12360 SW JAMES COURT i
N
W
rn
Cl
D
m
cn
12360 SW JAMES St
01F ������ PLUMBING PERMIT
CITY �
DEVELOPMENT SERVICES PE-SSUEIVIT �: 1//17003 oa5�6
DATEISSUED: 11/17/03
1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S103C6-01400
CITE ADDRESS: 12360 SW JAMES ST
SUBDIVISION: WILLAMETTE ZONING: IG
BLOCK: _ LOT: 039
JJURISDICTION: TTIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: H3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_---FIXTURES LAUNDRY TRAYS: 3F RAIN DRAINS:
—SINKS URINALS: GREASE T1 +PS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: tt
WATER CLOSETS: WATER LINE. 74 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 74ft. water line. —
_ _---FEES _ --
Owner: - — Des^ription Date Amount
FITZPATRICK, WESLEY RUTH �I'LUMBI I'ernui I rr 11/17/03 $72.50
12360 SW JAMES ST g� titatr Surrhar, 11/17/03 $5.80
TIGARD, OR 97223 — _ —
Total $78.30
Phone
Contractor:
HD PLUMBING
PO BOX 61651
VANCOUVER, OR 98666 REQUIRED INSPECTIONS
Water Line Insp
Phone : 1(,()-887-4559 Final Inspection
Reg #: I.IC 151697
111 %4 26-7261113
This pei mit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Issued By: - �r3 � _ _ Permittee Signaturey -�,�= -�
Call (50:3) 639-4175 by 7:00 P.M. for an inspection needed the next business day
vim
Building Fixtures
Plumbing, 'ermit Application ReceivedPinmhinE
Date/13y/ Permit Nu..��/11� r
Planning pro al Sewer
City of Tigard Date, : Permit NO..
13115 SW Hall Blvd. Plan Review Other
ate/By: Permit No.:
Tigard,Oregon 97223 Post-Review land Use
Phone: 503-639-4171 Fax: 503-598-1960 _T Datc/B y. Case No.: —
Internet: www.ci.tigard.or.us Contact ugSee Page 2 for
24-hour inspection Request: 503-639-4175 Namur/Method: 1 supplemental Information.
TYPE OF WORK FEE*SCHEDULE(fors ecial info mation use checklist
- Description Ot;'. Fee(cn•) Total
New construction Demolition - �—
New i-&2-family dwel Ings
Addition/alteration/re lacers [�Other. (includes too ft.f6r each utlllt•Cal neclion
CATECOWY OF CONSTRUCTION SFR(i bath 249.20 _
1 &2-Family dwelling_ Commercial/Industrial SFR 7_ bath 350.00
Accessory Building Multi-rami! _ SFR 3 bath _ 399.00 _
Mostcr Builder
Other: Each additional bath/kitchcn 45.00 JOB SITE INFORMATION and LOCATION Fire sprinkler-sq.fl.: Page 2
Site Utilld 5 _
Job site address: Catch basin/arca drain 16•60
Suite M. Bldg/�A it'#' Dr ell/leach line/trench drain 16.60
Project Name: Footin drain nolinear fl. Pae 2
Cross street/Directions to job site: Manufactured home utilities 11110.00
Manholes 16.60
Rain drain connector 16.60
Sanitar sewer no. linear fl.) Pa e 2
Storm sewer no. linear fl. _ 11 �'2
Subdivision: Lot#: Water service no. linear fl. Pa a 2_
'Fax ma / arcel #: _ Fixture or Item
DESCRIPTION OF WORK Ab sor tion valve 16.60
Backflow prcventer _ _ Page 2
_,_..___�---------- --- --J Backwater valve _ 16.60
--"— Clothes washer _ _ 16.66
Dishwash:. 16,60
— Drinking fountain 16.60
PROPERTY OWNER TENANTE'cctors/sum — 16.60
,L(`/ Expansion tank 16.60
Name: �'S - �� —_ 16.60
Fixture/sewer cap
Address: /,Z 3�Q -- Floor drain/floor sink/hub _ 16.60
Cit�/State/Zi : t*— �� Garbs a dis oral 16.60 _
Phone- t Fax:�_— --- Hose bib _ 16.60
APPLICANT CONTACT PERSnN Ice maker _ _ _ 16.60 _
Interceptor/grewce trap 16.60
Name: t,%�� ti' --- – Pae 2
Mcdical2as-valur S
Address: C Fr mer 16.60
city/State/Zip: iC /wi4 i° R(of drain(commercial) 16.60
Phone:34D Jq r"y�Ss �' Fax:-_ Sink/basin/lavatory IG.GO
Tu)/shower/shower pan r 16.60
E-mail_ _ 16.60
kWratct
CONTRACT R closet 16.60
Business Name: -- - - heater 16.60 _
Address: — _Cit /State/Zl -
Plumbing Permit Fees" —.—
Phone: :, (�- Fax: ( 62�27,�266
Subtotal
CCB Ll C. #: ' ��/ Plumb. Li(. Minimum Permit Fee$72 50 S
Authorif" ��-- 7-/yam Residential Backflow Minimum Fee$36.25
Slpaaentg" _. �•l_ Date: % Cis --
1J �_ Plan Review 25%of Permit Fee) S
r,� n Stetc Surchar c 8%of Permit Fec S
_ TOTAL.PERMIT FEE s —_
(Please print name)
Notices This permit apPllcatlon expires If a permit is not obtained within All new cnmmerelal hulldings require 2 sets of plans with Isometric or
180 days after it has been accepted as complete. riser diagram for plan review.
