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Permit
CITY TIGARD PLUMBING PERMIT I i DEVELOPMENT SERVICES PERMIT #: PLM2006 -00486 Aisl- -II. . DATE ISSUED: 10/17/2006 - -- — -- -- — 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102BB - 00407 SITE ADDRESS: 12100 SW KAROL CT ZONING: R - 4.5 SUBDIVISION: KAROL COURT LOT: 006 JURISDICTION: TIG Project Description: 75' of water service replace. CLASS OF WORK: OTR 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: 75 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES SCHMASOW, WALLACE I AND ANN MARIE Description Date Amount 12100 SW KAROL CT [PLUMB] Permit Fee 10/17/200€ $72.50 TIGARD, OR 97223 [TAX] 8% State Surcha 10/17/200€ $5.80 Phone : 503- 639 -9508 Total $78.30 Contractor: BRUNER PLUMBING PO BOX 23985 TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 624 -4880 FAX 503- 624 -2173 Reg #: LIC 81837 PLM 26 -445PB 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: E X � 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. B Fixtures Plumbing Permit Applioat i�t�E `� . - - `._ FOR on 1C1': us • O Nll t a ri4 ¢ • City of Tigard Date/By i o b Permit No (, R T 6 ep o 0 Wi :J , 13 125 S W Hall Blvd., Tigard, OR 97223 OCT i 6 20 t6 Plan Revie w / 7 / Ob I Phone: 503.639.4171 Fax: 503.598.1960 - - - / /si +1i x - — — - - Other - Permit No N�ll, }, I" Date /By 1 24- Hour Inspection Line: 503.639.4175 CITY OF TIG A 1: Date Ready /By ® See Page 2 for Internet: www.ci.tigard.or.us BUILDING DI.15 ON Notfied/Method: / / L-1 Supplemental Information =TYPE ;OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description Qty. 1 Pa. "total j Add ition /alteration/replacement ❑ Other. New I- 2- family dwellings (includes 100 ft for each utility connection) 3`CATEGORY:;OF CONSTRUCTION SFR (I) bath 249 20 WI- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 F ❑ Accessory building ❑ Multi- family SFR (3) bath 399 OU ❑Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq 0) Page 2 i .,JOB:SIT AND LOCATION Site utilities Job site address: 1 21 00 SLJ irz.) ( C Catch basin or area drain 16.60 1 City /State /ZIP: 177A, 0 -g-, q ' 2Z3 Drywell, leach line, or trench drain 16 60 Suite/bldg. /apt no.: "(/ Project name: Alair4 5.-c),,,.yvA,s ( A. Footing drain (no. linear ft.• ) Page 2 Manufactured home utilities 110 00 Cross street /directions to job site: 119 511--- E � (4410 -i . 1 Manholes 16 60 i ■ Rain drain connector 16 60 Sanitary sewer (no. linear It : ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Water service (no linear ft.: 75) Page J.) - i Lot no.: Fixture or item Tax map /parcel no.: Absorption valve 16 60 • '''' DESCRIPTION'OF 'WORK Back flow presenter Page 2 l r er le4/ - . 1,..04 '1( -) Backwater valve 1660 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16 60 1 - ❑ PROPERTY`OWNERe,'' ❑ TENANT Ejectors /sump 16.60 j Name. Expansion tank 16.60 Address: Fixture /sewer cap 16 60 City/State /ZIP: Floor drain /floor sink /hub 16.60 Garbage disposal I o 60 Phony. ( ) Fax: ( ) g P ❑ APPLICANT -• ❑ CONTACT PERSON r Hose bib 6.60 ' Ice maker 16.60 Business name: �� 0-.0 glibdi Interceptor /grease trap 16,60 Contact name: SC'1 ..-- 'MO Medical gas (value' $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16 60 Phone. ( '70g (v3 I -150 Fax • ( ) Sink /basin /lavatory 16.60 ` Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 " " ". " CONTRACTOR Water closet I6 -60 Business name: 1-3 R(j s eW R CA4 . i i Water heater / t c . 660 ' Address g0 2 Qor_ 3 1� 8 . S Other • City /State /ZIP /` ��.--. ©e 1 ` C- 7Z .3'1 -? 