DashNumberEnd 13280 SW Ash Drive
i
CITYOF 1 i GAR D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: Pt M2003-00063
Li 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/25/03
PARCEL: 2S102CA-00242
SITE ADDRESS: 13280 SW ASH DR
SUBDIVISION: VIEWCREST TERRACE ZONING: R-4.5
BLOCK: 02 LOT: 003 �^ JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP- R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS.
FIXTI1KES LAUNDRY TRAYS: SF RAIN DRAINS:
—� SI,NKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SIEWER LINE: ft
WATER CLOSETS: WATER LINE: :iii ft
DISHWASHERS: RAIN LRAIN: ft
Remarks: Installation of 35'water service. _
_ FEES
Owner:
- Description Date Amount
JANIS WATANABE [I'LUM111 I'cnnit Cee 2/25/03 $72.50
13280 SW ASH DR
TIGARD. OR 97223 [TAX] K 1)
Slate Tax 2!25/03 $5.8
Total $78.30
Phone : 503-598-0)02
Contractor: _
MR ROOTER OF PORTLAND
PORTLAND SERVICES INC
15033 SE MCLOUGHLIN BLVD#344 REQUIRED INSPECTIONS
MILWAL)KIE, OR 972.67 ---- —--- -----
Water Service Insp
Phone : 503-653-5301 Final Inspection
Reg#: LIC 139941
PLM 3-434PR
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 wo-k 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 foLow rules adopted by the Oregon
Issued By: >6� Permittee Signature: -- _
Call (503) 639-4175 by 7:00 P.M. for an inspection needed tete next busin s day
Plumbing Permit Application
Date receiv -Q Permit no. .-(,}gyp
City of Tigard Sewer permit no.: Building permit no.:
AJdress: 1:3125 SW hall 13;vd, Tigard,OR 9722'
Cit),of Tigard Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approvai: • -- Case file no.: Payment type:
U I &2 family dwelling or accessory U Commerci�.Vindustrial U Multi-family Cl Tenant improvement
U New construction U.Additionialteration/replacement U Food service U O(her:
DescriJob address: ,_, � �� yv c� ��( — 2-family
Qt Fec(�a.) 'Total
7-7SFR 1-and 1.-family dn�ellhtgs only:Bldg.no.: Suite no.: �es 100 R.for each utility connection)
Tax map/tax lot/account no.: I')bath
Lot: Block: Subdivision: SFR(2)bath -
Project name: SFF.(3)bath
Citykounty�(,� _ ZIP: 3 each additional bath/kitchen
Description and 1 ion work on premises: Sitewilltles:
� Catch basin/area drain
Est.date of coinpletion/inspection: Doting-ral-n(leach lin trench drain _
Footin drain(no.lin.ft.) _
Manufactured home utilities
Business name: Manholes
A.:Idress: Rain drain connector
Cit): /21LS e: ZIP: Sanitary sewer(no.lin.ft.)
v - Storm sewer(no.lin.ft.)
Phone: � <"5'G Fax: •..r E-mail: - —
umbbus.re no:3113q Water service(no.lin. t.)
. —
CCB no.: fixture or kem:
City/metrolic.no.; la•I"1.03 ��t ° Abso tion valve
Contractor's representative signature: Bac flow revonter
Print name: Date: Backwater valve
Basinsllavatory _
Clothes washer
Narne: L ►\ Dishwasher
Address: _—u Drinking fountains)
City: State: ZIP: Ejectors/sump
Phone: r ? Fax: E-mltil Expansion tank —
Fixture/sewer cap
Floor drains/floor ginks/hub
Name(print): _ n Garbage disposal
Mailing address:�` � <. {}91� f,
_ Hose bibb
City: C V� — State ZIP: 2 Ice maker _
Phone: - Z Fax: E-mail: Interce tor/ rease trap
Owner installation/residentia! maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s), ays(s)
(owners signature: Date: Sum
Tubs/shower/shower pan
Urinal
Name: Water closet _
Address: _ _ Water be
ZIP: �- Other:
Phone: Fax: E-mail: Total
_ _ Minimum fee................$ __��• �_
(Nd all jtviadictlow axept credit cads,please call jurisdiction for mare informss on. Notice:'This permit application Plan review f e.. __ ....
