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Permit
CITY OF TIGARD PLUMBING PERMIT 1111 2 COMMUNITY DEVELOPMENT Permit #: PLM2011 -00123 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/19/2011 Parcel: 2S114BB17000 Jurisdiction: Tigard Site address: 10227 SW STUART CT Project: JOHNSON Subdivision: RIVERVIEW ESTATES Lot: 16 Project Description: 30 ft. of water service. Contractor: WESTERN PLUMBING Owner: JOHNSON, RANDALL W & KRISTEN R 9460 SW TIGARD, AVE STE 101 10227 SW STUART CT TIGARD, OR 97223 TIGARD, OR 97224 PHONE: 503 - 639 -5296 PHONE: FAX: 503 - 684 -9015 FEES Quantity Description Date Amount 30 If Water Service 04/19/2011 $62.54 Specifics: 1 12% State Surcharge - 04/19/2011 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment - 04/19/2011 $9.96 Plumbing 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 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.89.0 44. Issued By: „� -i Permittee Signature: / / I Call 503.639.4175 by 7:00 a.m. for the next available inspection 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. 04/18/2011 08:49 5036849015 WESTERN PLUMBING INC PAGE 01/03 Plu__..A Permit A, licr4C EivED Building Fixtures APR 19 2011 : fo K irptiE ' Y • L . - .: • City of Tigard Received t i 13125 SW Hall Blvd.., Tigard, lJatrJBy $. ! i Pla ta • 1i eview W // ��/ Permit N a.: • " Lk.) 18 Phone: 503.639.4171 Fxtc 50 . TiGA�D rlGnlzo ,, i ��7�UILDING DIVISION i ao Ready/By: Other PcmtitNo.: Internet: PE &3 see Page 2 for Notified/Method- or' wo .: .a' S . , nisi Information 0 New construction l?ZsF. *: SGDLtI B. Demctlitiorl For , , ur ormatron arse checklist 12 Addition/alteration/replacement ©Olher New 1- 2- faalE� dwellings e+� Ea. Total CATF,GORy' OF ot IIUCTION1 !s includes 100 R. for each utility connection SF () bath 312.70 NM `` 1- and 2-family dwelling CI Commercial/industrial SFR (2) bath A ZEI ccessory building ©M 1� ' 4 uttr tily 50032 MEI © Master builder ❑ Other: Each additional bath/kitchen 25.02 MN ;PCjIf' ;1P+tf01tMATTOAi AND • ` Fire sprinkler sq., ft. 1rt�GA7l I+D She utilities: Job site address - = - fL ! G _ � Catch basin or area drafty �� City/State/ZIP!' i:� i / ,4 1 Dryweii, leach line, or trench drain �� Suite/bldg. /apt. no.:' PrOjeet flame Footing drain (no. linear ft: �) Cross Steer/directions to job site: :1 MVP ► l t 1Kaautachtred home utilities Ifffil 50,03 lylsaltoles 1$.76 Rain drain connector 18.76 ME Sanitary sewer (no. linear ft : ) EMI Storm sewer (no. linear ft: ___) ME Page 2 Sulxiivision: wat service (no. linear $: . � Page 2 M ill Lot no.: Fixtures � Tae; map /parcel Ito.: Backflow preventer 3127 • O1si OF WORK $adcwater valve MIER / 25.02 Clothes „ ushe r I, '. 6 t , y Dishwasher 25.02 w , Drinking fou jairt 25.02 , ... , rTtTY.?p9FTi3��t :... , . - 25,02 CI T161KAANT Expansion tank MEI 12.51 i n None a .• .. : `fi. ; i �, Fixtus/seor MI 25.02 Address: wf Floor drain/floor sink/huh x5.62 City /State/ZIP Garbage disposal 25.02 Phone: ( ) Box bib 25.02 Mall Far ( ) Ice maker ,0 APPLICANT' � `� .CONTACT I'IyRSQ1Y. 25.02 Business name: - Medical gas (value: S ) IIIII Contact name: pa.. 12,51 Address: Roof drain (commercial) IN. 12.51 MUM - Sink/basin/lavatory Ciry /StateJZll?: T Solar lar units (pota(potable ble water) Phone: ( ) l Fax ; ( ) Tub /shower /shower pan Ell 12 - 51 &mail: Urinal 25.02 MI lNFItAC�4R c MEI 25.02 ',_„ water inset Business name: Westerns lc"luanbitlg, Inc were neater 37.52 Address: 9460 Tigard Avenue Suite 10I Water pip W V 56.29 Other: IMO 25.02 MIIIII City/Stahl?: Tigard, OR 97223 „ Subtotal • i Phone: (503) 639-296 Fax: (503) 684 -9015 Minimum permit fee: $72.50 ig . IIIIIIIII CCB Lic.: 2439 Plumbing Lic. no.: 34 -29P$ Ptah review (25% of Peron t