•Fee methodology ser by'1'rI-('pent} Building Industry Service Board.
i:\Usts\permi:Forms0mPermitApp.doc 01/03
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
F-e Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ca) Total S ware Footage: Permit Fee:
Footing drain-I" I(N)' 55,00 0 to 2,000 $11500
Footing dt..m-each additional 100' 46.40 2,001 to 3,600 $160.00 _
3,601 to 7,200 $220.0
Sewer- 1st 100' -55.00 7,201 and greater _ $309.00
Sewer-each additional 100' 46.40
Water Service-Ist I(V 55.00 Medical GaS SStMS:
Water Service-each additional 100' 46.40 Valuation: Permit Fee:
Storni&Rain Drain-1st 100' 55.00 $1.00 to$5,000.00 Minimum lee$72.50
Storm&Rain Drain-each additional 100' 46,40 $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
Fixture or Item Qlg. For(oa) .blal
including$10000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to$25,000.00 $149.50 for the first$10,000.00 and$1.54 for
Residential Backflow Prevention Device each 'ditional$100.00 or fraction thereof,to
(minimum permit fee$36.25 _ 27.55 and including$25,000.00.
Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000 00 and$1.45 for
each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or and including$50,000.OG.
Speeiall rcues,cd inspections-per hour 72.50 $50.00;M and up $742.00 for the first$50,000.00 and$1.20 for
Subtotal: each additional$100.00 or fraction thereof.
F;xture Work:
r ou capping, moving,or replacing existing fixtures". If
,please indicate work performed by fixture. Failure to
accurately report fixti:-es count result in increased sewer fees*.
—! 'luantil b Fixture Work Performed I Comments regrrdiug fixture work:
Flxlure Type: Replace v
New Mored Exlslln C!pend
Ba tist /Pont ---
Bath -Tub/Shower — _-
-Jacuzzi/Whirl pool
Car Wash Wash -Each Stall -- --
-Drive Thru
Cus idor/Water Aspirator — — —
Dishwasher -Commercial -- ---- ---
-Domestic
Drinking Fountain V
Eye Wash
Floor
— -----— —.— ��— --
Floor Drain/sink 2"
3„ -
4"
Car Wash Drain _ *Note: If the fixture work under this permit results in an
Garbage -Domestic increase of sewer EDtis,a sewer permit Nvill be issaed and
Disposal -Commercial
-industrial fees :resesse 1 for the sewer increase most he paid before the.
tee Mach./Ref .Drains plumhlug permit can be issued.
Oil Separator(Gas Station —
Rec.Vcnicic Dump Station
Shower -Gang
-Sial
Sink -Bar/l.:,vatory _
-Bradley
-Commci cial
_-Service_
Swimming Pool Filter
Washer-Clothes _ —
Water Fxtractor _
Water Closet-Toilet —
Urinal --
Other Fixtures
i\t)sts\Permit Forms\Plmi'rrm,tAppl'g2 doc OP03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP ----.�_
Received 2 1_:,:�_ 42"ate Requested � AMPM _ BUP —_— —
Location Z ►"�(1j Suite_—___. _ MEC _ c -
Contact Person _.—�L�`� ,e L/ ��tr� F�° Ph ( — �Lz2_ PL `�
Contractor PI",I K-19-__ . --- Ph ( ) — — SWR
BUILDING _ Tenant/Ownerl -- ,T ELC
Footing —
Fiundation Access: ELC
Ftg Drain ELR
:trawl Drain _ ---- -'
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors ------------------ ----- -----____----- -- -- ----- -----
Ext Sheath/Shear
Int Sheath/Shear -
Framing --------- --- ---- --- -------- - -
- ._----.__.--------
Insulation �J -
Drywall Nailing -- — --� ----- -- -- - --- ----
Firewall
,7 '=ire Sprinkler _,.._..._--
Fire Alai
Susp'd Ceiling --
Roof
Other: ----- - — --
Final
PASS_PART FAIL -_---_- '-`
PLUMBING
Post 8 Beam ----- - - --- -- --- --- - -
Under Slab ---- - _ - ------- ----- — ---—
Rough-In_'
alter Service) - --
Ftain Drc4ins __- - ---------- - ---------
Catch Basin/Manhole
Storm Drain - - ---- -- ------------ - - -- --
Shower Ilan
Otheri
Fi
SS PART FAIL
ANICAL
Post& Beam
W)ugh-In - - ---------
Gas Line
Smoke Dampers ------ - -
Final A----- -' ____--- --
PASS PART FAIL - - --- - --------- -
ELECTRICAL
Service — -- ------__-
F;ouyh-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE �] Please call for reinspection RE:- �_� Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date - � _ Insaector - _ v __-- Ext _-
Other 1
Final DO NOT (REMOVE this !nspectlon record from the job site.
PASS PART FAIL