Permit iii CITY OF TIGARD
COMMUNITY DEVELOPMENT PLUMBING PERMIT
PERMIT #: PLM2008 -00257
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/10/2008
PARCEL: 2S 102AD - 00700
SITE ADDRESS: 12665 SW HALL BLVD ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: GABRIELLE'S SALON
Project Description: Interior plumbing. Capping (1) shower stall, (1) lavatory and (1) water closet.
CLASS OF WORK: GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 0 URINALS: GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES:
TUB/SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
DAVID & GA MAHER
17014 SW RIVENDELL DR Description Date Amount
DURHAM, OR 97224 [PLUMB] Permit Fee 6/10/2008 $132.80
[TAX] 12% State Surch 6/10/2008 $15.94
Phone : 503 -516 -7240 Total $148.74
Contractor:
JOE PETRO PLUMBING
PO BOX 98
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 913 -1221
FAX 503 -625 -6307
Reg #: LIC 91524
PLM 3 -469PB
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 • '�t.� - Permittee Signature:
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.
Plumhing Permit Application 93 10 - -u (Std • ,, : 1b�.:
Building Fixtures FOR OFFICE USE ONLY
City of Tigard _ Receive% y DateB �p /�3/ rmttNo.: a� ,
11 .1 a 13125 SW Hall Blvd., Tigard, OR 9 ' ' Ck U'
Plan Review
Phone: 503.639.4171 Fax: 503.59%1 ": i " � 0�� Date/By: Other Permit No. � ()®0008.. OO /9
T 1 G A R D Inspection Line: 503.639.4175 ``` \\w\ 1 Date Ready /By: Janis: ® See Page 2 for
Internet: www.tigard- or.gov V \`� N ified/Method: Supplemental Information
-'• : ' 'r" "FEE* . SCHEDULE ', ;
❑ New construction ❑ De.i, x - For special information use checklist
�tt--®® 111 Description Qty. Ea. Total
Addition /alteration/replacement ❑�thl `r : New 1- 2- family dwellings (includes 100 ft. for each utility connection)
- ',CATEGORY' , OF. CONSTRUCTIO e - SFR (1) bath 24920
❑ I- and 2- family dwelling J Commercial /industrial SFR (2) bath 350.00
❑ Accessory building CI Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
rJOB`°'SITE `INFO_ RMATION. AND :.LOCATION - , ' Site utilities
Job site address: 1 a 6 S \ � H 1 LL e uV Catch basin or area drain 16.60
City /State /ZIP: T 1. 1 1 Z40 OR Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: l Project name: 48A, ELL L ' � , es s 104 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
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DE SCRIPTION OFWORKE - i
'� . � � - - =� � - ..'.,5: Backflow preventer Page 2
Cci' Vert n$I c. 1-0 1911 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
';❑' PROPERTY' OWNER' . ' � I - ' El ' TENANT :. . T
^ & Q 1'7 D pp 'n^ , , ( gy p Ejectors /sump 16.60
Name: 0 4VIO q o 6I ( j / Y 1 ••7 H J� Expansion tank 16.60
Address: n0 1 [L S W Ki Va ks:AL UR \ Z Fixture /sewer cap - 3 16:60 i fg v
P
City /State /ZIP: V PL l LawO e. q -72 Floor drain/floor sink/hub 16.60
Phone: 61:3) GI 6 . Fax: 6- t,&ci_ (
' ,,� Garbage disposal • 16.60
RU � _ -! Hose bib 16.60
•
,`❑. ,. ❑' CONTACT° PERSON`
" _ .5._ 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
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 3 16.60 in
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60 t�
,,
CONTRACTOR , -1 - ; ;.-, - " Water cl oset �. 16.60 � Pte+
Business name: ' �=} ; y �� t _� � / Water heater 16.60
Address: `'. U • /de, Y. c/ 6 ,.ma / Other:
q7 Subtotal
City /State /ZIP:
4., i 6• . 'e9 A) l� I l v �F:� d E - ✓ 7 O 7't:5 Minimum permit fee: $72.50 ,' i
Phone: (56 j ) 7/3 -% i t / Fax: (,p5) ‘Z5 eJv7 Residential backflow minimum permit fee: $36.25
CCB Lic.: //124// Plumbing Lic. no.: 4/24/P `,L Plan review (25% of permit fee)
,r /-�- `
TOTAL PERMIT FEE . State surcharge (12% of permit fee) /5; N
Authorized signature: i� J "- ` r'e j'1 it / v
Print name:
"7;5,4-,-.)/V _ 2) `��e� ‘.44,,(-''
" Date: r This permit application expires if a permit is not obtained within
` r � // � 180 days after it has been accepted as complete.
