Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020-00447
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/10/2020
Tf�+ Parcel: 2S101AB01604
Jurisdiction: Tigard
Site address: 7307 SW BEVELAND RD 110
Project: Range Financial Subdivision: HERMOSO PARK Lot: 16
Project Description: ADD plumbing fixtures for office kitchen: (1)dishwasher,(1)garbage disposal,(1)ice maker,(1)break room sink.
Contractor: LOTUS PLUMBING COMPANY Owner: MISSION INCREASE FOUNDATION INC
8100 SW ELMWOOD ST 7357 SW BEVELAND ST#200
PORTLAND, OR 97223 TIGARD, OR 97223
PHONE: 503-522-2728 PHONE:
FAX: 503-892-2639
FEES
Quantity Description Date Amount
1 ea Dishwasher 11/09/2020 $25.02
Specifics: 1 ea Garbage Disposal 11/09/2020 $25.02
1 ea Ice Maker 11/09/2020 $12.51
Type of Use: COM 1 ea Sink 11/09/2020 $25.02
Class of Work: ALT 1 12%State Surcharge- 11/09/2020 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $98.08
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: \p1�. _ ^
Cllallrl1503.639.4175 by 7:00 a.m.for the next available inspection 1date.
► �1(
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
Building Fixtures RECEIVE IOR 1)1IICL 1Si': ONII
City of Tigard ReceivedIN Permit �.t gam, �/y
Nov 0 5 Date/By: ►►/Co/1:-) -90 I-i I Zazo,�OO + 1.7
i 13I25 S W Hall Blvd.,Tigard,OR 97223 O Z�, Plan Review ��n
Phone: 503.718.2439 Fax: 503.598.1960 palsy. Other Permit No.: 202C. ►?a,
I it;A R 1�
Inspection Line: 503.639.4175 CITY OF TI GAR D to lteadylsy. tads Hf See P 2 for
Internet: W W W.tigBtd-Ol'.gOV DUI DiNQ DIVISIQ ,i ,(lef, ; ll/b/ 1.i.� Supplemental leformadon
TYPE OF WORK EP I R'f L A- EL. FEE* SCHEDULE
❑N w construction ❑Demolition For special information use checklist
Description Qty. I Ea. Total
Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRJCTION SFR(1)bath 312.70
El1-and 2-family dwelling Commercial
LJ/ /industrial SFR(2)bath 437.78
❑Accessory building El Multi-family
SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: � give\C-1 . -k- • Cash basin or area dram 18.76
Drywell,leach line,or trench drain 18.76
City tate/ZIP:'-T C Cki C. ? CV , o\-�„
` -• A Footing drain(no.linear ft.:_) Page 2
Sui dgJapt.no.: ll Project name: F � 4o V Manufactured home utilities 50.03
ss street/directions to job site: j Manholes 18.76
t-ko 1 X.I Rain chain 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflowpreventer 3i.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
c ctct .... \(----/l C 1*e rl Dishwasher ` 25.02 �G�•43-
41 L/s /V i 1 /am t a En /=/ )C 714 i `-c Drinking fountain - 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ] 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Q.�
Garbage disposal 1 25.02 a
City/Statc/ZW: Hose bib 25.02
Phone:( ) Ice maker \ 12.51 I a. �
Lotus PiumbilxF • „ y
APPLICA11Hi sw E . . ,l ONTACT PERSON Interceptor/grease trap 25.02
Business name: Portland, OR 97223 Medical gas(value:$ ) Page 2
Contact name: 503-522-2728 Primer 12:51
Roof drain(commercial) 12.51
Address: C,CB# 189416 oa
Sink/basin/lavatory ` 25.02 a
City/Statt/ZIP: \c) , ,17:kr\c)r,r1.�r't\ -f - c-Nca:_t\i• Solar units(potable water) 62.54
Phone:( ) 'Six: ( ) CereThTub/shower/shower pan 12.51 •
E-mail: Lotus Plumbing.Company Urinal 25.oz
81( Vv JC+e*ood St. Water closet 25:02 '
Business name: Portland, OR 9/223 Water heater 37.52
503-5L2-2728 Water piping DW V 56.29
Address: Other. 25.02
City/State/ZIP: CCB# 189416 Subtotal `1. .1
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: X' I LJ I j Plumbing Lie.no.: \ Plan review (25%of permit fee)
State surcharge(12%of permit fee) X()- ,
Authorized signature: 1 TOTAL PERMIT FEE
Print name: 1 �-t4 S Date: ti\ 1'i�"i � This permit application expires if a permit is not obtained within 180 days
' ` t after It has beer acce�nqh�l as cam lets.
*Fee methOdo1ne 1153
-` EMI Al 14 Service soar Or
1:tauildieg\Pnmas\PLMU-PnmfiApp.d°c 10/01/09 440.4616T(10/02/COM/WER) `� r
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
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
$1.00 to S5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to SI0,000.00 $72.50 for the first S5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
P and including$I0,000.00.
Inspection of existing plumbing or for $10,001.00 to S25,000.00 $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 S50,000.00.
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 ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: Tub Shower
engineer.
-3acuni/Whirlpool
Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure
-Drive Thtu as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
❑ Any multipurpose fire sprinkler system.
Dishwasher: Comn1ercial
-Domestic . ❑ Any complex structure as defined in OAR9 I 8-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric of Riser Diagram
•
0 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 �!y /Jc.:'' 4-3-... "� 6-23 A aci. . /C� Ci ' ,
-industrial food related
Ice Mach./Refrig.Drains t Comments regarding fixturework:
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:
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