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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00372 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/24/2020 TIGARD Parcel: 2S102BA02101 Jurisdiction: Tigard Site address: 9945 SW JOHNSON ST Project: JONES Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 20 Project Description: Replacing 50 ft.of sanitary sewer. Contractor: BLACK ROCK UNDERGROUND LLC Owner: JONES, MATTHEW Q& 267 NE 34TH PLACE PENCE-JONES, ANNA R HILLSBORO, OR 97124 9945 SW JOHNSON ST TIGARD, OR 97223 PHONE: 503-747-9312 PHONE: FAX: 503-214-5886 FEES Quantity Description Date Amount 50 If Sanitary Sewer 09/24/2020 $62.54 Specifics: 10 Minimum Fee Adjustment- 09/24/2020 $9.96 Plumbing Type of Use: SF 9 12%State Surcharge- 09/24/2020 $8.70 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: G Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit AnnlicntiiFCEIVED Site utilities Sr-p 1 } 11)11 i1111c I 1 .I itvI t City 0I'r�,KhJard Received SI r$.k,F+y /a3A Pe"'P.;..-,6!►'b?r�ar)4.)3 • 13125 tit\I tall Blvd,Tigard,OR ,G31 'OF TIGARD I��x.,�» I 21. PM+nn sr11.71R.2,O0 Fru Sf1� �MG DIVISION 1IIF$elPeinueNt,.. If le nk 1'[ AlGih lIlpt lion l rah: 503_63_4175 SIGN tiae 1i.,..vII 5 Page Ina rn>ct: -*ww,ri•atd-aw,-lack'', ,�Y(! s ,r ]had I g � n.aL'4k•1'IcN'. supplemental la(ieruaitlue TYPE OF WORK FEE4 SCHEDULE ❑Neu c l.n,uu.n.,n ©D 7tt tliturn For special injortairdon roe(heath& (ksctipII.n I @y. I Fa. I Totul - '.15kAddut n...hCI,tl:.n1 rrplacrutcni ©(thee 1 Neu I-2-fumlty dwching%tincIudea I00 fl,rureach utility connection) (".\1 F( ORY OF CONSTRUCTION SFR 1I4 Mfh 312,70 hi-..1'-Lein)}dty.11atp ❑ContmareiuVindustriai SFR 424hath 437,7E SFR 134 bath 5111P32 (]Acco.,uls hunting El\lutu-)boil} Each additional hadihitehen 25.02 El Maste-huildca- [7,i tihet: Fire"milder t__att.d I Page t JOB SITE 1NEOR0t4'1ION AND LOCATION Site utilities: lub rice atkrns+: '11 y 5 5 tAJ -'-D N rd sopa 5I ('mch basin or erne dram It1.76 (loy/Suue ZIP t .C 0 ¢, Foohnnll-leach hoe,ur trends drain age I Touting drain(no.linear R,:T) Page 2 Suitethldsoagt,no,: Pnyectn:mu:�/1 .c. Manufacm un:rcdhtutilities 50.03 (rims%Reet'dirc litm to job site, hlanhok-, 18.76 Rain dram conneewe 18,76 Sanitary scacr(no.linear II.:bil1 ' Page 2 0.,y17 Storni sewer(no linear Il.._I Page 2 Mart sm see I nu.Mimi R.: 1 Page Suladlcnitm: Lot on.. Moamar item: Tax map I+.n:ei no. Presenter 31.77 - OP SCRIPT ION OF Id'ORK Rackwaterealrc t25t ('kehe.wmtice 25.02 CPI/te \:t )(`S�r ('el\0\.cC_ 51/06;k0i0 J► StW'Ix Di hwvslie'r 25.02 D r I C Op IA\�. Ifinbng fountain 25.02 \ `_, ..-.--'' Fjecturx'sulttp 25.02 0 PROP' , 1ai Y OW Nick F❑ TENANT Expamitrn oral: 12,51 Fixime‘mem yap 25.02 NNam: j `R 7�,l Floor drairJfluie'ainkFlwh 25.112 Aiklass. .-- ^ (iarfage disposal 25.02 CityiSinle ZIP, Ilene bib 25.02 Phone:( 1 Fas:I i Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Intercepwo'gnasc trap 25,02 Rusintss name: Medical gas(valise:5 1 Pep2 Prhncr 12,51 ('onlaet name: Roof dram(commercial) 12.51 Address: Sirfk)hasin'Iavamry 25.02 Lily/State ZIP: Solar undo Iptaabk water 62.54 Plural,: 1 t 1 Fax::i I Tub'$hnwcr$hewer pan 12.51 I-mind: 11 oe,5bk .iIro�+kdr t-oV7n&..cowl, Urinal 25.02 Wain dose) 25.02 CONTRACT Wain healer 37.52 liuNatr.,sari: I\ACV. c4.0CK U„kin...OIJV L 1 L LC Water i n 'I}W\' S6.2u �t, t J p ni 8 Ada atn�1 Jr , 4-�- s p1 Oilier 25.02 City/Slaw ru. { Sublets! a,5'h 1.-VA oil, 91)014 Phone:(515 1141 q 3117e Fax:I i Minimum Permit Ice: 572.50 -'7;.577 1.(1i Ltc. 1 `, i '9 Piumfung Lie,nor?�,y L� Plan resit)* t?S°i.of 1xnrar 1.r1 i State Wuvluvge 1.12%nlpermit fuel f(',, '1mho:llcd sigiratttrc. " .. TOTAL.PERMIT F FLIeR I.aa' r Pont Ionic. p t x [j icc� 'q 1 F '�„p'),O 'Fhh prruull sppHoallatr a$plm(1 a perwll h as.tlMslaed wirllfnYMl 4+r}. C. W 'e-'°Y,iJ 'het It hat been aeeepied re eampiele. Fr,nI.duidi.Ivg4 tag hr lei-1'.4uts trtuidmp Initi,Its Sri..'Kum} I.oait4iN rim,"Witt-R'rnz 51W 1n111 Vr 441-0It-hl.Nk I.t 1]I 44 IIN Pinrnbint„. Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities qty. Fee Oa) ' Total Square Footage: Permit Fee: !u.•uuy In.un- I" Ilxr i0.01 0to2,000 S121A0 tnatiop.luann-each Zulu2.001 to .tWtt SI69.0 3.601 to 7.200 5233,20 ?-9 cr. kt 62.54 C` . 7.20t told greater S327.54 Sewer•each additional 11.10' 37 52 Water Serviee. 1st 100' 62.54 Medical Gas Systems: Water Service-each addii Ulna'liar 37.52 Valuation: Permit Fee: Shinn&Rain Drain-1st 100• ro< 51.00 to$5.000.00 Minimum fir S72.50 Sumo&Ruin Main-each additional If0t' 55,001.00tn S I I)000.f10 S72 50 for the first 55.000.00 and S I.i2 for Other Inspections or Fees Qiy. Fur tea) Total each additional 5100 AI or nuctionMount,to mu1 including S10.0n0.0n. Inspection of existing phnubing set for S I0.0ttl ixn M S25,0011,011 ' I J8$0 for the tint S IO.00u.n l and$1.54(or • ntich at,k.e is specifically indicated 941.01_11a h additional SlOnf10 ur fraction theteor.to (omen uin charge-12 huur) tiny its boding 525.000.00. Inspection outside of normal Inwinitt txl.ffhtr $25-001.00lu s.o,000.cuo N:"150 Ii.Y the first S25.000110 and 41.45 tot hours tmininnnn ch ngtc-2 hours) cavil additional 5100.00 or fracture Mercer,to keensl100ionn rttl 90,001lt and including 550,000.00. Additional plan tonics.'for revisions 90,001n S30.001.011 and up S 742,gt for the Out$50I1041.011 and 51.241 for (minimum charge-1.2 hour) each additional 5100,IKI or fraction Memo( Stuntman C:omntercial 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*. Quannlhl FhtrarcT)ite ['Ian Review for Plumbing Installations Fixture 1.pc tar Urinate: \Yar4.Per(Performed: C'apprJ laarol atlnrarr Plan retina Is requirdti I,.atn of the following. 1)aptistr?dFant Please check all that apply. Bath -7u1nSfwwtr ❑ Any new commercial building with we ter service.2"and Jacuzzi w'hulprw,l greater,except systems designed and atampcd by licensed Cot Waih -Each Stall engineer. [revs)2 nd 0 New exterior plumbing site utilities fur any complex structure funpidur'N'ater hspiractn as defined in OAR41 K-7t0-CK)4U. Dishwasher -('ullurunail ❑ Medical gas and%actuunn systems lire health cats fat rbtk •304mmuic 0 Any multipurpose tire sprinkler system. DM ding Fountain 0 Any complex structure as defined in OAR9I K 1IW(1f14U. 1 s:wash loot Drain sink -2" tiuhmit 2 seta of plans with an, of the shave. ' Isometric or Riser Diagram Cat Nash Wain o,1iugc -DrmmJic-rart•tixd 0 Isometric or riser diagram is required Mr new buildings Disposal -Domestic-rood related that meet the qualifications above. -C ommercial-bur!related -Industrial-food related lac Afach.;Refrig.Drains I hi Sepnratia(Citn Station, Comments regarding fixture work: Rec.\'stuck Dania%union mhower -fionp -Stall Sink.Las •Yon-loud related -Bradley -Commercial.food related -Service Swimming uhe - Pool Film •Noir: 1f the fixture work under this permit results lit an Washer-Clothes Water Eaauimr increase of sewer E:DUs,a sewer permit will be Issued land Wain Closet-Toile' fees assessed for the sewer increase must be paid before the Urinal plumbing permit can he.issued. Other Fixtures: IABuilding,Peoria+PLMU__PenniiApp.dve 2 Branden Taggart From: Branden Taggart Sent: Wednesday, September 23, 2020 11:06 AM To: nick@knightrealtygroup.com Cc: Black Rock Underground, LLC Subject: Sanitary Sewer Replacement: PLM2020-00372 - 9945 SW Johnson St. Attachments: Invoice.pdf Hi Nick, The Plumbing permit to replace the sanitary sewer, located at 9945 SW Johnson Street, is ready to issue now. The balance due is$81.20, and I have attached an invoice above for you to reference. The permit fees can be paid online through our website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit number(PLM2020-00372) in the Record Number field, and click Search. Once paid, please notify us at TigardBuildingPermits@tigard-or.gov, and we will email the permit paperwork to you. Thanks, Bran.den Taggart City of Tigard ie s Senior Permit Technician Community Development TIGARD 13125 SW Hall Blvd Tigard, OR 97223 (5031718-2449 brandent©tigard-or.gov 1