Permit CITY OF TIGARD f a ins ., .1. PLUMBING PERMIT
s COMMUNITY DEVELOPMENT tetz.liz` Permit#: PLM2021-00270
Date Issued: 6/28/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S111AD19000
Jurisdiction: Tigard
Site address: 14865 SW JONAGOLD TER
Project: Watts Subdivision: LADY APPLE Lot: 14
Project Description: Convert existing bathroom to larger ADA compliant.Replace existing(1)toilet and(1)sink in powder room,add
(1)new shower. 8/17/2021: REPRINT permit to add(1)2"floor drain.
Contractor: PERFECT FLUSH PLUMBING Owner: WATTS, JAMES C&MARCY M
24023 NE SHEA LANE SUITE 107 14865 SW JONAGOLD TER
WOOD VILLAGE, OR 97060 TIGARD, OR 97224
PHONE: 503-985-9461 PHONE.
FAX:
FEES
Quantity Description Date Amount
1 ea Lavatories 06/28/2021 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 06/28/2021 $12.51
1 ea Water Closet 06/28/2021 $25.02
Type of Use: SF 1 12%State Surcharge- 06/28/2021 $8.70
Class of Work: ALT Plumbing
Type of Const:
10 ea Minimum Fee Adjustment- 06/28/2021 $9.95
Occupancy Grp: Plumbing
Stories: 1 ea Floor Drain/Floor Sink/Hub 08/18/2021 $25.02
0 12%State Surcharge- 08/18/2021 $3.00
Plumbing
Total $109.22
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: Fio- 3 Va,,A,Pe, Wege, Permittee Signature: Ow Apr-Liza-14.03A-
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
■
COMMUNITY DEVELOPMENT Permit#: PLM2021-00270
T f G_A R L) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/28/2021
Parcel: 2S111AD19000
Jurisdiction: Tigard
Site address: 14865 SW JONAGOLD TER
Project: Watts Subdivision: LADY APPLE Lot: 14
Project Description: Convert existing bathroom to larger ADA compliant. Replace existing(1)toilet and(1)sink in powder room,add (1)
new shower.
Contractor: PERFECT FLUSH PLUMBING Owner: WATTS,JAMES C& MARCY M
24023 NE SHEA LANE SUITE 107 14865 SW JONAGOLD TER
WOOD VILLAGE, OR 97060 TIGARD, OR 97224
PHONE: 503-985-9461 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Lavatories 06/28/2021 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 06/28/2021 $12.51
1 ea Water Closet 06/28/2021 $25.02
Type of Use: SF 1 12%State Surcharge- 06/28/2021 $8.70
Class of Work: ALT Plumbing
Type of Const: 10 ea Minimum Fee Adjustment- 06/28/2021 $9.95
Plumbing
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 AurdifitykuEL I D
Building Fixtures FOR OFFICE USE cisl
City of Tigard 1 U N 2 3 2021 Received ���sss
• 13125 SWHal►Bl d,Tigard OR 9T22 may: � 5/12/ 14%Perrmt h ./41 AI 2/- etW 7,
U Phone: 503:7I82439 Pax! 5p� .r TIGARD Plan Review /
Ihtcar. Other Perini'No.:
1!GARD Inspection Line: so3.639.a17�UILDiNGDIVISION
Internet: www.tigard-or.gov
KedY:mI -/_ ,� ! 1 kris B Sec Page 2 for
--__ �S/� (J 1 Supplemental term-mum)
7YPF. OF WORK FEE• SCIIEDULI.
