Permit ., II CITY OF TIGARD
PLUMBING PERMIT
"t ° COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00381
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/26/2008
PARCEL: 2S112BB-08800
SITE ADDRESS: 14255 SW FANNO CREEK LP ZONING: R -7
SUBDIVISION: COLONY CREEK ESTATES NO. 3 LOT: 070 JURISDICTION: TIG
PROJECT: HOOKER
Project Description: Replace 35' of water service.
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: ft
WATER CLOSETS: WATER LINE: 35 ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
SHERRY HOOKER
14255 SW FANNO CREEK CT Description Date Amount
TIGARD, OR 97224 [PLUMB] Permit Fee 9/26/2008 $72.50
[TAX] 12% State Surch 9/26/2008 $8.70
Phone : Total $81.20
Contractor:
SERVICE PLUMBING CO
308 NE 74TH
PORTLAND, OR 97213 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -252 -2572
Reg #: LIC 25477
PLM 26 -605PB
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 B ,► � � ■) Permittee Signature: ,99,_
,De.._ ) ,
..„,,,„
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 ,1
. City of Tigard Received q go £1 t/ r/ -'
Date /By: / 1 Permit No.: U 3�/
74
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.:
T I'GA R D Inspection Line: 503.639.4175 Date Ready /By: lur See Page 2 for
Internet: www.tigard- or.gov Notified/Method: • ' / /Q Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description Qty. I Ea. I 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
® 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: 0 a, gSer S \rJ vlq f J O Lg `(ro f Catch basin or area drain 16.60
City /State /ZIP: .4) ( wet a 0 kg_ 17 13, 3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear R: _) 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.: . 1 . „ . 7 Page 2
Subdivision: I Lot no.: Water service (no. linear ft.:. L D) Page 2
Fixture or item
Tax map /parcel no.:
- Absorption valve 16.60
' DESCRIPTION OF WORK Backflow preventer Page 2
Backwater valve 16.60
N � / r , kw $) N) W r1i LI AIQ , Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER - . I ❑ TENANT Drinking fountain 16.60
+ Ejectors /sump 16.60
S Name: h goo kr,4 Expansion tank 16.60
Address: / Y a, S L.) 12A0. v 6 A , L Fixture /sewer cap 16.60
{.
City /State /ZIP: { j Al t- k (5 A-Q Floor drain /floor sink/hub 16.60
( )
Phone: ( ) Fax: Garbage disposal 16.60
'. ❑, APPLICANT . .. . ❑ CONTACT PERSON Hose bib 16.60
e' Ice maker 16.60
Business name: S C+ e V t [, a PC VA Q�
Q Interceptor /grease trap 16.60
Contact name: 6,„ e d D e kl , `f-il Medical gas (value: $ ) Page 2
Address: 3 0 N C 7 y Primer 16.60
City /State /ZIP: O�,1-- Q 432- Roof dram (commercial) 16.60
( 3 ZS 3 -z.%, ,7 Z I ( ) Sink /basin/lavatory 16.60
Phone: Fax:
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Iv, tt(Z) 55 Water closet 16.60
Business name: p L Iry 8 e d Water heater 16.60
Address: ,o O 1 y Other:
City /State /ZIP: -A t ' Asz P. ("a , .9 7 a„ ( Subtotal 4`5, IA)
Minimum permit fee: $72.50 e;
Phone: ( ) - LS 1 S Fax: ( ) Residential backflow minimum permit fee: $36.25 7 �s Q
CCB Lie.: 1 7 713k (1b Plumbing Lic. no.:Z to (o I2° Plan review (25% of permit fee)
Authorized signature: 1 \ ta % 7/1 f( State surcharge (12% of permit fee) % 1 (2
!� TOTAL PERMIT FEE R" ) a (j
Print name: t r t t (1 (, e O C V 1 1 1 ' R 1 3 ate: ' 7l l<,� 07 This permit application expires if a permit is not obtained within
T 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
t.\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 �;„ :Qt . . °Fee (ea) "Total : ' ; Square Footage Perinit:Fee:rir g _
Footing drain - 1s` 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' 7 55.00 �S Medical Gas Systems:
Water Service - each additional 100' 1 46 40
`Va l»atio n :; _ ; .: Permit
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
a :a s additional $100 00 or fraction thereof, to and
FI%tlil'e "OrTte111..= , ',QtYr;: Fee`(ea) ' _Total
- � 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: r $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work: Review'for‘Plumbing In'stallataons' ' •
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*. 111 Any new commercial building with water service 2" and
Quantity by (FixturejWork 'Performed = greater, except systems designed and stamped by licensed
�Fixtur'e ''e: _ Replace ' engineer.
YP.• .
„ • - - . ' � Previous: - Capped_ . Added " Fasting ❑ 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 Isome 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:
i \Bu lding\Permits\PLM- PermitApp.doc 12/27/06
,
CITY OF TIGARD i.,
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Pt 9
�m I _/2612008
Phone: (503) 639 - 4171 ,, 11 1��i,'�I
Inspection Requests (24 Hrs.): (503) 639 -4175 ,„_11
INSPECTION WORKSHEET FOR DATE: 9/29/2008 TIME: 7 :02AM PAGE: 11
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 14255 SW FANNO CREEK LP
COLONY CREEK ESTATES NO.3 LOT #: 070 TYPE OF USE:
PROJECT NAME:
HOOKER
DESCRIPTION: Replace 35' of water service.
OWNER: HOOKER, SHERRY PHONE #:
CONTRACTOR: SERVICE PLUMBING CO PHONE #: 503.2 52- '3572
Inspection Request Scheduled For: Date: 912912008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 076054 -02 503.1391 -4493 N
Corrections/Comments/Instructions:
Col, b `-.-
•
•
PASS I 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: LN(,) \1 Date: G` r2o\ `OQ1 Phone #: (503) 718 -
d
CITY OF TIGARD 4:ir
BUILDING DIVISION PERMIT #:
P1.1\42008-00381
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2612008
Phone: (503) 639 -4171 : AM
�"Ii�i6f�l�
Inspection Requests (24 Hrs.): (503) 639 -4175 ... _�� Wilt
INSPECTION WORKSHEET FOR DATE: 9/29/2008 TIME: 7:02A PAGE 12
SITE ADDRESS: 14255 SW FANNO CREEK LP CLASS OF WORK:
• SUBDIVISION: COLONY CREEK ESTATES NO. 3 LOT #: 070 TYPE OF USE:
PROJECT NAME: HOOKER
DESCRIPTION: Replace 35' of water service.
•
OWNER: HOOKER, SHERRY PHONE #:
CONTRACTOR: SERVICE PLUMBING CO PHONE #: 503-2.52-2572
Inspection Request Scheduled For: Date: ' 9/290008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 076054 -01 503 -891 -4493 N
Corrections /Comments /Instructions:
SI PASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
fl FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: (3 \ \=`
Date: 40_,q 1 j)z Phone #: (503) 718-