Permit c w eA
CITY OF TIGARD
PLUMBING PERMIT
�,�'� I I DEVELOPMENT SERVICES PERMIT #: PLM2006 -00152
3+r c � 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4124/2006
11
PARCEL: 2S 103CA -00210
SITE ADDRESS: 13080 SW HOWARD DR ZONING: R -4.5
SUBDIVISION: WOODCREST NO.2 LOT: 026 JURISDICTION: TIG
Project Description: Backflow prevention device 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
DANNY VALENTINO
13080 SW HOWARD DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/24/2006 $36.25
[TAX] 8% State Surcha 4/24/2006 $2.90
Phone : 503 -579 -3192 Total $39.15
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 rul -or to OUNC by calling 503 - 246 -6699 or -1- 800 - 332 -2344.
Iss ed By: ja V Permittee Signature: -- "" i ✓�Ti7
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 FOR omcl USE ONLY /
City of Tigard Date/By: i- � D � / P N o.: 11 /17 / 4006 3 _1�.
II 13125 SW Hall Blvd., Tigard, OR 97223 x ���`"
Plan Review
C ;'• Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.:
Inspection Line: 503.639.4175 J°
T I G AR D Internet: www.ti and -or. ov Date Ready/By: ® See Page 2 for
g g Notified/Method: l Vg Supplemental Information
TYPE OF WORK - FEE* SCHEDULE •
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New 1 dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: / 3 ()go srA) h/ umMB pie Catch basin or area drain 16.60
City /State /ZIP: 77&AA OR 97 3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions
/ irectieonns to job site: p� Manholes 16.60
/
it O A 0 w a4 A U „ PA 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
. , . DESCRIPTI OF WORK �� -
Back flow preventer / Page 2 A7 J S
.4a4Ck FL C PA •Q o re a Backwater valve 16.60
f Je t w, t4 rw 1\) Clothes washer 16.60
Dishwasher 16.60
JSZ D
PROPERTY OWNER I ❑TENANT Drinking fountain 16.60
Ejectors /sump 16.60
Name: D94,4'y U;ciee A1ripe /a Expansion tank 16.60
Address: /3 O &" 0 5 to heo wAR D DA Fixture /sewer cap 16.60
City /State /ZIP: , 6 .4dD vie 9722,1 Floor drain /floor sink/hub 16.60
Phone: (SO J 5-77 .3 /1z, Fax: ( ) Garbage disposal 16.60
❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
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
Phonc: ( ) I Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: O w N L A Water heater 16.60
Address: /3 0 St SW ,i O Wff 4 D ,d),t Other:
City /State /ZIP: 7) � 4j D 0 A ( 7 z2-7 Minimum Subtotal
nimum permit fee: $72.50 � / ,.o��
Phone: (S•63 , 77-31 7 Z Fax: ( ) Residential backflow minimum permit fee: $36.25 CO
CCBLic.: P m 'ngLic.no.: Plan review (25% of permit fee)
Authorized signature: State surcharge (8% of permit fee) 90
�� TOTAL PERMIT FEE 3,1 /5 /
Print name: Date: 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.
1:\ Building \Pemuts\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: - •, PerznifFee: - .
Footing drain - l' 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: '" ,'
$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
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 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 i
specially requested inspections - per hour 72.50 and including $50,000.00.
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.
❑ My new commercial building. , , , • .
Quantity by (Fixture) Work Performed . - `
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 1 3 -D multipurposetfire 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
Washer - Clothes
Water Extractor *Note: If the fixture work under this permit results in an
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.
i:\ Building \Pennits\PLM- PermitApp.doc 07/06/05
. .
CITY OF TIGARD ,..
BUILDING DIVISION
- PERMIT #: PLM200(3-00 in2
13125 SW Hall Blvd., Tigard, OR 97223 ,-- DATE ISSUED: 4124/2006
Phone: (503) 639-4171 :1090111
Inspection Requests (24 Hrs.): (503) 639-4175 .. slfr 11.
INSPECTION WORKSHEET FOR DATE: 514/2006 TIME: 7:00AM PAGE: 48
SITE ADDRESS: 13080 SW HOWARD DR CLASS OF WORK:
SUBDIVISION: WOODCREST NO.2 LOT #: 026 TYPE OF USE:
PROJECT NAME: VALENTINO
DESCRIPTION: Backflow prevention device for irrigation.
OWNER: VALENTINO, DANNY PHONE #: 60.f79-3192
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: - 514/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 029294-01 503-32(3-5209 N
Corrections/Comments/Instructions:
PASS n PARTIAL APPROVAL CANCEL I I NO ACCESS
1 i FAIL n CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: fi i i k -. Date: i ' Phone #: (503) 718- ..2-0