Permit C ITY OF TIGARD PLUMBING PERMIT
( DEVELOPMENT SERVICES PERMIT #: PLM2006 - 00417
� , 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/11/2006
PARCEL: 2S 103DB -06800
SITE ADDRESS: 11180 SW EDEN CT ZONING: R -4.5
SUBDIVISION: GENESIS NO. 3 LOT: 053 JURISDICTION: TIG
Project Description: Backflow preventer for irrigation.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
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: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
GEORGE & C BUSHNELL
11180 SW EDEN CT Description Date Amount
TIGARD, OR 97223 [TAX] 8% State Surcha 9/11/2006 $2.90
[PLUMB] Permit Fee 9/11/2006 $36.25
Phone : 503- 670 -8516 Total $39.15
Contractor:
DENNIS' 7 DEES LANDSCAPING
7355 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 777 -7777
FAX 503- 777 -2399
Reg #: LIC 5009
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: , : y Permittee Signature: N
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.
-�:. �� •a 610 3' r •
Plumbing Permit Application
City of 'Tigard ePermit No 13125 SW HaII Blvd , Tigard, OR 97223 - / i _0 "u �� C '/ 7
Other Permit No
Phone. 503.639.4171 Fax. 503.598 1960 (a■mlt j j) '� Dare By
24- Hour Inspection Line:' 503.639 4175 ' ■ '•_') I Date Read /By tut,/(5... ® See Page 2 for
Internet: www.ci.tigard.or US Notified/Method I Supplemental Information
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FEE = SGHDt I E L
❑ New construction ❑ Demolition For special information use checklist.
Description 1 Qty I Ea I Total
❑ Addition/alteration/replacement @ Other: LANDSCAPE New 1- 2- family dwellings (includes 100 ft for each utility connection)
x ;-' "� . >': CATEGORY OF ,CONSTRUCTION;: ' S FR ( 1 ) 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
N`, 1 ::" , JQIIYSITEiINfO,.. ATION� .,. Site utilities
Job site address: / / / �- 5 ) C( G '(J()/ Catch basin or area drain 16.60
City /State /ZIP: � ( 6 , ' r K Q g _ 9 - 7, 9 3 Drywell, leach line, or trench drain 16 60
Suite/bldg- /apt. no.: I Project name: 605MV G/____ Footing drain (no linear ft ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16 60
Rain drain connector 16.60
Sanitary sewer (no linear ft ) Page 2
Storm sewer (no linear ft ) Page 2
Water service no linear ft Page 2
Subdivision: l Lot no.: service ( no g
Fixture or item
Tax map /parcel no.:
Absorption valve 16 60
PESCR1PTIUN :OF'WOR s.:',''' `
_ :�,'?- _ - -----=:=„ ., _ - ' .. � � = ••i. � '
Backflow preventer 1 Page 2
INSTALL BACKFLOW DEVICE Backwater Valve 1660
Clothes washer 16 60
Dishwasher 16 60
❑ . YPRR T Y O WNER ' "' ❑.TENANT.` , 4 . Drinking fountain 1660
:,'pz OPE ;;# ::�: °' ^;_ , ` - , . . r ` Ejectors /sump 16 60
Name: ("teit6r 74 C 4&677 /'$/!7 & -C Expansion tank 16 60
Address: S 2 19-73012L Fixture /sewer cap 16 60
City /State /ZIP: Floor drain/floor sink/hub 16 60
Phone: ( 503) (`1O — f S Fax: ( ) Garbage disposal 16 60
t -'• : =:❑ 'APPLICAN31';°,:. .. ` ' , = :0 Hose bib 16 60
CONT PE - :,`
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
Sink/basin/lavatory 16 60
Phone: ( ) Fax:: ( )
Tub /shower /shower pan 16 60
E-mail: Urinal 16 60
`CONTRACTOR` ' ' ''
„., ._ . , .. _... - ,� �.., ., .... __ ' ".tea .. , ; Water closet 16.60
Business name: DENNIS' SEVEN DEES LANDSCAPING, INC Water heater 16 60
Address: 7355 SE JOHNSON CREEK BOULEVARD Other
City /State /ZIP: PORTLAND, OR 97206 Subtotal
Minimum permit fee $72.50 2 . 2,s
Phone: ( 503 ) 777 Fax: (503 ) 777 - 2399 Residential backflow minimum permit fee $36 25 ,J
CCB Lic.: 5009 Plumbing Lic. no.: 05LIBDI Plan review (25% of permit fee)
State surcharge (8% of permit fee) 3 2 C �` ( . v
Authorized signature: � � f � f TOTAL PERMIT FEE 39. ( 5
Print name: DEAN SNODGRASS Date: f/r/G This permit application expires if a permit is not obtained within
TT 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board
i Bwidrng\Permits\PLM- PermdApp doc 12/03 440- 4616T(10 /02 /COM/WEa)
i
Plumbing Permit Application - City of Tigard
Page 2 .- Supple mental Information
Fee Schedule: Residential Fire Suppression Systems:
Fee (ea).: ".Total
�•S uare. oifa' e: :°Per ><t= .e�
�Site�Utila_tes' -����� _.... _. . �. „•,� .., . .,.. , saw ..._,,. _,. � ,F . _ g , . m F
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
100,' 55.00 3,601 to 7,200 $220 00
Sewer = 1st 100
. 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
t
Storm & Rain Drain - I st 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
sue`
•, Q ty: s: 9Fee (ea)' .M tal • additional $100.00 or fraction thereof, to and
Fixture'oritem '. ,` °,; z; • =.; ;:: z =�: :� _ To
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 $50,001 00 and up $742.00 for the first $50,000 00 and $1 20 for
Subtotal: 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 •
N rQuantityby '(Fiature)�PorkPerformed' ,
Fixture Type:
e 1} " ;'.Mop a t; tmg Capped 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"
-3
-4"
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
'Budding \Permds\PLM-PermnApp doc 3/03
, .
CITY OF TIGAR1;76
BUILDING DIVISION PERMIT #: PLM2006-00417
• ‘
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/2006
Phone: (503) 639-4171 /
Ja_Pilliti
Inspection Requests (24 Hrs.): (503) 639-4175 U.
INSPECTION WORKSHEET FOR DATE: 10/3/2006 TIME: 7 PAGE: 63
SITE ADDRESS: lila° SW EDEN 1....7 CLASS OF WORK:
SUBDIVISION: GENESIS NO 3 LOT #: 053 TYPE OF USE:
PROJECT NAME: BUSHNELL
,
DESCRIPTION: Baddlow preventer for irrigation. . .
OWNER: BUSHNFLL, GEORGE & CHARLOTTE PHONE #: 503-670-8516
CONTRACTOR: DENNIS* 7 DEES LANDSCAPING PHONE #: 503_777_7777
Inspection Request Scheduled For: Date: 1002006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
396 Misc. inspection 037527-01 603-777-7777 N
Corrections/Comments/Instructions:
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174: / -. S I I PARTIAL APPROVAL pi CANCEL NO ACCESS
• FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
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Inspector: A ) 4 Date: 0 , Phone #: (503) 718
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