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Permit CITY OF TIGARD PLUMBING PERMIT 111 ' COMMUNITY DEVELOPMENT Permit #: PLM2013 00439 T t G A P J) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/31/2013 Parcel: 2S 102 D 600800 Jurisdiction: Tigard Site address: 13140 SW ASH AVE Project: HARDWICK Subdivision: BURNHAM PARK Lot: 2 Project Description: Repairing 60 ft. of sanitary sewer. Contractor: ROOT EXCAVATION Owner: HARDWICK, JEFFREY W & ERIN E 10824 E OAK ST 1809 AMBAS DR MILWAUKIE, OR 97222 LAKE HAVASU CITY, AZ 86403 PHONE: 503 - 656 -6610 PHONE: FAX: 503 - 656 -6625 FEES Quantity Description Date Amount 60 If Sewer Service 12/31/2013 $62.54 Specifics: 1 12% State Surcharge - 12/31/2013 $8.70 Plumbing 10 ea Minimum Fee Adjustment - 12/31/2013 $9.96 Type of Use: SF Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: , •mittee Signature: 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 Building Fixtures �� FOR OFFICE 1 SE ONLY City of Tigard Received Permit No.: h' g c ' � DateB id ) /1 3 q- ,ry/y�ao t 3 - ao 13125 SW Hall Blvd., Tigard, OR 972 % ✓ \� J / � ��� 1 �O plan Review I a Phone: 503.718.2439 Fax: 503.598. % 1 Date/By: Other Permit No.: Inspection Line: 503.639.4175 T I G A R I? O PQ� Date Ready/By: tuns ® See Page 2 for Internet: www.tigard or.gov O G `� 9 ot i fied/Method. '1" Supp Information TYPE OF WORK G �� � (. M��`` + )` FEE* SCHEDULE ❑ New construction ❑ Dem 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 (l) bath 312.70 1- an 2-family dwelling SFR (2) bath 437.78 ® y g ❑ Commercial/industrial ❑ Accessory building ❑ Multi- family SFR (3) bath 500.32 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: 13140 SW Ash Drive Catch basin or area drain 18.76 City /State /ZIP: Tigard Oregon Drywell, leach line, or trench drain 18.76 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: CA-ft- Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: 611) 1 Page 2 Q .51A. Storm sewer (no. linear ft.: __) Page 2 Water service (no. linear ft.: , ) Page 2 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 Repair the on property residentian sanitary sewer line Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Maggie /' t ••et Fl 25.02 1 Floor drain/floor sink/hub 25.02 Address: 13140 SW Ash Druve Garbage disposal 25.02 City /State /ZIP: Tigard Oregon Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker I 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Root Excavation Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Bridget Roof drain (commercial) 12.51 Address: 10824 SE Oak Street # 322 Sink/basin/lavatory 25.02 City /State/ZIP: Milwaukie Oregon 97222 Solar units (potable water) 62.54 Phone: (503) 656-6610 I Fax: : (503) 656 -6625 Tub/shower /shower pan 12.51 E -mail: bridget @raglandsinc.com Urinal _ 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Root Excavation Water P i to WV 56.29 Address: 10824 SE Oak Street # 322 Other: 25.02 City/State /ZIP: Milwaukie Oregon 97222 Subtotal Phone: (503) 656 -6610 Fax: (503) 656 -6625 Minimum permit fee: 572.50 l 66 CCB Lic.: 134498 Plumbing Lic. no.: 3 -433pb Plan review (25% of permit fee)_ State surcharge (12% of permit fee) E1 Authorized signature: TOTAL PERMIT FEE Print name: Bridget Wilson Date: 12/26/2013 I This permit application expires if a permit is not obtained withi ti ( a� '- after it has been accepted as complete. *Fee methodology set by Tri - County Building Industry Service Board Plum binE 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 62.54 3,601 to 7,200 $233.20 Sewer - 1st 100' 62 t 601.1i/ 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 Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $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 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: ( 1 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 * . Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ d for review is required an of the following. Performed: Capped Added Relocate q any flli g' Baptistry/Font Please check all that apply. Bath - Tub /Shower ❑ Any new commercial building with water service 2" and - Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser Diagram Car Wash Drain Garbage - Domestic - non - food ❑ Isometric or riser diagram is required for new buildings Disposal - Domestic - food related that meet the qualifications above. - Commercial -food related - Industrial -food related Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lav - Non -food related - Bradley - Commercial -food related - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this permit results in an Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet - Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: CITY OF TIGARD PLUMBING PERMIT 111 Permit #: PLM2013 -00439 » COMMUNITY DEVELOPMENT Date Issued: 12/31/2013 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S102CA00230 Jurisdiction: Tigard Site address: 13140 SW ASH DR Project: HARDWICK Subdivision: VIEWCREST TERRACE Lot: 15 Project Description: Repairing 60 ft. of sanitary sewer. 1/2/2014: REPRINT permit to correct site address from Ash Ave to ASH DRIVE. Contractor: ROOT EXCAVATION Owner: HARDWICK, JEFFREY W & ERIN E 10824 E OAK ST 1809 AMBAS DR MILWAUKIE, OR 97222 LAKE HAVASU CITY, AZ 86403 PHONE: 503 - 656 -6610 PHONE. FAX: 503 - 656 -6625 FEES Quantity Description Date Amount 60 If Sewer Service 12/31/2013 $62.54 Specifics: 1 12% State Surcharge - 12/31/2013 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment - 12/31/2013 $9.96 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to O NC b Ding 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: a(' 9 e- Q 7 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. Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 13140 SW ASH DR, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing final PASS - No C of O April 16, 2015 at 8:26:05 AM PLM2013-00439 George Heimos Camera of repair provided to Plumbing Department and passed. Violation Summary: Inspector Contractor