Permit CITY OF TIGARD PLUMBING PERMIT
� '! COMMUNITY DEVELOPMENT Permit#: PLM2021-00065
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/23/2021
Parcel: 2S102CB03101
Jurisdiction: Tigard
Site address: 12950 SW PACIFIC HWY 285
Project: Spec Space Subdivision: FREWING'S ORCHARD TRACTS Lot: 21
Project Description: Interior plumbing:Adding(1)sink.
Contractor: JTR PLUMBING INC Owner: HUDSON PLAZA LLC
4272 NE BEAUMEAD ST 11795 SW KATHERINE ST
HILLSBORO, OR 97124 TIGARD, OR 97223
PHONE: 503-209-4290 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 02/18/2021 $25.02
Specifics: 1 12%State Surcharge- 02/18/2021 $8.70
Plumbing
47 ea Minimum Fee Adjustment- 02/18/2021 $47.48
Type of Use: COM 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 952-001-0010 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: ,,„
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
RECEIVE i
Building Fixtures FOR OFFICE USE ONLY
City Of Tigard FEB U 4 2021 Received �h �� _
Date/By: 7/ '8,j Permit No.,,,,,,,„.....,,
,,„�GZ_.
IN • 13125 SW Hall Blvd.,Tigard,OR 97223r QF TIraARL7 Plan ReviewL �!>: Phone: 503.718.2439 Fax: 503.598.I (� c A,Date/By: Other Permit No.:( l_,_ 0,3/
Inspection Line: 503.639.4175 ING DIVISIOI�IDate Ready/By: Juris: ® See Page 2 for c7 W
TIGARD ig g Pf /` " /�.,'' 7,76 pp Internet: www.tigard-or.gov Uv Notitied/Method: (/� -��/ /.`V Supplemental information
'TYPE OF WORK e vts2. ')�, FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
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(I)bath 312.70
- -
❑ 1-and 2-family dwelling X 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
JOB SITE INFORMATION AND LOCATION Site utilities:
Y.5® c IA, pa C f t, �/ Catch basin or area drain 18.76
Job site address: Ch /' /7 ����/ Drywell,leach line,or trench drain 18.76
City/State/ZIP: V/�+,
7" - Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 2 A S Project name: r G pA62., 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.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: ). j( /(. }-63 O 3/ Backflowpresenter 31.27
P
Backwater valve 12.51
DESCRIPTION OF WORK
- -- Clothes washer' 25.02
^1 Q -- ,j2 __ 2 f -- -__-- _-_--_--- Dishwasher 25.02
/ ell) f r X-r,,,?-r:'" _ _- Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ 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
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
- Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory i 25.02 025-;10..
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: /J tJL{'f g Urinal 25.02
1-,F'��"r r��. �� � `�� Water closet 25.02
C _ TRACTOR
Water heater 37.52
Business name: ,./7ic nItj M A//y Water piping/DWV 56.29
Address: !J n i7 z-- - )r 3, Other: 25.02
Subtotal )3";
City/State/ZIP:bt,-//S fja ro 02-' 97/`_Si -- - -
Phone:(e0�) 2 4 Cj - C�� �/�j Fax:( ) J _-- Minimum permit fee: $72.50 7
CCB Lie.: / / '%i, f Plumbing Lie.no.: 3 f1 L'2� Plan review (25%of permit fee)
S Y 1l 7 State surcharge(12%of permit fee)
Authorized signature: � ��'� TOTAL PERMIT FEE / i)
This permit application expires if a permit is not obtained wit m ISO days
Print name: Date: / 2 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Budding'Permits\PLMU-PermitApp.doc 10/01/09 440-461 6T(IO/02/CUM/WEB) a
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
WaterService- Ist 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Stonn&Rain Drain-1st 100' 62.54 L00 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$1(10.00 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 S50,000.00 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 Review for Plumbing 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: Capped Added Relocate ID Any Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator - ❑ Medical gas and vacuum systems for health care facilities.
❑ Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
Domestic El Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
e Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
Isometric or Riser 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 Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) -
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service I *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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Branden Taggart
From: Branden Taggart
Sent: Wednesday, February 17, 2021 5:37 PM
To: jtrplumbing66@outlook.com
Subject: Plumbing Permit for 12950 SW Pacific Hwy Suite 285: PLM2021-00065 &
SW R2021-00031
Attachments: Invoices &Sewer Tally.pdf
Hi Jorge,
The spec space Plumbing and Sewer permits, located at 12950 SW Pacific Hwy Suite 285,are ready to issue now. I have
attached invoices above for you to reference,and the fees due are as follows:
Spec Space
Permit# Fees Due
PLM2021-00065 $ 81.20
SWR2021-00031 $ 1,102.00
Total: $ 1,183.20
The above fees can be paid online through our website: https://aca.accela.com/TIGARD/Default.aspx. From there, click
on the Building tab, enter the permit numbers in the Record Number field, and click Search. Once paid online, please
notify us at tigardbuildingpermits@tigard-or.gov, and I will email the permit paperwork to you. Furthermore,the permit
fees for both permits will need to be paid before we can issue either of them. Please let me know if you have
questions.
Thank you,
Branden Taggart
III City of Tigard
N Senior Permit Technician
Community Development
T4i;ARD
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
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