Permit CITY OF TIGARD PLUMBING PERMIT
.1111
COMMUNITY DEVELOPMENT Permit#: PLM2021-00038
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 1/27/2021
T I C.L4It I-) g Parcel: 2S110DA00300
Jurisdiction: Tigard
Site address: 10771 SW LADY MARION DR
Project: Trillium Hill Subdivision: TRILLIUM HILL Lot:
Project Description: Backflow preventer for irrigation to sale trailer.
Contractor: TRADEMARK LANDSCAPES INC Owner: CASCADE CIVIL DEVELOPMENT INC
PO BOX 2410 PO BOX 1060
OREGON CITY, OR 97006 WOODBURN, OR 97071
PHONE: 503-631-3893 PHONE:
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 01/27/2021 $31.27
Specifics: 1 12%State Surcharge- 01/27/2021 $8.70
Plumbing
Type of Use: MF 41 ea Minimum Fee Adjustment- 01/27/2021 $41.23
Class of Work: ALT 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 mo : the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules . - 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 50 . .1987 or 1.800.332.2344.
Issued By: Permittee Signature: L� AWA16477.01(
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.
1 Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application //fit/ --
' Building Fixtures RECEIVE I FOR OFFICE/i USE ONLY
)� �r��I�(�
City of Tigard a DateiByy a//27 20/ \ Permit N 2 2 O
JAN 1 Date/B
• 13125 SW Hall Blvd.,Tigard,OR 9722320�� Plan Review
L. Phone: 503.718.2439 Fax: 503.598.1960 Date By: Other Permit No.:
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Readyily: Juris El See Page 2 for
Internet: www.tigard-or BUILDING 17F1f1 Notified.Method: Supplemental Information
TYPE OF WORK DIVISION FEE* SCHEDULE
For special information use checklist.
®New construction El Demolition
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building EJ Multi-fancily
yEach additional bath/kitchen 25.02
❑Master builder ®Other:Manufactured Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:
i O 1?I •J L - Li Catch basin or area drain 8.76
Drywell,leach line,or trench drain 18.76 •
City/State/ZIP:Tigard/OR/97223 (t'j (LiUN
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Trillium Hill 1)I' Manufactured home utilities 50.03
Cross street/directions to job site:SW 109th Ave and SW Lady Marion Drive 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:Trillium Hill Lot no.:4 Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
Irrigation and backflow to lot 4 for sales trailer landscaping
Dishwasher 25.02
Drinking fountain 25.02
• Ejectors/sump 25.02
I PROPERTY OWNER ( ❑ TENANT Expansion tank 12.51
Name:Weekley Homes LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 1905 NW 169'Place Suite 102
Garbage disposal 25.02
City/State/ZIP:Beaverton/OR/97006 Hose bib 25.02
Phone:(503)213-4415 Fax:( ) Ice maker 12.51
0 APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name: David Weekley Homes Medical gas(value:$_) Page 2
Printer 12.51
Contact name:Michele Schiedler
Roof drain(commercial) 12.51
Address:1905 NW 169th Place Suite 102 Sink/basin/lavatory 25.02
City/State/ZIP:Beaverton/OR/97006 Solar units(potable water) 62.54
Phone:(503)213-4415 Fax::( ) Tub/shower/shower pan 12.51
E-mail: , SJ ,cdkr@Q/v✓60r-CS-Gom Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:Trademark Landscapes,Inc Water p tPing/DWV 56.29
Address:PO Box 2410 Other: 25.02
City/State/ZIP:Oregon City, 4 ' '7045 Subtotal
Phone:(503)6320319 / Fax ( ) Minimum permit fee: $72.50
CCB Lie.:LCB#6796 Pt ing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Michele Schiet Date 1/l8/21 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.
19 Budding\Pcnnits.PLMC-PerrnitApp_doe 10;01.:09 440-1616T(10/02/COMIWEB)
• 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-1' 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$5,000.00 Minimum lee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 S72.50 for the first$5,000.00 and S 1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof;to
I� 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 S25,000.00 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/hr $50,001.00 and up $742.00 for the tirst$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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace! Plan review is required for anyof the following.
Work Performed: Capped Added Relocate 9 n
Baptistry/Font Please check all that apply.
ath Tub/Shower ❑ Any new commercial building with water service 2"and
Bgreater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool
Car Wash -Each Stall engineer.
-Drive Th,u 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial D Medical gas and vacuum systems for health care facilities.
-Domestic 0 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
lee Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
SinlcJLav -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
WaterCloset-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
U:\Communities\68029999-POR-2017-Summerbrook\Sales Trailer\Sumn2rbrook Sales Trailer Plumbing Permit. Irrigation and Backflow.doc