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Permit
v CITY OF TIGARD PLUMBING PERMIT ..... - -- COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00191 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/15/2007 PARCEL: 2S 102C D - 02001 SITE ADDRESS: 09630 SW O'MARA ST ZONING: R - 4.5 SUBDIVISION: EDGEWOOD LOT: 020 JURISDICTION: TIG PROJECT: MCDILL Project Description: Connect existing house to sewer lateral. Septic tank is to be pumped and filled. Sewer Reimbursement District #28 fee paid this date. 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: 120 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES STEVEN & K MCDILL 9630 SW O'MARA ST Description Date Amount TIGARD, OR 97223 [PLUMB] Permit Fee 5/15/2007 $101.40 [TAX] 8% State Surcha 5/15/2007 $8.11 Phone : 503- 936 -6047 Total $109.51 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 a•opted by the Oregon Utility No - - '• 'ter. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You obtain copies of these les or direct que 'ons to OUNC by calling 503.246.6699 or 1.800.332.2344. Iss ed By: /�� y� i e 4 P ermittee Signature: '== •- /` I/ l / Call 503.639.4175 by 7:00 a.m. for an inspection that business d . This permit card shall be kept in a conspicuous place on the job site until comp • ion of the project. Approved plans are required on the job site at the time of each inspection. • Plumbing Permit Application s. . FOR OFFICE USE ONLY City of Tigard Received Permit No.: /�,,� /9/ 1 114 a 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: �5 d' �e J17 �T d Phone: 503.639.4171 Fax: 503.598.1960 Plan atte/By ew Other Permit No klk:b7.-evlO g T I G A 11 D Inspection Line: 503.639.4175 Date Ready/By: . M See Page 2 for Internet: www.tigard - or.gov Notified/Method: I (' 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:,," je.( 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 ID Accessory building ❑ Multi- family SFR (3) bath 399.00 ❑ Master builder iii Othe . Each additional bath/kitchen 45.00 � .. Fire sprinkler ( sq. R) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities Job site address: q(p j,w. C) r 1.c ro, Si- - Catch basin or area drain 16.60 City/State/ZIP: ' c c ` - S1-2,13 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: t J I Project name: c ) 11 S G Footing drain (no. linear R.: _) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: � Manholes 16.60 C .r t C V ,, , ,,.(� � Rain drain connector I / 16.60 t 0 ft' .A4 .. , Sanitary sewer (no. linear ft.: ( ! z Page 2 /0/'.---- Storm sewer (no. linear ft.: _) Page 2 Subdivision: Lot nu.: Water service (no. linear ft.: ) ?age 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF -WORK Backflow preventer Page 2 t AJP1 CT r ,) tke -U.. i 9 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60 c' Ejectors/sump I 16.60 Name: eu ) C 1'C ;„v G) U Expansion tank 16.60 Address: °Toy, 5 ,w. O y'rtarec 5} ' Fixture/sewer cap 16.60 City/State/ZIP: ©i - Xt � ) � � ZZ 3 Floor drain/floor sink/hub 16.60 Phone: ( ) _ l Fax: ( ) Garbage disposal l 16.60 ❑ APPLICANT CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: c t 1 f' Medical gas (value: $ ) Page 2 Address: INGprt/v17o .G .G-ga5E ( ' Primer 16.60 City/State/ZIP: Roof drain (commercial) • 16.60 Phone: (`j ('8) Q - 5cp --� e� 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: Trte:V►Q. O - Water heater 16.60 I Address: Other: City/ State/ZIP: Subtotal Minimum permit fee: $72.50 r Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 ,/Q �'G CCB Lic.: / �' umbing Lic. no.: Plan review (25% of permit fee) �i / � State surcharge (8% of permit fee) ?. // Authorized signature: / TOTAL PERMIT FEE I Print name: i / "` 6t / I Date: ''57/'Y /( 7. . This permit application expires if a permit is not obtaineu within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\ Building \Permits\PLM- PermitApp.doe 12/27 /06 440- 46I6T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard - Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Tom Square Footage: Permit Fee: Footing drain - 1 a 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: Are you capping, adding or replacing fixtures? If "yes", Plan Review for Plumbing Installations please indicate work performed by fixture. Failure to Plan review is required for any of the following. accurately report fixtures could result in increased sewer fees * . Please check all that apply. Quantity by (Future) Work Performed ❑ Any new