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Permit CITY OF TIGARD PLUMBING PERMIT 2 : COMMUNITY DEVELOPMENT Permit#: PLM2021-00066 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 2/19/2021 Parcel: 2S109AC00600 Jurisdiction: Tigard Site address: 14715 SW 133RD AVE Project: RIETMAN Subdivision: None Lot: None Project Description: 125 ft.of sanitary sewer to connect existing house to sewer. Septic tank to be pumped and filled. Contractor: SUPERIOR UNDERGROUND LLC Owner: RIETMAN, SHAWN C&B JORINE 6400 SE 101ST AVENUE SUITE 3 14715 SW 133RD AVE PORTLAND, OR 97266 TIGARD, OR 97224 PHONE: 503-750-0020 PHONE: FAX: FEES Quantity Description Date Amount 125 If Sanitary Sewer 02/18/2021 $100.06 Specifics: 1 12%State Surcharge- 02/18/2021 $12.01 Plumbing Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $112.07 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: i!bGz-Y Permittee Signature: ©/V / /©G/ C- 41 �T7o 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 ApplicationE-2 21 nP_ Site Utilities ' 'a..,. � .°• FOR OFFICE USE ONLY City of Tigard Received 114 +t 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �1f 7/'�! Permit No.:/2G .2 _����yy Phone: 503.718.2439 Fax: 503.598.1960 Plan Review t.C.t, '2 4,7-` Date/By:th Other Permit No.:� 1 j_ n Inspection Line: 503.639.4175 i a( m, T i G ARI) Internet: www.tigard-or.gov Date Ready/By: �l Jur,s See page 2 for Notified Method: �� J).t > "(1 Supplemental Information TYPE OF WORK ;;, a( 4 j:7.0--- FEE* SCHEDULE, ❑New construction ❑Demolition For special in Urination use checklist, j Description Qty. Ea. Total Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CA1EGORI OF CONSTRUCTION SFR(1)bath 312.70 ,w 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78 - ❑Accessory building _ ❑Multi-family SFR(3)bath 500.32 Master builder Each additional bath/kitchen 25.02 ❑Other Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION' AND LOCATION Site utilities: Job site address: j -� {t( Catch basin or area drain 18.76 � Drywell,leach line,or trench drain 18.76 City/State/ZIP: -I;0 Ct.tr' J ! co 1'.e4 Footing drain(no,linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: ^� Manufactured home utilities 50.03 Cross street/directions to job site:,'c eu.1/ f) ilteii , 1 ec(. Manholes 18.76 (A.) /5 Z '''•A Rain drain connector 18.76 /6 +oil Sanitary sewer(no,linear ft.:(2�7pl, Page 2 / 1 j t. Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: BackIlow preventer 31.27 DESCRIPTION OFWORK Backwater valve 12.51 r . Clothes washer 25.02 Ei'lt�"t � Y�� 'S-e- d-e 6 +''`''r.A.,- �+,C'1-e t"... JA,c t'' .",J " Dishwasher 25.02 c`4Y I0,[,^" " "t Lrp /' - . 4 ] 4. Trey(( f'l J+.. Drinking fountain 25.02 1A- ( If/ i' C - 3Q3`'1 1''-'Li"C._ Ejectors/sump 25.02 --1011 PROPERTY OWNER [ ❑ TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZI'P: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 " APPLICANT PERSON Interceptor/grease trap 25.02 Business name: mod. / Lt.- Medical gas(value:$ ) Page 2 Y' G/v•jar- lA.�lfs'� fx�o Contact name: CLAA CJ Primer 12-51 Address: t0 j�as t��I St .f Roof drain(commercial) 12.51 .6 • e.. - 7 _ Sink/basin/lavatory 25.02 City/State/ZIP: /gr..4.--( / 49 `°T? Solar units(potable water) 62.54 Phone:(TO) 7 5 ) ,_e-70 2 0 Fax::( ) Tub/shower/shower pan 12.51 E-mail: t dW � / g Urinal 25.02 u e ro LL k4ret-.et { : Lic. - CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: 5 ,'rf O rk_ �/ i rt-+-'- Water ptpmg/DWV 56.29 Address: Other: 25.02 City/State/ZIP: 1'U L.<6,... -- -it OO 1.5/ 7 7 7 Subtotal It ".l"-ii..k Minimum permit fee: $72.50 Phone:( ) Fax:( ) CCB Lie.: *Z.,_i 9' j/CI ,� 1 rl).Z Plumbing Lie.no.: Pete,Z- Plan review (25%of permit fee) ,�"�' r State surcharge(12%of permit fee) /) G'7 j Authorized signature: C:✓L..r-- `� y TOTAL PERMIT FEE r77 Print name: f47 This permit application expires if a permit is not obtained within 1ti Jays after it has been accepted as compete. *Fee methodology set by Tri-County Building Industry Service Board. i Build ag\Peraixs PLbit1 YormIIApp doe 10/01/09 440 4616 J(I i/O2 CO vvwEB) ws z.i. Plumbing Permit Application - City of Tigard Page 2 -Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Fee: Qty. Fee(ea) Total Square Footage: Permit Site Utilities Footage: Footing drain-t"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' LE) (1 62.54 7,201 and greater $327.54 Sewer-each additional 100' .i 37.52 Water Service-f st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 --- Valuation: PerInit 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) Tow 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$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 (minimum charge-I/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! Work Performed: capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath -Tub/Shower ❑ 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 Dornrstic-non-food El Isometric or riser diagram is required for new buildings Disposal -Domeatic-lhod related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice MachJRcfrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: 'tee.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. Alai V` W : Other Fixtures: s� � � p ac ° r fn fir, �'F a�,G a+�".7£ jtr" �?nmr'+"i f".� %Fax "`4 -0 y �,o i . ' `� ( " 1xt � "i ����h 0410 s r A� I:ABuilding\Permrts\PLMU_PermitApp.doe 2 • k. �d v aW x" 1,.. Branden Taggart From: Branden Taggart Sent: Thursday, February 18, 2021 10:38 AM To: Superior Underground Subject: Permits for 14715 SW 133rd Avenue: PLM2021-00066 & SWR2021-00032 Attachments: Invoices.pdf Hi Ryan, The Plumbing and Sewer permits for 14715 SW 133rd Avenue have been created and they are ready to issue now. I have attached invoices above for you to reference, and the fees due are as follows: Permit# Fees Due PLM2021-00066 $ 112.07 SWR2021-00032 $ 5,835.00 Total: $ 5,947.07 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 we 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 a City of Tigard $ ,. Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent©tigard-or.gov 1