Permit .t
t. CITY OF TIGARD PLUMBING PERMIT
l DATE ISSUED: 9/20/2006
DEVELOPMENT SERVICES
PE
DEVELOPMENT PLM2006-00430
Ail 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S135BB -00700
SITE ADDRESS: 10685 SW GREENBURG RD ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Site utilities. Install 290' concrete culvert.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M 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: 290 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 0 ft
Owner: FEES
LANPHERE ENTERPRISES
10685 SW GREENBURG Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/15/2006 $147.80
[PLMPLN] Plan Review 9/15/2006 $36.95
Phone : [TAX] 8% State Surcha 9/15/2006 $11.82
•
Total $196.57
Contractor:
ADVANCED PLUMBING
CHUCK MCALLISTER
PO BOX 593 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97207
Contact # : PRI 503- 478 -9735
FAX 360 -571 -4188
Reg #: LIC 140302
PLM 37 -477PB
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.
C I��{
Issued By: ' Permittee Signatufe: _ ��
.� //
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.
Site Utilities
n ,
Plumbing Permit Applicatian ( C (�; 8VE® FOR OFFICE USE ONLY •
Received
City of Tigard ((� 1� �C /
n 1 3125 S W Hall Blvd., Tigard, OR 97223 F 1 Plan Re w /� 'f �' _ // y �D
.1114 Il Phone: 503.639.4171 Fax: 503.598.1960' P 5 200 f 6 Other Permit No.:
Date/By
Inspection Line: 503.639.4175
T -1 G A R D CITY OF TIGARD Date Ready/By. y ® See Page 2 for
Internet: www.tigard- or.gov ¢=1 III now; fI /IGlnN Notified/Method' �' Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. Total
131.Addition/alteration/replacement 12 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 /
• El Accessory building El Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00 C
❑ Master builder VI Other:
Fire sprinkler ( sq. ft.) Page 2 G.
JOB INFORMATION AND LOCATION Site utilities �`
Job site address: r Q,( Dc-5 C V G a`N 401ec 41 Catch basin or area drain 16.60 n
City /State /ZIP: T/ c D O /2 - Drywell, leach line, or trench drain 16.60 (
Suite/bldg. /apt. no.: I Project name: Culve7tT / /� t i46e- t.j✓ T Footing drain (no. linear ft.: _) Page 2
7
Manufactured home utilities 110.00
Cross street /directions to job site: ft wY -2./ 7 ‘, 0-,,,,,,p,,, A. Manholes 16.60
Z/ G 'etc C i4'4 E
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: _ ) Page 2 [. n
. Storm sewer (no. linear ft.: 3 ) , Page 2 ],Cf
Subdivision: I Lot no.: 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
"1.11 E 2-To r Lo /C/16T G r s ( pb72.7 Backwater valve 16.60
Clothes washer 16.60 "`
Dishwasher 16.60
it PROPERTY OWNER ❑ TENANT
Drinking fountain 16.60
Ejectors/sump 16.60
Name: t ?H t7/ t' &-A T- T- S C
S Expansion tank 16.60
. Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink /hub 16.60
Phone: ( ) om�,, Fax: ( ) Garbage disposal 16.60
In APPLICANT ❑ CONTACT PERSON Hose bib 16.60
tt
Ice maker 16.60
Business name: B Co A/Leo Cbn! 577LA eT /O,J
Interceptor /grease trap 16.60
Contact name: G /,/A24. 6'5 t' AWL/VE:4 Medical gas (value: $ ) Page 2
Address: S Y 20 ,j . L . 4/2..T[ /) //w Y Primer 16.60
City/State/ZIP: p Roof drain (commercial) 16:60
y p0� `��� 2 � 2. r Sink/basin/lavatory 16.60
Phone: (5 ) Z$ `l - `t?3 S F- Fax: : (SG3) 2.8 Z - 5 Z , S
Tub /shower /shower pan 16.60
E -mail: Qi/ 2 1g& -- ' /NC. GO +- Urinal 16.60
'CONTRACTOR Water closet 16.60
Business name t (K\ V 1 \)\)\,.., c -2 d, "4 \ �� : ,,� Water heater 16.60
I Address: > g .--?, 0 < , 9 3 Oth er:
Subtotal
City /State /ZIP: �N k. 9 1-2 Q -
Minimum permit fee: $72.50 �� t , /'
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 gV
CCB Lic.: [� 3a L Plumbing Lic. no.: 37 -(77 7 Plan review (25% of permit fee) X 15
State surcharge (8% of permit fee) I/ . g.
Authorized signatureL„--------- TOTAL PERMIT FEE //G , 67
Print name: A tGe ,..-e, C A Ce.,4-/2- f .) Date: - S 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.
F :\ Building\ Permits\ PLMU- PermitApp.doc 06/26/06 440-46t 6T(10/02/COM /WEB)
Plumbin! Permit Application - City of Tigard ,
4'
Page 2 - Supplemental Information ,
Fee Schedule: , - Residential Fire Suppression Systems:
-Site Utilities , . - Qty.• Fee (eaj Total ` :.Square.Footage: . , .• Permit _ . - ' .,,
• 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
•
Storm & Rain Drain - 1st 100' 55.00 Valuation:, Permit Fee: .
