Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES
PE
DEVELOPMENT PLM2006 -00433
'�� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/19/2006
PARCEL: 2S 111 CA -13400
SITE ADDRESS: 09670 SW DARMEL CT ZONING: R -3.5
SUBDIVISION: DARMEL NO.2 LOT: 036 JURISDICTION: TIG
Project Description: Replace rain drains, footing drains & water line.
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: 100 ft
WATER CLOSETS: WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: 100 ft
Owner: FEES
KELLY COLLINS
9670 SW DARMEL CT Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/19/2006 $165.00
[TAX] 8% State Surcha 9/19/2006 $13.20
Phone : 503- 670 -9404 Total $178.20
Contractor:
AAPPLE PLUMBING
PO BOX 1543
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 936 -7461
FAX 503- 647 -2736
Reg #: LIC 104311
PLM 34 -308PB
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: // ���'Z��!j Permittee Signature: __R . - O\D,
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.
Sep 1_9 06 10: 15a 5036472736 p. 2
Plumbing Permit Ap iiiliCatnin. FOR OFFICE USE • Oti.I.Y
City of Tigard [P 1 0 2006 Date/By: '0 , p 4, Permit Nai \L„ / • l/0 1.
13I25 SW Hall Blvd., Tigard, OR 97223 SC v Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 i x , Date/By: Other Permit No.:
� o
24- Hour Inspection Line: 503.639.4175 �. $ s i. 1 i@.} : 'op Date Ready/By: orris: el Sec Page 2 for
Internet: www.ci.tigard.or.us `... 1 S - . .. . :.. . `V y � 1 ; ,1 ! Notified/Method: Supplemental Information
... r - ic ,::. :. . .
.Tns�'�:aF�;�%oRh .:.:.::::. : : :.: >':•.:...:::.:,'.: ,. :,:.: ;�FEx- scit�vuil:;. - :: ;: , "
For special information use checklist
❑ New construction ❑Demolition
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:::CONSTRUCIION .:;.' ".:' .:.:. • r.'`':'. SFR (I) bath 249 -20
® I - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
0 Accessory building ❑ Multi- family
SIR (3) bath 3 99.0 11
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler (_ sq. ft.) Page 2
:JOB 'SI . INFORMATION 'AND : T; O CATION: : :.. ` si
utiliti es
Job site address: 9670 Darmel Ct. Catch basin or area drain 16.60
City /State/ZIP: Tigard, OR Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Kelly Collins Footing drain (no. linear ft.: Less Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: 96 & Darmel
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear IL: ____) Page 2
Storm sewer (no. linear It.: less than 1 Page 2
Subdivision: I Lot no.: Water service (no. linear it.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
D oF> WORT{ > : = : ` ac o tenter Paget
Replacing rain drains, footing drains & water lines. Backwater valve 16.60 '
Clothes washer 16.60
Dishwasher 16.60
n fountain
. TENANT...:
. .. .. .. . .... ®. PROPERTY OWNER ❑'::
,. ... Drinking o
�'. i -:. '.:` : •: '.' `:.' .. .....: , .. Ejectors/sump 16.60
Name: Kelly Collins Expansion tank 16.60
Address: 9670 Darmel Ct. Fixture /sewer cap 16.60
City/ State/ZIP: Tigard Floor drain/floor sink/hub 16.60
Phone: (670 -9404) Fax: ( ) Garbage disposal 16.60
Hose bib ❑ • APE..... r. r " : : : . : ` .,. ®CO1siTACT; - ' cc maker H � b�b
Ice 16.60
Business name: Bill Wren & Sons, Inc. Interceptor /grease trap 16.60
Contact name: Joe Wren Medical gas (value: $ ) Page 2
Address: PO Box 980 Primer 16.60
City/State/ZIP: North Plains, OR 97133 Roof drain (commercial) 16.60
Phone: (503) 936 -7461 I Fax: : (503) 647 -2736 Sink /basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
- : ' .. CONTRACTOR;:; ::.': : :: 7 :' .. i' '.:.. Water closet
• ...... : ':' Wa i 1G G0
Business name: aapple Plumbing Water healer 16.60
Address: PO Box 1543 Other:
City /State/ZIP: Hillsboro OR 97123 Subtotal
Minimum permit fee: $72.50 a
Phone: (503) 648 -1855 Fax: ( ) Residential backflow minimum permit fee: $36.25 / ..
CCB Lie.: 104311 Plumbing Lic. no.: 34308 Plan review (25% of permit fee)
State surcharge (8% of permit fee) /Ji L0
Authorized signature: '
TOTAL PERMIT FEE / '7' '.L
T his permit application expires if a permit is not obtained within
Print name: • —�.� � -
;r,,,�.�! Date: �j /`/,�. Pc PP P Pe • I80 days after it has been accepted as complete.
