Permit CITY OF TIGARD PLUMBING PERMIT
'' Permit#: PLM2021-00274
COMMUNITY DEVELOPMENT
Date Issued: 6/29/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102AC01701
Jurisdiction: Tigard
Site address: 12700 SW PACIFIC HWY
Project: Pipeline Plumbing Subdivision: None Lot: None
Project Description: Interior plumbing: Relocating(1)sink,(1)clothes washer,and (1)water closet;installing(30)ft.of sanitary sewer.
Contractor: PIPELINE PLUMBING Owner: FARENHEIGHT LLC
333 S STATE ST SUITE V-108 1885 CREST DR
LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97034
PHONE: 503-624-1906 PHONE:
FAX: 503-624-1926
FEES
Quantity Description Date Amount
1 ea Clothes Washer 06/29/2021 $25.02
Specifics: 1 ea Sink 06/29/2021 $25.02
1 ea Water Closet 06/29/2021 $25.02
Type of Use: COM 30 If Sanitary Sewer 06/29/2021 $62.54
Class of Work: ALT 1 12%State Surcharge- 06/29/2021 $16.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $154.11
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 OUNCNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: /4....‘4/ �"(.— r-z--� Permittee Signature: �!✓ (}7�PG! �D�/
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.
#lumbing Permit Applicatio ECEIVED -7 21
Building Fixtures JUN 7 2021
City of Tigard Received Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 972
31�OF TIGARL1 DateBy: ��� /�(/1i2 i- Z7H
Plan Review
Phone: 503.718.2439 Fax: 503.5 1 Date/By: Other Permit No.:�i�e7.,,9)_ J it,
1.H44�IN�; DI1/ISI�P' (�'r 0'W Gn
Inspection Line: 503.639.4175
TIGARD
Date Ready/By: r ® See age2for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
ppp,,, Description 1 Qty. I Ea. I Total
lyl Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling t\Commercial/industrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 12,-1()O S W VaG 1.4 W Catch basin or area drain 18.76
? \ ry,n t 1�/ - Dr�J owe drain(line,or trench drain 18.76
2
City/State/ZIP: � V K Footing drain(no.linear ft.:_) Page 2
�) 8
Suite/bldg./apt.no.: I Project name: r (l� P�.Vs b
k;s4 t� ilAry Manufactured home utilities 50.03
Cross street/directions to job site: / Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.1 3 V i Page 2 62-5/
b... Stoma sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
l 1y� 1�DE(^DESCRIPTION OF WORK ,, D� Clothes washer , 25.02 ZCJ,V�
M v V` }rn '✓4 t' 1 y v N LO ` t-in Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: I'�461 Fixturelsewer cap 25.02
*t -1 `AI ' - r Floor drain/floor sink/hub 25.02
Address: 1Z 16 V v �(� n ��/ , ����/✓V 1!, Garbage disposal 25.02
City/State/ZIP:'`' V� Hose bib 25.02
Phone:( ) Fax:(- ) Ice maker 12.51
'. It APPLICANT /�] CONTACT PERSON Interceptor/grease trap 25.02
�� Business name: P 1`{ I I raj 0 i. J l _ y� Medical gas(value:$_) Page 2
\e ' ,,l^7 w D 01 V 1t� J Primer 12.51
Contact name: 1 V V'I L t.
' p�� � ) Roof drain(commercial) 12.51
Address: ?�20;3 S t-SV O-i''p V 10 Sink/basin/lavatory 1 25.02
City/State/ZIP: 10tV c)1�- "1 1� 4 (potable ) 2 s U�.
tY t Solar units water 62.54
Phone:I: y2b)to7,4.. loin,. Fax::(�7J. . 1pl.1 Tub/shower/shower pan 12.51
E-mail: 5 0\1� `(�'� >�1 i A Llo 1 Um 10 i p Urinal 25.02
CONTRACTOR
f Water closet 1 25.02 2 S. O 2
Water heater 37.52
Business name: kr?'42 /{v I,, t � ��Ql1 WaterpipingDWV 56.29
Address: 3 ?7} t vS g V--10 t Other: 25.02
City/State/ZIP:1 jay, O ?J 4,, Subtotal /37
Phone:( ) to 2 4 - 0 ev Fax:57 4 l .2.4 . 19 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: l ssk,..l u(�>�) Plumbing Lie,no.: 6 5 10 tab /,(a, .J
'lG I` State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE LSt,
'A iiiThispermit application expires ifs days
Print name: �tt,.-i'i/�� r( 1 Date:l -, PP Paccepted
last p et e. within 18D days
1 r � f W after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:\Building\Permits\PLMU-PennitApp.doe 10/OI/09 440-4616T(10/07/COM/WEB)
' • RECEIVED
Piuibbing Permit Application- City of Tigard
Page 2-Supplemental Information JUN 1 6 1021
•
Fee Schedule: R.! h_�D.0,-,R. ,�
. —' -" �L
' erasion Systems:
Site U ., ter- x�(�) Taal t r r�
Footing drnia-1a iDe. .�4' ,,� - in,..