fee) Authorized signature' • /*� • r / State surcharge (1296 of permit fee) +g� r/ � ' TOTAL PERMIT FEE ► • � E Print acme: haute Jensen / �� — Date! 4 It) This permit appticy doe expires W permit to naY obtained maim 180 days after It has been accepted vs complete. -a.. n+>.h..Anlne , eor s.., Tri_Cm..,h, Anil riinn r.A.rInt Crw:,... AnarA 04/18/2011 08:49 5036849015 WESTERN PLUMBING INC PAGE 02/03 umble Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: 4 • Residential f ire S u ressiot Systems: Sane tilih es Qty ' : ' t?ee (ea) n o r ' S -� � Y u4r Root 1 e': h F ,: Footing drat t -1"100' 50.03 Footing drain - each additional 100' _ , 0 to 2LOQQ $121,90 3 ?.52 2001 10 3600 $169.69 ^ Server .1st 100' — 62.54 -. 3 6 x .01 to 7,200 ``` - -� $233.20 Sewer - each additional 100' 37.52 -` , 7,201 and greater �" $327.54 Water Service _ 1st 100' 7 62.54 Water Service - each additional 1067— 37.52 �ra Stoma 8c Rain Drain • 1st 1 Q0' �` 62.54 nation• Fee: Storer && Rain Drain -each additional 10 7.52 $1.00 to $5,000.00 Minimum, fee $72.50 $5,001,00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other. ltl ectiofs .or Fees 4 1 6 ' Fee (pqy Total each additional $I00,00 or fraction thereof, to Inspection of existing plumbing or for _wand including $ I O 400.00. which no fee is specifically indicated 90.00/hr $10,001.00 to $25,OOO.QO $14$.50 forthe first $10,000.00 and $1.54 for (miazitnuan charge: 112 ) each additional $100.00 or fraction thereof, to Inspections outside of normal b business 90 00/hr and including 525,000,00. hours �aatiittuma charge - 2 h ur $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for — Itsinsp®ction Pees 0 -OORu — `- each additional $100.00 or fraction thereof to Additional platy review for revisions 90_00/hr $50,001.00 and u and iuclndi $SO,000.00, 0 f th (minimum charge - 1/2 hour) P s----'1,2.0 12----- first $50,000.00 and $1.20 for Subtot each additional $100.00 or fraction thereof Comm ercial P ixtur W rk Are you capping, adding or replacing fixtures? tf - _ please indicate work performed by fixture. Failure to "yes", Plan Review for, o f t i r e ik1 .:Z1tl tlotl5 accurately re fixtures could result in Increased sewer fees *. Plan review is required for any o f the following. - -� Please check all that apply. Qtuin . b thine ed Work. Performed- ❑ Airy new conuneresal build Ron ',iype: ergaee > with water service 2" and Maus c5.. .. l iddod Rcml greater, except ,systems designed and stem }3aptistay/Foalt � engineer. P by licensed Bath -Tub/Shower ,u. New exterior plumbing u for any complex structure - Jacuzzi/WI/hi . • oI as defined in QAR918- 780 -0040. Car Wash -Each Stall _ _____ _____ ______ 1.1111MINIME 0 Medical gas and vacuum s -Drive Thna = d Any mul i .pose fire sprinkler for health care facilities. Cuspidarf Water Aspirator Axty corn lei structure SyS2eu1• ❑ Dishwasher r�ial � p as defined in OAR9 i 8 -780 p040. Drinkii FDoanest`c� Submit 2 sets of plans with any of the above. >g Eye Wash - Floor Drain/sink - 2' Isometric - . or Riser Dlagrarnl - -3" M�� ❑ Isometric ox riser dit�gt3n1 is required for new buildings - 4 that Inset the qualifications above. Car Wash Drain Garbage - Domestic Disposal - Commercial EMIR -I g. D 11111.1=11.1.111.111 Comments regarding fixture work: Ice Mach /Berri& DratOe Qi1 Separate (Gas Station) 11111 El Recce Dump Station Shower -Gan Sink - Ber/1,avatory - Bradley -Commercial " Service 5 Note: If the fixture work under this permit results in an Swimming Pool rvice increase of sewer EDT's, a sewer permit will be issued and Washer - Clothes fees assessed for the sewer increase mast be paid before the water Extractor plu nhing permit can be issued. Water Closet .Toilet Urinal Other Fixtures: