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Permit
„ CITY OF TIGARD PLUMBING PERMIT :11111 $ COMMUNITY DEVELOPMENT Permit#: PLM2021-00407 Date Issued: 11/16/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 134DC03001 Jurisdiction: Tigard Site address: 11130 SW TIGARD ST Project: Dirksen Nature Park Subdivision: CHERRY HILL ACRE TRACTS Lot: 6 Project Description: Site utilities:297 ft.of storm sewer. The site is located on the left or south side of the roadway between the Fanno Creek bridge crossing and Gallo Avenue. Contractor: LEE CONTRACTORS LLC Owner: TIGARD,CITY OF PO BOX 896 13125 SW HALL BLVD BATTLEGROUND,WA 98604 TIGARD,OR 97223 PHONE: 360-852-2317 PHONE. FAX: FEES Quantity Description Date Amount 297 If Storm Sewer 11/10/2021 $137.58 Specifics: 1 12%State Surcharge- 11/10/2021 $16.51 Plumbing Type of Use: COM 1 Plan Review 11/10/2021 $34.40 Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $188.49 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: Hc-LL V°AA,Dr% W2ge. Permittee Signature: Qw A. . 1:, -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. r Plumbing Permit Application a 46 2 V Site Utilities RECEIVED�-y) ..-. orFICE USE ONLYCity of Tigard Received .p� Date/By: 4 3d )i ✓�I ^ Permit No.. `• t 01.17.3O 1111 • 13125 SW Hall Blvd.,Tigard,OR 97223 ty qOq� ■ r / �i C PlDate/By: an Review/0 / }g1 A Phone: 503.718.2439 Fax: 503.598.19Sq / / Other Permit No.: Inspection Line: 503.639.4175 Date By: T I c i A It I) Date Ready/By Tuns HI See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARL Notified/Method 11 fr/�( .71e •• �-tupplemental Information TYPE OF WO�iKt•Lq{NG DIVISI01� '� FEE* SCHEDULE New construction ❑UDemolition For special information use checklist. Description I Qty. I Ea. I Total ❑Addition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 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: 11 130 SW Tigard Street Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 tY Tigard,OR 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Dirsken Nature Park Manufactured home utilities 50.03 Cross street/directions to job site: SW Cornell Place Manholes 18.76 From Permit Center to Burnham St.to Main St.to Tigard St.across the Fanno Rain drain connector 18.76 Creek bridge and site is on the left or south side of the roadway between the Sanitary sewer(no.linear ft.:_) Page 2 bridge crossing and Gallo Ave. Storm sewer(no.linear ft.: ) 297 Page 2 137.58 Water service(no.linear ft.: ) Page 2 Subdivision: Cherry Hill Acre Tracts I Lot no.: 6 Fixture or item: is Tax map/parcel no- 1 lsanc 3ulK 3om,iuo 1.irol.sx s�,o.val Backflow preventer 31.27 I/11a1)11 [ i ,. .1�1Ali ^_il '��\ .I.\If ._ni DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 „stV Installation of 6"and 10"drainage pipe daylighting in rip-rap basins. Dishwasher 25.02 `N Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: City of Tigard Fixture/sewer cap 25.02 "e Floor drain/floor sink/hub 25.02 .< Address: 13125 SW Hall Blvd \ Garbage disposal 25.02 City/State/ZIP: Tigard,OR.97223 Hose bib 25.02 Phone:(503 )639-4171 Fax:( ) Ice maker 12.51 ❑ APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02 /" ,a Business name: City of Tigard Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Jeff Peck Roof drain(commercial) 12.51 Address: 13125 SW Hall Blvd Sink/basin/lavatory 25.02 City/State/ZIP: Tigard,OR. 97223 Solar units(potable water) 62.54 Phone:( 503)718-2466 or 971-295-6588 Fax: :( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: jeffp@tigard-or.gov CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: e e Co>nkra Oro rj Water piping/DWV 56.29 Address: PU M0 Other: 25.02 City/State/ZIP: gQ. s C a LASA. 41 O`Do ( Subtotal 137.58 Phone:( ) Fax ( ) Minimum permit fee: $72.50 CCB Lie.: t ND S 'S S Plumbing Lic.no.: Plan review (25%of permit fee) CJ State surcharge(12%of permit fee) /6. i Authorized signature: _-_--)..."0,1( C / - TOTAL PERMIT FEE kf t, i f r, Print name: Jeff Peck Date: 9/28/21 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:\Building\Permits\PLMU-PermilApp.doe 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 C 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' 100 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 197 37.52 75.04 $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 A and including$10,000.00. Inspection of existing plumbing or Or $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. Performed: Capped Added Relocate q Baptistry Font Please check all that apply. Bath Tub/Shower ❑ 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 ❑ 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 OAR9 1 8-780-0040. 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 ❑ 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: I:\Building\Permits\PLMU_PermitApp.doc 2 Branden Taggart From: Branden Taggart Sent: Monday, November 8, 2021 5:20 PM To: Jeff Peck Subject: Dirksen Nature Park Plumbing Permit: PLM2021-00407 - 11130 SW Tigard St. Attachments: Plumbing Permit Invoice.pdf Jeff, The Site Utilities Plumbing permit for Dirksen Nature Park is ready to issue now. The balance due is $188.49, and I have attached an invoice above for you to reference. These fees can be paid online at https://aca- prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number PLM2021-00407 under the Building tab. There is a 3% service fee for credit cards, but e-checks do not have a service fee. Once paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may issue this permit and make the site copy set of plans available for pick up. Please note that the contractor's license information is required prior to issuance. Thank you, Branden Taggart .. City of Tigard c; Senior Permit Technician Community Development t 13125 SW Hall Blvd Tigard, OR 97223 (503)718-2449 brandent©tigard-or.gov 1