Loading...
Permit 4 11. CITY OF TIGARD PLUMBING PERMIT " DEVELOPMENT SERVICES PERMIT #: PLM2005 -00182 �l 13125 SW Hall BIvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/2/2005 PARCEL: 2S 103BC -03200 SITE ADDRESS: 12270 SW ALBERTA AVE ZONING: R -4.5 SUBDIVISION: CANOGA PARK LOT: 006 JURISDICTION: TIG Project Description: Sewer connection, reversed plumbing. 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: 90 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES NASH, DOUGLAS E Description Date Amount NANCY LOU 12270 SW ALBERTA ST [PLUMB] Permit Fee 5/2/2005 $105.00 TIGARD, OR 97223 [TAX] 8% State Surcharl 5/2/2005 $8.40 Phone : 503 - 590 - 6274 Total $113.40 Contractor: BABBITT PLUMBING INC 7611 SW ALDEN ST REQUIRED ITEMS AND REPORTS PORTLAND, OR 97222 Phone : 503 244 - 5279 Reg #: LIC 30869 PLM 26 - 86PB 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 -00 0 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 504- 246 -..99 or -800-332-2344. Issued B• k X & .y/t/t Permittee Signature: ,, 2 tect 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. Building Fixtures Plumbing Permit Application . , ,.,. ¢�_ - +':� p °� FOR OF USE 'ONLY' e ate , • „,. City of Tigard Received Date/By: Permit No.: \ (�_ ,� 13125 SW Hall Blvd., Tigard, OR 97223 1 1 "bC U(� j (/Q / �,� Plan Review OBnNi 1 � Other Permit No.: .44\v\ IV' � I� DateBy: yBy 0 See Page for '/,/� O p Phone: 503.639.4171 Fax: 503.598.1960 24- Hour Inspection Line: 503.639.4175 ` _` . Otis: L w Date Read e 2 for Internet: www.ci.tigard.or.us / B Notified/Method: -T-4,-- Supplemental Information % sus ` � . x 5 ,v ..>v >: �s "L .,i.` `'.s: x , 5 t: 'fltf e' „ §" ,; r''' 7 ' : '''':' : -.;,.. 24',,%,. " S�:g '' : �. � >'YP•E ° F �VV O • `� �, � , � . r �_. � � ���_F.�. , ,._ F� , .,..'.:� ter::. s�= _� >. .�.. �, � .. ` "�,. �.; " �"�' ' ''�`i °° ...y� r 'R,.� � � � tm �,.� .. E *�,� C;g;F'D.>rIT; E`� . �_ �sr >sc=x. ��� >�m�'�Sv�a �n a *. .:xs,- rgd S: xsc� i:. ua,. rs� vsa " m� z- tx;,zw:m�_. :., :: , El New construction El Demolition For special information use checklist. �jj Other: L Description I Qty. Ea. . Total ❑ Addition /alteration/replacement J"' •Ceov r I00A V f New 1- 2-family am dwellings (includes 1 ; , 7 ,,, ,,.x'° 5,14=° ra ,v.,,w ,a . ,:- .:r age,. ;: ,, :. ;;�,-r> il y g ( 100 ft. for each utility connection ) .ektWa: ATEG AYI? 9A,S R C.TI®N, ,3 ; g ° r s; SFR (1) bath 249.20 ig 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 11 Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath kitchen 45.00 El Master builder El Other: ., , °,> rr:,. � x;,•:. i, :vs ; Fire sprinkler ( sq. ft.) Page 2 ' ' 16 `a=S 011141® TIOI\' ID LOCATION s'` .05 � .., �•- ° �. �r ..�.� =:a• '..a�µ._.. Site utilities Job site address: (;� 2 `)Q 5 1.1.4 �! beN i� Si; Catch basin or area drain 16.60 City/State /ZIP: -7752.10,11 ©A e 9 7x2,3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: Manufactured home utilities 110.00 Wed of j e ' Manholes 1 6.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ?0 ) _ Page 2 3 Storm sewer (no. linear ft.: ) Page 2 Subdivision: l Lot no.: Water service (no. linear ft.: ) Page 2 Tax map /parcel no.: Fixture or item 1 3s . - :,.r- •d.-':;r. ter: ;;,. x .., k Absorption valve 16.60 °DESCRIPTION OF' A a ,i Ji i� " ` °.r �'i -i -� ft . t , -°. ... : : � �4 r. , . a =, 1 *,,.� _ ,.. ]suet..., : :'., . � ,a,. ' Backflow preventer Page 2 / k e c; '''t / tit' / 7 /(Jfl /J 'io ,c etae�^ Backwater valve 16.60 f Clothes washer 16.60 Dishwasher 16.60 ; >w f , , .. A' S` j5+'+ e^° r,`:.`!>. 3`` "'%:':?R^..u.b =, u"!!! °. `, iGA'.8ss�,•. - i a ' AN . Drinking fountain 16.60 �� k PItOPERT O WNER aX li'r� `..E ik e 1441=,1� "° " € 3 l/ �' ,( Ejectors /sump 16.60 Name: Paul t o s `h s A 4 / AA's G / Expansion tank 16.60 Address: ! 2 7 d cab, 4 �b E' fr /A ? Fixture /sewer cap 16.60 City/State /ZIP: 7 j d (9i,,,,e 97123 Floor drain/floor sink/hub 16.60 Phone: (S D3) c 0 6 2.7 y Fax ( ) Garbage disposal 16.60 4 C l .. a - t , ,�t S � rV Hose bib 16.60 APiPi. CANT' AIRS ' ; , ° .CO1VTrkC:T PERSON ...''� .•���, . �_�• � � � , ., °� � �:� � �.��� Ice maker / -. t 16.60 Business name: 8abLi . P /vim /1 4 t � Al A ,; L. Medical gas 162 /v Contact name: D/ 6 Medical dical gas s (value: $ ) Page 2 Address: (� r g e �6 `/ ar , fJ1 k .N Primer 16.60 . City/State /ZIP: 81 :11 A ©p Roof drain (commercial) 16.60 Phone: 6 ).. 