Permit ) CITY OF TIGARD PLUMBING PERMIT
t ,+ COMMUNITY DEVELOPMENT ;TT Permit#: PLM2021-00180
' 1 iit Date Issued: 5/3/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S103BB10800
Jurisdiction: TIG
Site address: 12105 SW 123RD CT
Project: LIANG Subdivision: Lot:
Project Description: Additional work associated with MST2006-00163:Adding(2)sinks,(1)tub/shower,and(1)water closet.
10/20/22: REPRINTED permit to add(1)clothes washer,(1)dishwasher,(1)garbage disposal,(1)ice maker,
and(1)sink.
Contractor: OWNER Owner: CIMIN LIANG
JUAN LIU
12105 SW 123RD CT
TIGARD, OR 97223
PHONE: PHONE: 503-524-6015
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 05/03/2021 $50.04
Specifics: 1 ea Tub/Shower/Shower Pan 05/03/2021 $12.51
1 ea Water Closet 05/03/2021 $25.02
Type of Use: SF 1 12%State Surcharge- 05/03/2021 S10.51
Class of Work: ALT Plumbing
Type of Const: 1 ea Clothes Washer 10/20/2022 $25.02
Occupancy Grp: 1 ea Dishwasher 10/20/2022 $25.02
Stories: 1 ea Garbage Disposal 10/20/2022 $25.02
1 ea Ice Maker 10/20/2022 $12.51
1 ea Sink 10/20/2022 $25.02
0 12%State Surcharge- 10/20/2022 $13.51
Plumbing
Total $224.18
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
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
Building Fixtures City Tigard
nd ECEIVE eya t y,1I? /6 ! Permit i No.:po►) f
SC)
.71 ■ 13125 SW Hall Blvd.,Tigard,OR 97229
Plan Review
' Phone: 503.718.2439 Fax: 503.598.1960 OCT 2 0 202E DateBy: Other Pmmit No.:
Inspection Line: 503.639.4175 Date ReadyBy: hair RI See Page 2 for
T I G A R D Internet: www.tigard-or.gov 0, ii . LipNotified/Method: 'y- S .plemental Information
^ ^ l ;: - Ifety 'i
� ; For special injonnution use checklist
❑New construction ❑Demolition Description I Qly. I Ea. I Total
❑Addition/alteration/replacement 0 Other: a, ,: li New 1-2-family dwellings(includes 100 ft.for each utility connection)
:::,: :11 1,,, gs I/ i�S:c`,t.t( SFR(I)bath 312.70
. I SFR(2)bath 437.78
0 l•and 2-family dwelling ❑Comm SFR(3)bath 500.32
❑Accessory building 0 Multi-family Each additional bath/lotchen 25.02
❑Master builder ❑lei: Fire sprinkler( sq.ft.) Page 2
- - -- F E I , ` , tii:::l :t'1/` ,`it ^ v.;r--. - --- Site utilities:
S LV �L3 / Cj'f' T Catch basin or area drain 18.76
Job site address: �/Ck f r Drywell,leach line,or trench dram 18.76
City/State/ZIP: 97 2- .3 1 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: 44/ r /�• i Manufactured home utilities 50.03
Cross street/directions to job site: ( 0 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: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: 12.51
1 Backwater valve
t#s� � � j Tsic�;t:? _Clothes washer " 25.02
_r
Dishwasher ! 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank 12.51
�ry;� Lr,.r
/ Fixture/sewer cap 25.02
ma-)
Name: C' . , e -Q/1 Floor drain/floor sink/hub25.02
Address: /y/O� �J) /2?� Garbage disposal 25.02
City/State/ZIP: 7= y l ( ?)2-2-3Hose bib 25.02
Phone:(S-9 ! 2 . 03 Fax:( ) Ice maker ) 12.51
- " r , ��;.k1 Interceptor/grease trap I 25.02
Medical gas(value:$_) Page 2
Business name: Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: LC a-/L-e G!...1 a-- /d7/'e Sink/basin/lavatory 1 25.02
City/State/ZIP: Solar units(potable water) 62.54
Fax::( ) Tub/shower/shower pan 12.51
Phone:( ) Urinal 25.02
E-mail: 25.02
_ .. Water closet rr.cr "y� .r ec�`yet;K�t ht� ` -" - ,.. >' 37.52
^ Water heater
Business name: p-y„y,L,- Water piping/DW V 56.29
Address: c I e a-a G+Ija,-"e Other: 25.02
Subtotal /1,2
City/State/ZIP: a ! Minimum permit fee: $72.50
Phone:(S Djl --2 2 p �O 3 O� F ( ) Plan review(25%of permit fee)
CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) 1 3,5
Authorized signature: TOTAL PERMIT FEE 1 _to
This permit applkatioa expires if a permit is not obtained within ISO days
Print name: 7 X ii.� Zr Date: /(J/// 1 after it has been accepted as complete.
R' � *Fee methodology set by Tri-Couoty Building Industry Service Board.
1\Building1Perntils1PLMU-PernulAppdoc 10/01/09 440-4616T(10/02/COMN'EB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sur r ression S stems:
+ fi ft °'t7s� 'fix. ,t h 'h` rtmf3 s F1'� � '. I zvar'�
r
Footing drain-I 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 y eater $327.54
Sewer-each additional 100' 37,52
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52 1„ ,��+j��j�:�a� y
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
each additional$100.00 or fraction thereof,to
}C ` iK I P t f ? j x t.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$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$100.00 or fraction thereof.
(minimum charge—1/2 hour)
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees* ,,p is 17.Y; '` '[trF �mot I J � _ ;pi
Qdaatitytb�iFdctiireper„*?' Plan review is required for any of the following.
