Permit 74 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020-00188
T I G AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/07/2020
Parcel: 1 Si36ACO2200
Jurisdiction: Tigard
Site address: 10719 SW TOPPING PL
Project: Topping Corner Subdivision Subdivision: TOPPING CORNER Lot:
Project Description: 547 ft.of water service for lots 10, 11, 12,and 13.
Contractor: RGA SERVICES INC Owner: STAFFORD DEVELOPMENT CO LLC
PO BOX 161 8840 SW HOLLY LN
DAYTON, OR 97114 WILSONVILLE, OR 97070
PHONE: 503-550-5880 PHONE:
FAX:
FEES
Quantity Description Date Amount
547 If Water Service 05/06/2020 $250.14
Specifics: 1 12%State Surcharge- 05/06/2020 $30.02
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $280.16
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:
_as
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
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`"': City of Tigard 1 i v :M: lved
v rn,°i a 13125 SW Hall B1vd.,Tigard,OR 97223 Dau•'By: 52// Permit No.:JOrM�Jn 0C� y
Phone: 503.718.2439 Fax: 503.598.1960Pate G� II
Inspection Line: 503.639.4175 APR 2 8 202( Date/By:tcRea Other Permit No.:
Tic,%R 1:1 r��;{�to Ready.By: kris: BJ See Page 2 for
Internet: www.tigard-or.gov 'F-f G iiiii g
tifudlMenwd: '�-� Supplemental Information
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,T>iPlz 1t1_ WORIc: ;' DIVISION DIVlSI PEP' SCHEDULE❑New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement ❑Other. New 1-2-family dwellings(includes 100 ft.for each utility connection)
` CATEGORY OF CONSTRUCTION SFR(1)bath _ 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builderEach additional bath/kitchen 25.02
0 Other; Fire sprinkler( sq.ft.) Page 2
JOB SUE INFORMI&TIO*i 1ND LOCATION - _Site utilities:
Catch basin or area drain 18.76
Job site addres Ws�Z ' St ,111l-yJ 19 7;99)'...L
City/State/Zr?: Tigard, OR 97224 / J fltYwell,leach line or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: Topping Corner Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
SW Spruce St . & SW 72nd Ave . Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: 6 Page 2 4 jt) ',>
Subdivision: Topping Corner {not recorded) I Lotno.: Fixture or item:
Tax map/parcelno.: 1S136AC 2200 (Existing Parcel) Backflawpreventer 31.27
• ' . DESCRIPTION OF WORK - Backwater valve l2.51
Clothes washer 25.02
Private waterline installation Dishwasher 25.02
from meter boxes to four future Drinking fountain 25.02
lots located off private drive, Tract D Ejectors/sump 25.02
r
1:4 PROPERTY OWNER 1 0S'EN.1NI Expansion tank 12.51
-Name: Stafford Development Company, LLC Fixture/sewercap 25.02
Floor drain/floor sink/hub 25.02
Address: 8840 SW Holly Ln.
Garbage disposal 25.02
city/state/ZIP: Wilsonville, OR 97070 Hose bib 25.02
Phone:(503) 250-3651 Fax:( ) Ice maker 12.51
❑ ApPLIC:ANT - 0 CONI.CT:v i soly Interceptor/grease trap 25.02 Business name: Stafford Development Company, LLC- Medical gas(value:$_) Paget
Contact name: Levi Levasa
Primer 12.51
Roof drain(commercial) 12.51
Address: 8840 SW Holly Ln. Sink/basin/lavatory 25.02
Ciry/state/ZIP: Wilsonville, OR 97070 Solar units(potable water) 62.54
Phone:F 0 3)2 5 0-3 6 51 Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Levi@staffordlandcompany. com Urinal 25.02
(ONTR►CTOR
Water closet 25.02
Water heater 37.52
Business name: 2Cx.� .S€R aici f /4.k Water pip r g/DW V 56.29
Address: P,OP Box. /4/ Other: 25.02
City/State/ZIP: N 474< 97 /q Subtotal /wL
Phone:(coy) S. O ,_ op° Fax:( ) Minimum permit fee:permitfee)
CCB Lic.: Plan review (25%of fee)
/(,.�'F,y �, Plumbing Lic.no.:672' zP�P� Z State surcharge(12%of permit fee) 3 0/
Authorized signature; 14. . 7/07) TOTAL PERMIT FE
This permit application expires if a permit Is obtained within 190 Jaya Print name: CNAD /04Jp1„S' Date: y..1y-20
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industy Service Board.
t:,nuildioy.Pe`mitsILMU-PerettApp.doc 10/01 09 440-4616T(10.02 COMiWy.8)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities • QtY• Fee fea) Total r Square Footage: Permit Fee:
Footing drain- le 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 ojiZ > Medical Gas Systems:
Water Service-each additional 100' J 37.52 j, 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 0.00.
Inspection of existing plumbing or for first
$10,001.00 to$25,000.00 $148.50 for thee first$10,000.00 and$l.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: 77,i ]rrti
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 0 Any new commercial building with water service 2'and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
CarWash: Each Stall El New exterior plumbing site utilities for any complex structure
Drive Ttuu as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher. Commercial ❑ Any 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
4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage -Domestic non-food that meet the qualifications above.
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
-Corn/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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures;
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