Sep 19 06 10:15a 5036472736 P - 3
- •
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
•
Site Utilities • ..:: :.:Y .' :: ' Square Footage ::Teriiiit Fee :: :.- : • '...:::: ,-, .-:
Footing drain - 1' 100' 1 55.00 0
. ,
. °U 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' 1 55 c... CV
'--) ) --- Medical Gas Systems:
Water Service - each additional 100' 46.40
,, ,-- k''.,„_...' .'Vihiatiiiiii •'.;:::,..:•:, : • . :'.:-..::;
Storm & Rain Drain - 1st 100' 1 55.00 :1) ...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 51,52 for each
additional $100.00 or fraction thereof, to and
. Fiitiiiiiieiii f•.' : -•:: - • ' • : :.-:' ;•:'•4":. - :: F .Lt ( " 0 : :T•`).‘ :.
• .. including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for thc first $10,000.00 and $1.54 for
Residential l3ackflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rti - r ,.. pc,k5Inanifick. , ylv litre ''''s■.''''•,,,/'',1„/N.„....",.......,...--„.. $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
U
$5001. and $742.00
tu,C< ,000 d up $742. for the first $50,000.00 and $1.20 for
Subtotal:
each additional $100.00 or fraction thereof
Fixture Work: ; '.:•:••••.: ,.. ,;:;'Pliii42e*iii.iii:ifor. 1 :taiiiipleii,StiiiCifiliteS
.
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.
:...:-: ,1,. :. - : : : :- . ::. . - - 'QuanWlij(Fitititii)WOik 0 Any new commercial building.
0 Any new exterior plumbing site utilities.
Fixture Type :..:: . .:' : i :ia: . :: :::•:ttiliittik: 0 A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub/Shower 0 Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall 111 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 0 Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain 0 Any NFPA 13-D multipurpose fire sprinkler system.
Eye Wash ,
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
Car Wash in - ..
Garbage -Domestic b 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 permit results in an
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.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200& 00433
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2006
Phone: (503) 639 -4171 avIl IittlII'i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/21/2006 TIME: 7:O2AM PAGE: 42
SITE ADDRESS: 09670 SW DARMEL CT CLASS OF WORK:
SUBDIVISION: DARMEL NO.2 LOT #: 036 TYPE OF USE:
PROJECT NAME: COLLINS
DESCRIPTION: Replace rain drains, footing drains & water line.
OWNER: COLLINS, KELLY PHONE #: 603 - 670.9404
CONTRACTOR: AAPPLE PLUMBING PHONE #: 503 - 936 -7461
Inspection Request Scheduled For: Date: 9/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 036961 -01 503-936-7461 Y
Corrections/ Comments /Instructions:
•
I_► -ASS PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: V Date: , ' Phone #: (503) 718- 0//
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PLM2006.00433
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9119/'00;
Phone: (503) 639 -4171 - L ov iti l �I
Inspection Requests (24 Hrs.): (503) 639 -4175 ' _I..
INSPECTION WORKSHEET FOR DATE: 9/21/2006 TIME: 7 : 02AM PAGE: 40
SITE ADDRESS: 09670 SW DARMEL CT CLASS OF WORK:
SUBDIVISION: DARMEL NO.2 LOT #: 036 TYPE OF USE:
PROJECT NAME: COLLINS
DESCRIPTION: Repl rain drains, footing drains & water line. •
OWNER: COLLINS, KELLY PHONE #: 503 -670-9404
CONTRACTOR: AAPPLE PLUMBING PHONE #: 503-936-7461
Inspection Request Scheduled For: Date: 9/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 036961 -03 503-936-7461 N
Corrections /Comments/ Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL H CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
r � Inspector: 1(101(
w i\pj Date: i3 ` / Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005- 00433
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9119/2006
Phone: (503) 639 -4171 /emu 9p lil
Inspection Requests •(24 Hrs.): (503) 639 -4175 .._'
INSPECTION WORKSHEET FOR DATE: 9/21/2006 TIME: 7 :02AM PAGE: 41
SITE ADDRESS: 09670 SW DARMEL CT CLASS OF WORK:
SUBDIVISION: DARMEL NO.2 LOT #: 036 TYPE OF USE:
PROJECT NAME: COLLINS
DESCRIPTION: Replace rain drains, footing drains & water line.
OWNER: COLLINS, KELLY PHONE #: 503-670.9404
CONTRACTOR: AAPPLE PLUMBING PHONE #: 503.936 -7461
Inspection Request Scheduled For: Date: 9/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
336 Rain drain 036961 -02 603. 936.7461 N
Corrections /Comments /Instructions: t /
PASS I PARTIAL APPROVAL ( CANCEL I I NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED )1, 4/:
Inspector: 1 Date: / I Phone #: (503) 718 -i