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Permit (24) CITY OF TIGARD PLUMBING PERMIT 741 COMMUNITY DEVELOPMENT Permit#: PLM2016 00387 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2016 Parcel: 2S 104AA14300 Jurisdiction: Tigard Site address: 12150 SW 128TH AVE Project: Zapp Subdivision: BELLWOOD NO.3 Lot: 162 Project Description: Installation of residential backflow preventer for irrigation. Contractor: DENNIS'SEVEN DEES LANDSCAPING INC Owner: ZAPP, MICHAEL J&CAROLEE A 7355 SE JOHNSON CK BLVD 12150 SW 128TH AVE PORTLAND, OR 97206-9329 TIGARD, OR 97223 PHONE: 503-777-7777 PHONE: FAX: 503-777-2399 FEES Quantity Description Date Amount 1 ea Backflow Preventer 07/20/2016 $31.27 Specifics: 1 12%State Surcharge- 07/20/2016 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 07/20/2016 $41.23 Plumbing Class of Work: OTR 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 que ,OUNC by calling 503.232.1987 or 1.800.332.2344. Issued y: Uref)("A....)0_14 Permittee Signator i, �� ' Jeer(' • 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 /6/3,9-(c /do 5-//f Site Utilitiesv FOR OFFICE t SF: ONLY City of Tigard : r Received l Permit No.:, .. 2��y,-� III 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: 7 ea /lo / �O�ls �3° 7 1 Phone: 503.718.2439 Fax: 503.598.1960 ?,'elan Review Other Permit No.: ti`,` Date/By: 7 i G^R D Inspection Line: 503.639.4175 -l dy/By: loris: to See Page 2 for Internet: www.tigard-or.gov - 'altlhtlffed_,ethod: Supplemental Information „moto sur .,, .-_. __.. _ > ,., :�». . � - �'.- ❑New construction 0 Demoliticir For special information use checklist Description I Qty. I Ea. I Total ❑Addition/alteration/replacement ®Other:LANDSCAPE New 1-2-family dwellings(includes 100 ft.for each utility connection) , E '` o :.,fit t;w. 041,4),,,,,:7„,„737,,i.1 ;' , SFR(1)bath 312.70 ® 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 ta , ,: *, i B 1 , . �c Site utilities: '''''*4,,;,..t6;-,,'V Job site address:12150 SW 128TH AVE Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name:ZAPP 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.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 F Backwater valve 12.51 Clothes washer 25.02 INSTALL BACKFLOW PREVENTER Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 4 Expansion tank 12.51r t ' w Fixture/sewer cap 25.02 Name: Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 �� 1 sst� , .. t mediIntercal ga (vase lue: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 � , x • Water closet�` , �tl , rt <; - e 25.02 . d ' Water heater 37.52 Business name: Water piping/DWV 56.29 Dennis'Seven Dees Landscaping, Inc. Address: 7355 SE Johnson Creek Boulevard Other: 25.02 City/State/ZIP: Portland, OR 97206 Subtotal 503.777.7777/503.777.2399 Minimum permit fee: $72.50 72.50 Phone:( ) 7d i d tiffan b ennsees.com Y @ Plan review (25%of permit fee) CCB Lic.: Icb:5009 plumb lic:05LIBDI State surcharge(12%of permit fee) 8.70 Authorized signature: ---- TOTAL PERMIT FEE 81.20 Print name:TIFFANY BRIGHT Date:7/6/16 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(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su s 'ression S stems: _ 7°,1'7;cps,FT-Mi ttirmsi prkvist 4 Footing drain-l'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 neater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 , . Storm&Rain Drain-1st 100' 62.54 �1 _r.* $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 each additional$100.00 or fraction thereof,to and includin_$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$100.00or fraction thereof,to (minimum char•a-1/2 hour) anddincludin:$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 char:e-2 hours each additional$100.00 or fraction thereof,to Reinspection Fees _ 90.00/hr and includin_$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 char_e-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*. _ £ Y Plan review is required for any of the following. Please check all that apply. Baptistry/Font pp y 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 Thm ❑ 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" Car Wash Drain Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the 'ualifications 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 *Note: If the fixture work under this permit results in an Washer-Clothes 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: http://www.tigard-or.gov/document_center/Building/PLMU_PermitApp.d2c 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 12150 SW 128TH AVE, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2016-00387 Don Sylvester Violation Summary: Inspector Contractor