Permit CITY OF TIGARD PLUMBING PERMIT
_ COMMUNITY DEVELOPMENT Permit#: PLM2021-00212
Date Issued: 7/19/2021
T I C A R f3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 113AA00200
Jurisdiction: Tigard
Site address: 16364 SW 72ND AVE B8
Project: General Parts Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Interior plumbing for TI:Adding(2)sinks.
Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 757 ATTN: N PIVEN
WILSONVILLE, OR 97070 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-780-9486 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 07/19/2021 $50.04
Specifics: 1 12%State Surcharge- 07/19/2021 $8.70
Plumbing
Type of Use: COM 22 ea Minimum Fee Adjustment- 07/19/2021 $22.46
Class of Work: ALT Plumbing
Type of Const:
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
Issued By: 1 oVDCZWege Permittee Signature: OwApp -fin
`"'`"'`"'JJ"" 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 Applicatio E�'EiVED �'�°" ��� e -
Building Fixtures th q 7 FOR OFFICE USE ONLY
Ant 2 Q 2021 Received
City of Tigard Permit No.:
Date/By: S 'f�J'l - �.s-iavai- a/.z
1,11 • 13125 SW Hall Blvd.,Tigard,OR 97z�3,ITy OF TIGA Plan Review ^/ q
M Phone: 503.718.2439 Fax: 503.5 �� /u Other Permit No.: ,, ,)ab5.
Date/By:
T I G A R D Inspection Line: 503.639.4175 ING°I1/ISIO' Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov Notificd/Mcthod: , / i ,Dr- 1� Supplemental Information
w,/".' t' YPE OF WORK aP y ,,� .. --f SCHEDULE
D New construction ❑Demolition For'pedal information use checklist
Description Qty. Ea. Total
®Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
R ATEGORY OF CONSTRUCTION SFR(l)bath 312.70
❑ 1-and 2-family dwelling INCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
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: 16364 sw 72nd ave Catch basin or area drain 18.76
City/State/ZIP: tigard or 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ff.: ) Page 2
Suite/bldg./apt.no.: I Project name: general parts Manufactured home utilities 50.03
Cross street/directions to job site: 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:
Tax map/parcel no.: as/` �1 d�• Backflow preventer 31.27
DESCRIPTION e ' Backwater valve 12.51
Clothes washer 25.02
install 2 new sinks
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
IN PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Pacific Realty Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 6650 SW Redwood Ln Ste 290
Garbage disposal 25.02
City/State/ZIP: Portland/ OR/ 97224 Hose bib 25.02
Phone:( 503) 624-6300 Fax:( ) lee maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:Always Faithful Plumbing
Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Corey Chamberlain
Roof drain(commercial) 12.51
Address: PO Box 757 Sink/basin/lavatory 2 25.02 cm
City/State/ZIP:Wilsonville OR 97070 Solar units(potable water) 62.54
Phone:(503)780-9486 Fax::( ) Tub/shower/shower pan 12.51
E-mail:alwaysfaithfulplumbing@yahoo.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Always Faithful Plumbing Water piping/DWV 56.29
Address: PO Box 757 Other: 25.02
City/State/ZIP: Wilsonville, OR 97070 Subtotal c,-y
Phone:(503)780-9486 Fax:( ) Minimum permit fee: $72.50 -7,2 y�
CCB Lie.: 217284 Plumbing Lic.no.:PB1940 Plan review (25%of permit fee)
//// State surcharge(12%of permit fee) 3J,7v
Authorized signature:l�, r/ � TOTAL PERMIT FEE /6I.-).0
Print name:Corey Chamberlain Date: 4/2 9/21 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1.1Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB)
J/J5 - `\r^ ,..n � r "=`1Fy
`
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-Ia 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
Storm&Rain Drain-1st 100' 62.54 Valuation: P ,7nit Fee
$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 ec Ins tions or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
h 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-12 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*. a311 & eV1'for Plumbing Installations_AL
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replacel Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry Font El Any new commercial building with water service 2"and
Bath:pt -Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-Jacuzzi/Whirlpool
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher -Commercial ElAny multipurpose fire sprinkler system.
Domestic El Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
3" Isometric or Riser Diagram
4" ❑ 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: -LavBar non-food related 2
-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
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Accumulative Sewer Tally
0
Tenant Name: GENERAL PARTS SWR# 2021-00129
Site Address: 16364 SW 72ND AVE PLM# 2021-00212
TIGARD
Parcel#: 2S113AA00200
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 0 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 2 4 2 4
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 0 0 2 4 2 4
Current Fixture Value 4 divided by 16= 0.250 Current EDU 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change 4 divided by 16= 0.250 over (under) $ 1,450.00
Enter EDU Change Here 0.250
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes:
Authorized Name/Signature: BRANDF.N TAGGART X2449 Date: 5/19/2021 X2449
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTally Sheet_5800_070119.xlsx
Branden Taggart
From: Branden Taggart
Sent: Wednesday, May 19, 2021 10:27 AM
To: Always Faithful Plumbing
Subject: General Parts Interior Plumbing: PLM2021-00212 &SWR2021-00129 - 16364 SW 72nd
Ave.
Attachments: Invoices & Sewer Tally.pdf
Corey,
The Plumbing and Sewer permits for General Parts are ready to issue now. I have attached invoices above for you to
reference, and the fees due are as follows:
General Parts
Permit# Fees Due
PLM2021-00212 $ 81.20
SWR2021-00129 $ 1,450.00
Total: $ 1,531.20
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, please notify us
at tigardbuildingpermits@tigard-or.gov so that we may issue these permits and 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.
Thanks,
Branden Taggart
■ City of Tigard
w; Senior Permit Technician
Community Development
T lCAFtD
13125 SW Hall Blvd
Tigard, OR 97223
(5431718-2449
brand entitigard-o€:gov
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