Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00364
;JAI DATE ISSUED: 7/28/2006
Al— 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102DD -00903
SITE ADDRESS: 08880 SW EDGEWOOD ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT: 006 JURISDICTION: TIG
Project Description: Install 85' - 100' of sanitary sewer line work. For future use, not connecting to lateral or house at
this time.
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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MICHAEL MCELEVEY
8880 SW EDGEWOOD Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 7/28/2006 $72.50
[TAX] 8% State Surcha 7/28/2006 $5.80
Phone : 503- 939 -9026 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact # :
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 to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Permittee SignatUfgl
•
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 r - ,, soli (OFFICE', USE- 'OI LI . .
w ,.
IN e City of Tigard Date /By I :2 D 10 C3,49
Permit No.' c tigeo6; v v0 36
o� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
10 Phone. 503 639.4171 Fax 503.598.1960 Date /By Other Permit No.
'' ' Inspection Line: 503.639.4175 $
T1 `G ' A R-13 Date Ready /By ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method - 7 t Supplemental Information
TYPE OF WORK FEE SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. 1 Ea. I Total
X Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION ' ' , SFR (I) bath 249.20
►: - 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: ?3OU s(,J • / odd 't Catch basin or area drain 16 60
City /State /ZIP: i I J (,� I c2 e' ZZ3 Drywell, leach line, or trench drain 16.60
—
Suite/bldg. /apt. no.: I Project name: n/eu Footing drain (no. linear ft . ) Page 2
r Manufactured home utilities 110.00
Cross street /directions to job site: On q beAva b f
e� y J C _ n Manholes 16.60
Ed Gd / ,QLJLd S+. 7 D ots JO1,L+k (7f Rain drain connector 16.60
'J. _A Zr / J -+ Sanitary sewer (no. linear ft.' MO ) Page 2 5
Storm sewer (no linear ft.: ) Page 2
Subdivision: I Lot no ' Water service (no. linear ft.: fiefr ) Page 2
Fixture or item
Tax map /parcel no.: 251 2'b D J Q 03 Absorption valve 16 60
DESCRIPTION OF WORK Back flow preventer Page 2
- R , � o rnG i'�. � o c�cornm %s�orr 5bD 5' (CA. q o t- 0 l It
' IN ra i a; . . • S'ewe- Y1 t ) Backwater valve 16.60
Cts'nry't. Clothes washer 16.60
�
Selo M &� /, r Dishwasher 16.60
j � ((,t(, � ( Drinking fountain 16.60
PROPERTY OWNER I ,❑ TENANT
� Ejectors /sump 16.60
Name: ` v l , c1j a el ,T , M E /e ° cos _a_ y 1 Expansion tank 16 60
Address. : 1 t do *(4 ji / . fi _ r C) b 5; Fixture /sewer cap 16.60
City /State /ZIP: Ti azeo
r�' k 97-223 Floor drain /floor sink/hub 16.60
Phone: (563) q — OZlo Fax' ( ) 114/0L, Garbage disposal 16 60
Hose bib 16 60
`
APPLICANT ❑ CONTACT PERSON
Ice maker 16.60
Business name: yllet Interceptor /grease trap 16.60
Contact name: DIA }Am Q , . Q 1J0Ve, Medical gas (value' $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) I F : ( ) Sink /basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR •• , Water closet 16.60
Business name: `�` t , I• , s Le. Water heater 16.60
Address: Other:
City /State /ZIP: WI'9 ' ) f/ f a 11 1 °' Subtotal
Minimum permit fee: $72.50 �fn r7-�
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 /�(
/ I mg ,�.. Plan review (25% of permit fee)
CCB Lic.: P�yi
Authorized signature Y �� / f� State surcharge (8% of permit fee)
/.' 4 . ; LL TOTAL PERMIT FEE 7 c ,L
Print name: 1' L /[f i i Di 1-70-0& This permit application expires if a permit is not obtained within
v 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1 \BwldingWermits\PLMF- PermitApp doc 04/06/06 440-4616T(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' 6 55.00 7,201 and greater $309.00
Sewer - each additional 100' 0 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
F1Xture 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
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 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.
Quantity by (Fixture) Work Performed - , ❑ Any new commercial building.
