Permit CITY OF TIGARD PLUMBING PERMIT
111 _. COMMUNITY DEVELOPMENT Permit#: PLM2021-00071
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/15/2021
T(q 1(i.f) g Parcel: 2S115AA00100
Jurisdiction: Tigard
Site address: 16114 SW 108TH AVE 31
Project: Brightwaters at Redhawk Subdivision: WILLOW-BROOK-FARM Lot: 36
Project Description: Replacing water piping throughout unit.
Contractor: MP PLUMBING CO Owner: DHP BRIGHTWATERS LLC
PO BOX 393 32 MEADOW HILL DR
CLACKAMAS,OR 97015 TIBURON,CA 94920
PHONE: 503-655-9161 PHONE:
FAX: 503-655-1726
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 02/19/2021 $56.29
Specifics: 1 12%State Surcharge- 02/19/2021 $8.70
Plumbing
Type of Use: MF 16 ea Minimum Fee Adjustment- 02/19/2021 $16.21
Plumbing
Class of Work: ALT
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 952-001-0010through 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: Hotly
V[a-i'VDP/j11P.e Permittee Signature: OW r4Yi7iLLcatwn
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 E- 2 n 2 i
Building Fixtures Flilt UFFiri 1 St. tiNI,N
rt nyy Received �] /'
. 8 CB l 1 7t!L� DoleJB, .? ./ 91 Panic Na: i i-`0_o,`",
P3125 S 503.718.2439ralllvd. Fax: 503.59223 Plan Review / / 4 '
b' g �_
III II 13125 SW Hall Blvd.,Tigard,OR 972
I : 1960 1 nDalciBTOther Permit No,:
T I G Res late]Inspection Line: 503.639.4175 Date Ready/By: ® See Pape 2 far
Internet: www.tigard-otg0v ' Notified/Method: Supplemental Information
TYPE OF':WORK : FEE` SCHEDULE
❑New construction ❑Demolition For special information use checklist
,_./ Description I Qty. I Ea. I Total
Ili Addition,alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 fl.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
- .
[31-and 2-family dwelling ❑Commerciai/industrial SFR(2)bath 437.78
,�/ SFR(3)bath 500.32
El Accessory building (;Q 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: ib J I i-I . W 1 tx3 1% A-t/�,•• Catch basin or area drain 18.76
�1 Drywell,leach line,or trench drain 18.76
City/State/ZIP: 'r6yr 2 OR g794 Footing drain(no.linear ft.: Page 2
Suite/bldg/apt.no.: 31 , Project name: 'y .j ei* * Manufactured home Utilities 50.03
Cross street/directions to job site: 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.:JkQ) .2 Page 2 IX.CC
Subdivision: I Lot no.: Fixture or Item:
Tax map/parcel no.: Backflow preventer 31.27
-- ' ' . Backwater valve 12.51
DESCRIPTION OF WORK
' [r Clothes washer 25.02
RIICI.C'lfpFO of?rOX!/1`)a7Te)y IbQ` Ot' um1-C/ Dishwasher 25.02
•
•',,:: Fr`l'.l si¢ r tA/1t4"' v? I Drinking fountain 25.02
Ejectors:sump 25.02
❑ PROPERTY OWNER . -❑ TENANT Expansion tank I2.51
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
0 APPLICANT ''.' , ' * 0 CONTACT PERSON Interceptor/greasetrap 25.02
Medical gas(value:S ) Page 2
Business name:
Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sinklbasinllavatory 25.02
City/Stale/ZIP: Solar units(potable water) 62.54
Phone:( ) { Fax;:( )
Tub%shower/showerpan. 12.51
Urinal 25.02
E-mail:
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: / `'l f t
/7 �I rl�l.Wl/jtnfi Ci(J. WaterpipinglD�W / 56.29
Address: /Ox 343 11 Other: 25.02
City/State/ZIP: G p,c Kalh4sl 'sr q 70(5 Subtotal 72.50 .
Phone:(5 ) �,S 1141 Fax:($pa ) 650 7050 Plan Minimum permit fee:permitfee)
a7r/� ���„ n review (25%of fee)
CCB Lie.: 7r/ Plumbing Lie,no.: j 1 Slate surcharge(12%of permit fee)
Authorized signature: ( TOTAL PERMIT FEE
r This permit application expires if a permit is not obtained within ISO days,
I Print name: All s're,�I G ce,re Date: 2-1! - after It has been accepted as complete.
•Fee methodology set by Tn-County Building Industry Service Board
I\Basklmgtamita9't.iAtU'PemuiApp.dac 10/01/09 40.4616Tt10/O2/COMJWEBt
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 S 121.90
Footing drain•each additional 100' 37 52 2.001 to 3,600 S169.69
3,601 to 7,200 S233.20
Sewer-1st l00' 62.54 7,201 and greater S327.54
Scwcr-each additional 100' -'7..52
Water Service-1st 100' "� '` 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-Ist 100' 62 S4 $1 00 to$5.00000 Minimum fee$72 50
Storm&Rain Drain-each additional 100' 37.52 55,001.00 to 510,000.00 S72.50 for the first$5,000.00 and 51.52 for
Other Inspections or Fees Qh'• Pei(n) Taal each additional$100.00 or fraction thereof,to
and including S10,000.00.
Inspection of existing plumbing or for $10,001.0010 S25,000,00 S 148.50 for the first 510,000.00 and 51.54 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 S25,000.00.
Inspections outside of normal business 90.00/hr S25,001.00 to S50,000.00 $379.50 for the first S25,000.00 and SI.45 for
hours(minimum charge—2 hours) each additional S 100.00 or fraction thereof,to
Reinspeclian Fees 90.00/hr and including S50,000.00..
Additional plan review for revisions 90.00/hr S50,001.00 and up S742.00 for the first$50,000..00 and S 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 far Roland Please check all that apply.
Work Performed; Capped Added 'Relocate`
Baptistry/font 0 Any new commercial building with water service 2"and
' greater,except systems designed and stamped by licensed
Bath -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040..
ElCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher. Carnmercial 0 Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit j sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Rlser Diagram .
4' ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage -Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice MachlRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec Vehicle Dump Station
Shower -Gang
-Stall
Sink; -LavBar non-food related
-Bradley
-Corn/Seri/Nth food related
-Service *Note: if the fixture work under this permit results in an
Swimming Pool Filler 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
Dther Fixtures:
3uilding\Permits\PLMF_PelmitApp.doc 08.1042011 2