Loading...
Permitr Plumbing Permit AnPlicatipp]]--��CC�EI11 Building Fixtures V EQ City of Tigard SEP 1 1 Rd 2020 .2 P 1Dat&Bv,.:% yzv Oe ':rn,it' 2o'2o roo37 13125 SW Hall Blvd.,Tigard,OR 97223 pion nevi • ''! Phone: 503.718.2439 Fax: 503.5�8It 0OF TI Date/By: Other Permit Nay(,L,)e_20'0,_00154 Inspection Line: 503.639.4175 GARD 1 �, p _� g �I I���I�G D p Date Ready/By: tuns 6J Sr.Page 2 for Internet: wow ti�ard-or. ov V DIVISION Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction 0 Demolition For special information rise checklist. Description I Qty. I Ea. 1 Total ®Addition/alteration/replaceinent 0 Other: New 1-2-family dwellings(includes 100 R.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler(_sq.fl.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 16100 SW 72ND AVE Catch basin or area drain 18.76 City/State/ZIP:TIGARD, OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear It:_) Page 2 Suite/bldg./apt.no.: I Project name:20-258 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear B._) Page 2 Storm sewer(no linear fl.._) 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 Clothes washer 25.02 MODA CLEAN ROOM SINK Dishwasher 25 02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 1251 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name:POWER PLUMBING CO. Medical gas(value:S_) Page 2 Primer 12.51 Contact name: MIKE WARREN Roof drain(commercial) 12.51 Address: P.O. BOX 19418 Sink/basin/lavatory 1 25.02 City/State/ZIP: PORTLAND,OR 97280-9418 Solar units(potable water) 62.54 Phone:( 503-244-1900 Fax: :( 503-244-8825 Tub/shower/shower pan 12.51 E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name:POWER PLUMBING CO. Waterpiping/DWV 56.29 Address:6611 SW MULTNOMAH BLVD Other: 25.02 City/State/ZIP,PORTLAND, OR 97223 Subtotal Phone:( 503-244-1900 Fax:( 503)-244-8825 Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lie.:52378 Plumbing Lic.no.: 34-1 OPB State surchar ge rge(12%of permit fee) Authorized signature: fr'e �`" TOTAL PERMIT FEE e /, To Print name:KRISTIE=LL Date:9-11-2020 This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. 'Fee methodology set by Ili-County Building Industry Service Board. MBuitding Permits`PLSIU.PermitApp doe 1001r09 440-46167(10/02/COMM'EB) 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-I"100- 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-1st 100' 62.54 3,601 to 7.200 $233.20 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 $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 oty. Fee tea) 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 S379.50 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 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Batty -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash Each Stall 0 New exterior plumbing site utilities for any complex structure -Drive as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher -Commercial 0 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 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. B Garbage -Domestic non-food 9 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 PLEASE CALL MIKE WARREN WITH QUESTIONS 503-936-5929 Shower: -Gang -Stall Sink: -Lav/Bar non-food related r -Bradley -Cam/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-ClothesP Water Extractorfees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF_PennitApp.doc 08/04/2011 2