Permit CITY OF TIGARD PLUMBING PERMIT
111 COMMUNITY DEVELOPMENT Permit#: PLM2021-00416
Date Issued: 10/7/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S125DA04700
Jurisdiction: Tigard
Site address: 6695 SW ALFRED ST
Project: Westland Homes Subdivision: KINGS VIEW Lot: 32
Project Description: Adding backflow preventer for landscape irrigation.
Contractor: ROME PLUMBING INC Owner: WESTLAND CUSTOM HOMES LLC
17295 SW EDY RD 385 1ST ST
SHERWOOD, OR 97140 LAKE OSWEGO, OR 97034
PHONE: 503-625-1452 PHONE:
FAX: 503-625-1452
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 10/07/2021 $31.27
Specifics: 1 12%State Surcharge- 10/07/2021 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 10/07/2021 $41.23
Class of Work: OTR 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: Permittee Signature:
/7/V//(47a,1)74,t_
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
Site Utilities FOR OFFICE ( F \I.l
RECEIVED (1 Received / /
City of Tigard L�`7 .2.( � 11
III 111 13125 SW Hall Blvd.,Tigard,OR 97223 OCT 7
I Phone: 503.718.2439 Fax: 503.598.1960 Zo� Date/By:Plan Review Other Permit No.:
Inspection Line: 503.639.4175 '' Cry r Date Read/B i Juris: ger See Page 2 for
I 1 C' R D Internet: www.tigard-or.gov �' ®r I����`� Notified/ y-hod u /.�-/ �� Supplemental Information
TYPE OF WO! LD GDIVISION FEE* SCHEDULE
El New construction 0 Demolition For special information use checklist.
;a/Ad/� Description Qty. ( Ea. I Total
a Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
dition/alteration/replacement
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building El Multi-family
SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
�,.` NG � Catch basin or area drain 18.76
45 I
Job site address: bb� , W I t`
City/State/ZIP: � �rr� ,,�t�ii_ Op, a'1�3 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: ^ Manholes 18.76
���+++ () -Da \ /r Rain drain connector 18.76
ty\ �� Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: l Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 z1
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
(ZKROPERTY OWNER ( 0 TENANT Expansion tank 12.51
•t}r�/t„r,� A,, r`04 jk 4.(/ Fixture/sewer cap 25.02
Name: 1 AJ It;,T✓«{l ` �i1.7
Y �Wr�_[_ Floor drain/floor sink/hub 25.02
Address: 0,00 o� 6
Garbage disposal 25.02
City/State/ZIP:/\&XV 6� CIPAP�! Hose bib 25.02
Phone:9*) It - L�/�/ Fax:433),'- -2D (
Ice maker 12.51
APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
4v (S 'J� �� Medical gas(value:$ ) Page 2
Business name: 1_ %
Contact name: /3 ION &� t 14 Primer (commercial) 12.51
1'^>11t 1O 4!,6 4 l;t'' Roof drain12.51
Address: p /���� Sink/basin/lavatory 25.02
City/State/ZIP: `i pr_,, L- 2 Cl 2Zi) Solar units(potable water) 62.54
Phone:( Oita
Fax::( ) Tub/shower/shower pan 12.51
E-mail: y�`r• ✓`L,l V f(f(1 _. 1, Urinal 25.02
i�✓ 1 Or Water closet 25.02
4
CONTRACTOR
Business name: M pa j I 0 C., • Water heater 37.52 Water piping/DWV 56.29
11zq' s� .. .1.4)1)jat"
Address: • Other: 25.02
City/State/ZIP: De.. ct-1 iy-D Subtotal
Phone:(eV)) b 26'- '05V Fax:(03 �25 ^Ili b?j Minimum permit fee: $72.50
CCB Lic.: ��f1b L//7�_LJ Plumbing Lic.no.:'34 . 5 � Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: 7///2-3 TOTAL PERMIT FEE
Print name: ) li +i�-� Date: C� .' 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.
V
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
.. _ . . - .
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- Is'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$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 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$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 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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.
Work Performed: Capped Added Relocate q ow g'
Baptistry/Font Please check all that apply.
Bath Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/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 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 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 ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food q g
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:
I:\Building\Permits\PLMU PetmitApp.doc 2
Julie Drinkwater
From: #Building Permit Technicians
Sent: Thursday, October 7, 2021 11:27 AM
To: jswestland@aol.com
Subject: PLM2021-00416, 6695 SW Alfred, Westland Custom Homes
Attachments: Invoice.pdf; Receipt.pdf
Hello Jim
The permit for Westland Custom Homes is ready to be issued. After the payment in the amount of$31.27 that was
made by check, the remaining balance due is$49.93. Attached please find the invoice and copy of the receipt for your
review.
The fees can be paid online at https://aca-prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record
number under the Building tab. There is a service fee of 3%for payments by card, and there no service fee for payments
made by e-check. On the payment screen, select the payment method from the dropdown list next to the 'payment'
field.
Please email the permit technicians at TigardBuildingPermits@tigard-or.gov once the fees are paid so that they can
issue the permit and make it available to you.
Thank you and please let us know if you have any questions.
Julie Drinkwater
Permit Technician
City of Tigard I Building Department
13125 SW Hall Blvd
'Tigard,OR 97223
503-718-2804
Due to an increased demand for services, please expect longer wait times for responses to emails,voice messages and building
inspections. Requests for permit status may not be responded to until the permit is ready to issue. Other requests deemed non-
essential,such as fee estimates, may take longer to respond. In the meantime, please view this quick guide on how to submit
common service requests.
1