Permit CITY OF TIGARD PLUMBING PERMIT
''1 J° COMMUNITY DEVELOPMENT Permit#: PLM2021-00411
Date Issued: 10/5/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 111 BA00802
Jurisdiction:
Site address: 14170 SW 100TH AVE
Project: Wamala Subdivision: Lot:
Project Description: Installing 100 feet of sanitary sewer line and 70 feet of water line.
Contractor: PDX SEWER&DRAIN Owner: WAMALA, RONALD& ELIZABETH
PO BOX 25472 14170 SW 100TH AVE
PORTLAND, OR 97298 TIGARD, OR 97224
PHONE: 503-308-8098 PHONE:
FAX:
FEES
Quantity Description Date Amount
100 If Sanitary Sewer 10/04/2021 $62 54
Specifics: 70 If Water Service 10/04/2021 $62 54
1 12%State Surcharge- 10/04/2021 $15.01
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $140 09
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: Hal,Ly Vim,De,w2.3li Permittee Signature:
Ow Ap-p-ttic,a+Lo-vt,
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 RECEIVED
Building Fixtures SEP 2 u 2621 FOR OFFICE USE ONLY
City of Tigard ,iTY OF fGARI� Received
Date/By: 7 �/�1 /% r t�e�►./-C2v VI/
• 13125 SW Hall Blvd.,Tigard,O 77Aj2�1•' Plan Review
s Phone: 503.718.2439 Fax: 5 98E7 IticK DIVISION DateBy ` ¢ e N _/!/ '�-r/ �i
7 I G A K I Inspection Line: 503.639.4175 Date Ready/By. lulu ® See Page 2 for /
Internet: www.tigard-or.gov Notified/Method. L1 Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
- ------- Description I Qty. I Ea. I Total
®Addition/alteration/replacement ❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
® 1-and 2-family dwelling ❑Commercial/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:
lob site address:14170 Sw 100th Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: W Ma la Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
East side of SW 100th Ave, 200 feet south of SW Mcdonald St Ram drain connector 18.76
Sanitary sewer(no.linear ft.:A ) Page 2
Storm 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
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Install 100 Feet of sewer pipe and 70 Feet of water line Dishwasher 25.02
' 6-1 l N7-, - - Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
- - Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:PDX Sewer& Drain Medical gas(value.$ ) Page 2
Primer 12.51
Contact name:Patricia Jack
Roof drain(commercial) 12.51
Address:2212 Se 32nd Ave Sink/basin/lavatory 25.02
1 City/State/ZIP:Hillsboro, OR 97123 Solar units(potable water) 62.54
Phone:( 503/924-9682 Fax::( ) Tub/shower/shower pan 12.51
Urinal 25.02
Email: dxseweranddraingmail.com
p Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:PDX Sewer& Drain Water piping/DWV 56.29
Address:2212 Se 32nd Ave Other: 25.02
City/State/ZIP:Hillsboro, OR 97123 Subtotal
Phone:( 503-924-9682 Fax:( ) 7//r(.2.3 _ Minimum permit fee: $72.50
CCB Lie.:229615 ,2/4/I-2 Plumbing Lic.no.:PB2368 Plan review (25°o%ofpermit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Patricia Jack Date:09/23/2021 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
11Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(t0/02/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-I"100' 50.03 0 to 2,000 $I21.90
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
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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
W 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator Cpirator al ❑ Any multipurpose fire sprinkler system.
Dishwasher:
Domestic ❑ 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" 0 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 Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar non-food related
-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
Julie Drinkwater
From: #Building Permit Technicians
Sent: Monday, October 4, 2021 9:37 AM
To: pdxseweranddrain@gmail.com
Subject: PLM2021-00411, 14170 SW 100, Wamala
Attachments: Invoice.pdf
Hello Patricia
The permit for the Wamala project is ready to be issued.The balance due is$140.09. Attached please find the invoice 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 for pick up.
Thank you
Julie Drinkwater
Permit Technician
City of Tigard Building Department
13125 SW Hail 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.
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