Permit CITY OF TIGARD PLUMBING PERMIT
111 COMMUNITY DEVELOPMENT Permit#: PLM2021-00020
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/23/2021
T I i ;1 R.t, g Parcel: 2S101 BC00500
Jurisdiction: Tigard
Site address: 12300 SW KNOLL DR
Project: Fredrick Stolt Subdivision: KNOLL ACRES Lot: 10
Project Description: Install(1)lavatory,(1)water closet,(1)shower stall in new bathroom,and replace(1)lavatory,,(1)bath/shower
combo and(1)water closet in existing bathroom
Contractor: OWNER Owner: STOLT, FREDERICK
12300 SW KNOLL DR
TIGARD,OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Lavatories 02/22/2021 $50.04
Specifics: 2 ea Tub/Shower/Shower Pan 02/22/2021 $25.02
2 ea Water Closet 02/22/2021 $50.04
Type of Use: SF 1 12%State Surcharge- 02/22/2021 $15.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $140.11
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.
7\ci\A
Issued By: �,fle `�� Permittee Signature: •r��t '�„�
on CAppl
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.
Amminimmiiiii
Plumbing Permit AnnlicatiBECEIVED
- Building Fixtures JAN 4 20Z1 FOR OFFICE USE ONLY
City of Tigard Revciyed %i i 4‘IA v‘•) Permit No:?1.01107A•"00020.
.. „...a 13125 SW Hall Blvd.,Tigard,OR 972;rrry OF TGARD
II IliteAly:_
_„___
Plan Iteview
-
X Phone: 303.7 18.2439 Fax: 503.598 Date4iy:.11K) Other Permit No.:
' Inspection Line 503.039,4175 BuaDING owistoN --6-77 R ad s . % % h" -
TIGARD sacaeinetitMYethYtO‘Wil A NW) : 61 See Pegs.2 I*"Internet: www.tigard-ongov
Sup Information
. .. ....__
TYPE OF WORK Etts'Nes;I et FEE* SCHEDULE
Ej New construction
- . ______4 0 Demolition__
- DescAr;Mon ,or special mform an ah use elfeekhAt
1 QVV. i Fa. L Tot,t 4.
1 It Addition/alteration/replacement 0 Other:
New I-2-famlly dwellings(includes 100 ft Inc stitch utility connection)
- -
CATEGORY OF CONSTRUCTION SFR(I)bath 0 312.70
-----1----- m _
SFR(2)bath a 437.78 (2)
1(5 1-and 2-family dwelling 0 Commercial/industrial -__ _____
SFR(3)bath 0 500.12
I4 0 Accessory buildir;„ 0 Multi-family
Each additional bath/kitchen a 25.02
Ei Master builder 0 Other:
Fire sprinkler( sq.It) AZ Page 2 04) *
JOB srrE INFORMATION AND LOCATION Site utilities: ______ ____
Catch basin or area drain 0 18,76
Job site address: (24S
lia3(//0, , -;;(11 trtzx LL '4)7
Drywell,leach line,or trench drain a 18.76 (25
City/State/ZIP: mr. (--.).(2 ci-7;)D 3 Footing drain(no.linear ft.: _) e) , Page 2 (2r
Suitelbldgl home
apt.no.: Project name: a _ _ Manufactured utilities Cr, 50.03
---__
Cross street/directions to job site: /0 ,.--)14% j.)ci lijtil 4,„,,,,) 61-y Manholes 18.76
Ha II 1 C' 11-* / 1.40/1_._DIL..... ____6_rey IUNA-Cr'' Rain drain connector
18.76 125
19 a 1
Ott4 / Sanitary sewer(no.linear tt.:_1 0 Page 2
tsit It4+, . _ Fr- Storm sewer(no.linear ft.: ,) a rage 2 V
.
