Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020-00509
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/21/2020
TIGARD 13125 2S104CD01600
Jurisdiction: Tigard
Site address: 13995 SW MISTLETOE DR
Project: Schmidt Subdivision: HILLSHIRE ESTATES Lot: 16
Project Description: Install(1)new sink in kitchen island and replace(1)existing lavatory sink in powder bathroom. Water meter upsize
is not required per UB.
Contractor: PRESTIGE PLUMBING LLC Owner: SCHMIDT,TIMOTHY&KAREN
164 HARDING BLVD 203 S POPLAR AVE
OREGON CITY, OR 97045 BREA, CA 92821
PHONE: 503-702-9269 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 12/21/2020 $25.02
Specifics: 1 ea Lavatories 12/21/2020 $25.02
1 12%State Surcharge- 12/21/2020 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 12/21/2020 $22.46
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: 'e`e Permittee Signature: 1:94/ (!t0/47E.,e- -r7O
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 Application /� y�
Building Fixtures RECE VED �i Pnu WFI( . l Si 0A1.1'
- City of Tigard DEC 4 e 2020 Ri;:ivy: i2/1e V Permit No.pL� ZQ GV'dV�Ql
• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 -tlt) ��Y: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 - .,,,! Date Ready/By: turn: ® See Page 2 for
Internet: www.tl gard-or.gov Nolified/Method: Supplemental Information
TYPE OF WORK 1. FEE" SCHEDULE aMil
0 New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
X❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTEN lirSFR(I)bath 312.70
❑X 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
e C I ORMATION AND LOCATIO 1 Site utilities:
Catch basin or area drain 18.76
Job site address: 13995 SW Mistletoe Dr.
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard,OR 97223
Footing drain(no.linear ft.: 1 Page 2
Suite/bldg./apt.no.: I Project name: R2OSMD Manufactured home utilities 50.03
Cross street/directions to job site: SW Hillshire and SW Mistletoe Dr. Manholes 18.76
Rain drain 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: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Remodel project: Install two new sinks. Dishwasher 25.02
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/Stale/ZIP: Hose bib 25.02
Phone:( ) Fax: ( ) Ice maker 12.51
T El CONTACT PERSON Interceptor/grease trap 25.02
b" :... ❑ APPLICANT
Medical gas(value:$_) Page 2
Business name: LHL Homes,Inc.
Primer 12.51
Contact name: Tim Leslie
Roof drain(commercial) 12.51
Address: 11580 SW 67th Ave. Sink/basin/lavatory 2 25.02 50.04
City/State/ZIP: Portland,OR 97223 Solar units(potable water) 62.54
Phone:( 503)348-3001 Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: tleslie@lhlhomes.com
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Prestige Plumbing LLC Water piping/DWV 56.29
Address: 164 Harding Blvd, Other: 25.02
City/State/ZIP: Subtotal 50.04
Oregon City.OR
Minimum permit fee: $72.50 72.50 y
Phone:(503 ) 702-9269 Fax:( ) /Plan review (25%of permit fee) _3044-
CCB Lic.: 207987 Plumbing Lic.no.: pg1651
// State surcharge(12%of permit fee) ..14 l0""d ,7 O
Authorized signature: F-Ltron SiGrr`et` rn, v.riketl e,Gar Pole, TOTAL PERMIT FEE
Q,un.n
Print name: Aaron Sharer Date: This permit application expires if a permit Is not obtained within 180 days
12/07/2020 after it has been accepted as complete. tip
*Fee methodology set by Tri-County Building Industry Service Boar.
I:1Building\Permils\PLMU-PermilApp.doc 10,01,09 440-4616T(I NOUCOMIWEB)
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities lialf& Qty. Fec1 a) Tom" 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: f 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 Qty. Fee(ea) 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 $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$50,000.00.
Additional plan review for revisions 90.00/lu $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 flew for Plumbing Installatffns
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
-Jacuzzi/Whirlpool engineer.
❑
Car Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El Any multipurpose fire sprinkler system.
Domestic ID 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"
Isometric or Riser Diagram ME
4 ❑ 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: -Lair/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
Water Extractor fees 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_PermitApp.doc 08/04/2011 2
Water Meter Fixture Unit Worksheet for Additions/Remodels/AD Us
Please complete the following information:
Customer Name: Tim and Karen Schmidt
Service Address: Street/Suite#: 13995 SW Mistletoe Dr.
City: Tigard State: OR Zip: 97223
Phone Number: Email:
Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add.
Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at
total. the proposed total.
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
Bar sink x l = 1 x 1 = 1
Bidet x 1 = x 1 = 0
Clothes washer 1 x 4 = 4 x 4 = 4
Dishwasher 1 x 1.5 = 1.5 x 1.5 = 1.5
Hose bib 1 x 2.5 = 2.5 x 2.5 = 2.5
Hose bib,each 1 x 1 = 1 x I = 1
Kitchen sink 1 x 1.5 = 1.5 x 1.5 = 1.5
Laundry sink 1 x 1.5 = 1.5 x 1.5 = 1.5
Lavatory 5 x 1 = 5 x 1 = 5
Water closet, 1.6 GPF 4 x 2.5 = 10 x 2.5 = 10
Bathtub/whirlpool 1 x 4 = 4 x 4 = 4
Shower stall 1 x 2 = 2 x 2 = 2
Bath/shower combo 1 x 4 = 4 x 4 = 4
Current Points: 37 Proposed Increase: 38
Current Points+Proposed Increase= 38 =New Total Points =Required Meter Size
1"
Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points='/a" 37.5 and over points= 1"
New Meter Size Needed for New Total Points: 1 Cost: $ (see page 1)
Current Meter Size per Utility Billing: 1 Cost: $ (see page 1)
New Meter Size Cost minus Current Meter Size Cost= $ No Changes
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units)
*************************************************************************************
FOR OFFICE USE ONLY ,-'
Current Meter Size Confirmed with UB f Semi` 12/17/20
Signature of UB Representative Date
I:/Building/Forms/WaterMeters_070119 Add.dOCX Page 2
Dianna Ornelas
From: UB Online
Sent: Thursday, December 17, 2020 6:22 PM
To: #Building Permit Technicians; UB Online
Cc: Prestige Plumbing
Subject: RE: FW: Plumbing Permit/13995 SW Mistletoe
Attachments: 13995 SW Mistletoe Dr 121720.pdf
Categories: Dianna
The above-mentioned address currently has a one (1) inch meter so will not need any upgrades.
Kind Regards,
Jill
(she/her/hers)
�i A WOiL,.t." Jill
EI415CAM8EANyi c; . ' City of Tigard -UtihtyBilling
N�• ■ Senior Accounting Asst
1 'A '. (888)826-7211 Payments
tk (503)718-2460 UB Main
jilib@tigard-or,gov
(503)718-2494
Aril I lel, 13125 SW Tigard,OR Hall
97223
From:
3
From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Sent:Thursday, December 17, 2020 12:21 PM
To: UB Online<UBOnlinepay@tigard-or.gov>
Cc: Prestige Plumbing<prestigeplumbingpdx@gm.ail.com>
Subject: FW: FW: Plumbing Permit/13995 SW Mistletoe
Hello UB,
Please see attached water meter worksheet for your review and approval.
Thank you.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
From: Prestige Plumbing<prestigeplumbingpdx@gmail.com>
Sent:Thursday, December 17, 2020 11:56 AM
1