Permit 7 r r
C ITY OF TIGARD PLUMBING PERMIT
1 . COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00016
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2007
PARCEL: 25111 AD -18900
SITE ADDRESS: 14873 SW JONAGOLD TERR ZONING: R -4.5
SUBDIVISION: LADY APPLE LOT: 013 JURISDICTION: TIG
Project Description: Install residential 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: 1 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
BEACON HOMES NW, INC Description Date Amount
12703 SW 67TH
TIGARD, OR 97223 [PLUMB] Permit Fee 1/23/2007 $36.25
[TAX] 8% State Surcharl 1/23/2007 $2.90
Phone : 503 -570 -8828 Total $39.15
Contractor:
CONTOUR LANDSCAPING INC
12485 SW TOOZE RD
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 682 - 1302
FAX na
Reg #: LIC 5698
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. Thos- _ -re set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions
to OU NC calling 503.'16.6699 o 1.800.332.2344.
Issue By: 1i//r�� 4 Permittee Signature: l ' 6-14.7
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 '1 f o i.I i i .1 SL O. i _ , ,r , ay
' City of Received .k
IN Tigard /
ll Pl Re j �3 67 Permit No.: I 1 I 7 a M 1 h
u 13125 SW Hall Blvd, Tigard, OR 97223 plan Review �t I'J W
• ` Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit No.:
Inspection Line: 503.639.4175 Date Read B
T I G Q K D Y Y � ®See Page 2 for
r - Y, Internet: www.tigard- or.gov _, Notifed/Method (r(.�' Supplemental Information
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'
t, c . N ' T]'PE WORK r ;�` * , ;,r : "� ...t FEE*
`� 4, .r . � .. �.� :� fl�'n,• -a �r ..;�et1�: d a .w.a n - �^;��;"�`b�';`�' " °' ^ �:,;# �?�'c: sxs +���_�,:'�afi' SCIIEDULE ..,�.�. �� �.:'''
New construction ❑ Demolition For special information use checklist:
Description I Qty. I Ea. 1 Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
/ j �:EY. a '� 'F �y'. Y &.j'p'r..�'yyk,; rz'�^ "r .. %''�� `+F.'.yfr. ... @(yy3.,��•.�'F `. " 4. _ � , . §�.. .._
tf' *. s.� �GATEGORYV OF pi' � ' t• SFR 1 24920
�. t,. .���i'�..ar• CONS`TRUGTION;�' „� . ,� .r` , .. r? '' � ( ) bath 249
/`-"- and 2- family dwelling ❑ Commercial /industrial SFR ( bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
..,
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
i�V'�{ Fire sprinkler ft.
[n- ' '°`" ,, t,i,o'g'' " 6 aaE', ,, Y'mrn�L* :aa,•E.;zr ,r.;,�e rA.,t.,,xn,;{,m,, '.: ;or,,; • , .. , , .„ " , f,+ : , , , , ,: p ( sq. ft.) Page 2
F
. ',. ,, r Z ") ' ;+ .0013 SITE INFORMATION ^,'AND .LOGATIQIV z '',e
�. ' �i ,�. ° �,� + �, ae" t� � �. �r. rar�74,. »o-n:.:e�n- .��,,u; x�•��a - Wtw ats•x�„mrv�:.w.. ax, , ..,,r� ., a+ °a'�St .. .. A? m Slte YtlhtlCS
Job site address: / //g 75 sl/t) J . T eetA , Catch basin or area drain 16.60
City /State/ZIP: C ,n) i8- Yt-1)a 2 -I 2-2 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 to job site: j Manholes 16.60
Z f ` Su) C.. 1 ' / --� 1 &L- Rain drain connector 16.60
• Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: Z--l( t I Lot no.: 13 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
3. ? i. m -rF::. fi •_:: . ; . v Absorption valve 16.60
o.."1.40' : �zt,,,,A' DESCRIPTTON OF W .: , : fn a^
�, � � -� �.� � . � .�t�y .�� � �. 4,,, n�� °3 ° �`
.;;;�'�ts't z �� ?j Baekflow preventer I Page 2
4 6 e•�._ ._56/41 Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
;•. r-ri:s 'v. tx _. a . 4 Drinking fountain 16.60
"ZOOM, p ROPER TY O WNER?�i-'e� - ® ENANT ;SV. , vas
Ejectors/sump 16.60
Name: � ) hfr/ N c. /ULU
S Expansion tank 16.60
Address: I , -.7 D3 .s ck 6 .72 Fixture /sewer cap 16.60
City /State/ZIP: / 2 Floor drain/floor sink/hub 16.60
Phone: (3103) 0 s s y / F ax: ( ) Garbage disposal 16.60
�,., ,Ir:.�:'* �^ ar4,; . , fit. - .. .. ._._ "wyg v¢ 3e .. - �m,.,,.;� >� �;-x:. - -mx:. �'�''. r se bib � 16.60
: raWit, z[lib.ANT, r , „eY CO a o
m1".�.m, "- crr & _a .ter. -r.,. . „tr ,,_ a >> - „,,, ,,,,, 0*,5MR 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: ( ) F es:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
v v yg; },- Urinal 16.60
- r:,:ti; c' . ,31;,,:;H,IX:'At "�,` ",V. 1 .- . _ . it , -.y` ,•. o-t'vr. ^ , � t4 , :;;y:n:{p,�- ,.,i. d=,'.` ,4,AvV
r ,, < ,,,,,,,,.. r, ,,,,,. „ . ,,,,s: a . „t . � CONT ;
�,�` � ,ti _ ` c� =%�t�. t��..' w�,l��r. t �r� � Water closet 16.60
Business name: 6-10w1 un - (,441,,,,io S.G 1l,U . .- Gu e Water heater 16.60
Address: 1 a-1 &..5 .5 j 00 P. ( Other:
City/State/ZIP: i \ -7
Subtotal
y S /- Pt�`rJ`�'0�� ( t (9A-It- ! 7/ Y.v Minimum permit fee: $72.50
Phone: (S't,3) ..8'.. - (3 O Fax: ( ) s Wvr-1 e Residential backflow minimum permit fee: $36.25
CCB Lic.: Sbig Plumbing Lic. no.:
Plan review (25% of permit fee)
State surcharge (8% of permit fee) /
Authorized signature: �e,_e >M w TOTAL PERMIT FEE c 4: 49 / ,
Print name: (?- iit.L (''t Co Lull 0 b•v I Date: / 4a-,3 /07- 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.