13 cicVic 1.4iiakr _Fs.1-iAre- WI iti6r 6 - '.. 1'C UrkezA Water service(no.linear ft.: ) 0 Page 2 q5
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Rackflow preventer 0 31.27
, _______
"---------- Backwater valve (2) . 12.51 0
DESCRIPTION OF WORK
0 -
Clothes washer - •
15 02
175
(1..e,,) •SrAhrooro.,..y ?Lem hiact _F",..r Dishwasher 25,02
,-.1.1... , ,of
25.02
g
..1 plciL,,e...nen...L_ botsaticoacra_ Drinking fountain
Eteetors/surup re 25'02_,
I a PROPERTY OWNER 0 TENANT Expansion tank 12.31
Fixture/sewer cap (25 25.02 (c?,
Name: Fr-,,.. 1. ,...-,i._i '' .-.6.tE __
Floor drain/floor sink/hub 25.02 0c
e?...5,
Address: , T, : : _ ^'S(4) ... Garbage,disposal Om 25.02
City/State/ZIP: --rr1j cz, cri Da3 I
1 Hose bib -
0 25.02 EX
-- t 3- - _ .y....."
I Phone:(903,) 3 i',: .-0 4,6-7 Fax:t ) 4 Ice maker C/5 12.51
,...„
St APPLICANT 0 CONTACT PERSON Interceptor/grease trap _I--a- 25.02
_____,..,____
Medical PS(value:$ ) Paec 2 05 Business name: Ni -
Primer _ 12.51
- - -
Contact name: „,--
Roof drain(commercial) 0, 12.51
Address: .,,, i f" e sinkibasindavatory '64 25.02 11,5-0,0;
..._ ......
City/State/ZIP: Solar units(potable water) (5 62.54 0
Phone:( ) Fax::( ) Tub/shower/shower pan .g 12.51
- _
rinal 0 25.02 ri5
E-mail::
'------ Water closet D 25.02
CONTRACTOR
a-, Water heater 'r 37.52 in
Business name: 1/074'1,) nurdeL. Water piping/DWV 0 56.29
.<"Address:
,....t_ flk-Ve Other: 0 25.02 0
City/State/ZIP: Subtotal $1)6;ia,
...._
Minimum permit te: $72.50 $
Phone:( ) Fax ( )
- Plan review (25%of permit fee) 0
.
CCI3 tie.: I Plumbing Lie.no.:
L State surcharge(12%of permit fee) Ii /5,ce:Ii
,
Authorized signature: Ejtadezie.,; ., TOTAL PERMIT FIT, II MOO I j
. ,
Print name: 1-...7_.e.j ' , I 4.7 Jr. i 4--
i _es:A ,) c... IL 0,,,, ' - "--] This permit applielion expires Ira permit Is nut obtained within ISO days
- erter it has been accepted as complete.
.Fee methodology set by Tri-Coutuy Building Industry Service Boon.
rOinildinreemnis'sPodu-PciennApp,doc 'fruity lit ote,a2/cosvwca)
I4 Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule:
, Residential Fire Supjression Systems:
Site Utilities Qty. Feel ) Total
.., - S uare Footage: .Permit Fee:
Footing drain- l'100 50.03 0 to 2,000 S121.90
2,001 3,600 S169.69 Footing drain-each additional IOU' 37.52 to _....-__
Sewer• 1st IOU' 62.54 3 601 to 7"00, ,- S233.20
37,52 7.261 andireater S327.54
Sewer-each additional 100'
Water Service-1st IOU'
Winer IW 37.52 62.54
Medical Gas Systems:
Wer Service-each additional O
..Systems:
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
.
s 1.0o 10$5,00600 Minintutn 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 5I.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and includin S10,000.00.
Inspection of existing plumbing or bit $10,001.00 to$25,000.00 $148.50 fir 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 includip025 000.00.
Inspections outside of normal business 90.1)0/hr S25,001.00 to$50,000.00 $379.50 lot 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/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
each additional S100.00 or fraction thereof,
0 imininium charge.s I/2 hour)
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: Cupped Added Reloode
C3 Any new commercial building with water service 2"and
Baptistry/Font , . . greater,except systems designed and stamped by licensed
Bath: •Tub/Shower engineer.
-Jactzzi/Whirlpaol , 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall
as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
CuspidoriWatcr Aspirator
0 Any multipurpose fire sprinkler system.
Dishwasher; -Commercial — 0 Any complex structure as defined in 0AR918-780-0040.
