Permit CITY OF TIGARD PLUMBING PERMIT
II •
COMMUNITY DEVELOPMENT Permit#: PLM2021-00489
Date Issued: 12/7/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S133CD00100
Jurisdiction: Tigard
Site address: 11503 SW 135TH AVE 110
Project: Sunflower Apartments Subdivision: None Lot: None
Project Description: Replacing existing fixtures due to fire damage:(2)sinks,(1)tub/shower,(1)water closet,and (1)water heater.
Contractor: REA MECH INC Owner: SUNFLOWER COMMUNITY INC
30330 SW GRABEL RD. 2555 HUNTINGTON DR STE A
HILLSBORO, OR 97124 SAN MARINO, CA 91108
PHONE: 503-969-6252 PHONE:
FAX: 503-640-9344
FEES
Quantity Description Date Amount
2 ea Sink 12/03/2021 $50.04
Specifics: 1 ea Tub/Shower/Shower Pan 12/03/2021 $12.51
1 ea Water Closet 12/03/2021 $25.02
Type of Use: MF 1 ea Water Heater 12/03/2021 $37.52
Class of Work: ALT 1 12%State Surcharge- 12/03/2021 $15.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $140.10
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: ‘g-e VA-Za-aevr.
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 ApplicaC4;11
EIVE
Building Fixtures
NOV 9 ZnZI FOR Orl l('1•: L SI ON1.1
City of Tigard RE' eN
ived
q114 13125 SW Hall Blvd.,Tigard,OR 91(a} Y OF CIGARUPennit No.: �✓ Lra,s Phone: 503.718.2439 Fax: 503l� [Cj
h Inspection Line: 503.639.4175 1 ING DIVISION Dat*�Y Other Permit No.:
TIGARD
Internet: www.tigard-or.gov DateReady/By: 1 See Page 2 for
Notified/Method: j1,C' J S Su
TYPE OF WORK Pplementai Information
FEE* SCHEDULE
\ ❑New construction 0 Demolition
For special information use checklist
ddition/alteration/replacementDescription Qty. I Es. Total
Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF F CONSTRUCTION - SFR(1)bath
312.70
•
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath
437.78
❑Accessory building XMulti-family c SFR(3)bath 50032
❑Master builder Each additional bath/ken itch
N CI 25.02
Fire sprinkler( sq.fl.) Page age2
Y.
11 t JOB sum INFORMATION;ilsID LOCATION Site utilities:
Job site address: ��, 11- 18.76
�� V�i "_ - \r`� Catch basin or area drain
City/State/ZIP: �`(k�, .� �� Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: \\ I Project name: v y\ .\V,(jti-r Footing drain(no,linear ft.: i 2
Manufactured home utilities Page
7 Cross street/directions to job site: 50.03
Manholes 18.76
`, Rain drain connector 18.76
�l �\ . ,(�� V, 1 B )-` - Z .a`\. Sanitary sewer(no.Linear ft.: ) Page 2
JJJ Storm sewer(no.linear ft.: ) Page 2
( Water service
7 Subdivision:
I Lot no.: (no.linear ft.: ) Page 2
Fixture or item:
Tax map/parcel no.: Backflow preventer
31.27
DESCRIPTION OF WORK Backwater valve 12.51
j3 \ -t i�t.` .l y Z- C\ f t�Q Clothes washer 25.02
Dishwasher 25.02
d Drinking fountain 25.02
yJ Ejectors/sump 25.02
0 PROPERTY OWNER J , 0 TENANT Expansion tank
12.51
Name: Fixture/sewer cap
25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( ) Hose bib 25.02
Fax ( )
Ice maker
APPLICANT Q COIVT`.�1 , ,.-1** Interceptor/grease 12.51
25.02
E. Business name: Medical gas(value:$
Page 2
Contact name: mer 12.51
�
Address: Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
Solar units(potable water) t 1
City/State/ZIP:ess:
Phone:( ) 62.54
Fax::( ) Tub/shower/shower pan
E-mail: ` 12.51 /et 7
_ Urinal
25.02
CONTRACTOR Water closet i 25.02 U
Water heater ��
Business name: - ,, �` \ 37.52 37.5-di
Address: �.�) \ y� J-\5 Waterpiping/17wv 56.29
City/State/Z"" �\`\�t)..j�N'v c, cl n-\ a Other: 25.02
total
Phone:( j1) ) l�rl-\o}`� Fax: r�' Subtotal z25,G)`i
(`. ) �y C"CI J ki 1 Minimum permit fee: $72.50
CCB Lic.: vki L} 1 Plumbing Lic.no.:?,q-3 i Cl i Plan review (25%of permit fee)
n
A,ithoeized signature: \ ;� pnt,. '-� Ototy au�.:Ltu It%o Or ) `S '�1\a b'e C petmtt Fee /
TOTAL PERMIT FEE n d/r,)
Print name:N\-Z...A\-'',.. --T-% c- v,y.-- Date: \\� r - 1 I This permit application expires Ira
J ".\3 permit is not obtained wl la 180 days
after It bas*Fee methodology set by Tt�Couaccepted
ty g Building Industry Service Board.
LA Building 10/01/09
440-4616r(1 tvovCOM/W EB)
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-1F'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*. 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
-Jacuzzi/Whirlpool engineer.
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive 7hru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
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
0 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
-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: e.* 2shw
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