I:\ Building \Permits\P1.M- PermitApp.doc 06/26/06 440-4616TO0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: t1 Residential Fire Suppression Systems:
'�� � 9'.�a' "�' "�,' "�[ .Fee" ea � �r'TO 1 �!' �,k+�w" +.� ✓.t "•eeF ".r^wx ..�.i„r Y'�krt,� t : a >xa .'rs. "•",>. -� sr�A� ", xa ,�4, :a <
$ite Utilit es a rs�m :- ?'. e t „ls uare Foota Perm><t Fee � � ,
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 :eYF :t t�.� YvS
Storm & Rain Drain - 1st 100' 55.00 V a1uatlon:� X wP cinmee: ' : M
$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
F xture o>r Itegii 4 � ' * !�, t Fee ea) ' jot a"l�. additional $100.00 or fraction thereof to and
' '&tik" Yf..�r'. -i.' ,t 4n �rt ±'�. x74)'. ',,,,A ,i ;. ;fi
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 Back flow 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
Inspection of existing plumbing or each additional $100.00 or fraction thereof to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001 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�farPlumbi><e Installaticis
- g=
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*. ❑ Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
"Fiut6re.7 ` " ' k M :';e "*" 4t -> : t*' kz. ; i Re cep'" engineer.
wJr *= ` .. Ptreviouscanpedti.Added< „ Eiistin>;�'� ❑ 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
sI smetric:olrt serD raa ,� � ,O
Drinking Fountain »�'� '��� %� ... g �
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain /sink -2" that meet the qualifications above.
-3"
4„ C regarding fixture work:
Car Wash Dra g g
Garbage - Domestic
Disposal - Commercial
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
- Stall *Note: If the fixture work under this permit results in an
Sink - Bar/Lavatory ' increase of sewer EDUs, a sewer permit will be issued and
- Bradley fees assessed 'for the sewer increase must be paid before the
- Commercial
Service • plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures: -
is\ Building \Permits \PLM- PermitApp.doc 0927106
. •
<--- -„,--?___.c.--1, -
CITY OF TIGARD .:
BUILDING DIVISION PERMIT #: PLM2007-00016
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/23/2007
Phone: (503) 639-4171 l i Noo lick\
Inspection Requests (24 Hrs.): (503) 639-4175 ,._ ,Ili r --1 _ .
INSPECTION WORKSHEET FOR DATE: 1131/2007 TIME: 7:02AM PAGE: 21
. •
SITE ADDRESS: 14873 SW JONAGOLD TERR CLASS OF WORK:
:
SUBDIVISION: LADY APPLE LOT #: 013 TYPE OF USE:
PROJECT NAME: LADY APPLE
DESCRIPTION: Install residential backtlow prevention device for irrigation.
OWNER: BEACON HOMES NW, INC, PHONE #: 503-570-8828
CONTRACTOR: CONTOUR LANDSCAPING INC PHONE #: 503-682-1302
Inspection Request Scheduled For: ,_ Date: 1/3112007 Pour Time:
Code # Inspection Descritpk,C ' Confirm # Contact # Message
r'
396 Misc. inspection 042763-01 503-320-0183 N
Corrections/O mments/lnstructions:
`re. 5.1_.- a(
•-tv t 7 k( c ---
•
p .Q (----°----------H .
fi s - p - Ass I I PARTIAL APPROVAL Ei CANCEL NO ACCESS
I I FAIL 1 CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
• Inspector: \L
Date: (/D)Phone #: (503) 718- r ZYZ i
. ,
. , . .