Permit •
C ITY OF, TIGARD PLUMBING PERMIT
Avitt DEVELOPMENT SERVICES PERMIT #: PLM2006 -00406
:4 I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/5/2006
PARCEL: 1 S 133DC -02200
SITE ADDRESS: 11930 SW MORNING HILL DR ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 1 LOT: 050 JURISDICTION: TIG
Project Description: Install backflow prevention device for irrigation system.
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
BOB GEORGE
11930 SW MORNING HILL DR Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/5/2006 $36.25
[TAX] 8% State Surcha 9/5/2006 $2.90
Phone : 503 -524 -3465 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 irect questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Is ued By: /' �/ J ► / A Permittee Signature: M �
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 3 .
Plullihbin2 Permit Application FOR OFFICE t ISE ()NIA'
lig City of Tigard Received Date/By.
`l f ' a91 I �� -+� DO' g 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/gy. Other Permit No.:
T I G A K l7 Inspection Line: 503.639 Date Ready/By: r El See Page 2 for
Internet: www.tigard- or.gov Notified/Method f 0., 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- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
I- 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: k1 CA 5 O gw V\Or , t A. '2_ Catch basin or area drain 16.60
City /State/ZIP: e
U Q�clt i 01 q -? ZZ 3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: re s P,� ) CJ Footing drain (no. linear ft.: Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: PA a f o r
` C ( JC r�?X IMOI^t1 t {� Manholes 16.60
5 w S f\t5 y' ? )r t n - 5( / Rain drain connector 16.60
Sanitary sewer (no. linear ft.: __) Page 2
Storm sewer (no. linear ft.: ) Page 2
^n 1 1 ` 1 /� I
Subdivision: ( j� `OYy∎\v"j R \ Lot no.: Water service (no. linear ft.: ) Page 2
Tax map/parcel no.: J Fixture or item
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer 1 Page 2
■/'■S-'- A\\ C..-i k ui (dub fp c r., ll) vo\\t,,e Backwater valve 16.60
5 er►vxl
Clothes washer 16.60
Dishwasher 16.60
It-PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump ctors/sump 16.60
Name: �� ('c �. Expansion tank 16.60
Address: I \)o S w Q y y� 1� I4 � (( V Fixture/sewer cap 16.60
t
City /State/ZIP: ( ay • 1 Oil__ J 21_3 Floor drain/floor sink/hub 16.60
Phone: ( ^p 3 �� Fax: 5 3) h��� ( ) Garbage disposal 16.60
APPLICANT 'CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: E50 gQ-a v �
- , yy_ c o u � �
0 n Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State/ZIP: Roof drain (commercial) 16.60
Phone: ( ) I F es:: ( ) Sink/basin/lavatory 16.60
Tub /shower/shower pan 16.60
E-mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name: H(6, _ 64.,0.0._.i >r,> Water heater 16.60
Address: Other:
Subtotal
City /State/ZIP: i
Minimum permit fee: $72.50 / _ (3
Phone: ( )
Fax ( ) Residential backflow minimum permit fee: $36.25 (/
CCB Lic.: bang Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee) -1---
Authorized si r 5-.?, TOTAL PERMIT FEE
Print name: if, /J✓� a L Date: 9 O 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 Board.
I:\Bu lding\Pmnits\P1.MF- PamitApp.doc 04/06/06 410.4616T(I0/OZ/COM/WFB)
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 - 1 u 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 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
and including $50,000.00.
specially requested inspections - per hour 72.50
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.
Quantity by (Fixture) Work Performed ❑ Any new commercial building.
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 I 3-D multipurpose fire 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 *Note: If the fixture work under this permit results in an
Water Extractor
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- PennitApp.doe 07/06/05
CITY OF TIGARD .. - ,� aL H ?AD 6 - tea 4661
BUILDING DIVISION ` PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 w '4l Ili(
Inspection Requests (24 Hrs.): (503) 639 -4175 �:
INSPECTION WORKSHEET FOR DATE: Z 0 e TIME: t& S PAGE:
SITE ADDRESS: 1 1g°j, D imb N t 1` ' U I 1 LASS OF WORK:
SUBDIVISION: L T #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
. --d 4,j PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 V5A 0 - 1 - tilf0 ctivi 6-Q
Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Acck,.___. Date: LCi; SV`( Phone #: (503) 718 -(T I
CITY OF TIGARD .
BUILDING DIVISION ,PERMIT #: PLM2006 -00406
13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED: 9/5/2006
Phone: (503) 639 -4171 P Requests ( ection nests 24 Hrs.) : (503) , w l.
■ F�I II
Inspection Re _.
) 639 -4175 .......� - _.
INSPECTION WORKSHEET FOR DATE: 9/8/2006 TIME: 7:00AM PAGE: 50
SITE ADDRESS: 11930 SW MORNING HILL DR CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 1 LOT #: A50 TYPE OF USE:
PROJECT NAME: GEORGE
DESCRIPTION: Install backflow prevention device for irrigation system.
OWNER: GEORGE, BOB PHONE #: 503-524-3465
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 902006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 036230 -01 503-317-5358 N
Corrections /Comments /Instructions: 4
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❑ PAS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS
X FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ ( b �i id Inspector: 4/NN Dater !� Phone #: (503) 718- 24 2-'1