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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00269 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/29/2020 Parcel: 2S 111 AD21400 Jurisdiction: Tigard Site address: 8615 SW PINEBROOK ST Project: Ping Subdivision: 2015-021 PARTITION PLAT Lot: 1 Project Description: Remove shower and replace with bathtub. Move faucet,shower head and drain to align with new bathtub. Contractor: OWNER Owner: PING, WILLIAM L& ELIZABETH D 8615 SW PINEBROOK ST TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Tub/Shower/Shower Pan 07/29/2020 $12.51 Specifics: 1 ea Water Piping/DWV 07/29/2020 $56.29 1 12%State Surcharge- 07/29/2020 $8.7D Type of Use: SF Plumbing Class of Work: ALT 4 ea Minimum Fee Adjustment- 07/29/2020 $3.70 Plumbing 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 or 1.800.332.2344. Issued By: � Permittee Signature: o Gl�.. © ' 'T i f' i C.,1-77 // 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 Applicatiof EC i V a Building Fixtures FOR OFFICE USE ONLI' JUN 24 2020 Received t City of Tigard _ Date/By: -2/f D'1 Permit Nrui ZC7 ,..-al y 427 • 13125 SW Hall Blvd.,Tigard OR 972? ":`�/ c'' f A t l- y: ,..,r.a`1\ !l� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 ')I n,7 7t i ) t 1l L�lC"illateBy: Other Permit No.: T I.G ARD Inspection Line. 503.639 4175 Date Ready/By turfs ® See Page 2 for Internet www-tigard-or goy Nutilied/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist. Description I Qty. ] Ea. 1 Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) i CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 El Accessory buildingSFR(3)bath 500.32 0 Multi-family Each additional bath kitchen 25.02 ❑ Master builder 0 Other: Fire sprinkler(T sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:8615 SW Pinebrook St Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard, OR, 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name:Bathroom Remodel Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear It: ) 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.: Baekflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Remove zero entry shower and replace with bathtub. Move faucet, Dishwasher 25.02 shower head, and drain to aling with new bathtub. Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPEKLY OWNER " 0 TENANT Expansion° Ex ansion tank 12.51 Name:William Ping Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address:8615 SW Pinebrook St Garbage disposal 25.02 City/State/ZIP:Tigard, OR, 97224 Hose bib 25.02 Phone: ( 971 )470 9149 Fax:( ) Ice maker 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease 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 1 12.51 12.51 E-mail: Urinal 25.02 Water closet 25.02 r )I CONTRACTOR t; °' t " $)€ 4 Water heater 37.52 Business name:Property owner Water piping/DWV 1 56.29 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 68.80 Phone:( ) Fax:( ) Minimum permit fee: $72.50 72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%ofpermit fee). tam. ,, I��/ State surcharge(12%of permit fee) 8.7 Authorized signature: W6r 42.1yfi Pe-•0 TOTAL PERMIT FEE,�9.32-- Print name:William Ping Date:6/24/20 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. r *Fee methodology set by Tri-County Building Industry Service d. I',1BuildingWermits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) Plumbint 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 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 $I.00 to$5.000.00 Minimum fee$7250 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 Tnspections 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: 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 -Jacuzzi/Whirlpool engineer. Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial ElAny 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 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 EDUs,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