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Permit CITY OF TIGARD ` PLUMBING PERMIT c. COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00334 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/27/2007 PARCEL: 2S 104BC - 09100 SITE ADDRESS: 14030 SW KARLEY CT ZONING: R -7 SUBDIVISION: HILLSHIRE CREST LOT: 013 JURISDICTION: TIG PROJECT: HILLSHIRE CREST Project Description: Backflow preventer 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 RIDGECREST CONST CO. INC 6600 SW 92ND AVE Description Date Amount PORTLAND, OR 97223 [PLUMB] Permit Fee 7/27/2007 $36.25 [TAX] 8% State Surcha 7/27/2007 $2.90 Phone : 503- 246 -8808 Total $39.15 Contractor: CONTOUR LANDSCAPING INC 12485 SW TOOZE RD SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS Contact # : PRI 503- 682 -1302 FAX Same as above Reg #: LIC 5698 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. §pecialty Codes -and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if wp, k 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 ruleVadopted\b the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 -0 01 -0100. You may obtain' opies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued.: / i � _ _ - Permittee Signatu f� / ` I W Call 503.639.4175 by 7 :00 a.m. for an inspection that busi ess day. This permit card shall be kept in a conspicuous place on the job site until ompletion of the project. Approved plans are required on the job site at the time of each inspection. Pleimbing Permit Application Building Fixtures r C tmr FOR OFFICE USE ONLY City of Ti 2 1 L 2 7 2007 Received 7 / 7 , i 5 PermitN.. ae j 3� lig - a 13125 SW Hall Blvd., Tigard, OR 97 Plan Re : ! [ (/� Plan Revie - Other Permit No.: Phone: 503.639.4171 Fax: 503.58. ?60f } w ' ir � Date /By: Inspection Line: 503.639.4175 i � c Date Read B 1u ® See Page 2 for TIGARD Internet: www.tigard- or.gov � �� g1�� f 9J � ©� Notified/Method:� Supplementallnformation TYPE OF WORK FEE* SCHEDULE , New construction ❑ Demolition For special information use checklist. Description 1 Qt Ea. I Total ❑ Addition/alteration/replacement ❑ 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 ID Multi-family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE 'INFORMATION AND LOCATION. �' Site utilities Job site address: /'/o t f 5p 5 0 / L & % C-4- Catch basin or area drain 16 60 City /State /ZIP: 7/ C14 �b cam- ` Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: 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.: it-/ 3 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 4 / -p ,ls ,i2-- C(576fl Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 lki-PROpERTY OWNER ❑ TENANT Drinking fountain 16.60 ) c _ T S _ Ejectors /sump 16.60 Name: (� ` Expansion tank 16.60 Address: cac q e- Fixture /sewer cap 16.60 City /State /ZIP: (��T 0 b q 1 * 3 Floor drain/floor sink/hub 16.60 Phone: (93) V `' t Le eS 00 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 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 - CONTRACTOR - - . „_ Water closet 16.60 Business name: e A- O t)t- Z.---/S Water heater 16.60 Address: l 2_6(8 --7-OpZ, Fe., Other: City /State /ZIP: (,( 07.70 ot 9 loo Subtotal 3 . / Minimum permit fee. $36.25 Phone: ( ) �� Fax: ( ) Residential backflow minimum permit fee. $36.25 CCB Lic.: / / PI ' bing Lic. no.: - Plan review (25% of permit fee) State surcharge- (8 %-of permit fee)- - Authorized signature: / / TOTAL PERMIT FEE 39_ / 3 Print name: /VI J l . I! I 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. I:\Building4Permits\PLMF- PermitApp.doc 12/27/06 440-46! 6T( I 0 /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: Permit .Fee: Footing drain - 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: Permit Fee: 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 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 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 Plumbing Installations 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 Quantity by (Fixture) Work Performed greater, except systems designed and stamped by licensed engineer. Fixture Type: Replace g Previous Capped Added Existing ❑ 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 Drinking Fountain Isometric or.Riser' Diagram Eye Wash ❑ 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 Sink - Bar /Lavatory - 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 Urinal 'Other Fixtures: i:\Building \Permits \PLM- PermitApp doc 12/27/06 CITY OF TIGARD a BUILDING DIVISION PERMIT #: PLM2007 -00334 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2007 Phone: (503) 639- 4171 t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/3/2007 TIME: 7:03AM PAGE: 32 SITE ADDRESS: 14030 SW KARLEY CT CLASS OF WORK: SUBDIVISION: HILLSHIRE CREST LOT #: 013 TYPE OF USE: PROJECT NAME: HILLSHIRE CREST DESCRIPTION: Rackflow preventer for irrigation. OWNER: RIDGECREST CONST CO. INC, PHONE #: 503 -246 -8808 CONTRACTOR: CONTOUR LANDSCAPING INC PHONE #: 503.682 -1302 Inspection Request Scheduled For: Date: 8/3/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 3 Misc. inspection 053380.01 503 - 3280183 N Corrections /Comments /Instructions: ca.tre- • tg PASS _ _ PARTIAL APPROVAL El CANCEL I. NO ACCESS ❑ FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: ( �✓� r^^A� Date: 8 , 3 J ( Phone #: (503) 718-