�^ (<7 *Fee methodolo y set by Tri -County ilding Industry Service Board.
1 \ 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:
'SitiWtilitie :::'.' 12. , ''', e fi. (i 9) '': : . 1 igifiliii,POOka10 ‘' Ilt 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; ' ;- -• • '--,'''•; :'''-!• ' - - J - ';', 7 7 - .§: -
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
iliiiilie4it`.• ;'''. ':- , '.
' • .,, .,.= , ;-, ,Total.: additional $100.00 or fraction thereof, to and
Ite , qty, Fee (ea)
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 . $37950 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.
Commercial Fixture Work: - , -,•;;;•:Plan RevieW-Inrielninhing IligtallatiiiiiS .:
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
Quantiby iitUi Performed greater, except systems designed and stamped by licensed
I' ''... ' ' ' ' ' .. ,;: -<, : '• , ty_ (F .
.Fixture Type: , : .. :,- , ' ,, _,' , 4_,,. , , --,; ,, . engineer.
--.. - Replace :
" ' ' ' - Pi-ennui .Capped ': iiaaid 1:Existin 0 New exterior plumbing site utilities for any complex structure
Baptistry/Font ;1 as defined in OAR918-780-0040.
Bath - Tub/Shower 0 Medical gas and vacuum systems for health care facilities.
-Jacuzzi/Whirlpool 0 Any multipurpose fire sprinkler system.
Car Wash -Each Stall 0 Any complex structure as defined in OAR918
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher -Commercial
-Domestic Iiotheiric or ,
'O kigi ''
.•,. ,,,-,,,.: . • :- : '. r Diagrant' .
.. '• .:, :,„, .:. -:-
Drinking Fountain
Eye Wash El 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 1. .
Sink -Bar/Lavatory / 5 . . • '
-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 WIVI■ , 7 -
Urinal .
Other Fixtures:
NI
i:\Buiiding\Permits\PLM-PermitApp do C 12/27/06 '
. .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2008- 00257
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/10/2008
Phone: (503) 639 -4171 1111111
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 9/17/2008 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 1266; SW HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GABRIELLE'S SALON
DESCRIPTION: Interior plumbing. Capping (1) shower stall, (1) lavatory and (1) water closet.
OWNER: MAHER, DAVID & GABRIELLE PHONE #: 503 -616 -7240
CONTRACTOR: JOE PETRO PLUMBING PHONE #: 603- 913 -1221
Inspection Request Scheduled For: Date: 9/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 075556 -01 503 - 516 -7240 N
S: RS
Corrections/Comments/Instructions:
D,e iPvo , ;- =4—e 2. IP ,oe U«e." .,
CA pit. 9 1 "- I
•
X PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: (R 6 i b L..K_ Date: e l I t. ? (,) 7') Phone #: (503) 718 -
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: PLM2008-00257
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/10/2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 9/3/2008 TIME: 7:01AM PAGE: 35
SITE ADDRESS: 12666 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GABRIELLE'S SALON
DESCRIPTION: Interior plumbing. Capping (1) shower stall, (1) lavatory and (1) water closet.
OWNER: MAHER, DAVID & GABRIELLE PHONE #: 503-516-7240
CONTRACTOR: JOE PETRO PLUMBING PHONE #: 503
Inspection Request Scheduled For: Date: 9/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 074968-01 503-616-7240
Corrections/Comments/Instructions:
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I PASS El PARTIAL APPROVAL El CANCEL fl NO ACCESS
FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: (i 1/14--t--) Date: )3 I Phone #: (503) 718-
' .
'�
CITY OF TIGARD ��nn n ��n nm���mna�� ^" `_
BUILDING DIVISION '
~�~~"~~~°""°~° ~~"°"=~"~~"~ PERMIT #:
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/102008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A- ^ � � �
INSPECTION WORKSHEET FOR DATE: 6112/2O08 TIME: 7:02AM PAGE: 12
SITE ADDRESS: 12G65 HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GABRIELLE'S SALON
DESCRIPTION: Interior plumbing. Capping (1) shower stall, (1) lavatory and M\ water closet.
OWNER: kAAHER. DAVID &GABRIELLE PHONE #: 503-510'7210
CONTRACTOR: JOE PETRO PLUMBING PHONE #: 603-913-1221
Inspection Request Scheduled For: Date: 6/12/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough-in 071289-01 503-516-7240 Y
Corrections/Comments/Instructions:
X PASS �i ��|ALAPP��L � �AN�EL � NO ACCESS u u u
|| FAIL 0 CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: [)eta: C t 12 \ r�S\ Phone #: (503) 718-