Permit ...
,
: --- '114
CITY OF TIGARD PLUMBING PERMIT
■ . COMMUNITY DEVELOPMENT Permit#: PLM2022 00155
TIC;A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/28/2022
Parcel: 2S 101 AA00100
Jurisdiction: Tigard
Site address: 12300 SW 68TH AVE
Project: Landmark Ford Parts Building Backflow Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Installing backflow at building required by water provider.
Contractor: POWER PLUMBING CO Owner: CORLISS,JAMES L&CORA K
PO BOX 19418 PO BOX 23970
PORTLAND,OR 97280 TIGARD, OR 97281
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 04/28/2022 $31.27
Specifics: 1 12%State Surcharge- 04/28/2022 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 04/28/2022 $41.23
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: f4.i./.1ctA) Permiftee Signature: -63C_ C/c40 'rc4h -/\
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.
EIVEC
Plumbing Permit ApplicatliRonEC e
Building Fixtures APR 14 2022 FOR OFIIC : I si: ONl.1
City of Tigard GI T Y OF IGAti-L Receieea
Date/By: /p1 47d i Permit No.:R(t'\"1 CJ"y4. - c v 1 5_
', , . 13125 SW Hall Blvd.,Tigard,OR %t 3.1mG DIVI Plan Review
1(� (y
Phone: 503.718.2439 Fax: 503.5'8. IN42 tl ��Q Date/By: 674 Other Permit No
1 1 e 1 Ft Date Line: >03b39.4175 Date Ready/By: La//ip,J H See Page 2 for
Internet: www.tigard-or.gov Notified/Method I leic Supplemental Information
t TYPE OF WORK FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description 1 Qty. J Ea. 1 Total
®Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
0 I-and 2-famil dwellingSFR(2)bath 437.78
) ®Commercial/industrial
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: 12300 SW 68TH AVE Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP.TIGARD, OR 97223
Footing drain(no.linear ft 1 Page 2
Suite/bldg./apt.no. -1 Project name:22-575 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. 13ackflow preventer 1 31.27
DESCRIPTION OF WORK Backwater valve 12.51
i-
-
Clothes washer 25.02
LANDMARK FORD PARTS/SVC BUILDING BACKFLOW Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER 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.POWER PLUMBING CO. Medical gas(value:S_) Page 2
- -- Primer 12.51
Contact name:JOSH CRUME
Roof drain(commercial) 12.51
Address: P.O. BOX 19418 Sink/basin/lavatory 25.02
City/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62 54
Phone:( 503-244-1900 l'ax: .( 503)-244-8825 Tub/shower/shower pan 12 51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:POWER PLUMBING CO. - _ Water piping/DWV 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP PORTLAND, OR 97223 subtotal
Phone:( 503-244-1900 Fax:I 503L244-8825 Minimum permit fee: 572.50
Plan review (25%of permit fee)
CCB Etc.:52378 Plumbing Lic.no.: 34-150PB
State surcharge(12%of permit fee)
�
Authorized signature: C- � ( TOTAL PERMIT FEE
a4.
Print name:KRISTIE BRAMWELL Date:4 14 2022 This permit application expires if a permit is not obtained within NO days
after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I'Duitding'Permits'PLMU-Permit.{pp doe 1001109 440.4616T(IO102/COMWGB)
.
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total S uare Footage: Permit Fee:
Footing drain-I"1(XI. 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 reater $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 $7250 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
rshich 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$120 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
Quantit'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
13a uistrv/Pont ❑ Any new commercial building with water service 2"and
1 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
Thru as defined in OAR9l8-780-0040.
-Drive ❑
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
4„ ❑ 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 MachiRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station) _
Rec.Vehicle Dutnp Station PLEASE CALL JOSH CRUME WITH QUESTIONS 503-936-5669
Shower: -Gang
-Stall —
Sink' -Lay/Bar non-food related -
-Bradley
-Com/Sere/t ltil 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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures: t
•
I:\\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2