Permit y u CITY OF TIGARD PLUMBING PERMIT
• �'1' � :. v COMMUNITY DEVELOPMENT Permit #: PLM2013 -00095
• TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/21 /2013
•
Parcel: 2S103AD00401
Jurisdiction: Tigard
Site address: 10880 SW ERROL ST
Project: Sevick Subdivision: ECHO HEIGHTS Lot: 13
Project Description: 50' of water service and repipe only of house, not the structure in rear of property.
Contractor: REA MECH INC Owner: SEVCIK, SHASTA TRUST
30330 SW GRABEL RD. BY REINDEL, DONNA J TR
HILLSBORO, OR 97124 16810 VALLEY RD
AUBURN, OH 44023
•
PHONE: 503 - 969 -6252 PHONE:
FAX: 503 - 640 -9344
• FEES
Quantity Description Date Amount
50 If Water Service 03/21/2013 $62.54
Specifics: 1 ea Water Piping /DWV 03/21/2013 $56.29
1 12 %State Surcharge - 03/21/2013 $14.26
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const: -
Occupancy Grp:
Stories:
Total $133.09
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N• ' a ion - • -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or di • ct questions to OUN • calli ! • 503.232.1987 or 1.800.332.2344.
• I-sued By: / � rub Permittee Signature: /71.4a0
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Plumbing Permit Application
Fixtures NVI I ON FOR OFFICE USE ONLY
QaV9I17 V / 1I J Recei _
City of Tigard Date/By: 3 a / ( � ' , Permit No.: , f , j - 06O
FS
lig v 13125 SW Hall Blvd., Tigard,OR 97,2�2�7 T v�./IAI Plan Review
0 Phone: 503.718.2439 Fax: 503.5 1�1 60 lb a V I'r Date/By: Other Permit No.:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF FEE* SCHEDULE
❑ New construction ID Demolition For special information use checklist
Description I Qty. I Ea. I Total
g Addition/alteration /replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
0 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I c06 g O s1/4.0 e rro 1 S } Catch basin or area drain 18.76
City /State /ZIP: - 7'1 (�Y ` Drywell, leach line, or trench drain 18.76
S S. LL Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: d € 0 Cl V--\ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: SO) Page 2 (920
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
r °L,..`) 4X.,+ e r Se_ Ell c%e_ Dishwasher 25.02
"\2.wI W c.-t k-ei+- e P e Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State /ZIP: Hose bib ..- 25.02
Phone: ( ) Fax: ( ) Ice maker1
12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
t � Water heater 37.52
Business name: Itec,oniec� 1 h C Water piping/DWV / 56.29, 3
Address: 3 033 0 ,9 ( i (Z a Other: 25.02
City/State /ZIP: 1-.%1 \k S‘31... C c -7 ( � 3 Subtotal i/q • 6 J
Phone: 6 ) 9 y _� Z 5 Z Fax: 607 ) ( 934 Minimum permit fee. $72.50
CCB Lic.: l g y 3 / Plumbing Lic. no.: 34- 3gq PC review (25% of permit fee)
4
State surcharge (12% of permit fee) / el .
Authorized signature: TOTAL PERMIT FEE l
This permit application expires if a permit is not obtained withirl" 180 days
Print name: Y1/1't G �,,� I v Date: j L 1 -1 3
after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1: \Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(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) Total Square Footage: Permit Fee:
Footing drain - 1 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
p and including $10,000.00.
Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font
CI Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
Bath: - Tub /Shower
- Jacuzzi/Whirlpool engineer.
12 Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918- 780 -0040.
El Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918 -780 -0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: - 2"
3" Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non -food that meet the qualifications above.
Disposal: - Domestic food related
- Commercial food related
- Industrial food related
Ice Mach./Refrig. Drains Comments regarding fixture work:
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non -food related
- Bradley
- Com/Serv/Util food related
- Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10880 SW ERROL ST, TIGARD, OR, 97223
Residential - Plumbing
320 Plumbing rough-in
03/27/2013 00:00
PLM2013-00095
FAIL
1. Proof of electrical grounding required when replacing metal water piping with plastic
604.8. (You will need to have an electrician get an electrical permit and have his work, if
any, inspected and approved).
2, freeze protection, needed at: crawl space to protect new water pipe in unconditioned
space 313.6
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10880 SW ERROL ST, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
06/04/2013 10:50
PLM2013-00095
FAIL
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10880 SW ERROL ST, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
06/04/2013 10:50
PLM2013-00095
FAIL
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10880 SW ERROL ST, TIGARD, OR, 97223
Residential - Plumbing
330 Water service
06/04/2013 00:00
PLM2013-00095
FAIL
1. Electrical minor label is not allowed for use on electrical grounding. The OAR's
require that an electrical permit be pulled for an inspection. If you have any questions,
please call Jeff Grove, electrical inspector for the City at, 503-367-0492.
George H.
Violation Summary:
Inspector Contractor