Ftixture$ype4ot ' �"..` ' �, !Otlit4re` Please check all that apply.
'V'Vork Perioismed ca ai",;fiAd �''.._ x'°bwc■e:. ❑ 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 ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
Wrator 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator Dishwasher. -Commercial ❑ Any multipurpose fire sprinkler system.
merEl Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink' -2"
-4" • Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food `-
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: -IavBar non-food related
-Bradley
-Com/Serv/Util food related
-Service *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 plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00180
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Date Issued: 5/3/2021
ri/(o Parcel: 2S103BB10800
Jurisdiction: TIG
Site address: 12105 SW 123RD CT
Project: LIANG Subdivision: Lot:
Project Description: Additional work associated with MST2006-00163:Adding(2)sinks,(1)tub/shower,and(1)water closet.
Contractor: OWNER Owner: CIMIN LIANG
JUAN LIU
12105 SW 123RD CT
TIGARD,OR 97223
PHONE: PHONE: 503-524-6015
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 05/03/2021 $50.04
Specifics: 1 ea Tub/Shower/Shower Pan 05/03/2021 $12.51
ea Water Closet 05/03/2021 $25.02
Type of Use: SF 1 12%State Surcharge- 05/03/2021 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.08
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: Pennittee 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.
CITY OF TIGARD
PLUMBING PERMIT
I ' COMMUNITY DEVELOPMENT Permit#: PLM202 1-00 1 80
T I C A.R t j 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5!3/2021
Parcel: 2S103BB10800
Jurisdiction: TIG
Site address: 12105 SW 123RD CT
Project: LIANG Subdivision: Lot:
Project Description: Additional work associated with MST2006-00163:Adding(2)sinks,(1)tub/shower,and(1)water closet.
Contractor: OWNER Owner: CIMIN LIANG
TUAN LIU
12105 SW 123RD CT
TIGARD, OR 97223
PHONE: PHONE: 503-524-6015
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 05/03/2021 S50.04
Specifics: 1 ea Tub/Shower/Shower Pan 05/03/2021 $12.51
1 ea Water Closet 05/03/2021 $25.02
Type of Use: SF 1 12%State Surcharge- 05/03/2021 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.08
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 _
Building Fixtures EIVED
City of Ti and C Received u ll Date/By: ! A/y/ *a- Permit No.: p�4.s.z,3j_QU%rrjl
IIIM 13125 SW Hall Blvd.,Tigard,OR 97223, ,R 1 3 2021 Plan Review Lw •r7[Y' vim+_
■ Phone: 503.718.2439 Fax: 503.598.1 ti t Date.By 0# Other Permit No.:"+7-/ri0,,,tvt le
Inspection Line: 503.639.4175 Date Ready/By: // J kris:'f I GA R D Internet: www.tigard-or.gov ,v Notified/Method: +71,?I r 'fr 'We' Supplemental Information
g i l ) OF DIVISION a� //
TYPE OF WO1 DING a Ilit 3- � FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist.
Addition/alteration/replacementexisting Permit New l-2-family
Qty. Ea. Total
® rep ®Other. Add to New I- dwellings
pings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ElCommercial/industtial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
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:12105 SW 123rd Ct. Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard.Oregon 97223
Footing drain(no.linear ft.:_1 Page 2
Suite/bldg./apt.no.: I Project name:12 05SW 123rd CI Addition Manufactured home utilities 50.03
Cross street/directions to job site: SW Katherine St.and SW 123rd CI. 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.:_ J Page 2
Snhdivision:YE-OLDEWINDMILL I Lot no.:28 Fixture or item:
Tax map/parcel no.:2S103BB10800 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Adding to existing permit MST2006-00163.Adjustments to Addition were made that
Dishwasher 25.02
required additional nennitting that we did not know about until inspection_Adding the Drinking fountain 25.02
necessary permits now. Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:Cimin Liang&Juan Liu Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:12105 SW 123rd Ct
Garbage disposal 25.02
City/State/ZIP:Tigard,Oregon 97223
I lose bib 25.02
Phone:( 503)928-0368 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:Cimin Liang &Juan Liu"Owner Builder" Roof drain(commercial) 12.51
Address:12105 SW 123rd Ct
Sink/basin/lavatory 2 25.02 $50.04
City/State/ZIP:Tigard,Oregon 97223 Solar units(potable water) 62.54
Phone:( 503 )929-0369 Fax::( ) Tub/shower/shower pan I 12.51 $12.51
E-mail: sueluan2009@gmail.com orxieo5565@gmail.com Urinal 25.02
CONTRACTOR Water closet I 25.02 $25.02
Water heater 37.52
Business name:Cimin Liang&Juan Liu"Owner Builder"
Water piping/DWV 56.29
Address:12105 SW 123rd C1 Other: 25.02
City/State/ZIP:Tigard,Oregon 97223 Subtotal
Minimum permit fee: $72.50 $87.57
Phone:( 503)928-0368 Fax:( )
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) N/A
j State surcharge(12%of permit fee) $10.51
Authorized signnaturG. O�~ TOTAL PERMIT FEE S98.08
M3/2021 This permit application expires if a permit is not obtained within 180 days
Print name: Cimin Liang 8 Juan Liu Date: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:`,Building\Permits\PLMU-PermitApp.doc 10/01/09 440.4616T(10/02JCOM/WEn)
it
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 S5,000.00 Minimum fcc$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 S50,000.00 $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-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 pp y'
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
-Drive Thm as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher. Commercial CI Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Lye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4 in 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/Sere/Util food related
-Service *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:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2