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Permit
to Q CITY OF TIGARD PLUMBING PERMIT ° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00260 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/11/2008 PARCEL: 2S 103DA -05492 SITE ADDRESS: 13435 SW 107TH AVE ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: KUMMER Project Description: Replace 60' of water service, CLASS OF WORK: ALT 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: 60 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES KRISTY KUMMER 13435 SW 107TH AVE Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 6/11/2008 $72.50 [TAX] 12% State Surch 6/11/2008 $8.70 Phone : Total $81.20 Contractor: NOLAN PLUMBING PO BOX 671 WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 267 -4646 FAX 503 - 6786959 Reg #: LIC 78388 PLM 3 -269PB 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. Issue By: L ...... /1/ / J/ 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 Building Fixtures RECEIVED . FOR OFFICE USE ONLY City of Tigard 1 0 2008 Date/By: to lO d �S Permit No.: iL�/e -pb j - • 13125 SW Hall Blvd., Tigard, OR 97223 JUN I Phone: 503.639.4171 Fax: 503.598.1960 Plan Review Date/By: Other Permit No.: Inspection Line: 503.639.4175 O� CITY TIGARD T I GA RD i `' c t fi� Date Ready /By: _furls: la See Page 2 for Internet: www.tigard- or.gov " ' �� TYPE TtLD1N('j DI V IS Supplemental Information YPE OF WORK U l SJ FEE* SCHEDULE ❑ 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) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ 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: /' ? j 1 & � , 7 7"eyl�c-- Catch basin or area drain 16.60 City /State /ZIP: / . f' 7 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: () lI H f i !� L 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 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: ,6 4 Page 2 5t ° C) ' Fixture or item • Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer Page 2 ,4-' . A /(.4 , <*r--e -2 z Backwater valve 16.60 9 / Clothes washer 16.60 , Dishwasher 16.60 16ROPERTY OWNER, I 0 TENANT Drinking fountain 16.60 �n n Ejectors /sump 16.60 Name: V))\I C� -. ` ,- 7 �/ 1/ H p �- Expansion tank 16.60 Address: 20'Li I L Ax..) /c) (.) , L Fixture /sewer cap 16.60 City /State /ZIP: .---r n-72 n-72 c /� . 9 7 2 9 ?j Floor drain /floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 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 Sink/basin/lavatory 16.60 Phone: ( ) I Fax::( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 7 Business name: / } ��yl-7 z3->a. - 1_.4-zC Water heater 16.60 Address: a 7( 44 7f Other: City/State/ZIP: / Subtotal Cit y ref �t/ ox..., ��� ` / O Minimum permit fee: $72.50 Phone: ( ) 2 7_ ll l,.6-L � 6 70 -,69 Residential backflow minimum permit fee: $36.25 72 7g Q � Fax: ( 9 �© Plan review (25% of permit fee) CCB Lic.: 3 �� �� � Plu / TOTAL PERMIT FEE = mbi� Lic. no.: 3 -...z6 , /� Authorized signature: �/f,� l �( ���i ` State surcharge (12% of permit fee) q.- 7 ,, 0 '` ' t ccr . y Print name: /4/ c. / //O /40 Date: 1 `�. 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. I:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T( I 0 /02/COM/WEB) 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 - li 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 Valuation: Permit Fee: 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 Qt F (ea) Total additional $100.00 or fraction thereof, to and oa 'Fixture or Item 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 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 Revi 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 El Isometric or riser diagram is required for new buildings Floor Drain/sink - 2" that meet the qualifications above. -3" 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: i:\Building\Permits\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD BUILDING DIVISION ' ' PERMIT #: PLM2008- 00260 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/11/2008 Phone: (503) 639 -4171 im v44i llf'1I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/13/2008 TIME: 7 :01AM PAGE: 7 SITE ADDRESS: 13430 SW 107TH AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: KUMMER DESCRIPTION: Replace 60' of water service. OWNER: KUMMER, KRISTY PHONE #: . CONTRACTOR: NOLAN PLUMBING PHONE #: 503- 267 -4646 Inspection Request Scheduled For: Date: 6/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 IA/ater service 071372 -01 503- 267 -4646 N Corrections/Comments/Instructions: PASS _ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: QIA1 -.11\ Date: C. i llIDT\ Phone #: (503) 718- INSPECTOR'S SIGNATURES ARE NOT Inspections Required for: ilt REQUIRED ON GREEN INSPECTION CARD. ✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By BUP - Building Permit ELC - Electrical Permit 405 Excavation 105 Underground /slab cover 410 Fill 110 Temporary electrical service 415 Grading 115 Electrical service 205 Footing 120 Electrical rough -in 805 MFG- Structure grading /footing 125 Wall cover 210 Foundation walls _ 130 Ceiling cover 215 Footing drain 135 Low voltage 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post /beam structural 150 Hot tub /spa /pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors 199 Electrical final 240 Exterior sheathing 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG- Structure set -up MEC - Mechanical Permit 280 Insulation I 605 Post /beam mechanical 285 Drywall nailing 610 Gas line 287 Suspended ceiling 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG - Structure final 625 Duct work 498 Grading final 630 Fire damper 299 Final inspection 635 Smoke detector shutdown 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 915 Fire alarm rough -in 305 Plumbing underslab 310 Crawl drain 920 Suppression trip test 315 Post /beam plumbing 995 Misc. inspection: 998 Alarm final 320 Plumbing rough -in 999 Sprinkler final 322 Shower pan \pC 330 Water service 335 a Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 405 Excavation 345 Culvert /catch basin 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: 205 Footing 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines —1 SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: _ 499 Final inspection 599 Final inspection I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07 C ITY OF TIGARD PLUMBING PERMIT °, DEVELOPMENT COMMUNITY PERMIT #: PLM2008 -00260 'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/11/2008 PARCEL: 2S 103DA - 05492 SITE ADDRESS: 13435 SW 107TH AVE ZONING: R -3.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: KUMMER Project Description: Replace 60' of water service, CLASS OF WORK: ALT 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: 60 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES KRISTY KUMMER 13435 SW 107TH AVE Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 6/11 /2008 $72.50 [TAX] 12% State Surch 6/11/2008 $8.70 Phone : Total $81.20 Contractor: NOLAN PLUMBING PO BOX 671 WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS CO Contact # : PRI 503- 267 -4646 FAX 503- 678 -6959 0 Reg #: LIC 78388 0 PLM 3 -269PB P 0 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. Issue By: ; %` � / /I Permittee Signature: kleig 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.