9 8� Subtotal Phone. ( v3) Fax: p ) ax: ( / -7 Minimum permit fee" $72 ?0 S bZ� g- v $ fp7. � Z. i 7 Residential backflow minimum permit fee $36.25 CCB Lie.: 7 e.3 ^7 Plumbing Lie, no " -V 5L,5" PE Plan review (25% of permit tee) State surcharge (8% of permit fee I Authorized signature ' 7 t TOTAL PERMIT FEE 3 1 Print name: A./G2•ti� gruel ei. .....-_ Date: /0///06 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 lio,trd i \ Building\Pernns\PL.MF- PermitApp doe 06/05 440 - salon) 10 /02 /COM/W[t3) Plumbing Permit Application - City of Tigard Page 2 - Supplemental. Information Fee Schedule: Residential Fire Suppression Systems: Srte: Utilities,. ^ "`Yt "trt; ?a, ii is , ;aw ....l:Qty' Fee (ea).; STotal,:4'' , S . i , quare, Footage: :Pke.rinifF,ee:. 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 Sewer - 1st 100' 3,601 to 7,200 $220.00 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' Valuation:.':`'.: Permit'Fee: 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 additional $100.00 or traction 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 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 $50,001.00 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. <; ;::;: •.d> CI Any new commercial building. "' � �`=� " ,,,,; _ ;;ti ?suiiutity;by (Flzture) �Work'Pe "rformed Fixture Type r, =:M: ❑ Any new exterior plumbing site utilities. � •:, .t. dt::< ;:': ?i:i: '. "Replace , r ,.,.- _. s_;,, ..: P Capped-....' 'Added— 'Existing •- r 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 DriveThru 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 tire sprinkler system. Eye Wash Floor Drain /sink - 2" 3.. Submit 2 sets of plans with any of the above. 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. -1 ndustrial g 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:\ Budding \Pennns\PLM- Pennit4pp.doc 07/06/05 ' , CITY OF ��mo n n��u TIGARD � BUILDING DIVISION PERMIT #: 2006-00486 13125 SW Hall Blvd., Tigard, OR 97223- DATE ISSUED: 10y17/2008 Phone: (503) 639-4171 At° . Inspection Requests (Z4H 175 - .. i t l INSPECTION WORKSHEET FOR DATE: 11M5/2806 TIME: 7:07Ah8 PAGE: 43 SITE ADDRESS: 13100 SWKAR(}LCT CLASS OF WORK: SUBDIVISION: KAROL COURT LOT #: 006 TYPE OF USE: PROJECT NAME: SCHk4ASDVy DESCRIPTION: 75' of water service replace. OWNER: SCHMASOW, WALLACE I AND, PHONE #: 503-839-9508 CONTRACTOR: BRUNER PLUMBING PHONE #: 503-624~4880 Inspection Request Scheduled For: Date: 11/16/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 039780'01 503-624~4B00 N Corrections/Comments/Instructions: /^ - / ` °y "~' ^ . / / � // i � ^ 2~~- -- 6 -,/ _~ '- ' , I | PARTIAL APPROVAL 0 CANCEL I I NO ACCESS I I FAIL ri CALL FOR INSPECTION ADDITIONAL _- . / } ^��' C |nap�Inspector: K� 0 [7. l�� Date: / / / / / / /`J �/ /\ �� Phone#: (503) 718- io ' ` .• - -- ' CITY OF TIGARD BUILDING DIVISION PERMIT #: PLM2006-00486 i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2006 , Phone: (503) 639-4171 gni oilliliii Inspection Requests (24 Hrs.): (503) 639-4175 L.A611- --u- INSPECTION WORKSHEET FOR DATE: 10/19/2006 TIME: 7:02AM PAGE: 73 SITE ADDRESS: 12100 SW KAROL CT CLASS OF WORK: SUBDIVISION: KAROL COURT LOT #: 006 TYPE OF USE: PROJECT NAME: SCHMASOW DESCRIPTION: 75 of water service replace. OWNER: SCHMASOW, WALLACE I AND, PHONE #: 503.639-8508 CONTRACTOR: BRUNER PLUMBING PHONE #: 503-624-4880 Inspection Request Scheduled For: Date: 10/1912006 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 038472-01. 503-6244880 N Corrections/Comments/Instructions: -.-- .1P _ / — / .i■f ___ ,r /" .. ..-- - , T/ //:-.„4" „di 40-11111111NWriore - , - _ l ' ASS PARTIAL APPROVAL ii _ CANCEL NO ACCESS FAIL I CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector:In) Date:/0 / , Phone #: (503) 718- 7,3 , .