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Permit CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00199 DATE ISSUED: 5/10/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 110DC - 90231 . SITE ADDRESS: 15565 SW 114TH CT 23 ZONING: R - SUBDIVISION: FOUNTAINS AT SUMMERFIELD CONDO LOT: 023 JURISDICTION: TIG Project Description: Replace backflow device, Located near the back of Unit 23 near water meter. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: 1 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 HARNS, JAMES R + PATRICIA S 14106 PENNYSTONE DR Description Date Amount SUN CITY WEST, AZ 85375 [PLUMB] Permit Fee 5/10/2006 $72.50 [TAX] 8% State Surcha 5/10/2006 $5.80 • Phone : Total $78.30 Contractor: WILLAMETTE LANDSCAPE SERVICES, INC. 18480 SW PACIFIC DR TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS Contact # : FAX 503- 625 -9714 PRI 503- 625 -9600 Reg #: LIC 6949 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, opies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. "/ 4 ,0 - 1 Issued By: .- 71) ���� 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. 4. Plumbing Permit Api1�ica °tio�n� City of Tigard '- - - FOR OFFICE USE ONLY d v Ct \‘''' Received U ^ Permit No.: -?W\,),/;0(-- )C -_ /99 13125 SW Hall Blvd., Tigard, OR 97223 Q�6 Date/By: �/ KV Pla Review Phone: 503.639.4171 Fax: 503.598.1960 \A N p��.n lit Date /By: Other Permit No.: ��� �m"ppur 24- Hour Inspection Line: 503.639.4175 • c"'* 07 _ Date Ready /By: Juris El See Page 2 for Internet: www.ci.tigard.or.us , 11.1V ( .)t _ _y�n��,t Notified/Method: 1/k Supplemental Information - . TYP. t y41 EEII G HED'ULE� " t . ❑ New construction B Avg ❑ 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 4 _ • SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 E] Accessory building ® Multi- family SFR (3) bath 399.00 ❑ Master builder ❑Other: Each additional bath /kitchen 45.00 Fire sprinkler ( sq. ft.) Page 2 JOB. ' SITE ,INFORMATION AND LOCATION , 6 •', Site utilities Job site address: 15565 SW 114 Court Catch basin or area drain 16.60 City /State /ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Unit #23 Project name: The Fountains at Summerfield Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: Pacific Hwy to Durham Rd to Summerfield Drive. Manufactured home utilities 110.00 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.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 - ;DESCRIPTION ;OF WORK - Backflow preventer Page 2 Replace aged PVB backflow device with DCVA in- ground device. Backwater valve 16.60 Device is located along 114 court nearest the back of Unit #23 next to the curb, Clothes washer 16.60 near the water meter. Dishwasher 16.60 y r - Drinking fountain 16.60 i PROPERTY'- OWNERF'' � ' " "'` � • - ,❑.TENANT " Ejectors /sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State /ZIP: Floor drain /floor sink /hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 ° ''J®' AP_PLICAN'T 'r < - "+, " Hose bib 16.60 ' . ■- CONTACT .PERSON .'_ -_ Ice maker 16.60 Business name: The Fountains at Summerfield Interceptor /grease trap 16.60 Contact name: Bob Young Medical gas (value: $ ) Page 2 Address: 15605 SW 114 Ct. #19 Primer 16.60 City /State /ZIP: Tigard, OR 97224 Roof drain (commercial) 16.60 . Sink/basin /lavatory 16.60 Phone: (503) 624 - 2046 Fax:: ( ) Tub /shower /shower pan 16.60 '- E -mail: Urinal 16.60 1 a " ." . . , CONT " . ° " - " Water closet 16.60 1 1%. Business name: Willamette Landscape Services, Inc. Water heater 16.60 Address: 18480 SW Pacific Drive Other: City /State /ZIP: Tualatin, OR 97062 Subtotal Minimum permit fee: 2.50 - . Phone: (503) 625 - 9600 Fax: (503) 625 - 9714 Residential backflow minimum permit fee: .25 CCB Lie.: LC " t < 9 y q Plumbing Lie. no.: Plan review (25% of permit fee) Authorized signature: / ii c,./....47. State surcharge (8% of permit fee) / TOTAL PERMIT FEE 7 ,, IC Print name: Matthew C. Triplett, VP Date: May 9, 2006 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 \PLM- PemiitApp doe 06/05 440- 4616T( I 0 /02 /COM /WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Slte Utilities °., t ' _ µhr'c - ' i4 Q ty nFee "(ea) Total Footing drain - I e 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 Storm & Rain Drain - 1st 100' 55.00 Valuat1611 y , e _ peCITlltee - �, - s .. $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 a OrItelll a p Qty ; = =F' )1; additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 1 46.40 GfG,l(O $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 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 =Reviewrrr =for Complex,Structures ,` Are you capping, adding or replacing fixtures? If "yes ", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria. accurately report fixtures could result in increased sewer fees *. Please check all that apply. _ ` 'd ",=.'