6 ,2 yy - 5•7(7 Fax: : (03) p lies - d 7 35- Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 ° ;:,.rqe r rx :; ,, 3 :. Urinal 16.60 _< :. i m : Ag, aik.t� , CONT'RACTOR � � � " s c. :- p �a. . , a ., u.. ,s�a �, `.� _, Water closet 16.60 Business name: S 45 a. U •P Water head 16.60 Address: Other: �� `' � ! , ,'F • City /State /ZIP: Subtotal trit_ 4,y Phone: Min permit fee: $72.50 1 ,4) ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 /O,' CCB Lic.: 308 6 G Plumbing Lic. no.: ,26- K ,P O Plan review (25% of permit fee) Authorized signature: 1 4 6 n n '•t/1 n'7� / v Vic 6 State surcharge (8% of permit fee) X. +10 � TOTAL PERMIT FEE //..50 Ye) Print name: 6e0lAgi Q Ir 44,6b78- -~+ FJ 4 ,6 („/- Date: • 29- es -- This permit application expires if a permit is not obtained w' V 180 days after it has been accepted as completr *Fee methodology set by Tri-County Building Industry Se i:\ Building \Permiu\PLMF- PermitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard T Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: • S>! e T3tarli i`e b q ° Qt ee eat � ` Tg a t ua e Perm>It Fee � �W - . � . _ :� , 1 x. lootage,e,g 5,414- . .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' 4640 F t:: `.i`,t-°`s aluat t F ee:� • 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 F Qty tree (ea) Tofal' additional $100.00 or fraction thereof, to and � a- • �,63s ..,. �, g�� m..as,� 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 Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 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: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . , � r t Quantlt b (R►z ure) R o Perf ktxture�Tyl - q at l teplacew, , 1 W ? a `», r b I A . .. N �,t r m �ea �s �ap�e_ Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" • Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial increase of sewer EDUs, a sewer permit will be issued and - Ice Mach. /Refrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink -Bar/Lavatory Quantity Total -Bradley Commercial Isometric or riser diagram is required if fixture quantity Service total is >9. - Swimming Pool Filter Washer - Clothes Water Extractor ..Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i: \ Building \Permits\PLM- PermitApp.doc 3/03 05/20/2005 07:52 5032450735 BABBITT PLUMBING PAGE 01 MAY 18,2005 10:48A ALOHA SANITARY 503 -844 -7598 page 1 / c 7 , /�r 5iiEe ll . h NNIMPINIRIPMPW ALOHA SANITARY SERVICE -- - INVOICE NO. 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 9669 50 644 -2797 * 503 -64 -6254 * 503 - 639.5188 NA ' ADDRESS: - - - CITY: STATE: Zip: I TOME: , Willi : / ELLL Jos SITE: r . 21 r . ir" - . _ . _ , .. ` P + • PAID By CHARG CHECK ❑ CA8M ❑ CREDrr CARD ❑ DATE 1 "'Y .65' DRIVER .11,1. 164 ,. I AMOUNT IIIII 1111111r PUMP SEPTIC TANK IIMIR ❑ LINE OPENING .. - MI ❑ INSPECTION PEE _ Ifil II ❑ SERVIOI CALL _ - - 1111111 0 LABOR, LOCATING, DIGGING, BACKFILL ❑ MATERIAL 1111111/1111 -- 166 e rn THIS Is NOT A SEPTIC ' YST M INSPECTION REPORT • • TOTAL $ Al .l - - REMARKS - - Ef 6 TYPO OP TANK: S ❑ CO METE ❑ PLASTIC C] HOMEMADE ❑ HO IZONTAL O ERTI • : L 0 RECTANGL © U OTHER SIZE OP TANK: 350 U 500 U 750 A 1000 U 250 0 1500 0 2000 U 3000 LID LOCATION: INLET O • TUT CI MID ❑ ENTIRE To U TANK CONDITION: GOOD ❑ F R 0 Po. ❑ FITTINGS: BAFFLES 0 CO •CRETE 0 -T IRON ❑ PLASTIC ❑ NEED NEW LID? YES CI BM GROUND COVER OVER TANK _ • COMMENTS ON CONOInON OF DRAINFIEI:D TC. /A!�KILi 1 -,.. 1 I rAdroM aye __ SIGNED BY DATE . CITY OF TIGARD - „- BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: PLM2005r00192 Phone: (503) 639 -4171 /,r' °yl,�uiilt� Inspection Requests (24 Hrs.): (503) 639 -4175 ':_.. INSPECTION WORKSHEET FOR DATE: TIME: TIME: 7.12AM PAGE: 20 SITE ADDRESS: CLASS OF WORK: 12270 SW ALBERTA AVE SUBDIVISION: CANOGA PARK LOT #: 005 TYPE OF USE PROJECT NAME: NASH DESCRIPTION: Sewer connection, reversed plumbing. OWNER: PHONE #: NASH DOUGLAS E, 503-690 -6274 CONTRACTOR: BABBITT PLUMBING INC PHONE #: 503-244-5279 Inspection Request Scheduled For: Date: 5/1112005 Pour Time: Code # Inspection Description Confirm # Contact # Message I 505 Sanitary sewer 006610 -01 503- 2445279 N Corrections /Comments /Instructions: • I ii P ASS lk; P RTIAL APPROVAL ❑ CANCEL _ NO ACCESS (l FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r 1 ' 1 Date: Il--S Phone #: (503) 718- " ✓