50.03 01o2,000 S12190
Footing drain-ach additional 100' 37.522 ODl to 3 600 SI69.64
233.20
Sewer-1st 100' 91 6234 (0 2 S 7 1 an to d S32734
Sower-each additional 100' 37.52 15327.54
Water serriae•1st 100' 62.54 Mcdit sl Gil t Systems:
Water Service-each additional 100' 37.52
alum Pure. ., _..
storm&Rain Duln-1si 100 62.54 s 1.00 to$5,000.00 Itdmimm OM S72.50
Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to$10,003.00 $72.50 for the frost S5,000.00 and$152 fbr
Other Inspections Or Fees QIF Bea(till Ybtil each.dditlonal s100.a0 or fraction thereof,to
Inspection areal sting plumBing err for end menacing$10,000.00.
,�no fee is $10,001.00 to S25 000.ao S1485D for the that SIO (Motion
00 end nrm for
Y each additional S100.00 or(Motion theme&to
(minimum clump—lrL Lone) _ and including S25,000.00.
Inspections outside afnormal bua®en 90.00/hr S25,001.00 to$50,000.00 S379.50 far the Bret$25,000.00 ad S1.45Sir
horns(minimum charge-2 bons)
Reinspectiott each additional3100.00 or faction doom;to
Fens 90.E and including S50,000.00.
-
Additional Men review fur revieicm 90.00/hr S50,001.00 and op 5742_00 for the first S50,000.00 and$1.20for
(minimum charge—112 hoer) each additional$100.00 er t4actioa dined
Sabeotal: (w�vl
Commercial Fixture Work:
Are you tapping,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
Fixtureby Fixture Type Plan review is required for any of the following.
Work P med: Capp e71added Please chair all that apply.
Sisa wont 0 Any new commercial building with water service r end
Bah: -Tub/Shower grantor,accept systems designed and stamped by licensed
daa,raAyhbipool engineer.
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex ettucptre Thin defined in OAR91 S-780-0040.rive
Llapidarlwater AaperMtor 0 Medical gas and vaca»m systems for health care faeilides.
Dishwasher: -Commercial Any multipurpose Eire sprinkler system.
-Domestic ❑ Anycomplex sesame as defined inoAIt91 saso anon.
Drinking Fountain
Eye Wash Sahmit/sets of plans with ray of the above_
Floor Drain/sink: -T'
- Diagram
or Riser Diagra
-Car wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic non-food that meet the qualifications above.
Disposal: -Domenic food related -
-Commercial road related
-bdastriai food rimed
Ice Mach/Rein.Dunn Comments regarding fixture work:
Oil Separator(Gas Station)
Res Vehicle Dump Station
Shower. -Gang
-Stall
Sink: -iav/Barnon-food related l
-Bradley
-ComP3erv/Util food related
-Service 'Note: If the fixture work under this permit results In an
Swianing Pool Miter
p/ _Clothes Increase of sewer EDUs,a sewer permit will be issued and
Wass Exaseter i fees assessed for the newer Increase must be paid before the
Water Closet-Toilet 1 plumbing permit can be issued
]hi ssI
Other fixtures:
I:\Bsild ng\Pemtits1PI.MF PcrrmtApp.doc 08/0412011 2
Branden Taggart
From: Branden Taggart
Sent: Monday, June 28, 2021 4:13 PM
To: sam@pipelineplumbing.net
Subject: FW: Pipeline Plumbing Plumbing Permit: PLM2021-00274 - 12700 SW Pacific Hwy
Attachments: 12700 SW Pacific Hwy - Pipeline Plumbing.pdf; Invoice.pdf
Hi Samantha,
The Plumbing permit for Pipeline Plumbing is ready to issue now. The balance due is$154.11, and I have attached an
invoice above for you to reference. These fees can be paid online now at httos://aca-
prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number PLM2021-00274 under the Building
tab. There is a 3%service fee for credit cards, but e-checks do not have a service fee. Please note that we will not take a
credit card payment over the phone for security purposes.
Once paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may issue this
permit and email you the permit paperwork.
Thank you,
Branden Taggart
a City of Tigard
,, Senior Permit Technician
Community Development
TIGARD
13125 SW Hall Blvd
Tigard,OR 97223
(503)718-2449
b rande nt@tigard-or,gov
From: Samantha Hill <sam@pipelineplumbing.net>
Sent:Wednesday,June 16, 2021 9:34 AM
To: Branden Taggart<brandent@tigard-or.gov>
Cc: 'Adam Faren' <adam@pipelineplumbing.net>
Subject: RE: Pipeline Plumbing Plumbing Permit- 12700 SW Pacific Hwy
Warning!This message was sent from outside your organization and we are unable to Allow sender I Block sender
verify the sender.
Hi Brandon,
Thank you so much. I filled out the commercial fixture portion on the 2'd page. Please let me know if you need anything
else to get this issued. I can pay via credit card over the phone for this permit as well.
Thanks,
.saw aititha t-ti.11
Service Coordinator
T: 503-624-1906 I F: 503-624-1926 I W:www.pipelineplumbing.net
1
From: Branden Taggart [mailto:brandent@tigard-or.gov]
Sent: Wednesday,June 16, 20219:17 AM
To: sam@pipelineplumbing.net
Subject: Pipeline Plumbing Plumbing Permit- 12700 SW Pacific Hwy
Hi Samantha,
We received your Plumbing permit submittal for Pipeline Plumbing. However,the Commercial Fixture Work section will
need to be completed in order to process the permit. I have attached the application above for you. Feel free to email
the completed application back to us.
Thanks,
Branden Taggart
City of Tigard
ir, w Senior Permit Technician
Community Development
TICAltff
13125 SW Hall Blvd
Tigard,OR 97223
(503)718-2449
brandent@tigard-or.gov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
2