❑Ncw construction ❑Demolition For speaFr/information use checklist
0 Addition/alteration/replacement 0 Other: Description I - I Ea I Taal
New I-2;am y dweBings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath _ 312.70
0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath
437.78
❑Accessory building 0 Multi-family SFR(3)bath 50032
❑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:14865 Southwest Jonagold Terrace Catch basin or area drain r I1.76
City/SiaceiZIP:Tigard,Oregon 97224 Drywell leach lam a tr oeh drain )8.76
Footing drain(no.linear ft.:_) Page 2
SuitelbldgJapt no.: Project name:Curtin
Manutactural home utilities 50.03
Cross streeb'diteciior4s to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: 1 Page 2
Storm sewer(no.linear IL:_) Page 2
Wal r service(no.linear It.:_J Page 2
Subdivision: I Lot no.: Future or iteun
Tax ntap/pareel no.: _ Backflow P^e"�R 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Existing toilet and bathroom sink in powder room. Clothes 25.02
-Glient s xpa(no�gi baairoorrrana relocatingexisting bathroom fixtures. Dishwasher 2s.o2
--x\\ -- S�� /7 77 Drinking fountain 25.02
Ejectors:sump 25.02
❑ PROPERTY OWNER 0 TENANT Expmsion tank
7251
Name: Fixture saever cap 25.02
Address: Floor drain floc sink/huh 25.02
City/State/ZIP:
P: Garbage disposal 25.02
Flow bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON interceptor/grcasetrap 25.02
Business name:Perfect Flush Plumbing Medical gas(value:$__) Page 2
Contact name:Krystle Battle Primer 12.51
Address: 24023 NE Shea Lane Suite 107 ROOF drain(commercial) 12.51
Sink/basin/lavatory 1 25.E
City/State/ZiP: Wood Vdtage,OR 97060 Solar units(potable water) 62.54
Phone ( 503)985-9461 Fax::( ) Tub/shower/showerpan 1 12.51
E-mail:office@perfectflushpdx.com - Urinal 25.02
CONTRACTOR Water closet 1 25.02
Business mine; Water beater 37.52
Perfect Flush Plumbing Water piping/DWV 56.29
Address:24023 NE Shea Lane Suite 107 --- ---
Other: 25.02
City/State/ZIP: woriia0p,nR cans Subtotal
xl vi
Phortc 503 9145-9461 Fax:( ) P Mininmm permit fee: 87230
CCB Lie.: 21190 /i/`L Plumbing Lie lb.. ill/ j. Plan review (25%ofpermit fa:)
Authorized sigma { Siam surcharge(12%of permit foe)
TOTAL.PERMrI'FEE d/,
Print name:Krystle B Date:06122J21 This permit application expires if a permit is not obtained within ISO days
after k has been accepted as complete
`Fee meth da!o -sec by Tr-County Building Industry Set-vim Board.
IEuildiaecnait%MU-PamLLAlpdoc I0i0I/09 440-tedeplOO2rint'WeiB
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"l00' 50.03 0 to 2,000 S121.90
Footing dram-each additional 100' 37.52 2,001 to 3,600 S169.69
3,601 to 7,200 S23320
Sewer- 1st 100' 62.54 7,201 and greater S32754
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 3752 Valuation: Permit Fee:
Sturm&Rain Drain-1st 100' 62.54 $1.00 to S5,000.00 Mininmm fcc S72_50
Storm&Rain Drain-cacti additional 100' 37.52 55,001.00 to S10,000.00 S7250 for the first S5,000.00 and$152 for
Other Inspections or Fees Fee(ea) Total_ each additional S100.00 or fraction thereof,to
p Q�' and including$10,000.00.
Inspection of existing plumbing or for S 10,001.00 to S25,000.00 S 148.50 for the fora S 10,000.00 and S 154 for
which no fee is specifically indicated 90.00.hr each additional S100.00 or fraction thereof,to
(minimum charge-1/2 hoar) and including S25,000.00.
Inspections outside of normal business 90.00/hr S25,001.00 to 550,000.00 S379.50 for the font S25.000.00 and$1.45 for
hours(minimum charge-2 hours) each additional S100.00 or fraction thereof,to
Reinymection 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 S50,000.00 and$110 for
(minimum charge-1/2 hour) each additional S100.00 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
Quantih be Fixture Type Plan review is required for any ofthc following.
Fixture Type for Repute/ Please check all that apply.
Copped Added Relocate
Work Performed:
0 Any new commercial building with water service 2"and
Bath: -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
New
Car Wash: -Each Stall ❑ exterior plumbing site utilities for any complex structure
Drive ihti as defined in OAR9 t 8-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher:r �o l ❑ Any multipurpose fire sprinkler system.
_Domestic 0 Any complex structure as defined in OAR91 S-780-0040.
Drinking Ftruasain
Eye Wash - Submit 2 sets of plans with an. of the above.
Fluor Drain'sink: -2"
3" Isometric or Riser Diagram
❑ 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 Mseh..Refrig Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -lav/Bar non-fad related
-Bradley -------
-ComfServ/Util food related
-Service *Note: if the fixture Nark under this permit results in an
Swimming Pool Filter increase of sewer EDUs.a server permit will be issued and
Washer-Clothes
water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can he issued.
Urinal
Other Fixtures:
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