Permit CITY OF TIGARD PLUMBING PERMIT
r' J .: COMMUNITY DEVELOPMENT Permit#: PLM2020-00291
Date Issued: 7/29/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel 2S101 DC03500
Jurisdiction: Tigard
Site address: 13475 SW 74TH AVE
Project: DRAGOMIR Subdivision: None Lot: None
Project Description: 200 ft.of sanitary sewer.
Contractor: A ABOVE ALL JOHN D PLUMBING Owner: DRAGOMIR, JOHN & MAGDALENA
7472 SW FIR STREET 13475 SW 74TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-620-7600 PHONE:
FAX: 503-598-9355
FEES
Quantity Description Date Amount
200 If Sanitary Sewer 07/28/2020 $100.06
Specifics: 1 12%State Surcharge- 07/28/2020 $12.01
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
•
Total $112.07
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: _ Permittee 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 USE (,NI 1
�`► i 1 Received
City of Tigard �-a .V e / 49.0 Permit No.: ,eMay,�_airgci 1
u 13125 SW Hall Blvd.,Tigard,OR 97223 Dare By. /"P w r+
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
11111 9 - Other Permit No.:
JUL 15 2020Date/By:
T I c A R D Inspection Line: 503.639.4175 t Date Ready/By: tore: ® See Page 2 for
Internet www.tigard-or.gov CITY OF TlGAAL Notified/Method: //`� /� / (� Supplemental information
TYPE OF WMILDING` DIVISIOi,s tg i`111"' jeji,, FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
'Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
101-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE� INFORMATION 'AN/D LOCATION Site utilities:
Job site address: '3 r•E-r75 5/AD -74-Tt it V t� - Catch basin or area drain 18.76
(� � 7 Drywell,leach line,or trench drain 18.76
City/State/ZIP:/State/ZIP: b ( O f L 17G7 Z 3�7 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: 24$( O H I CL Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
G` 1,n -�Z kck 1 tre S 60 cee-��� Rain drain connector 18.76
c) t/l/ `.0 -[��4� e- Sanitary sewer(no.linear ft.: I Page 2
Ul9 Storm sewer(no.linear It:_) 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
'-/nf �y Clothes washer 25.02
fieIAi SGt/JET& Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02 '
rlf PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: od f f 1/( b4-' 9col�( I(L. Fixture/sewer cap 25.02
L I Z � �( (2 c I r Floor drain floor sink/hub 25.02
Address: �r t` c7
Garbage disposal 25.02
City/State/ZIP: "I'( G>_b 1 0 (ic�7-• 17 2,Z.3 Hose bib 25.02
Phone:(56 3) 3(7- 223 3 Fax:( ) Ice maker 12.51
APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: 1 l-N, . '�V Y�-^red 0 Medical gas(value:$_) Page 2
V _ - -k) bz_7'cCat0 � (0 Primer 12.51
Contact name:
�.c� � � � //^^ Roof drain(commercial) 12.51
' Address: / L }s Sink/basin/lavatory 25.02
City/State/ZIP: Ile AIL-b. ( Q.E. _ /7 ZZS Solar units(potable water) 62.54
Phone:( } ) 'S 17- ZZ SZj^ Fax::( ) Tub/shower/shower pan 12.51
U 25.02
E-mail: f 31 �2? 33 fc+ (/q Cyr Waterlcloset 25.02
v1r \ CONTRACTOR
�f, 4.r, 1/ Water heater 37.52
�1
Business name: I3 • 'L oe B.-k Water piping/DWV 56.29
Address: 147.` 2, k(A.9 . (L. CJT• Other: 25.02
City/State/ZIP: `b(&Al2...1) / QV • ' 7Z7 3 Subtotal I00.0(,
Phone:(yrO! J(7 Z Z S Ij Fax:( ) Minimum permit fee: $72.50
CCB Lic.: ga5-31 /j , Plumbing Lie.no.: '34-7E1 Plan review (25%of permit fee)
r State surcharge(12%of permit fee) r�• Q7
Authorized signature: irAIA^� TOTAL PERMIT FEE I . di
Print name: ` }.I.e0 O rc(IZ/ Date:1 , (57 iG a Thu permit application expires if a permit is not obtained wit its
Q�
VV •, l ix
after it has been accepted as complete. /)
*Fee methodology set by Tri-County Building industry Service ard.
1:\Building1PermilsNLMO-PermaApp.doc 10/01/09 440-4616T(t0/02/COM/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-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
C 62 54 3,601 to 7,200 $233.20
Sewer-1st 100'
�p2•;l`� 7,201 and greater $327.54
Sewer-each additional 100' ' 37.52 31'S2
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
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: 1000(n
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
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Ea ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall
Ea as defined in OAR918-780-0040.
-Drive Taro
Cuspidor Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial 0 Any multipurpose fire sprinkler system.
Domestic 0 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
4" 0 Isometric or riser diagram is required for new buildings
-Car Wash Dram that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
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 EDUUs,a sewer permit will be issued and
Washer-Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
Branden Taggart
From: Branden Taggart
Sent: Tuesday,July 28, 2020 6:25 PM
To: n3172233@yahoo.com
Subject: Plumbing Permit: PLM2020-00291 - 13475 SW 74th Ave.
Attachments: Plumbing Permit Invoice.pdf
Hi John,
Your sanitary sewer Plumbing permit is ready to issue now. The balance due is$112.07, and I have attached an invoice
above for you to reference. You can pay these fees online through our
website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit number
(PLM2020-00291) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and I will email the permit paperwork to you.
Thank you,
Branden Taggart
City of Tigard
Senior Permit Technician
Community Development
ticAn
13125 SW Nast Blvd
Tigard, OR 97223
(503J 718-2445
b rande nt@tigard-a r;gov
1