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Permit
CITY OF TIGARD PLUMBING PERMIT 114-' COMMUNITY DEVELOPMENT Penult#: PLM2020-00398 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/21(2020 T I '"�Ix f i 9 Parcel: 2S114AD00100 Jurisdiction: Tigard Site address: 16605 SW 85TH AVE Project: Clean Water Services Subdivision: None Lot: None Project Description: Site utilities associated with the replacement of Fats,Oils,Grease(FOG)storage tanks and rainwater catchment for new awning structure. Contractor: STETTLER SUPPLY COMPANY Owner: CLEAN WATER SERVICES 4420 RIDGE DRIVE NE 2550 SW HILLSBORO HWY SALEM, OR 97301 HILLSBORO, OR 97123 PHONE: 503-585-5550 PHONE: FAX: FEES Quantity Description Date Amount 3 ea Catch Basin or Area Drain 12/18/2020 $56.28 Specifics: 1 ea Drywell,Leach Line or Trench 12/18/2020 $18.76 Drain Type of Use: COM 1 ea Rain Drain Connector 12/18/2020 $18.76 Class of Work: ALT 234 If Sanitary Sewer 12/18/2020 $137.58 Type of Const: 12 If Water Service 12/18/2020 $62.54 Occupancy Grp: 1 ea Floor Drain/Floor Sink/Hub 12/18/2020 $25.02 Stories: 2 ea Hose Bib 12/18/2020 $50.04 25 Misc Other Fee 12/18/2020 $25.02 1 Plan Review 12/18/2020 $98.50 1 12%State Surcharge- 12/18/2020 $47.28 Plumbing Total $539.78 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.Issued By:/ ,{ _/!;� / Permittee Signature: > T1'��r O 1t Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Site Utilities "s r FOR OFFICE USE ONLY City of Tigard � 'A""'t""°i\IL �`eeei°�d n�-/^� ,�7 D...,, t -o22r•�O a Permit No.: 2 o %) ■ 13125 SW Hall Blvd.,Tigard,OR 97223 �+� I C Phone: 503.718.2439 Fax: 503.598.1960 SE1' 2 1 2020 Daten/By: /9.,G`^ 04 Other PermitNo.�QJ„p' G 1t? Inspection Line. 503.639.4175 Date Ready/By: d J t� luris: Et See Page for vwY TICiARD Internet: www.Tigard-or.gov Notified/McthorliAlq. Supplemental Information TYPE OF WORK . ' ' '$.W e"^CNiAiidrt VTv✓ FEE* SCHEDULE Ill New construction ❑ Demolition For special information use checklist Description i Qty. I Ea. j Total ❑Addition/alteration/replacement El 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 NI Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory El Multi-family 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: 16605 SW 85th Ave Catch basin or area drain 3 18.76 6-6 j 8 Drywell,leach line,or trench drain / r 18.76 /8 t] o Ci ri/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite Bldg./apt.no.: I Project name:Durham FOG Tank Retrofit Manufactured home utilities 50.03 Cross street/directions to job site: SW 85th Ave I Durham Road Manholes 18.76 Rain drain connector 18.76 /8,7h Sanitary sewer(no.linear ft.:.23'j) 3 Page 2 137,5 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: !a.) / Page 2 6),54 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 - Replacement of existing concrete Fats, Oils, Grease (FOG) storage cl°they washer 25.02 tanks with new stainless tanks. Addition of a new awning structure Dishwasher 25.02 and slab on grade to cover new FOG screening equipment and _ Drinking fountain 25.02 associated catch basins and rainwater catchment for awning. Ejectors/sump 25.02 ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Clean Water Services Fixture sewer cap 25.02 Floor drain/floor sink/hub / 25.02 j5,0A Address: 16060 SW 85th Ave Garbage disposal 25.02 City/State/ZIP: Tigard, OR 97224 Hose bib 25.02 gad y Phone:(503) 547-8043 Fax:(503) 547-8196 Ice maker 12.51 ❑ APPLICANT E4 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Clean Water Services Medical gas(value:$_) Page 2 Primer 12.51 Contact name: Dan Garbely Roof drain(commercial) 12.51 Address: 16060 SW 85th Ave Sink/basin/lavatory 25.02 City/State/ZIP: Tigard, OR 97224 Solar units(potable water) 62.54 Phone:(503) 547-8043 Fax: :(503) 547-8196 Tub/shower/shower pan 12.51 E-mail: garbelyd@cleanwaterservices.org Urinal 25.02 Water closet 25.02 CONTRACTOR. TBDater heater 37.52 Business name: £ i e ii LE� £LI.4°6.r CoC© . Water r in WV 56.29 P�P' P� Address: L/L/ F Xt.. at ©/LI V-E- N t✓ Nose f 25.02 25,0 o� City/State/ZIP: S 9-(._ l 0, q 736 / Pose Raft( Subtotal 59%00 Phone:LS-03) S SSS D Fax:( ) Minimum permit fee: $72.50 CCB Lic.: 33 2_24. i 0 /17/21 Plumbing Lic.no.: 2_15o�� Plan review (25%of permit fee) 98,56 _ •' State surcharge(12%of permit fee) ipLi9, Authorized signature: ! -- -- =mil. ,, _C 7/I/23 TOTAL PERMIT FEE 53%Dig Print name: Daniel Garbely Date: 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-Comity Building Industry Service Board. i:`Building`Permits'PLMU-PermitApp.dor 10,01/09 440-4616T(10/02/COM/WEB) Plumbing Permit Application - Cityof 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' i 62.54 42.54' 7,201 and greater $327.54 Sewer-each additional 100' 'Z 37.52 955.0(f Water Service- 1st 100' , 62.54 0,54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit 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 p 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 Rcinspection 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) Subtotal: , dp,I,l 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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Work Performed: Capped Added Relocate Baptistry/Font Please check all that apply. Bath Tub Shower El Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser Diagram Car Wash Drain Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Permits\PLMU_PermitApp.doc 2 CleanWater Services 9/16/2020 RE.U SEP 21 202U TO: City of Tigard Building Department BOWING uIV 3ON RE: Plumbing Permit-Site Utilities For Jobsite Address: 16605 SW 85th Avenue Tigard, OR 97224 For Durham FOG Tank Retrofit project 6992. We are sending you: • Plumbing Permit— Site Utilities Application • Two sets of Site Civil Drawings. Thank you, Dan Garbely, Principal Engineer Clean Water Services 16060 SW 85th Avenue Tigard, OR 97224 503-927-9447 16060 5W 85th Avenue,Tigard,Oregon 97224 p:503.547.8150 f:503.547.8151 cleanwaterservices.org