Permit Support Document CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENTIII Permit#: PLM2020-00174
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Fri If 2 . ive Date Issued: 04/28/2020
Parcel: 1 S 134CD01000
Jurisdiction: Tigard
Site address: 11735 SW KATHERINE ST
Project: Finkel Subdivision: LERON HEIGHTS NO.3 Lot: 80
Project Description: gas line addition, bath remodel repipe and drain line. 5/14/2020: REPRINT permit to remove repipe and drain line,
and add(1)lay and(1)shower.
Contractor: GREEN BOX MECHANICAL Owner: FINKLE, BENJAMIN STEPHEN & BRITT
3265 NW 29TH AVE 11735 SW KATHERINE ST
PORTLAND, OR 97210 TIGARD, OR 97223
PHONE: 503-222-0555 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Lavatories 04/28/2020 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 04/28/2020 $12.51
35 Minimum Fee Adjustment- 04/28/2020 $34.97
Type of Use: SF Plumbing
Class of Work: ALT g 12%State Surcharge- 04/28/2020 $8.70
Type of Const: Plumbing
45 Cash Over 04/28/2020 $44.89
Occupancy Grp:
Stories:
Total $126.09
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: :::( 5Permittee 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 RECEIVED
Building Fixtures mm 13 2020 FOR OFFICE USE ONLY
City of Tigard Received s/� PennitNo'
. • 13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD DateBy: 'f 2C) Q(� �G/`7�D0-00/7`/
IVISIO Dan Review
Phone: 503.718.2439 Fax: 503.598.196�UILDING D Other Permit No.:
DateBy:
TIGARD Inspection Line. 503.639.4175 Date ReadvBy e//, /,. tons BI See Page 2 for
Internet: www.tigard-orgov Non fied/Method`- Supplemental Information
1 f al lf:;;�sst.._.
TYPE of wa -/ _- //c_ FEE* SCHEDULE
❑ New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
®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 ❑Commercial/industrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire.sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION- .. Site utilities:
Job site address:11735 SW Kathryn St Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, OR 97223 Footing dram(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Finkel plumbing Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) 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.: Backflow preventer 31.27
t Id ® E kt4t Backwa[ervalve 12.51
r _ Clothes washer 25.02
bath remodel -shower drain pan and fixture repipe Dishwasher 25.02
/�� 4-- ,[ � [�}O/S 77/✓6 /� /% Drinking fountain 25.02
/ 0 'De -(.2e/ 2 S E7y t/ Ejectors/sump 25.02
0 PROPERTY OWNER t�NANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT 0 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 1 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 1 12.51
E-mail: Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name:Green Box Mechanical Water piping/DWV 56.29
Address:3265 NW 29th Ave Other: 25.02
City/State/ZIP:Portland, OR 97210 Subtotal
Phone:(503)222-0555 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:214076 Plumbing Lie.no.:P61841 Plan review (25%of permit fee)
/� !� State surcharge(12%of permit fee)
Authorized signature: L.!(�A-B•el1t4,0`o61 TOTAL PERMIT FEE
Print name: J.C. Kootnekoff `I/ Date:05/13/2020 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permils\PLMU-PermilApp doe I0/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities �: Qty. Fee(ea) rota! 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 SI.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
A 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
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.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru 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 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„ ❑ 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. Comments regarding fixture work:
Drains
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
iu6� " 4_6
Dianna Ornelas
From: mike@greenboxmechanical.com
Sent: Wednesday, May 13, 2020 2:41 PM
To: #Building Permit Technicians
Cc: Sarah Fitz
Subject: Finkel Plumbing Permit Modification - PLM2020-00174
Attachments: Finkel Plumbing Permit Application.pdf
Warning!This message was sent from outside your organization and we are unable to verify the sender
Attached please find an application to revise an existing plumbing permit.
,2 do ,g-A.e• X.frV (� s�
The original permit had a quantity 2 of drain pipe which is not needed. Revised permit should have shower/drain and
pan and one lay faucet water line install
These modifications were identified during plumbing inspection.
Please let me know if you need any further information including revised fees.
Mike Llewelyn
General Manager
3265 NW 29th Ave.
Office 503-222-0555
Cell 503-819-3606
mikePgreenboxmechanical.com
www.greenboxmechanical.com
green
M E C i A Ir C A L
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