commercial building with water service 2" and Fixture Type: Replace greater, except systems designed and stamped by licensed Previous Capped Added Existing engineer. Baptistry/Font -Tub/Shower ❑ New exterior plumbing site utilities for any complex structure Bath - ower erlpool as 'defined in OAR918- 780 -0040. - Tub/S Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities. • Drive Thru ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040. Dishwasher - Commercial - Domestic Submit 2 sets of plans with any of the above. Drinking Fountain Eye Wash Isometric or Riser Diagram Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings - 3" that meet the qualifications above. -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 *Note: If the fixture work under this permit results in an - Bradley - 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: • is\ Building \Permiu\PLM- PermitApp.doc 12/27/06 .. TIGARD ' SAND & GRAVEL, LLC. \ ,,-_, i ,___-,)__- , ' e TONQUIN AND STAFFORD QUARRIES P.O. BOX 4810 • TUALATINi•OREGON 97062 PHONE (503) 692-1800 ' • , „ ..:• 1 V7Y,'1,::•,,,,'',.'oss\„1(60 . - 1 TICKET NO.: SOLD TO: DATE:" 54 . ,• INNOVATIVE LANDSCA TIME: PE '5/2A/2007 - • ` • " -- 9630 SW OMARA ST 'JOB NO.: 7 ' 32 .• joB: T 'GARD OR 97223 _ TRUCK NO.: I NN°1)(1717IZIIZI3 ..---.., • DELIVER TO: 9630 SW OMARA ST, T I ORDER NO.: 111611E4 GARD • • .? ... , . 9630 SW OMARA ST, TIGARD, 99W, R-MCDONAL. • 0, L--OMARA i T. G. 655 E-3 - ..-.. _..... :., ' • .' '-''.:.'•.;!`:- -:';' '''i" ''':;' :r4 ' ' '''. ',,' ''' •AIMO TS- . . - . 7 . - :':'' . 4 , 7: ; . , . .- . ,. '• • 446. - ''-' 'I, t-Oiez : ''':•' ''...-176* . .. - 7 9 ; 11.. olv: :7.7' , :tietitt- : atti i, ' - :: ':'- • III? i; ' ' " ''. Ii ,-:.••? ::::.: ..- .1 .,• ' - 46980 : 23060 11.53 9.30 RiER SAND Oth .,...„...„ . 1 . . ... . ..._ 10 46 ...i Net Metric Tons A • .. . D . ' "': . - st • RECEIVED BY: . ...,, _ __........—_-_-,.. • _ . - • . .. WE MAKE DELIVERIES INSIDE THE CURB LINE AND 0 E LOT AT TH - CUS ,) MER'S RISK ONLY AND ACCEPT NO RESPONSIBILITY WHATSOEVER FOR DAMAGE / . • RESULTING FROM SUCH D ALL CLAIMS FOR SHORTAGES . UST BE MADE IN WRITING WITHIN 5 DAYS FROM DATE OF DELIVERY FREE UNLOADING TIME OF 10 MINUTES FOR A SINGLE TRUCK AND 20 MINUTES FOR A TRUCK AND TRAILER IS ALLOWED. EXCESS TIME WILL BE CHARGED AT EXISTING RATES. CUSTOMER COPY / . . z › z m . --, 0 8 ...- c c - ' — -.• ; m 0 N 8 • A • m ci . . _ • < . m co M . , a \ : < 1 5 co m = 1-(_,--" : co ‘..) • -c --- . a 0 , ..--,-.2- 7 --- • Ix ki‘ 'kJ 41x i \ rt• 1 ' 6 ,---'----- ---. -.. v t G\ I‘ 1.4....... ' I t ..-.. v --,,,-• • : -.40‘ ..,: . -.._:,), . R. • \j‘ P • - :.,-- • , a ) cel -I (74 - - • ' — CA >01 , . - v ', 1 -',.- . 1 N Q c, 5 0 . . •,. . i lg ril : a-. ; Nil • 23. c 8 w, \A 0 1. 7 E 5 t r■ t`q 2 es Z rn N "ifil PO 33 44 rrt .., = ag po cv , .. D l'-••• <>. • ' —1 . ' • . • i _q > ,.., -0 1 n ,.... 3: 0 rr, 5 v\ i rii: rri ..i. . .. > Z 144 .... ' X . 4 3 0 o 0 C % . . . • ° A- Affordable Septic Service L.L.C. DEQ #3791$ (503) -682 -1929 CCB #158246 41, t- -"`{, • • P.O. BOX 1130 • WILSONVILLE, OR 97070 r -- PLH-cc/9/ May 21, 2007 • Steve McDill RECE VEU 9630 SW Omara St MAY 2 �+ Tigard, OR 97223 CITY Ur I ttimsiD Re: Receipt for services BUILDiNC.DIVISIQR Dear Mr: McDill • Enclosed you will find the job ticket for services provided by our company and a copy of, the credit card receipt. Please keep the pink copy and the credit receipt for your - records. . Please call with any questions. Thank you for the opportunity to serve you. Sincerely, - / A- Affordable Septic Service, LLC . • • • • • CITY OF TIGARD . BUILDING DIVISION PERMIT #: PLM2007 -00191 13125 SW Hall Blvd., Tigard, OR 97223 _. DATE ISSUED: 5/15/2007 Phone: (503) 639 -4171 / emu ° i ( ' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 5/18/2007 TIME: 7:02AM PAGE: 59 SITE ADDRESS: 09630 SW O'MARA ST CLASS OF WORK: SUBDIVISION: EDGE LOT #: 020 TYPE OF USE: PROJECT NAME: MCDILL DESCRIPTION: Connect existing house to sewer lateral. Septic tank is to be pumped and filled. Sewer Reimbursement District #28 fee paid this date. OWNER: MCDILL, STEVEN & KIMBERLY PHONE #: 503-936-6047 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 5/18/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 048569 -01 503-936-6047 N Corrections /Comments /Instructions: 1% / 0/I 0 , / � _ i 1 ✓mot �� Lj_EASS t9—EARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Phone #: 503 p / • Date: �� ( ) 718-