Permit rte'
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.1 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00014
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/16/2008
PARCEL: 2S104CA -05800
SITE ADDRESS: 13637 SW WESTRIDGE TERR ZONING: R -7
SUBDIVISION: HILLSHIRE LOT: 058 JURISDICTION: TIG
PROJECT: JOHNSON
Project Description: Tankless water heater install.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 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
MICHAEL JOHNSON Description Date Amount
13637 SW WESTRIDGE TERRACE
TIGARD, OR 97223 [PLUMB] Permit Fee 1/16/2008 $72.50
[TAX] 12% State Surch 1/16/2008 $8.70
Phone : 503 -524 -4027 Total $81.20
Contractor:
ROB'S SUPERIOR PLUMBING INC.
23701 SE ELM STREET
SCAPPOOSE, OR 97056 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -543 -8792
FAX 503 -NA
Reg #: LIC 163779
PLM PB5 -54 •
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1 800.332.2344.
Issued By: Permittee Signature• P � �
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i.• r
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
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- City Tigard Vim :^ D a te/Bydl /!b ry /x.
/0 �� �+ 6 0 Ai3 Permit 2 ,_� Q/`Y
v 13125 SW W Hall Blvd , Trgar i •f • :- ;,
Plan Revie
Date/By
IN
Phone 503 639 4171 Fax 503.$Q8 6 008
Other Permit No
JJ H
T I G A k ll Inspection Line 503 639 4175 Date Ready/By lur ®See Page 2 for
Internet www.tigard -or gov Gay O 11G RD / Notified/Method Supplemental lnformahon
TYPE OF fi, `a+, 13GolVlS FEE* SCHEDULE
For special information use checklist
(J New construction ❑ Demolition
Description Qty I Ea I Total
M Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249 20
11 1- 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 1'1 C ) - S ( ots.v_v_ J e <- /,q Catch basin or area drain 16 60
City /State /ZIP. —1-. 1 5J2 c. L 2
L I e1 2.5 C� Drywell, leach line, or trench drain 16 60
Sutte/bldg./apt. no.: Project name. -- .. c b t ! �� O , , Footing drain (no linear ft ) Page 2
Vi "V� Manufactured home utilities 110 00
Cross street/directions to job site:
Manholes 16 60
1 yl _ 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 Backflow preventer Page 2
L1 _ .I , _ :.e '- e' . PIT Backwater valve 16 60
-
Clothes washer 16 60
Dishwasher 16 60
PROPERTY OWNER I ❑TENANT
Drinking fountain 16 60
(-1 Ejectors/sump 16 60
Name: ■ (/...t. 't (-1 V ` So" Expansion tank 16 60
Address: ) 3 ( 3 ") 5 C�•LS 1- W C �(� � , 4.6. Fixture /sewer cap 16 60
City /State /ZIP: +��"� I Oct q- i ( L E 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: r q_ -
u�Q �i�-'U� �� 11 W' �"- —�fi�� Interceptor /grease trap 16 60
Contact name/ , 0 g
A . Y �_ / .... > Medical gas (value. $ ) Page 2
.
Address: 3 -2 0 I .S' cA S / Primer 16 60
Sink/basin/lavatory s t90 s_s_...)2_ c `i art Roof drain (commercial) 16 60
3 ) C �� Q 1 ( l ) Sink/basin/lavatory 16 60
Phone: J O Fax. .
Tub /shower /shower pan 16 60
E -mail:
Urinal 16 60
CONTRACTOR Water closet 16 60
Business name. + I S , L l r." Water heater 16 60
Address "y-7,0 i S 4 (k t� s..4. Other.
„„ _ n ii Os —/ Subtotal
City /State /ZIP: „ o , ten tl � ._ UVr - 1 ) to
Minimum permit fee $72 50
Phone: (a ) ) ( 5`1, 1 - .n 'f (� 2 Fax: ( ) 4.1' Residential backflow minimum permit fee $36 25 7.50
Plan review (25% permit fee
CCB Lic.: *� g. OA Plumbing Lic. no , ^_ ( P )
State surcharge (12% of permit fee) 9'.70
Authorized signature: IV" �. X7.,,0
l , � r TOTAL PERMIT FEE
Print name: ` .� , 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 Tn -County Building Industry Service Board
I \Buddmg\Perm(ts\PLMF- PermitApp dot 12/27/06 440- 4616T(10/02 /COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: ResidentialIFire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage:, Permit Fee:
Footing drain - 1' 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001ao 3;600A $160 00
$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 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 *. 12 Any new commercial building with water service 2" and
Quantity by (Fixture) Work Performed . greater, except systems designed and stamped by licensed
Fixture Type: - Replace engineer
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 D
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" 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
- 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 \Bu lding \Pern=\PLM-PermnApp doc 12/27/06
CITY OF TIGARD .
..
BUILDING DIVISION PERMIT #: (ELM200B -0 014
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ifienuo
Phone: (503) 639 -4171 A p,l
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �..
INSPECTION WORKSHEET FOR DATE: 1/17/2009 TIME: 7 PAGE: 42
SITE ADDRESS: 13537 SW 1MESTRIDGE TERR CLASS OF WORK: -- i
SUBDIVISION: HIE LSHIRE LOT #: 050 TYPE OF USE:
PROJECT NAME: JOHNSON
DESCRIPTION: TanWess water heater install.
OWNER: JOHNSON, MICHAEL PHONE #: 503-524-402/
CONTRACTOR: ROB'S SUPERIOR PLUMBING INC.. PHONE #: 503.543- -8792
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
396 Plumbing final 063410 -01 503 -257 -7853 N
Corrections /Comments /Instructions:
C'6u c, AZ-N.:L-494—i
XPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ME \/11 th -v..6-. Date: 1 1111'0S Phone #: (503) 718-