Permit `� al CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2021-00307
Date Issued: 11/2/2021
T f G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel 2S102DC00800
Jurisdiction: Tigard
Site address: 8870 SW OMARA ST
Project: Lally Subdivision: EDGEWOOD Lot: 9
Project Description: 60 If of sanitary sewer to connect existing dwelling to public sewer.
Contractor: 3 MOUNTAINS PLUMBING Owner: LALLY, DONALD P&BRENDA J
5304 N ALBINA AVE 8870 SW O'MARA ST
PORTLAND, OR 97217 TIGARD, OR 97223
PHONE: 503-670-1342 PHONE:
FAX:
FEES
Quantity Description Date Amount
60 If Sanitary Sewer 07/15/2021 $62.54
Specifics: 1 12%State Surcharge- 07/15/2021 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 07/15/2021 $9.96
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: Permittee Signature:
HoU-9 Vaw De Wege, Ow A Lix.c i,owvv
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 . E^E��/E "°
Building Fixtures i t+�,J 1ln FOR OFFICE USE ONLY
Cityof Tigard JUL 14 2021 Received _., r
III13125 SW Hall Blvd.,Tigard,OR 97223 C Date/By: r /S/'z/ Permit I�e La�1 �ji �`_�3 O
II Phone: 503.718.2439 Fax: 503.598.196�i1TY�' IGA(� Plan Review Other Permit +ty 1 4
TIGnRD Inspection Line: 503.639.4175 BUILDING DIVIS1014pateBy: �j�f-0���5
I Date Ready/By: .-7 Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:!/ff Aa Supplemental Information
TYPE OF WORK al/kV 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
❑Accessory building El 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:8870 SW Omara St, Tigard OR Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Portland OR 97223 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Donald Lally Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:60ft) 1 Page 2 1
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.: Backflow preventer 31.27
Backwater valve 12.51
�A
J t ( C/ j7 , t ION OF WORK Clothes washer 25.02
Installing sanitary sewer from home to existing lateral city Dishwasher 25.02
created. 60ft via trenching on property only Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name:Donald Lally Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
I Address:8870 SW Omara St, Tigard OR Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( 971)224 - 2180 Fax:( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:3 Mountains Plumbing
Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Andrea Basile - Excavation Coordinator
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( 503)455 - 8838 Fax:: ( ) Tub/shower/shower pan 12.51
E-mail:install@3mountainsplumbing.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:3 Mountains Plumbing Water piping/DWV 56.29
Address:5304 N Albina Ave, Portland OR 97217 Other: 25.02
City/State/ZIP: Subtotal
Phone:( 503)455-8838 Fax:( ) Minimum permit fee: $72.50 7Z,So
Plan review (25%of permit fee)
CCB Lie.:169499 Plumbing Lic.no.:PB 99
State surcharge(12%of permit fee) g"l 'I p
Authorized signature: .A �� 15 TOTAL PERMIT FEE 27, 2-0
Print name:Andrea Basile Date:07/14/2021 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.
1:ABuilding\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-1" 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
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-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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the billowing.
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
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thm
❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
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" ❑ 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: -Lay/Bar 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
Dianna Ornelas
From: #Building Permit Technicians
Sent: Thursday,July 15, 2021 10:30 AM
To: Install
Subject: PLM2021-00307 & SWR2021-00195 - 8870 SW Omara St - Lally
Attachments: PLM2021-00307.pdf; SWR2021-00195.pdf
Hi Andrea,
These permits are ready to issue and the balance due is shown below(see attached invoices):
• PLM2021-00307-$81.20
• SWR2021-00195-$6,120.00
The fees can be paid online at htt_pfiaca-prod.accela.com/TIGARD_ZyVelcome.asbx by searching for each permit record
number under the Building tab. Payment can be made by 'card'for a 3%service fee or select the 'check' payment
option and there is no service fee.
Please note that the sewer permit SDC fee must be paid prior to issuance of the plumbing permit.
Please email the permit technicians at TigardBuildingPermits@tgard-or.gov once the fees are paid so that we can
issue the permit and email a copy to you.
Thank you.
Dianna L. Ornelas
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
1