Permit CITY OF TIGARD PLUMBING PERMIT
" ! COMMUNITY DEVELOPMENT Permit#: PLM2022-00075
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/8I2022
Parcel: 2S110DB00200
Jurisdiction: Tigard
Site address: 15199 SW ROYALTY PKWY
Project: Arbor Heights Subdivision: WILLOW-BROOK-FARM Lot: 8
Project Description: Replacing 40 ft.of water service.
Contractor: MEP PROS INC Owner: KW FUND VI ARBOR HEIGHTS LLC
3901 SE NAEF RD ATTN ASSET MGR
PORTLAND, OR 97219 151 S EL CAMINO DR
BEVERLY HILLS, CA 90212
PHONE: 971-328-7181 PHONE:
FAX:
FEES
Quantity Description Date Amount
40 It Water Service 03/08/2022 $62.54
Specifics: 1 12%State Surcharge- 03/08/2022 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 03/08/2022 $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:
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 Applica(ilq�CEIVE� 0 Site Utilities ��--(( FOR OFFICE USE ONLY
City of Tigard FEBDatRece/Byed:
�/3 J �y Permit No.: 11 v 7`--
• 13125 SW Hall Blvd.,Tigard,OR 9722315 ZOZZ DaleB,. D / r/ �°l%/I �7?-t tJV J
' Plan Review �J� ,"
• Phone: 503.718.2439 Fax: 503.5ee�00F TIGARD Date/By: AAL Other Permit No.
Inspection Line: 503.639.4175 Date Read/B y y, ® See Page 2 for
I C.A I.l) 9 tuna
Internet: www.tigard-or.gov i3UILDING DIVISION Notified/Method: 3 f I Supplemental Information
TYPE OF WORK 0 igilew,,4--ce-t /�:- FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. J 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
ElAccessory building El 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:15199 SW ROYALTY PARKWAY 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.:Building G I Project name:ARBOR HEIGHTS Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: 40 ft G Page 2 S�
Subdivision: I Lot no.: Fixture or item: ` srxr
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
'' Clothes washer 25.02
Replce two water main up to 20'using 2" PEX Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ 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: 1-800-PLUMBER +AIR Medical gas(value:$_) Paget
Pr
Contact name:SAMI SCHMAUTZ ""eT 12.51
Roof drain(commercial) 12.51
Address:3901 SE NAEF RD Sink/basin/lavatory 25.02
City/State/ZIP:PORTLAND, OR 97267 Solar units(potable water) 62.54
Phone:(503 )676-3449 Fax::( ) Tub/shower/shower pan 12.51
E-mail:samis@1800plumber.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Business name:1-800-PLUMBER +AIR Water heater 37.52
Water piping/DWV 56.29
Address:3901 SE NAEF RD Other: 25.02
City/State/ZIP:PORTLAND, OR 97267 subtotal (-j 1
Phone:(503 )676-3449 Fax:( ) Minimum permit fee: $72.50 '7?�
CCB Lic.:229559 Plumbing Lic.no.:PB2303 Plan review (25%of permit fee)
State surcharge(12%of permit fee) i .90
Authorized signature: y TOTAL PERMIT FEE if ,
Print name:Sami Schmautz ate:02/15/2022 This permit application expires if permit is not obtained wi m 190 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
rlBuilding1 Permits\PLMU-PermilApp.doc 10/01/09 440-4616T(I0/02'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 -,,
� I �,-i ( Medical Gas Systems:
Water Service-each additional 100' 1......1
'1 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 ' Fee tea) 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
Subtotal: 1.4,- -71
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 any of the following.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
ElAny new commercial building with water service 2"and
Bath -Tub/Shower
-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 0 Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 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"
4" Isometric or Riser Diagram
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
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/L.av -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
1:1Building\Permits\PLMU_PermitApp.doc 2