Permit •
1 CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2006 -00004
w � J DEVELOPMENT SERVICES DATE ISSUED: 3/30/2006
`� 1 3125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 D C -Y P002
SITE ADDRESS: 09096 SW O'MARA ST ZONING: R -4.5
SUBDIVISION: YEDINAK PARTITION LOT: 002 JURISDICTION: TIG
Project Description: New SF rain drains and sanitary sewer only. Other plumbing work done under MST2006 00001.
CLASS OF WORK: NEW 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: 150 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 150 ft
Owner: FEES
MARTIN & C YEDINAK •
9090 SW O'MARA ST Description Date • Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 1/4/2006 $202.80
[TAX] 8% State Surcha 1/4/2006 $16.22
[PLUMB] Addl Permit 4/6/2006 $202.80
Phone : 503 - 684 - 3573 [TAX] 8% State Surcha 4/6/2006 $16.22
Total $438.04
Contractor:
TCJ CONSTRUCTION
19750 SW PAGE CT.
BEAVERTON, OR 97007 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 320 -7831
FAX 503- 259 -2432
Reg #:
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
•
Issued By: ��Gi � � Permittee Signature: Stzt, CZ$ `r(
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 11 LPG ac oo qST�oo • O• Ii.
Plu Permit AP CAVE® IOlz c)rrlcE l,sr ONi.\.
City of Tigard r�11 C R�� / 04, 71 Permit No.: � Lhopi3O ,P -0000
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 j / ij\ 3 20010-,,,,, . f ' � _ I . Date/B Other Permit No.:
24- Hour Inspection Line: 503.639.4175 � � Date Read B ! r El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGA; _ y x l '�4 / / K� g
Notified/Method:, S upplemental Information
T.iati*Mi DIVISIUN FEE* SCHEDULE
Itg 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
1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
El Master builder Each additional bath/kitchen 45.00
0 Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 9 O q ( ' 5 _ ) )v QJ . ' Catch basin or area drain 16.60
City / State/ZIP: ' T I AQ W £)( Cirr jg..3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 1 Pr 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.: r) Page 2 /fl /. 5(0
Storm sewer (no. linear ft.: L,2)) Page 2 /Q/ • yo
Subdivision: I Lot no.: 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
P )vvJ1 0 0...A l� / Czi' � t�� Backwater val 3P 16.60 .
Clothes washer 16.60
Dishwasher 16.60
❑ PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
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
❑ 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
Phone: ( ) I Fax:: ( )
Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet 16.60
Business name TC__ J o , -- O Water heater 16.60
Address: p / J C r Other:
Cit State/ZIP: ^ - Subtotal aOa. /s0
y ✓ � �� � / f
III I I o1 Minimum permit fee: $72.50
(�
Phone: fj) �'L& -' 4 Fax: ( ) \ Residential backflow minimum permit fec: $36.25
CCB Lic.: C L i C ( C- I IA, Plumbing Lic. no.: ;•./ - y�1 Plan review (25% of permit fee) -
Authorized signature: State surcharge (8% of permit fee) (( 32-
TOTAL PERMIT FEE 'a, I di .OZ
Print `` namer5 ),.. � ) ^ - =,..., I Date: ) 3 -O C., 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.
is\ Building \Pennib\PLMF- PermitApp.doe 06/05 4 0- 4616T(I0VDLCOM/WEB)
•
, Plumbine Permit Application L 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 - I" 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional f0O' 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
Q ty. Fee (ea) Total additional $100.00 or fraction thereof to and
Fixture or Item 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 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 fixture s 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
Eye Wash ❑ Any NFPA 13 - D multipurpose fire sprinkler system.