SS $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 2 46.40 713 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
fixture 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 forComplex 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 El 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 -D 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 fixture work:
Rec. Vehicle Dump Station .
Shower -Gang
• -Stall
Sink - Bar/Lavatory •
- Bradley
- Commercial
. - Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer - Clothes increase of sewer EDUs, a sewer permit will be issued and
Water Extractor
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
. ' Urinal , • plumbing permit can be issued.
Other Fixtures:
1ABuildin g\Pennits\PLM- PermitApp.doc 07/06/05
Oct 12 06 04:17p Ras Plumbing 360 992 9644 p.1
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
RAY'S PLUMBING
15200 NE CAPLES SUITE C
BRUSH PRAIRIE, WA 98606
(Plumbing Signature Form
Permit#: PLM2006 -00430
Date Issued: 9/20/2006
Parcel: 1 S135BB -00700
Site Address: 10685 SW GREENBURG RD
Subdivision:
Block: Lot:
Jurisdiction: I -P
Zoning: TIG
Remarks: Site utilities. Install 290' concrete culvert,
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing
permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing
Signature Form prior to the start of the work to the address above, ATTN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
LANPHERE ENTERPRISES RAY'S PLUMBING
10685 SW GREENBURG 15200 NE CAPLES SUITE C
TIGARD, OR 97223 BRUSH PRAIRIE, WA 98606
Phone #: Phone #: 360. 892.8700
Reg #: LIC 33217
PLM 37-449PB
•
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Jam'
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
F 7 1 - I 3 1 1 - 6 : sue - 6 a - 3) '
I0 /t0 39dd 1d3Q 9NIQ1IfH Q2lbDI1 tB9EVZJEaS 00 :VT 9002/ZT /OJT
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: PLM200 &.00430
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2006
Phone: (503) 639 -4171 �� �n� li t
Inspection Requests (24 Hrs.): (503) 639 -4175 ' !
INSPECTION WORKSHEET FOR DATE: 10/2E/27O6 TIME: 7 :03AM PAGE: 45
SITE ADDRESS: 10685 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LANPHERE ENTERPRISES DRAINGWY •
DESCRIPTION: Site utilities. Install 290' concrete culvert.
OWNER: LANPHERE ENTERPRISES, PHONE #:
CONTRACTOR: RAM'S PLUMBING PHONE #: 360 - 892.8700
Inspection Request Scheduled For: Date: 10/25/2806 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 038792-01 360 -892 -8700 Y
Corrections /Comments /Instructions:
is
I
,,
■
�; PASS PARTIAL APPROVAL n CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�
Inspector: m 1 �� /`� (/' Date: , 2 / Phone #: (503) 718-
,
• CITY OF TIGARD .
BUILDING DIVISION PERMIT #: PLM2006.00430
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2006 .
Phone: (503) 639 -4171 qua i "
Inspection Requests (24 Hrs.): (503) 639 -4175 ill!
INSPECTION WORKSHEET FOR DATE: i Oil 3/2006 TIME: 7 :00A PAGE: 19
SITE ADDRESS: 10685 SW GREENBURG RD CLASS OF WORK: •
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LANPHERE ENTERPRISES DRAINGWY
DESCRIPTION: Sites utilities. Install 290 concrete culvert.
OWNER: LANPHERE ENTERPRISES, PHONE #:
CONTRACTOR: RAY'S PLUMBING PHONE #: 3611.897 -8700
Inspection Request Scheduled For: Date: 10/13/2006 Pour Time: .
Code # Inspection Description Confirm # Contact # Message .
345 Culveitfcatch basin 038172 -01 603 -284 -8388 N
Corrections /Comments /Instructions:
Allell r(
- • -. r
•
4 1 5 ASS I 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: U A(--el . Date: b , Phone #: (503) 718 -
CITY OF TIGARD
• BUILDING DIVISION PERMIT #: PLM200600430
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2006
Phone: (503) 639 -4171 t, .
Inspection Requests (24 Hrs.): (503) 639 -4175 i `'' 1.
INSPECTION WORKSHEET FOR DATE: 11114/2006 TIME: 7:02AM PAGE: 54
SITE ADDRESS: 10685 SW GREENBURG RD CLASS OF WORK: 0 4
' SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LANPHERE ENTERPRISES DRAINGWY
DESCRIPTION: Site utilities. Install 290' concrete culvert. '
OWNER: LANPHERE ENTERPRISES, PHONE #:
CONTRACTOR: RAY'S PLUMBING PHONE #: 360
Inspection Request Scheduled For: Date: 11/1412006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
345 Culvert/catch basin 039688.01 503.284 -9368 N
Corrections /CoMm! nts /Instruc'fions �C
(3) C &t, - -, (-\/‘ c'
OPASZ I I PARTIAL APPROVAL CANCEL NO ACCESS
FAIL I I CALL FOR INSPECTION (l ADDITIONAL FEES ASSESSED
Inspector: (A./ Date: 1 VIk`Vb6 Phone #: (503) 718- 2 _ y 2