Permit •
y CITY , =t~ TIGARD \, PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/11/2008
PARCEL: 25101 DC -02500
SITE ADDRESS: 07650 SW CHERRY ST ZONING: R -3.5
SUBDIVISION: ROLLING HILLS PLAT 2 LOT: 031 JURISDICTION: TIG
PROJECT: MAYER
Project Description: Install sewer line to connect to sewer.
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: 100 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
MAYER, KENNETH D AND Description Date Amount
JANICE K
7650 SW CHERRY ST [PLUMB] Permit Fee 1/11/2008 $72.50
TIGARD, OR 97223 [TAX] 12% State Surch 1/11/2008 $8.70
Phone : Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # : PRI
Reg #:
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
' Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue• = /Pi/ 1 Permittee Signature: 41 ' L L' '
I
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plutikbin2 Permit Application . • -
Building Fixtures FOR OFFICE U SE ONLY
City f Ti and Received c
111 `� g I II Q 3/ ',Pit No.: 2.00$ _0000 p 1 3125 SW Hall Blvd., Tigard, OR 97223 Date/By: r
Phone: 503.639.4171 Fax: 503.598.1960 P
- OtherPetmit g
Inspection Line: 503.639.4175 •
y: V -0000441 T I G A R D Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction 0 Demolition For special information use checklist
Description Qty. Ea. 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
0 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: d U • F Catch basin or area drain 16.60
City /State /ZIP: Ty ry a ,�,CI ) Q Q ' 03 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project n / am ` e: d Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: /v� /J�„ n Lt
/7 U"� Manholes 16.60
/ • ` ■ Rain drain connector n 16.60
Sanitary sewer (no. linear ft.:4 VJ) I Page 2 S5 .00
Storm sewer (no. linear ft.: ) Page 2
Subdivision: R� (f Q Q „ 42 a Lot no.: 3 / 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
s ..L.c.: 4 o CtJY J- &A p-Q/L. -d-o f\.LL ...D Backwater valve 16.60
1 ,W1.7_, A . � ' _ !AL __...4• II t ! Clothes washer 16.60
/ Dishwasher 16.60
Drinking fountain 16.60
,PROPERTY OWNER ❑ TENANT
r Ejectors /sump 16.60
Name: T U C E Y`2.4^ C . e /\ Expansion tank 16.60
TCP
Address: G O S t V " ` Fixture /sewer cap 16.60
L
City /State /ZIP: - 7" , . (ND 6 -- 7..-7.- j Floor drain /floor sink/hub 16.60
Phone: (5(3 � g'r _ - � - �}} 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
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: \ l r�,.y y-- ) Water heater 16.60
Address: J Other:
City/State /ZIP: Subtotal
Minimum permit fee: $72.50 -i2 • c
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 0
CCB Lic.: Plumbing Lic. no Plan review (25% of permit fee)
State surchar f permit ,�
Authorized signature: T e (l2% PERMIT FEE fee) I 8 , 2.0
Print name: ��m �� t / e� Date: ! / I r �' This permit application expires if a permit is not obtained within
j 1 180 days after it has been accepted as complete.
*FFemethoodology set by Tri -County Building Industry Service Board.
I:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 46t6T(10 /02 /COM/TEB) 25 3
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 - 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' I 55.00 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
Fixture or Item Qty. Fee (ea) Total 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 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 Review 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) Woi k 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 ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3"
-4"
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:
1:\ Building \Permits\PLM- PermitApp.doc 12/27/06
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: PLM2008-00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ill i/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 202008 TIME: 7:00AM PAGE: 4
SITE ADDRESS: (7650 SW CHERRY ST CLASS OF WORK:
SUBDIVISION: ROLLING HILLS PLAT 2 LOT #: 031 TYPE OF USE:
PROJECT NAME: MAYER
DESCRIPTION: Install sewer lino to connect to sewer,
OWNER: MAYER, KENNESH 0 AND, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
ttifi Sanitry sewer 064757-01 3G0-449,2557
f 1.
ii•kt.
Corrections/Commen s/Instructions:
P t AA - Pv\t-,A.
Cart.
PASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
I FAIL CALL FOR INSPECTION Li ADDITIONAL FEES ASSESSED
Inspector: CT3 Date: 2 , (rce 1=0 7 Phone #: (503) 718-
•
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CITY OF TIGARD . .
., ., .
BUILDING DIVISION - '• .
PERMIT #: Pl..1v12008-00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: i/11/2000
Phone: (503) 639-4171 ea/SO i A
Inspection Requests (24 Hrs.): (503) 639-4175 ,411
= gm a.•
INSPECTION WORKSHEET FOR DATE: 2/7/2009 . TIME: 7:03AM PAGE: 10
SITE ADDRESS: 07660 SW CHERRY ST CLASS OF WORK:
SUBDIVISION: ROLLING HILLS PLAT 2 LOT #: 031 TYPE OF USE:
PROJECT NAME: MAYER
DESCRIPTION: Install sewer line to connect to sewer.
OWNER: MAYER, KENNETH 13 AND, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 217/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1101..■ Sault aly sewer 064691-01 50',359- 7995 Y
Corrections /Comments / Instructions:
a z-A 0 i H 0 v , ‘A-4, il 0 Li VW4e, r-- ((AA 13 uk,
0 PASS IX PARTIAL APPROVAL El CANCEL El NO ACCESS
EI FAIL 0 CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: \14- Date: 7, 0 ) 0 91 Phone #: (503) 718-
. . .
,
ALOHA SANITARY SERVICE
INVOICE NO.
8600 SW Hillsboro Hwy., Hillsboro, OR 97123 12910
503 - 644 -2797 * 503- 648 -6254 * 503 - 639 -5188 ,
NAME: `3 IJ t CR., n� Yh,A. Y -R—
ADDRESS: 7 (o. Z Q ' U•/ C,� _ Irz 1Z 1 /J7:V•2
CITY: I 1 ‘47..() STATE: ZIP:
HOME: [t[ ,14 - ZSa WORK: CELL:
JOB SITE: 3 Q 1 P.O. #:
Nrez=za,
PAID BY CHARGE ❑ t % C HEG� (� CASH CI CREDIT CARD CI
DATE 6 Z_G 7- Z DRIVER 00lN6 '74u14 'J1au/ AMOUNT
❑"'" PUMP SEPTIC TANK) Q
❑ LINE OPENING 1
❑ INSPECTION FEE
❑ SERVICE CALL
❑ LABOR, LOCATING, DIGGING, BACKFILL
u - v
❑ MATERIAL w
1
- - THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT - - I TOTAL $ 337J
A -- REMARKS - -
TYPE OF TANK: STEEL ❑ CONCRETE ❑ PLAST / HOMEMADE ❑
HORIZONTAL ❑ VERTICAL ❑ RRECTANGLE ❑ ❑ OTHER
SIZE OF TANK: 3 50- 500 ❑ 750 ❑ 1'000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: I NLET ❑ OUTL MIDDLE ❑ ENTIRE TOP ❑
TANK CONDITION: GOOD ❑ / ---- FAIR POOR ❑
FITTINGS: BAFFLES CONCRE U \ AST IRON ❑ PLASTIC ❑
, NEEDS NEW LID? YES SIZE
GROUND COVER -O " ER TANK
COMMENTS ON CONDITION OF DRAINFIELD ETC.
t '1;
SIGNED BY ' DATE
\P t