-Domestic ,
Drinking Fountain . .
Submit 2 sets of plans with any of the above.
Eve Wash
.
Floor Drain/sink: -2" -
Isometric or Riser Diagram
LirTs-onietric or riser diagram is required for new buildings-
-Car Wash Drain
• that meet ihe qualifications above.
Garbage -Domestic tion-food
Disposal: 'Domestic food related
-Commercial food related
-Industrial food related ..
Comments regarding fixture work:
Ice MachAefrig.Drains
_Oil Separator(Gas Station)
Rcc,Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Loy/Bar non-food related
-Bradley
-Curn/Servilitil food related
-Service .
*Note: If the fixture work under this permit results in an •
Swimming Pool Filter
increase of sewer Finis,a sewer permit will be issued and
Washer-Clohcs
fees assessed for the sewer increase must be paid before the
Wahl Extractor
Water Closet-"foilet . plumbing permit can be issued.
Urinal
other Fixtures: . .
1:1Building\Permits1PLMF_PermitApp.doe 08/04/20 I I 2
Branden Taggart
From: #Building Permit Technicians
Sent: Monday,January 4, 2021 7:56 AM
To: 'stolt77@comcast.net'
Cc: UB Online
Subject: FW: Permit Applications - Water Meter Worksheet Included - 12300 SW Knoll Dr.
Attachments: Scan_20201208.pdf
Hello Fred,
Thank you for your submittal. I have placed the above application in our queue to be processed. Please allow 1-3 weeks
for processing. We will contact you when the fees are ready to be paid online.
Utility Billing, please see the attached Water Meter Fixture Unit Worksheet.
Thank you,
Branden Taggart
s City of Tigard
a Senior Permit Technician
Community Development
licARO
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
b ra ndent@ti gard-or.gov
From: FRED STOLT<stolt77@comcast.net>
Sent:Sunday,January 3, 2021 6:40 PM
To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Subject: Permit Applications-Water Meter Worksheet Included - Pt 1
Caution!This message was sent from outside your organization.
1
RECEIVED
JAN 42021
Water Meter Fixture Unit Worksheet for Additions/R'enodeleADU
ITY O TIGARD
Please complete the following information: BUILDING SION
Customer Name: . tecl L.r\t G C,. s- 1
Service Address: Street/Suite#r 1, a0c) c`,iA) � ) Dr
City: "`(, elrj State: OR,: _ Zip: q17 D.. 3
Phone Number: Sic , 31 - 105 7 Email: 34z 7"'0 Corn
Please till in the number of each fixture you currently hate. 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 . I _- x 1 .44
Bidet x 1 x 1
Clothes washer x 4 x 4
Dishwasher j x 1.5 I S x 1.5 =
hose bib x 2.5 x 2.5
',, Hose bib,each x 1 - x 1
Kitchen sink x 1.5
l .. a t S' x 1.5
Laundry sink x 1.5 x 1.5
Lavatory ( x I ._. x I
Water closet, 1.6 GPF x 2.5 . - 5" x 2.5 _: ar—
Bathtub/whirlpool x . ' 4 _ �TM x 4 =
Shower stall x 2 =
1 , x 2 = a; '
Bath/shower combo t x 4 x 4 —
Current Points: ((p;S." Proposed Increase: e*S"'
Current Pointss/$
+ Proposed Increase �� ; =New Total Points Required- Meter Size
Meter Sizes: Ito 30 points 5/8" 30.5 to 37 points-3" ` . 37.5 and over points= 1"
New Meter Size Needed for New Total Points /f
$ tr Cost $ el,4t(t' Q. (see page 1)
Current Meter Size per Utility Billing: 5. A��. Costs $ (it y(� ,jt fZ'1. (see page t)
New Meter Size Cost minus Current Meter Size Cost= S Q
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units)
*************************************************************************************
FOR OFFICE USE ONLY
Current Meter Size Confirmed with Uii = ` ."
Sign tire of till epresentative e T
l Date
1:/Huilding/Forms/Water Meter s_070119;Add.doCX — Page 2