Permit lifq
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2022-00150
Date Issued: 5/16/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S126CA00200
Jurisdiction: Tigard
Site address: 9285 SW GREENBURG RD
Project: Raleigh Hills Upholstery Subdivision: None Lot: None
Project Description: Adding:(1)dishwasher and(1)sink
Contractor: LOTUS PLUMBING COMPANY Owner: LINDQUIST DEVELOPMENT CO INC
8100 SW ELMWOOD ST PO BOX 42135
PORTLAND, OR 97223 PORTLAND, OR 97242
PHONE: 503-522-2728 PHONE:
FAX: 503-892-2639
FEES
Quantity Description Date Amount
1 ea Dishwasher 05/09/2022 $25.02
Specifics: 1 ea Sink 05/09/2022 525 02
22 Minimum Fee Adjustment- 05/09/2022 $22.46
Type of Use: COM Plumbing
Class of Work: ALT 9 12%State Surcharge- 05/09/2022 $8.70
Type of Const: Plumbing
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: ' 7"— . ermittee Signature: /0/��i�4/�
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 Ap ' 'ou
Building Fixtures ��� FOR 0141(..H: 1 SF. LIN11
202t Received
i I316D. G meA I k
Cityof TigardPermit No.: ^Ci 150
UPI g oi ;. 3 Date sy: yr Lr� 'Si• hone3125 SW Hall Blvd.,Tigard,Fx: Plan Review Other Permit No.: /} 1 _o CC' J/
■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ��I'\:7vU
Inspection Line: 503.639.4175, /.,/yy ( Date Ready.By: ®See Page 2 for
1 tC;AKll Internet:www.ti and-or. ov.''! �' ''..� ��"t" - 1
g g Notified/Method: i Supplemental Information
mE+f11* Th'tfliG a /1%91 FEE'SCHEDULE
0 New construction ❑Demolition For special information use checklist
Description [Qty. 1 Ea. 1 Total
[3
Addition/alteration/replacement 0 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 Commerciallindustrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family 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: t/y- •
Catch basin or area drain 18.76
"o Drywell,leach lino,or trench drain 18.76
City/State/ZIP: - (,C � _� t r -- 1
[�,]�G C ��7f�j Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: •'-.) I Project name: 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.:_) Page 2
Subdivision: Lot no.: Fixture or Item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
•` 7 i t'Ci kc.`(r--C-3(Y-- -\Y -r-_,4� Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: j
------_____-__.__-- ----_----- -- Floor drain/floor sink/hub 25.02
Address: po
-
Garbs dis sel 25.02
City/State/ZIP: Hose bib 25.02
--
Phone:( ) Fax:( ) lee maker 12.51
TACT PERSON Interceptor/grease trap 25.02'
�'P���[Fis_Plumbin QI►C.,�<u►
Business name: 8100 SW Elmwood St. Medical gas("value:$_) Page 2Primer 12.51
Contact name: Portland,OR 97223 Roof drain(commercial) 12.51
Address: 51/3-522-2/28 Sink/basin/lavatory I 25.02
City/State/ZIP: CCB#189416 Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
� lc ore" i-e, C'� r•1‘cLa(-'----- Urinal 25.02
E-mail: I
t� Z--� Water closet 25.02
CATRACTOR Water heater 37.52
Business name: -_-- -,.-_----__ WaterpipingfDWV 56.29
Address: Lotus Plumbing Company Other: 25.02
City/State/ZIP: 8100 SW E1mW�21 St Subtotal z 'rn)`-'j
Purtlai id,OR 9 223 ) Minimum permit fee: $72.50 - : '
Phone:( ) �522 21 (S� Plan review(25%of permit fee)
CCB Lic.: c,c.R .) 94 f imbing Lic.no.:pe,to,".....„.: -
$, State surcharge(12%of permit fee) =.--- (�
Authorized signature. -C.. . -- TOTAL PERMIT FEE -,.-.1.:---)(___)
Authorized -%
Print name:}'\Q ,i k....., 4�Y�c,...„ Dale: y‘ 5 31 :7 This permit applktiorn i te pisr beefn aaprmedit I sasmeined within 1ba days
'Fee methodology set by Tri-County Building Industry Service Board.
IiBuddiog\PermilePLMU-PemutApp.doc I0/01/09 440-4616T(i002/COM/WEB)
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Plumbing Permit Application-City of Tigard
Page 2-Supplemental Information c� `�5� hi:-;-(C% .. '
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total 1 Square Footage: Permit Fee:
Footing drain-1°I00' 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
Pand 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 faction 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:
cAommercial Fixture Work:
re you capping,adding or replacing flu ures? If"yes",
please indicate work performed by f re. Failure to
,ac ort fixtu Fesult in increased sewer fees*. Plan Review for Plumbing Installations
Quantt y 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
Baptistry'Fom 0 Any new commercial building with water service 2"and I
Bath: -Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-lacurzi/Wlrirlpool
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
Drive Thm as defined in OAR918-780-0040.
Cuspidor Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial 0 Any multipurpose fire sprinkler system.
Domestic 0 Any complex structure as defined in OAR918-780-0040
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above. • 1
Floor Drain/sink- -2"
3" Isometric or Riser Diagram
4.. 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: -Lav/Bar non-food related I -
-Bradley --
-ComServ/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 bejssued.
Urinal
Other Fixtures:
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