Permit CITY OF TIGARD PLUMBING PERMIT
11,1
= COMMUNITY DEVELOPMENT Permit#: PLM2021-00296
Date Issued: 7/28/2021
T I C_G A R T) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112AB00800
Jurisdiction: Tigard
Site address: 14255 SW 72ND AVE
Project: Fought&Company Subdivision: None Lot: None
Project Description: Site utilities for(2)pump stations,(2)detention tanks,(2)storm water filter tanks. Includes(6)catch basins,(2)
manholes,and 1,785 ft.of storm sewer.
Contractor: MCKILLIP EXCAVATION INC Owner: FOUGHT COMPANY INC
PO BOX 585 PO BOX 23759
DONALD, OR 97020 TIGARD, OR 97223
PHONE: 503-209-0539 PHONE.
FAX:
FEES
Quantity Description Date Amount
6 ea Catch Basin or Area Drain 07/27/2021 $112.56
Specifics: 2 ea Manholes 07/27/2021 $37.52
1785 If Storm Sewer 07/27/2021 $700.38
Type of Use: COM 1 Plan Review 07/27/2021 $212.62
Class of Work: ALT 1 12%State Surcharge- 07/27/2021 $102.06
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $1,165.14
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: Holly Vc .1Je-Wage Permittee Signature: DwA t,Crati,d-vt
ppL
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.
` ..
PlumbinE Permit ApplicationFlECEI V EQ z
Site Utilities JUL 0 8 Z021 FOR OFFICE USE ()NI.)
Cl of Tigard Received pe mit N_p /w
13125 SW Hall Blvd.,Ti ard,oR 97223 I.tTY OF TiGARD Date/By: 7 4121 4Q(j T L• ! Z���00�
g Plan Review / /^t A // Other Permit No.:
S Phone: 503.718.2439 Fax: 503.598.1 :�ILDING DIVISION DateJBy: 7 ;_}//a� /.'fL41J
T I G A R O Inspection Line: 503.639.4175 Date Ready/By: / ® ` Page 2 for
Internet: www.tigard-or.gov Notified/Method: /if/ al Supplemental Information
TYPE OF WORK arm/k4 FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description
I Qty. I Ea. I Total
❑Addition/alteration/replacement ICI Other:Storm Water Imprvmnt New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
SFR(2)bath 437.78
❑ 1-and 2-family dwelling ®Commercial/industrial 500.32
SFR(3)bath
❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain 6 18.76 ((2 II'
Job site address: SW 72nd Ave _ Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, OR, 97224 rV(L&i/6 P COM/1471T Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: l Project name:Storm Water Improvements Manufactured home utilities 50.03 2
Cross street/directions to job site: Manholes `2. 18.76 3 7 S2
800' North of Bonita Street on the West side of 72nd Avenue Raindrainconnector 18.76
Sanitary sewer(no.linear*:_) Page 2
Storm sewer(no.linear ft.:(M,5 t p Page 2 ..14141.4.2
- ` = .,V
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: 12 51
Backwater valve
DESCRIPTION OF WORK Clothes washer 25.02
Insallation of 2 Pump Stations, 2 Detention Tanks, 2 Storm Water Dishwasher 25.02
Filter Tanks and associated piping Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ElTENANT Expansion tank 12.51 Fixture/sewer cap 25.02
Name:Fought& Company Floor drain/floor sink/hub 25.02
Address:14255 SW 72nd Avenue Garbage disposal 25.02
City/State/ZIP:Tigard, OR, 97224 Hose bib 25.02
Phone:(503 )639-3141 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:McKillip Excavation, Inc. 12.51Primer
Contact name:Sam McKillip Roof drain(commercial) 12.51
Address:PO Box 585 Sink/basin/lavatory 25.02
City/State/ZIP:Donald, OR, 97020 Solarunits(potable water) 62.54
Phone:(503 ) 209-0539 Fax::(503 ) 776-9667 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:mckilpexcavation@aol.eom Water closet 25.02
CONTRACTOR Water heater 37.52
Business name:MCKillip Excavation, Inc. Waterpiping/DWV 56.29
Address:PO Box 585 other: 25.02
Subtotal ����
City/State/ZIP:Donald, OR, 97020 Minimum permit fee: $72tal.50 SaT9 lr� ,
Phone:(503 ) 209-0539 Fax:(503 ) 776-9667 1
Plan review (25%of permit fee) z I I Z p'1d.4
CCB Lic.:OR CCB# 126154 Plumbing Lic.no.: State surcharge(12%of permit fee) (O I /02 (
Authorized signature l--2 a/�� r(A/,' f TOTAL PERMIT FEE I I 51`�,/1(g,
1• s^'K^/ Date:07/08/2021 This permit application expires if a permit a not obtained within 180 days
Print name:Sam McKillip after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
I:1Badding\Permrts\PLMU-PennitApp.doc 10/01/09 440-4616T(1 0l02/COM/WEB) /j/(5;/L/
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-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 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 ue,)7 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' i +' 37.52 018 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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 fractionf.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 keplaCe/ Plan review is required for any of'the following.
Work Performed: Capped Added Relocate
Baptistry/Pone Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
Jacuzzi/Whirlpool/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 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 Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.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.
Other Fixtures!
1:1Building\Permits\PLMU_PermitApp.doc 2
a •
IIIa Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional,drawn
to scale)labeled with:
A. D map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS -Two (2) complete sets,civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size,type of material,slope of piping,manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
1:1Building\Permits\PLMF-PermitApp.doc 12/30/05