Permit I. CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00295
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/11/2008
PARCEL: 2S114AA-00100
SITE ADDRESS: 09000 SW DURHAM RD ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: TIGARD HIGH SCHOOL
Project Description: Repair approximately 50' of sanitary sewer line at various locations.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: UNK 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: 50 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
TIGARD - TUALATIN SCHOOL DISTRICT 23J
6960 SW SANDBURG ST Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/11/2008 $72.50
[TAX] 12% State Surch 7/11/2008 $8.70
Phone : Total $81.20
Contractor:
RIVER CITY ENVIRONMENTAL
PO BOX 30087
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 252 -6144
FAX 503- 288 -3658
Reg #: LIC 147355
PLM 26 -789PB
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 • - t questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue. By: Permittee Signature: / /
Err
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.
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
Received b — (paw5
City of Tigard Re Date/By ? / � d
Permit No ���
1111 V
-
q 13125 SW Hall Blvd , Tigard, OR 972 Plan Review
Phone 503 639 4171 Fax 503.598.19 DateBy Other Permit No
TI G AR_D Inspection Line 503.639.4175 Date Ready/By lur See Page 2 far
Internet www tigard -or gov Notified/Method ( Supplemental Information
TYPE OF WORK FEE* SCHEDULE
El New construction ❑ Demolition For special information use checklist
Description I Qty I Ea I Total
❑ Addition/alteration/replacement Other: "RE /04 New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350 00
❑ Accessory building ❑ Multi - family SFR (3) bath 399 00
IN Other: additional bath/kitchen 45 00
❑ Master builder IN /Other: 5 HOC) L Fire sprinkler ( sq. ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 9 ow S w O )4107 eW O Catch basin or area drain 16.60
City /State /ZIP: --- A �,. g6 o R cr) 9.33 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Project name: Footing drain (no. linear ft _) Page 2
Manufactured home utilities 110 00
Cross street/directions to job site: —f'u O fh A 5 r;w,,oe ft i\ pA
�+ n (� Manholes 16.60
C o _ ' 1 Rain drain connector 16 60
sou ÷14 S j oe. p F �o Sanitary sewer (no linear ft . T:2) Page 2 55
/319 7 �IoMiA+� n12U L4z 8V1//�l N Storm sewer (no linear ft • ) Page 2
Sub ision. Lot no.: V 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
5 Awc. uT EXc A t.,cP-f� + - RE PA /.. 2 A . S E /�J Backwater valve 16 60
S -wei 4¢- Bo %to V 62411 1. 1 '.5, 1/i4/2/605 Clothes washer 16 60
Dishwasher 16 60
dG P
rl US —
❑ PROPERTY OWNER El TENANT
Drinking fountain 16 60
I 7 /' ,/� ` Ejectors /sump 16.60
Name: . 7 4 _ ,e,O UI4 / //y JC /✓
L /J / IZ icr
Expansion tank 16 60
Address: We 9 6 0 5( SAN Q)3())2 '6 I . Fixture /sewer cap 16 60
City /State /ZIP: T ookao DR- . .2 a3 Floor drain /floor sink/hub 16 60
Phone: ( 505 I.-1 - 1.1 O 1 ( ) Garbage disposal 16 60
[Ur PPLICANT ❑ CONTACT PERSON Hose bib 16 60
�S �` Ice maker 16 60
' '
Business name:I us.IZ 6/141/ EN id AU) A-i eA.74-4-1 / "e Interceptor /grease trap 16 60
_ Contact name: C C S , 0 W■2 Medical gas (value $ ) Page 2
Address: )0( 10 NE rn 41a x -- pa Primer 1660
City /State /ZIP: '.05r- Og . 9 7�av Roof drain (commercial) 16 60
'/ Sink/basin/lavatory 16.60
Phone: (50 262.- 6/ ye Fax: : (5p32is�- 3655
Tub /shower /shower pan 16 60
E -mail: Urinal 16 60
CONTRACTOR t Water closet 16 60
Business name:...0j Veit C1T E iviQDA) m ,L i, / //. Water heater 16 60
—
Address: ) O NE / �C 7.__O Other
City /State /ZIP: tior — A)Q Oi 5'792(7 Subtotal
Minimum permit fee: $72.50
Phone: ( j Zj _ , /L/(f Fax: (503 2- .. Residential backflow minimum permit fee $36.25 7�' '
CCB Lic.: / q ? 5 S , i 1/t; lof P bing Lic. no.:(,,-- l7 5 p8 Plan review (25% of permit fee) e
7/� f// State surcharge (12% of permit fee) V. 70
Authorized signature: '� I TOTAL PERMIT FEE g , a,c)
st 6
[
`I� '
Print name: cg /C, ii. , / QZ1 Date: f) J// OR" 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 \PLMF- PermitApp doc 12/27/06 440- 4616T(10/02/COM/WEB)
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' 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
Q ty. Fee (ea) Total additional $100 00 or fraction thereof, to and
Fixture or Item 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
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
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) Work 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"
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:
I \Bmldmg\Permtts\PLM- PermttApp doe 12/27/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: i'tM200$00295
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/11/2008
Phone: (503) 639 -4171 i44'u�80u j�I�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: l iQ120fk0 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 09000 SW DURHAM R! CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL
DESCRIPTION: Repair approximately 50' of sanitary sewer line at various locations.
OWNER: - PHONE #:
CONTRACTOR:
TIGARD- TUALATIN SCHOOL DISTRICT 23J, PHONE #•
RIVER CITY ENVIRONMENTAL 503.252-6144
Inspection Request Scheduled For: Date: 8/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 074194 -01 503.339 -4989 N
Corrections /Comments /Instructions: jj
Ca 'rut 91,1
] PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: writ.. A \ \f _ Date: 7 OT'i Phone #: (503) 718-
CITY OF TIGARD
!• .-a -
BUILDING DIVISION PERMIT #: PLIvI2008-00295
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/1112008
Phone: (503) 639-4171 Ji
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/23/2008 TIME: 7:02AM PAGE:
SITE ADDRESS: 09000 SW DURHAM RD CLASS OF WORK:
•
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: TIGARD HIGH SCHOOL
DESCRIPTION: Repair approximately 50' of sanitary sewer line at various locations.
OWNER: TIGARD-TUALATIN SCHOOL DISTRI ar 23J, PHONE #:
CONTRACTOR: RIVER CITY ENVIRONMENTAL. PHONE #: 503-252-6144
Inspection Request Scheduled For: Date: 7/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 073082-01 503-339-4989
Corrections /Comments / Instructions:
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I PASS PARTIAL APPROVAL LI CANCEL n NO ACCESS
I I FAIL LI CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED
Inspector: (17)..)C Date: '2)23) ocl Phone #: (503) 718-