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ 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
❑ Any NFPA 13 - multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink 2" Submit 2 sets of plans with any of the above.
-3"
4 "
Car Wash Drain Isometric or RiSer 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- work:
Rec. Vehicle Dump Station PLE !FR ii) 17RA'/RI f, £ Lelre72
Shower -Gang
-Stall 1 0 �^— CLEAN
�- � ��'��. d1�� v[ S C�
Sink - Bar /Lavatory -�}) L1) Pe.'Czz 1 P rio - t of j�RO��
- Bradley I
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
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.
r \Building \Pertnits\PLM- PevmlApp doc 07/06/05
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7/2/0 ro
To: Damon Reische, Clean Water Services
Re: Temporary Stream Corridor Encroachment
Dear Damon,
Thank you for taking time to walk me through the corridor encroachment permit process in person on
May 17. My application is enclosed, along with check and photos of the mitigation activities I have
already performed.
Project Description: I goal is to decommission my septic system and connect my home to a sewer main
via a 4" line. USA installed the main in 1995 and granted landowners tees as part of the easement terms.
To reach the sewer main, the 4" line will need to cross a small perennial stream on my property, and it is
for this that I'm requesting the permit.
Schedule and Plan: I would like to begin my project before the end of July if possible, though contractor
schedules may push me into early August. My plan is to dig a trench about 90 feet long, varying in
depth form 2 feet to 4 feet, and 18 to 24 inches wide. The bottom of the trench will be bedded with 3 "
of crushed rock to provide a base for the 4" sewer pipe. The sides and top of the pipe will also be
bedded after necessary inspections. Fifty feet of the trench will be north of the creek, and crosses only
lawn; 30 feet will be on the south side of the stream corridor, immediately underneath an existing path.
The trench will be cut everywhere except the stream bed, bedded with rock and the pipe laid.
Only 6 to 8 feet of the trench will impact the actual streambed. Once the non - crossing sections of pipe
are in place, this short section of trench will be cut through the stream bed, pipe laid and bedded with
rock, and covered with the original streambed material. The stream crossing will be completed, along
with re- establishment of the stream banks, within one work day. The stream crossing will be performed
only during minimal stream flow; in July and August the flow is near zero after 3 or 4 rain -free days.
Silt Control & Mitigation: What small amounts of silt that are released will be captured in my pond
about 25 feet downstream. This pond was dredged 20 and again 10 years ago, and has acted as a natural
silt trap with every winter rain. As discussed, I planted my entire property south of the stream, after
USA's contractor destroyed most of the vegetation south of the creek during installation of the main in
1995. USA planted three maple trees and two red osier dogwoods. I augmented this with several each
of cottonwood, red alder, big leaf maple, wild cherry, elderberry, Oregon ash, willow, Douglas fir, red
cedar, and western hemlock. Most of these trees are now over 10 feet high and some are as high as 40
feet. The total planted area is approximately 8,000 sq. ft., and is now so well shaded that very little else
will grow there.
I hope this information is enough to allow you to grant me a permit. Again, thank you, and please call if
you have any questions.
Sincere y,
Mike McElevey,
Mobile Tel: 503- 939 -9026
8880 SW Edgewood St.
Tigard, OR 97223
.• CITY OF TIGARD v
BUILDING DIVISION PERMIT #: PLM2006-00364
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/7006
Phone: (503) 639-4171 A.
.
Inspection Requests (24 Hrs.): (503) 639-4175 „,.....,...„ _.—
INSPECTION WORKSHEET FOR DATE: 10/5/2006 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 08880 SW EDGEWOOD ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: 006 TYPE OF USE: i
PROJECT NAME: MCELEVEY
DESCRIPTION: Install 85 - 100' of sanitary sewer line work. For future use, not connecting to lateral or house at this
time.
OWNER: MCELEVEY, MICHAEL PHONE #: 503.939_9026
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 101512006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 037748-01 503-939-9026 N /
,
Corrections/Comments/Instructions: i
.";
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1 37 , ./ 9141
4
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ASS It - . -TIAL APPROVAL 0 CANCEL NO ACCESS
FAIL $ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
J
Inspector: 1 11/ Date: Phone #: (503) 718-2'
•