Permit CITY OF TIGARD PLUMBING PERMIT
1114
a COMMUNITY DEVELOPMENT Permit#: PLM2020-00406
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2020
T I[;A R D g Parcel: 1 S 135AB00100
Jurisdiction: Tigard
Site address: 10350 SW LINCOLN ST
Project: Metzger Elementary School Subdivision: METZGER,TOWN OF Lot: None
Project Description: Interior plumbing:Replacing(1)drinking fountain near the gym.
Contractor: OWNER Owner: TIGARD-TUALATIN SCHOOL DIST 23J
6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Drinking Fountain 10/14/2020 $25.02
Specifics: 1 12%State Surcharge- 10/14/2020 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 10/14/2020 $47.48
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total 581.20
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: \\_6`1 ` ,ekr-A)`1 _,-� Permittee Signature: CEN a�
\/C`aallll 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.
Plumbini Permit Application 10 i /20 - 6
Building Fixtures 'I 4 ,,� �+\l t,a . ,, . FOR OFFICE USE ONLY
- � � 5 �� •�City Of Tigard Received Permit No..
III • 13125 SW Hall Blvd.,Tigard,OR(5193 1 2020 Date By. !Qla/� n4„hualirj-alLicit/
Plan Review /V
Phone: 503.718.2439 Fax: 503.598.1960 Date/B Other Permit No.
Inspection Line: 503.639 4175 't. ""' 9
T I G A RD Date Ready By: /, Q ^�� /� hula Ei See Page 2 for
Internet www.tigard-orgov Notified/Method U/ �>n-1T (+�
l0 /V /`� � Supplemental lntormalion
TYPE OF WORK ,.+ FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
_ddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
°2.4 SFR(1)bath 312.70
CATEGORY OF CONSTRUCTION 4
❑ I-and 2-family dwelling ommercial/industrial SFR(2)bath 437.78
❑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:/D 3 S b g w L I yv Sf Catch basin or area drain 18.76
;� p Drywell,leach line,or trench drain 18.76
! 1WrL�J
City/State/ZIP: , L.::; .
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I C)Project name:NS\I .f 7 &p t lewtt ivir,R/ Manufactured home utilities 50.03
Cross street/directions to job site: "w Manholes 18.76
Rain drain connector 18.76
e4Ji �Q i ei GA �,./ Sanitary sewer(no.linear ft.:_) Page 2
�✓ �[ yy J /' Storm sewer(no.linear ft.: ) Page 2
l `eJ/7 k f 7 6�2 / c.m C� Uj✓2• Water service(no.linear ft.:_) Page 2
Subdivision: l Aitiryiv 4.77 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
`§ t4 at •°' Backwater valve 12.51
DESCRIPTION OF WORK
mom ` ' : .t ``"`� "" Clothes washer 25.02
(�-E,11ACC. L3\ _CIpUvt1-4._t Let t✓I i'fk,e"-t.v Dishwasher 25.02
1c 7O 4 I e- 'Vt 1 I et2_ f p e D{z.4t t(ca oaR.-r,ztt in_ Drinking fountain , 25.02 ex5--,p a,
Ejectors/sump 25.02
PROPERTY OWNER ❑ TENANT Expansion tank 12.51
I Fixture/sewer cap 25.02
Name:I fj Yt IL\ 1 txt.,l m.I-t vt cSG t.t_GC.( t�-�-
�+ Floor drain/floor sink/hub 25.02
Address: Cr/rO -�� UtArIJ�10T-) Garbage disposal 25.02
City/State/ZIP:"n.rty4 h-\' Oa_ L 7 223 Hose bib 25.02
Phone:(503 ) �( Z 1 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: J 7- l i,n Gil yK 1-1
Roof drain(commercial) 12.51
Address:. F • )41,c lu Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:(t )3 -6/.-!Z r Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: tev k.I I rt q e,-t 51� Ii r 7-rs D, kit 2,Orr-, iJ 5
U Water closet 25.02
CONTRACTOR Nip (:V+ 'as Water heater 37.52
Business name: GyY-/^JC-tr Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal 2-5---4}
Phone:(5-63)?j(e7- -bi-1 2 Fax:( ) Minimum permit fee: $72.50 7.&-5V
6-� Plan review (25%of permit fee)
CCB Lie.: Plumbing Lie.no.: q 0(
State surcharge(12%of permit fee) 3'to
Authorized signature:j� TOTAL PERMIT FEE a tsjk w
Print name:i9'K�1/r G� Date:/Q_/ - ZOZO 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.
1:\Buildtg/Permils\PLMU-PermitApp.doc 10/01/09 440.4616T(10/02/COM/WEB)
Branden Taggart
From: Branden Taggart
Sent: Monday, October 12, 2020 8:07 AM
To: nklingensmith@ttsd.k12.or.us
Subject: Metzger Elementary Plumbing Permit: PLM2020-00406 - 10350 SW Lincoln St.
Attachments: Invoice.pdf
Hi Nat,
I received your voicemail,thank you. The Metzger Elementary Plumbing permit 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
(PLM2020-00406) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermitsna tigard-or.gov, and I will email the permit to you.
Thank you,
Branden Taggart
w City of Tigard
p1.r, Senior Permit Technician
Community Development
TIGARD
13125 SW Ffall Blvd
Tigard, OR 97223
(503}718-2449
brandent@bigard-or.gov
1