G visa U MasterCard expires if a permit is not obtained
within Igo days after it his been State surcharge(8%) ....$
Cttxtit card numt+.r� �—_.— .— — e�- G
-. --•--- accepted w complete. TOTAL .......................$
Nano d:atr9tolder u shrnvn on credit cant
-.---�Csrdhdda dpwutc ----� S Amuum_4 4104616(&WCOM)
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PLUMBING PERMIT FEES:
PRICE TOTAL_ New 1 and 2-family dwellings only:
FIXTURES Individual) + QTY e� AMOUNT I (includes all plumbing fixturas 1n 7 PRICE TOTALSink 16.60 the dwelling and the first100 ft. QTY�(ea) AMOUR'
Lavatory 16.60 - for each utility conrjction
Tub or Tub/shower Comb. - Ono 1 bath x249.20
6.60 _ Two 2 bath $350.00
Shower Only - 16.60 Three 3 bath
Water Closet 16.E0
Urinal �- SUOTOTAL
18.60 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL _
Garbage Disposal - e 16.60 TOTAL-
Laundry
OTALLaundry Tray - 16.60
Washing Machine Y 16.60
Fleur Drain/Floor Sink 2" 16.60
-7-- -- 16.60 - - PLEASE COMPLE'T'E:
4" - 16.60
Water Heater O conversion O like Lind 16.60 uantlty b ir Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 _Slnk
MFG Home New San/Storm Sewer 46.40 Lavatory - - --
Hoar,Bibs 18.60 Tub or Tub/Shover
___ Combination _
Rcof Drains 16.60 Shower Only
ririnking Fountain 16.60 Water Closet _
Jthwr Fixtures(Specify) 16.60 Urinal
--- Dishwasher _
-Garbage Disposal
Laundr
y Room Tray _
Washing Machine
Sewer-1st 100' 55.00 Floor Drain/Sink: 2"
3"
Sewer-each addilloneI 100' 46.40 4"
Water Service-'et 1r0' 55.00 Water Heater
Water Sewica-with additional 200'-'--- 46.40 - Other Fixtures
s{�ea
Storm&F,ain Drain-ist 160' _ 55.00
Storm&Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40 _
Re,Idential Backflow Prevention Device' 27.55
Latch Basin 16.60 _ ----
Inspection of Existing Plumbing or Specially 6250
Requested inspections _e,R r _ COMMENTS REGARDING ABOVE:
I lain Dr, i,single family dwelling 65.25
CrFaseTraps 16.60
QUANTITY TOTAL - -- -- - - -.._-
_ ---
Isometric or riser diagram Is required If -
Quantity Total Is >e
`SUBTOTAL _-
8%STATE SURCHARGE _
"PLAN REVIE-/Y 25%OF SUBTOTAL
Required only If fixture qty.total is>9 _
TOTAL
Minimum permit permit fee Is$72.50+8%state sucharge,except Residential Backflow
Prevention Device,which Is$36.25+8%state surcharge
.*All Now Commercis!Buildings require 2 sets of plena with Isometric or riser
diagram for pla-r review.
is\dsL;\form<#m-fees.doc 12/28/01
PLUMBING PERMIT FEES:
r PFcICE _ TOTAL New 1 and 2-family dwellings only:
l FIXTURES (individual) nTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUf
for each utility connection
16.80
Lavatory Y _ One 1)bath $249.20
Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00
Shower Only 16.80 Three(3)bath $399.00
Water Closet -� 18.80 - SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE
Dishwasher 16.60 FLAN REVIEW 25%OF SUBTOTAL _
- TOTAL
Garbage Disposal 16.60 - -
Laundry Tray 16.60
WFsufng Machine 16.60
Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60 _
Quantity b ir Work Performed
Water Heater O conversion O like kind 16.60
Fixture
Gas piping requires a separate mechanical Typo: New Moved Replaced Removed/
permit.
- Ca ed
MFG Home New Water Service 46.40 Sink Tub
or -
Lav
MFG Home New San/Storrs Sewer 46.40 T
_ -- Tub or Tub/Shower
Hose Bibs 16.80 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain - 16.60 Water Closet
16.60 Urinal
Other Fixtures(Specify) Dishwasher _
Garbs a Dls oral
Laundry Room Tray
----
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 at 100' 55.00 3"
Sewer-each additional 100' 46,40 4„ _
Water Service-1 st 100' J 55.00 Water Heater
Other Fixtures
Water Service-each addltlonal 200' 46.40_ _ Sed
Storm&Rain Drain-1st 100' 55.00
Storm 6 Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 62.50
Requested Inspections _ er/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 _
Grease Traps 16.60
QUANTIT f TOTAL
Isometric or cher diagram Is required If
Quantity Tota)Is >g --'-�
"SUBTOTAL
8%STATE SURCHARGE -
"PLAN REVIEW 25%OF SUBTOTAL
Requlred only if fixture gly.total is>9 _
TOTAL a
"Minimum parmlt fee Is$72.50•A%state surcharge,except Residential Backflow
Prevention Device,which Is$:1925*A%state surcha ge
'"All New Commercial Buildings require 2 soft of plans with Isometric or riser
diagram for pian review.
i:\dsts\forms\plm-fees.dac 12/26/01
CITY OF TIGARD 24-Hour
BUILDING; Inspection Line: (503)634-4175
INSPECTION DIVISION Business Line: (505)639-4171 MST --
/ BUP --- - -
Received �_ gate R quested �'��'tiP AM__—_-- PM BUP
Location __-- Z$� _ _-- -------Suite_..__- MEC
Contact Person _ —
—� ---- _-- - Ph PLM --Contractor Ph.._.._._-- -------- ---- Ph ( ) _ SWR
BUILDING TenanVOwner - __--_ ELC
-
Fcoting --
Foundation Access: ELC
Ftg Drain ELR
Crawl Dram - -- -- ---
Slab Inspection Notes: SIT'
Post& Beam
Shear Anchors -- ---
Ext Sheath/Shear
Int Shedth/Shear - — -
Framing
Insulation —
Drywall Nailing
Firewall
Fire Sprinkler -•_- KX -�(/ ,✓ fiL
Fire Alarm �✓
Susp'd Ceiling ---
Roof
Other:
Final
PASS PART FAIL — �— -
PLUMBING
Post& Beam _ 7
Under Slab �ca
Rough-In
Sanitary Sewer
Rain Drains
Catch Basin/Manhole j
Storm Drain -- _
Shower Pan
Other: — — --
� L
PA S_PART FAIL - --- `--`—
CHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL -------- --- __-- -- ..
ELECTRICAL
Rough-In
UG/Slab - --
Low Voltage
Fire Alarn ----- --------- ------- -- ---
Final I Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd.
PASS PART FAIL
SITE _ [j Please call for reinspection RE:--- _._. — -__- __ -� Unable to inspect-no access
Fire Supply Line i
ADA J
Approach/Sidewalk Dante - Inspector Ext
�__
-� _---- Extr
(ether: ///
Final DO NOT REMOVE this Inspectloir4ecord from the Job site.
PASS PART FAIL.