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 i ` t
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor un p
Water Closet - Toilet increase of sewer EDUs, a 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:tBuilding\Pennits PLM- PennitApp.doc 07 /06/05
CITY OF TIGARD
B
Pcm
UILDING DIVISION PERMIT #:-Z�c, _ `' �� , c
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171
/ar
Inspection Requests (24 Hrs.): (503) 639 -4175 ^ 'I �
INSPECTION WORKSHEET FOR DATE: /2 11456 5 TIME: PAGE:
SITE ADDRESS: 10 cp4, ..lJ �/�'L C„ 1 /�y-a1 i CLASS OF WORK:
SUBDIVISION: L OT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: APS tir.14' ' I I l eEb(ijkj PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 ThAhas nurc --
Corrections /Comments / Instructions:
ir, I i 041,
,►
Mir *FP ‘ No. r ---- -
J
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL IC CALL FOR INSPECTION ❑ ADDITIO L FE S ASSESSED
Inspector: A � Date: ( Phone #: (503) 718 -2�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006 00C)1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30/)00'6
Phone: (503) 639 -4171 40 . 7 4 �
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �_
INSPECTION WORKSHEET FOR DATE: 6/1/2006 TIME: 7:00AM PAGE: 10
SITE ADDRESS: 09096 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: YEDINAK PARTITION LOT #: 002 TYPE OF USE:
PROJECT NAME: YEDINAK PARTITION
DESCRIPTION: New SF i:lin ikrainc acid sVnitary sewer only. Other plumbing work done under MST200G 00001. i
OWNER: YEDINAK, MARTIN & CHRIS PHONE #: 603.68'1 3ti13
CONTRACTOR: TCJ GON FRUCTIC*1 PHONE #: 103320 - 78:41
■
Inspection Request Scheduled For: Date: 511/2015 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3.10 Storm drain 079043 -02 601 -320 7831 N
Corrections/Comments/Instructions:
`PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \ ` 31) `> Date: \ '\
1 v Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION T' PERMIT #: PLM200&•0U(14
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 3/30010',
Phone: (503) 639 -4171 N4- l
Inspection Requests (24 Hrs.): (503) 639 -4175 •'� ..
INSPECTION WORKSHEET FOR DATE: r,/1 /2006 TIME: /:00AM PAGE: 9
SITE ADDRESS: 09096 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: YFDINAK PARTITION LOT #: 002 TYPE OF USE:
PROJECT NAME: YL )INAK PARTI TION •
DESCRIPTION: New SF rain drains acid sanitary ,ewer only. Other plumbing wort; done ender MST200f• 00001,
OWNER: YEDINAK. MARTIN & CHRIS PHONE #: 503.68/1-35 /3
CONTRACTOR: TeJ CONSTRUCTION PHONE #: 503 -320 76'.0
Inspection Request Scheduled For: Date: 5/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
f:0f, , 111 ithtry sewer 02904' -03 503-320.78:41 N
Corrections /Comments /Instructions:
c:::„ C Y&
r 7/
�/
(� D l •
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: M ) i/ Date: ,.... /
f .
Inspector: Phone #: (503) 718- I( 3
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PI.M2006-010 Y4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30/2.006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 —'!!
INSPECTION WORKSHEET FOR DATE: 516/2006 TIME: 7:10AM PAGE: 1
SITE ADDRESS: 09096 SW O'MARA E CLASS OF WORK:
SUBDIVISION: YEDINAI PARTITION LOT #: 002 TYPE OF USE:
PROJECT NAME: YLOINAK PARTITION
DESCRIPTION: New SF rain drains and sclnitary sewer only. Othe1 plumbing work done under MST 1006- P9001-
OWNER: YEC)INAK, MARTIN & CHRIS PHONE #: 60: 684 3Q•3
CONTRACTOR: TCJ CONSTRUCTION PHONE #: 503 - 320 -7831
Inspection Request Scheduled For: Date: 5/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 � Rain drain 029381- 01 F,03-320. 7831 N
Corrections/Comments/Instructions:
./W (\•
rnPar AIIRP A .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i ng 1 V Date f 01 Phone #: (503) 718- "2-17/2--
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006- 00004
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30/2006
Phone: (503) 639 -4171 +
Inspection Requests (24 Hrs.): (503) 639 -4175 I I I ..
INSPECTION WORKSHEET FOR DATE: 7/31/2006 TIME: 7 :06AM PAGE: 60
SITE ADDRESS: 09096 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: YEDINAK PARTITION LOT #: Q02 TYPE OF USE:
PROJECT NAME: YF_DINAK PARTITION
DESCRIPTION: New SF rain drains and sanitary sewer only. Other plumbing work done under MST2006- 00001.
OWNER: YEDINAK, MARTIN & CHRIS PHONE #: 503.604..3573
CONTRACTOR: TCJ CONSTRUCTION PHONE #: 503. 320 -7831
Inspection Request Scheduled For: Date: 7/31/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 034050 -01 503-925.1342 N A 0 0'
Corrections /Comments /Instructions:
(:.
,-- "V 1/1944 (e
//
i t)/ .
PO /1/1 ,
e z ( - ) (ff -1 , z7 ) 91— I I
,,,
_,
0
❑ PASS Nj PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
t
AIL al ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v Date: 7 Phone #: (503) 718- /3)
1