �tTYPEyUF'� ,�;- .,� = , : ,.�+ : , � ��E '��•�, "+�,. �'(� r , °FEE . SCH�EDU I: E �, .�'�'r�:r�:, I.`..;,;,.,�;
. : a w•' �!:a; -.r -.. s, _ ._m+.w�.a •, ..,..,. S .Ir..tl .,_�... •s �x�l' � � 'T �? �r^ „� � ._..� R �`�`,i,_ � °- ''�' 4. „ .., , . �,,. , a d - 1, � . , 'JO � . � s ..� , tts.�
❑ New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
4, PV Via.' -',V, .,, ',XA §'... '-'''''''''''''.7'''' -mac.'" 4; '' v. ''' :,a,, rx.,. ", „, , y ..
3 '-c ; F , a 44P . t 4 4, c,ATEGORY' OF CONSTRUCTION wt:` `,: a )'e < SFR (l) bath 249 20
13R1- 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:
;.$ _ �' , b re k.m.. , , *•..,,�;. 4 a s 5,: Fire sprinkler ( sq. ft.) Page 2
, :,, it¢,, JOB�STfEINFORMAT10NxAND ; L.00ATION 4 7. 0,'
a ::,y. �, . ,f._ .->, . 5: ,:. _ __ ,,,u,. -zA` .,. c Site u
,' itilities
Job site address: / 9 5 I` Catch basin or area drain 16.60
City /State/ZIP: '11,6 �7 A'0 C97.-- 6 2 .4.2 Z ( % 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
f
Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear ft: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Tax map /parcel no.: -
Fixture or item
�; iSa,- tr�`'"`- °��.w •:^ .�. - .,,,.,;,-�;�; :, ; .:.,�« r •.��, ,
- aG•.. =.:,,;. u,� Absorption valve 16.60
°
..'' -, <ap. . tt rf .;�,�k` iiii RWTI N I . W R r :.o' , , s&' ,i "•; w`;w .
•'� • - Backflow preventer Page 2
13;11 IAJ-U Backwater valve 16.60
L. Ill Ll i L - ff • • +_ ` Clothes washer 16.60
Dishwasher 16.60
' a(]_�PROi ilif '- OWNER` ��. 4 I w ¥ u ❑ 97 ` T F `k �
::: 16.60
Name: , ittu p e4v6i e'-
I t� ,,11 r 1 Expansion tank 16.60
/ Address: T J ) Ski✓ 9 8 el. / 1- 0 Fixture/sewer cap 16.60
City /State/ZIP: -- 6 A4,/ iv' 0 9 .> t / Floor drain/floor sink/hub 16.60
Phone: (S ) (, 39 -- ?-9 y Fax: ( ) ( Garbage disposal 16.60
° ` " .'s:,� „;._;'a ,4.;f, „fi Hose bib • ' 16.60
'
APPLICAIVTP.r , {' .., ,?. r ; ❑ CokiAorTERSON 4- s
^t Ice maker 16.60
Business name:
Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City / State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) I Fax: ; ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
...,_ °r', c , , .. ......,�., rn., Urinal 16.60
''. 4 . , K -.-rs x a•CONTRACTOR " s'" , ;, ,r � , r - '.
e .' c z asp niu ':a . , .. . c:.. •¢ +r., a'b...r _ av; , • n a . , " ,' `' '�°, Water CIOSet 16.60
Business name: ( 1 4 , E )[.CrAJ 1Aji,-,- Water heater 16.60
Address: Other:
City /State/ZIP: A /a1/0i( Subtotal
Minimum permit fee: $72.50
Phone: ( 519 ) 6,; 0 0 ; 0 0 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 200 • , Psft bing Lic. no.: Plan review (25% of permit fee)
Authorized signatur.: � / / State surcharge (8% of permit fee) ` J • TOTAL PERMIT FEE / ,j o b
i )( , Print name: 'F / j P ! 7 f9/ N 8 t) f J Date: .3/9.3 1W 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 \PLM- PmnitApp.doc 06/26/06 440- 4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard f *
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
�' - � �b'3 � , �§r- ry� a�n:r'�c�x h . �'4 °' °•+- ��a�x+:t,�;- -.. 9 s
x Fee ea �To "fal
Cite ffilit es r ,. �� � ' 4 �v t amti uare=]Footage. . Pe>rm><t Fee , r. tir
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
S 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 :_,
uation: , " f1 ; rP e 71111 ACe a , M
="V
al MN.
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
Fixture or I t e iOti` Fee (eti) µ T 1} 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 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.
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
•
Fixture Work:
;;,Plan R'e "v><ew =for P_luinbin Installations+ °., I-
g °-
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all•that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
ae 4:AiT �fiVrili • ,�z � n�� ° „. °sntifYby (Fiatnre) Wock;Pecformed i greater, except systems designed and stamped by licensed
F ixtureType _ ' °'ww i` aM � '•. :. ?.$: ; r :.:• ReN �t engineer.
44;2 °;:`: , t' ' 's ' * y : e Previous�t ; Ca ` i br a' "' j r.,.,.
naed� t.ndded_.M taxEtiLsnng�..a ❑ 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 ,...• 1: , .=c :
Drinking Fountain 33 :Riser; e >:. „., '4 .. #s
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:
i:\Building\Pennrte\PLM- PermitApp.doc 09/22/06
CITY OF TIGARD �
BUILDING DIVISION PERMIT #: PLM2007 -00116
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/23/2007
Phone: (503) 639 -4171 �me lI" I(I
Inspection Requests (24 Hrs.): (503) 639 -4175 ..��
INSPECTION WORKSHEET FOR DATE: 3/29/2007 TIME: 7:00AM PAGE: 15
SITE ADDRESS: 14780 SW 98TH AVE CLASS OF WORK:
SUBDIVISION: DARNEL. LOT #: 001 TYPE OF USE:
PROJECT NAME: THORNBURG
DESCRIPTION: Line work for sewer connection. Septic system to be pumped and filled or removed.
OWNER: THORNBURG, PHILLIP PHONE #: 503-639.9379
CONTRACTOR: CANTRELL & SONS CONTRACTING PHONE #: 503•G38 -0000
Inspection Request Scheduled For: Date: 3/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 045687 -01 503- 638 -0800 N
Corrections /Comments /Instructions:
P/t
- T Seri-;c_. I q L " t/ 6 u 4 ( F! )14-11 � 'N Z rtaci L'1 " t4 tnr CI
i-e.A 4,=A-<494,-
r PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1.-w 1 11 awa Date: .3 291'0 7 Phone #: (503) 718-