Permit CITY OF TIGARD PLUMBING PERMIT
III COMMUNITY DEVELOPMENT Permit#: PLM2020-00486
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/14/2020
T I(;A R f� 9 Parcel: 2S113AB00300
Jurisdiction: Tigard
Site address: 16037 SW UPPER BOONES FERRY RD 135
Project: Oregon State Bar Subdivision: FANNO CREEK ACRE TRACTS Lot: 38
Project Description: Interior plumbing:Adding(1)dishwasher and(1)sink.
Contractor: A ABSOLUTE COMFORT HEATING& COOLING INC Owner: OREGON STATE BAR,THE
15886 PARK PLACE CT 16037 SW UPPER BOONES FERRY RD
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503-513-4795 PHONE:
FAX: 503-513-0797
FEES
Quantity Description Date Amount
1 ea Dishwasher 12/11/2020 $25.02
Specifics: 1 ea Sink 12/11/2020 $25.02
1 12%State Surcharge- 12/11/2020 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 12/11/2020 $22.46
Type of Const: Plumbing
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: i�` ,Q�� Permittee Signature: `tCei�Q�
V 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.
'"- •lnbing Permit Application t t/ _ P
Building Fixtures CI\i
City of �,d��
Tigard Received
Date!➢ : 41 Pentair No.: : _{-/i-4 t -oOy
11 II 13125 SW Nall Blvd.,Tigard,OR 97223 t. ti fJ 2.Q1 Pun Review
C Phone: 503.718.2439 Fax 503.598.1960 Datemy Other
PermiNo.: Pi n;~Yl"t_cZ /
Inspection97
Line: 503.639.4175
TlcnuD 'riir iiCUA [ to AesdYin runs: p See Page fo
Internet: www.tigard-or.gov *il E,V,4, rftl ,,,r/Melhod l' Supplemental Information
TYPE OF WORK + '. '. • -3 • FEE*SCHEDULE
❑New construction 0 Demolition For special itjformaliott use checklist
Description I Qty. I Ea, I Total
XI Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
•', CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
ElI-and 2-family dwelling K, Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 50032
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25,02
0 Master builder 0 Other: _ Fire sprinkler(____sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: UP 037 S( U. j'00f1CS krit( 'Pa. Catch basin or area drain 18.76
FCp J Drywall,leach line,or trench drain 18.76
City/State/ZIP: T4t.J I O . en n Footing drain(no,linear ft.: ) Page 2
Suite/bldg./apt.no.: f 1135 Project name: Ore n Ilk73c14. Manufactured home utilities 50,03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
-
Sanitary sewer(no.linear ft.: 1 Page 2
----- Storm sewer(no.linear ft.: 1 Page 2
Water service(no.linear ft.: 1 Page 2
Subdivision: l Lot no.: Fixture or item:
Tax map/parcel no.: 2570 0123 6fp Backftow preventer 31,27
Backwatervelve 12.51
DESCRIPTION OF WORK
/ Clothes washer 25.02
Tns .I l (I) brea.kramm SrnK A cifshwt2ser(tUdi ) Dishwasher 1 25.02 ?TA
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ❑ 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 12.51
NT APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
n.I . err Medical gas(value:$ ) Page 2
Business name: 841,mt as Co
Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 1 25.02 x,l;',i-
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail:QC� OI t;(�1� -Cam - _ Urinal 25.02
Water closet 25.02
,,.1 CONTRACTOROt� (� �• Water healer 37.52
Business name:A-Pt 6ol jte, Corn.56 hlec,ha` oral 1riC.. Water piping/DWV 56.29 -- -
Address: I5f (0 i LCJ ILr lace C �7 Other: 25.02
City/State/Z►PO rC n C i , �• 91Q15 Subtotal 5--et.c,
Phone:�rh3)51'1-'1 iC y Fax:(Jb3)5/3-Q 3 Minimum permit fee: $72.50 7 1
13z tin / ; '/fd / Planareview (25°e%ofpemvtfee)
CCB Lic.: Plumbing Lic,no,; r1,862,33 ?file
State surcharge(12/o of permit Lee) 7(,)
Authorized signature: TOTAL PERMIT FEE ri,h
Print name: Date: ioz,5 This permit application expires ifs permit is not obtained within 190 days
1�nd,re� G F>�61.r • i I�w�ur�" after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
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Plumbing Permit Aaalication - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site"Utilities Qty. fee iea1 Foal ; Square.Foo• tage: Permit Fee:
Footing drain-1"I00' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 59.69
3,601 to 7,200 $ 3.20
Sewer-1st 100' 62.54 22
7,201 and greater $3 7.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54 ValUetiQn Permit Fee.
$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 far the first$5,000.00 and$1.52 for
Other Inspections or Fees t2ty Nee WO Total ." each additional$100.00 or fraction thereof,to
p and including$10,000.00.
Inspection of existing plumbing or for 510,001.00 to$25,000.00 5148.50 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-12 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 5379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspeclion 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*. Bin Review:for Phimbmg'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: upped Added Relocate Baptistry/Font 0 Any new commercial building with water service 2',
and
Bath: -Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-Jacuzzi/Whirlpool •
Car Wash: Each Stall El New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
- hrCuspidor/WalerAsrive T El Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
-Domestic 1 ❑ 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 Miser Diagram
4.. 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
-Industrial food related
Ice Mach/Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non-food related
-Bradley
-Com/Serv/Util food related •
-Service *Note: if the fixture work under this permit results in an
Swimming Pool Filter
Washer-Clothes increase of sewer EDIIs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
•
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