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Permit CITY TIGARD PLUMBING PERMIT ° " COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00582 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/7/2006 PARCEL: 2 S 110 DA -06100 SITE ADDRESS: 10507 SW NAEVE ST ZONING: R -3.5 SUBDIVISION: ERICKSON HEIGHTS LOT: 022 JURISDICTION: TIG Project Description: Bathroom remodel. • 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: 2 SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES • LEE BATSON 10507 SW NAEVE ST Description Date Amount TIGARD, OR 97224 [PLUMB] Permit Fee 12/7/2006 $72.50 [TAX] 8% State Surcha 12/7/2006 $5.80 Phone : 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: 2 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. . , /wilding Fixtures • 1 , 1E ,0, �f Plumbing Permit Alpalifibli FOR OFFIC .1 USE ONLY City of Tigard ` � ' { 2006 Date/By a- / 01 � Permit No.P 1 .9of p6, ,z 13125 SW Hall Blvd., Tigard, OR 97223 U L� i• Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Q� �'Cka ',,., ,. I Date/By. Other Permit No.: • Y ): 24- Hour Inspection Line: 503.639.4175 jr� � OM ^ a j,�, •_�_1 Date Ready/By: ) u "� El See Page 2 for w Internet: ww.ci.tigard.or.us 130 Notified/Method: i Supplemental Information . F `c:•1`YPE 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 (I) bath 249.20 f - 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. fl.) Page 2 .JOB SIT IN AND LOCATION Site utilities Job site address: i i I / e S-f--. Catch basin or area drain 16.60 City /State /ZIP: - g, I ' Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: ' � 1l -' v ^ , Footing drain (no. linear ft.: ) Page 2 Zl` b " 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: Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF 'WORK Back flow preventer Page 2 • Q_ b_ W ` A/nD Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 1 6.60 ❑ PROPERTY, OWNER ' I ❑ TENANT Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State/ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 Hose bib 16.60 ❑ APPLICANT ❑ CONTACT PERSON 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: ( ) I Fax::( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 "' ' CONTRACTOR Water closet 16.60 V Business name: -y /� f / / /'�j y-� in Water heater 16.60 Address: "TO © it ` @ " 1 I� � Other: Subtotal City /State/ZIP: iG J A M - 7: 0 1 Minimum permit fee: $72.50 '1 Phone: (SO 4._ � ; F L� �� �'� R backftow minimum permit fee: $36.25 0 ! CCB Lie.: I Ct 3") Plumbing Lic. no.:e -Nyes Plan review (25% of permit fee) State surcharge (8% of permit fee) 51 Authorized signature: -. ■ TOTAL PERMIT FEE Print name: Date: / 2.. 'J 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.\ Building \Permis\PLMF- PermiiApp.doc 06/05 440.4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard „ • Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities _ ";' ' `f " °' Qty. Fee (ea) Total . Square. Footage: Permit 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 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 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. Quatidty 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 I3 -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 P 1Vater 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:\ Buildin \Penniu\PLM- PermitApp.doc 07/06/05 CITY OF TIGARD . , BUILDING DIVISION PERMIT #: PLM20000582 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2006 Phone: (503) 639 -4171 /t� fi Inspection Requests (24 Hrs.): (503) 639 -4175 "'I � INSPECTION WORKSHEET FOR DATE: 12/11/2006 TIME: 7:00AM PAGE: 28 SITE ADDRESS: 90507 SW NAEVE ST CLASS OF WORK: SUBDIVISION: ERICKSON HEIGHTS LOT #: 022 TYPE OF USE: PROJECT NAME: BATSON DESCRIPTION: Bathroom remodel. OWNER: BATSON, LEE PHONE #: CONTRACTOR: BRUNER PLUMBING PHONE #: 503 -624 -4880 Inspection Request Scheduled For: Date: 17111/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Plumbing rough -in 0408137 -01 503- 639 -2244 N Corrections /Comments/ Instructions: ' / / • I/: PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED / L Inspector: /'4L' Date: r / / 4.e Phone #: (503) 718 - 4" CITY OF TIGARD _ -. . . BUILDING. DIVISION . Ahl: PERMIT #: PLM2006 (30582 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2006 Phone: (503) 639 -4171 y Inspection Requests (24 Hrs.): (503) 639 -4175 ,.' "' L. INSPECTION WORKSHEET FOR DATE: 12/11/2006 TIME: 7 :00AM PAGE: 27 SITE ADDRESS: 10507 SW NAFVE ST CLASS OF WORK: SUBDIVISION: ERICKSON HEIGHTS LOT #: 022 TYPE OF USE: PROJECT NAME: BATSON DESCRIPTION: Bathroom remodel. OWNER: BATSON, LEE PHONE #: CONTRACTOR: BRUNER PLUMBING PHONE #: 50364 -4880 Inspection Request Scheduled For: Date: 12111/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 040887 -02 503-639-2244 N Corrections /Comments /Instructions: ❑ PASS ❑ PARTIAL APPROVAL j CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0 [' e Date: /13////a( // a( Phone #: (503) 718- 2 ^) • CITY OF TIGARD BUILDING DIVISION - PERMIT #: PLM200 &00582 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1217/2006 Phone: (503) 639-4171 tft Inspection Requests (24 Hrs.): (503) 639 -4175 r "Ii INSPECTION WORKSHEET FOR DATE: 12/1312006 TIME: 7 PAGE: 53 SITE ADDRESS: 10507 SW NAEVE ST CLASS OF WORK: SUBDIVISION: ERICKSON HEIGHTS LOT #: 027 TYPE OF USE: • PROJECT NAME: BATSON DESCRIPTION: Bathroom remodel. OWNER: BATSON, LEE PHONE #: CONTRACTOR: BRUNER PLUMBING PHONE #: 503-624 -48t30 Inspection Request Scheduled For: Date: 12113/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 322 Shower pan 041009-01 503- 639-2244 N Corrections /Comments /Instructions: • S El PARTIAL APPROVAL ❑ CANCEL El NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: PI v Date: Phone #: (503) 718- CITY OF TIGARD -_ BUILDING DIVISION PERMIT #: PLM2006 -00502 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/7/2006 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/1712007 TIME: 7 :00AM PAGE: 22 SITE ADDRESS: 10507 SW NAEVE ST CLASS OF WORK: SUBDIVISION: ERICKSON HEIGHTS LOT #: 022 TYPE OF USE: PROJECT NAME: BATSON DESCRIPTION: Bathroom remodel. OWNER: BATSON, LEE PHONE #: CONTRACTOR: BRUNER PLUMBING PHONE #: 503 - 4E1BD Inspection Request Scheduled For: Date: 1117/2007 Pour Tim . / D Code # Inspection Description Confirm • Contact # Mess e 399 Plumbing final i, . 04-11 503 - 218-2423 Corrections/Comments/Instructions: c- �i�x,✓ f / / S .& t4 " / PASS ❑ PART L APPR.V , ❑ CANCEL ❑ NO ACCESS ❑ FAIL MIL FO � ' CTION • ADDITI NAL FEE ASSESSED Inspector: Date: D hone #: (503) 7 -