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HomeMy WebLinkAboutPermit (5) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2022-00284 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/26/2022 Parcel: 2S 104AA03500 Jurisdiction: Tigard Site address: 12230 SW 126TH AVE Project: Moxley Subdivision: BELLWOOD Lot: 31 Project Description: Replace broken water line. Contractor: ENVIRONMENTAL WORKS LLC Owner: MOXLEY, ROBERT E&SHANNON M 2634 SE STEELE ST 12230 SW 126TH ST PORTLAND,OR 97202 TIGARD,OR 97223 PHONE: 503-719-6715 PHONE: FAX: 503-972-1866 FEES Quantity Description Date Amount 60 If Water Service 07/26/2022 $62.54 Specifics: 1 12%State Surcharge- 07/26/2022 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 07/26/2022 $9.96 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of he project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Site Utilities FOR OFFICE USE ONLY City of Tigard Received / {�[f ( Pennit No.: I tl r1� 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:Plan Review �-t Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Pennit No.: Inspection Line: 503.639.4175 Date Ready/By: Juris: EZ See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information T PE OF*O)ttK iVE* SC1FIEbiII E New construction For special information use checklist ❑ ❑Demolition .f Description t Ea. Total Addition/alter on/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) LATE R' b?'CONST lk6m()N SFR(1)bath 312.70 �1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 El Master budder ❑Other: Fire sprinkler( sq.ft.) Page 2 +Q$`SITER1ti1A1ICEN l 1LtD ?A3IbN Site utilities: Job site address: Catch basin or area drain 18.76 City/State/ZIP: Drywell,leach line,or trench drain 18.76 � � Z� Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Mlly 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 pEScRIP`10 OF WORT{ Backwater valve 12.51 ' Clothes washer 25.02 ora Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 1<'R(1tPERTY OWNER © TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 / .l Floor drain/floor sink/hub 25.02 Address: U ej G Garbage disposal 25.02 City/State/ZIP: I% /� ? �1 '/?Z3 Hose bib 25.02 Phone:6'03) S3 ({ Fax:( ) Ice maker 12.51 APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: g Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: �� Waterpiping/DWV 56.29 Address: Z,7F7,0 Ak se,K tSlvcl Other: 25.02 City/State/ZIP: he,;lCU 1 C t z If Subtotal Phone:(5-03) 9/q Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: I Plan review (25%of permit fee) � /� S State surcharge(12%of permit fee) Authorized signature: ^ TOTAL PERMIT FEE01 d / �G z 2 This permit application expires if a permit is not obtained within 180 days Print name: Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I;ABuilding\Pewits\PLW-PennitApp.doc 10/01/09 44046I6T(I0/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Sup1pression S stems: Site Utilities . ,Qty' Fee�ea� Total 'ua1CC"Ebola' a ParMit dee: 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-1 st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1 st 100' x 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Stonn&Rain Drain-I st 100' 62.54 �� $1.00 to$5,000.00 Minimum fee$72.50 Stone&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 Fee(ea} vital each additional$100.00 or fraction thereof,to O r.1 't3C1 1S;i1r� $ 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 char e-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*. Ouantity by Fixture Type Plan R��ievuf0ir�,kt 140 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. Bath Tub/Shower El Any new commercial building with water service 2"and greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool Car Wash -Each Stall engineer. Drive tall El 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 OAR918-780-0040. Eye Wash Floor Drain/sink 2" Submit 2 sets of plans with any of the above. 3" Isometric or 01 I)><a ram Car wash Drain 7tbsat Garbage -Domestic-non-food ometric or riser diagram is required for new buildings Disposal -Domestic-food related meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refri .Drains Oil Separator Gas Station Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related -Bradley -Conunercial-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 ■ Site Utilities — Plumbing Permit Application Plan Submittal Requirements A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. 1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn to scale) labeled with: A. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads with project location. 2. PLUMBING PLANS - Two (2) complete sets, civil only. All details listed below shall be incorporated into the plumbing plans: A. Storm drainage plan showing: 1) Finish elevations throughout the developed site. 2) Grade breaks determining area serving each catch basin. 3) Location of catch basins. 4) Pipe size. 5) Type of material. 6) Slope of piping. 7) Manholes and field drains. 8) Cleanouts provided for each 100 feet or fraction thereof. 9) Roof drain laterals specifying cleanouts at each upper terminal. 10) Location of existing or proposed connection to a public sewer line. B. Utilities plan showing: 1) Sanitary sewer line location,pipe size, type of material, slope of piping, manholes and cleanouts provided as required for storm. 2) Size and location of domestic water piping and drainage. 3) Proposed location of connection to a public water or sanitary sewer line. 1:\Building\Permits\PLMF-PennitApp.doc 12/30/05