% .. iQya itiiy,by (Fixture) WorkPerfornied° ❑ Any new commercial building. n new exterior plumbing FxtureTYPe1 " ms s- Re ce ❑ Any i P site utilities. a w ,, , Previous; , Capped= Added , .1F is r ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi /Whirlpool providing services to human beings. Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service - Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor /Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain Eye Wash ❑ Any NFPA 13 - D multipurpose fire sprinkler system. Floor Drain /sink - 2" 3 „ Submit 2 sets of plans with any of the above. -4 " Car Wash Drain IS 'metric or Rises' Diagram Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial three (3) or more stories in height. - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this ermit results in an Water Extractor p Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. is \Building \ Permits \PLM- PermitApp doc 07/06/05 CITY OF TIGARD ,.. ._ ,.. BUILDING DIVISION A, PERMIT #: PLM2006-00199 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1012006 Phone: (503) 639-4171 Inspection Requests Requests (24 Hrs.): (503) 639-4175 .., 11- .INSPECTION WORKSHEET FOR DATE: 912412007 TIME: 7:00AM PAGE: 46 SITE ADDRESS: 15565 SW 114TH CT 23 CLASS OF WORK: SUBDIVISION: FOUNTAINS AT SUMMERFIELD COND LOT #: 023 TYPE OF USE: PROJECT NAME: FOUNTAINS AT SUMMERFIELD DESCRIPTION: Replace backflow device, Located near the back of Unit 23 near water meter. Plumber paid reinspection fee and has 30 days to complete work and get final inspection. SLN OWNER: HARNS, JAMES R + PATRICIA 3, PHONE #: CONTRACTOR: WILLAME. 1 I E LANDSCAPE SERVICES, INC. PHONE #: 503-625-9600 Inspection Request Scheduled For: Date: 9/24/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 056160-01 503-572-8427 Y Corrections/Comments/Instructions: D t . ..Ac e... 1 C g-e-tpd/ r-exit-c v./4)U p PASS I I PARTIAL APPROVAL n CANCEL I I NO ACCESS I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: cra v‘,...A..../4 ,41\--,_ Date: 9 \ -24 Jo T? Phone #: (503) 718- . _ . . Inspections Required for: PLM2006 -00199 ✓ 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 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 305 Plumbing underslab 915 Fire alarm rough -in 310 Crawl drain 920 Suppression trip test 315 Post/beam plumbing 995 Misc. inspection: 320 Plumbing rough -in 998 Alarm final 322 Shower pan 999 Sprinkler final 330 Water service 335 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 X 399 Plumbing final 0 11D - 110 - 7 OA/ 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I: \Building \Inspection Cards \Forms \AOP- InspCard- Blank.doc 12/09/2005 CITY TIGARD PLUMBING PERMIT i DEVELOPMENT SERVICES PERMIT #: PLM2006 -00199 � n DATE ISSUED: 5/10/2006 �--- - - -- ` Y- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S110DC 90231 SITE ADDRESS: 15565 SW 114TH CT 23 ZONING: R -25 SUBDIVISION: FOUNTAINS AT SUMMERFIELD CONDO LOT: 023 JURISDICTION: TIG Project Description: Replace backflow device, Located near the back of Unit 23 near water meter. CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: 1 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 I HARNS, JAMES R + PATRICIA S Description Date Amount 14106 PENNYSTONE DR SUN CITY WEST, AZ 85375 [PLUMB] Permit Fee 5/10/2006 $72.50 [TAX] 8% State Surcha 5/10/2006 $5.80 Phone : Total $78.30 Contractor: r WILLAMETTE LANDSCAPE SERVICES, INC. 18480 SW PACIFIC DR ' t TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS ZI'' Contact # : FAX 503- 625 -9714 _ 11 PRI 503- 625 -9600 r i`` E Reg #: LIC 6949 l O O 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. .. Issued By '' . _re !„ ,_,� 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.