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Permit CITY OF TIGARD PLUMBING PERMIT • COMMUNITY DEVELOPMENT Permit#: PLM2014-00298 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/03/2014 T I t'A �� g Parcel: 1 S134AD07400 Jurisdiction: Tigard Site address: 10569 SW WINDSOR PL Project: SNODGRASS Subdivision: WINDSOR PLACE Lot: 11 Project Description: Backflow for irrigation. Contractor: OWNER Owner: SNODGRASS,JONATHAN JOHN SNODGRASS 10569 SW WINDSOR PL 10569 SW WINDSOR PL TIGARD,OR 97223 TIGARD,OR 97223 PHONE PHONE: FAX: FEES Quantity Description Date Amount 1 ea Backflow Preventer 09/03/2014 $31.27 Specifics: 1 12%State Surcharge- 09/03/2014 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 09/03/2014 $41.23 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 0 .; •. •• . Issued By: /� � ittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available.' -pection 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. USE ONL1 Cl of Tigard r;j. Received Permit No is ipq g V Date/By: '1 3 u V1 1J Ili vC' It 13125 SW Hall Blvd.,Tigard,OR 9r Plan Review 1 a. Phone: 503.718.2439 Fax: 503.598.1960 I-°N Date/By: Other Permit No.: T I G A R D Inspection Line: 503.639.4175 `Q Date Ready/By: Juris ® See Page 2 for Internet: www.tigard-or.gov S I.l4 \) tNootified/Method: 7' f Supplemental Information tiV TYPE OF WORK �[++ rcY V 1��`'x51�1� FEE* SCHEDULE ❑New construction ❑Dern*f jpl�G��,l For s,eciai in ormation use checklist. UV Description Qty. Ea. Total ❑Addition/alteration/replacement Etta •t L t it,'ITr 4 t f .k h.. 1.4) New 1-2-family dwellings(includes 100 ft.for each utility connection)_ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 , 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 TION AND LOCATION Site utilities: Job site address: I QS6' S i ink N OSO( P , Catch basin or area drain 18.76 City/State/ZIP: �'11;1t-(L 0 /0 R /q 7 aa3 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: n �ljti,cj�ss Manufactured home utilities 50.03 Cross street/directions to job site: i'�of(Tti Oh h+0 +-7V+� ' 106T4 r" Manholes 18.76 W■N OS v a t.- Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.: ) Page 2 '1 Water service(no.linear It.: ) Page 2 Subdivision: W%N O56 A ?1_, I Lot no.: `1 Fixture or item: Tax map/parcel no.: & t y l q as 0 Backflow preventer 1 31.27 3 L.X? DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 7. N5,-ocLk..err rcA 0 F Ica-‘(../4-114)./4 toRLk14.47o,•J Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Name: �s Fixture/sewer cap 25.02 JOB rJ J NaDG gAs.s Floor drain/floor sink/hub 25.02 Address: 10c6't 51J h11 A p5iatt 1)(, Garbage disposal 25.02 City/State/ZIP: -Motto /Q& /47?).3 Hose bib 25.02 Phone:(5 6 5 ) CI b c i- 5( a 4, Fax:( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: �,r M I` Medical gas(value:$ ) Page 2 U`'` Q �s G44,�c�� 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 Water heater 37.52 Business name: /4)ASC-r Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 3l.a7 Phone:( ) Fax:( ) Minimum permit fee: $72.50 72_50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) '"---- State surcharge(12%of permit fee) $ 7 b J Authorized signature: ��/ TOTAL PERMIT FEE V).01,D Print name: 014!y sr,�OK�ttES Date: 1/3/11 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. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02JCOM/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- 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 h 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 ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. 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) 0 tiJ 4L•a- I,J merit op BAULELt;a t-eK- Rec.Vehicle Dump Station UMW.) Shower: -Gang -Stall Sink: -Lav/Bar 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 WaterCloset-Toilet plumbing permit can be issued. Urinal Other Fixtures: L:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical,and plumbing per mits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Print Name of Permit Applicant /3/14 Signatu Permi •pplicant Date Permit#: Pan" ao Address: /OS J w • WiL'v r°L. Issued by: 0' • Date: 1/VV �'>< This Copy for Permit Offices 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 10569 SW WINDSOR PL, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2014-00298 George Heimos 1" model 850, serial no. HD43429 Violation Summary: Inspector Contractor 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 10569 SW WINDSOR PL, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal FAIL PLM2014-00298 George Heimos 1. Back ﬂow device: provide lawn irrigation device backﬂow test results. 603.3.3 2. Recall inspection when corrections have been completed. Re-inspection required. 103.5.6.1 All else ok snoodgrass.john@live.com Violation Summary: Inspector Contractor