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Permit (6) CITY OF TIGARD PLUMBING PERMIT = COMMUNITY DEVELOPMENT Permit#: PLM2022-00288 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 7/27/2022Parcel: 2S102AC01000 Jurisdiction: Tigard Site address: 12575 SW MAIN ST Project: Wei Li Acupuncture Subdivision: None Lot: None Project Description: Replacing 60 If of sanitary sewer line on private property. Contractor: LOVETT INC Owner: 12575 SW MAIN STREET LLC 6920 NE 42ND AVE 12575 SW MAIN ST PORTLAND, OR 97218 TIGARD, OR 97223 PHONE: 503-737-8423 PHONE: FAX: 503-288-1630 FEES Quantity Description Date Amount 60 If Sanitary Sewer 07/27/2022 $62.54 Specifics: 1 12%State Surcharge- 07/27/2022 $8.70 Plumbing Type of Use: COM 10 ea Minimum Fee Adjustment- 07/27/2022 $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 Application Site Utilities RECEIVED FOR OFFICE USE ONLY CI Of Tigard Received / 1 w 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 2 7 2022 Date/B � P t y: �L Plan Review Phone: 503.718.2439 Fax: 503.598.IJ �., r Other Permit No.: i.!l i Y �.J TIQ:j��(�U Date/By: Inspection Line: 503.639.4175 �. Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov ::nmi DING ONI .'I�;N Notified/Method: Supplemental Information r. ❑New construction ❑Demolition For special information use checklist. Description I Qty. I Ea. Total ❑Addition/alteration/replacement ,Other: New I-2-family dwellings(includes 100 ft.for each utility connection) SFR(1)bath 312.70 ❑ 1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78 ❑Accessory building SFR(3)bath 500.32 g ❑Multi-family Each additional bath/kitchen 25.02 ❑Master builder ❑Other ,✓ r t \ Fire sprinkler sq.ft.) Page 2 DO ffi )( Site utilities: ",� Job site address: 2 S 7S S L /VIATW s I- Catch basin or area drain 18.76 City/State/ZIP:' 6 O '� 3 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 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.:-k-) ( 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 31.27 150,AiMF, � TC1N 5N'bi �s Backwater valve 12.51 APP Clothes washer 25.02 �Qr vcl 60 �f Dishwasher 25.02 L rw £ /✓ Drinking fountain 25.02 Flo /j,t Ej ectors/sump 25.02 ti, LLi2TY trIANT Expansion tank 12.51 Name: �£ L C V�Lr n Fixture/sewer cap 25.02 V� Address: �-5 S Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 4IIrJC ' © I pERSUlY Interceptor/grease trap 25.02 .. � � Business name: . Medical gas(value:$ ) Page 2 1LV�- Q Contact name: 1J S {E� <V Primer 12.51 Roof drain(commercial) 12.51 Address: <'ji q- S Sink/basin/lavatory 25.02 City/State/ZIP: �„ 1-1-#'Vo V'L Solar units(potable water) 62.54 Phone:6o3 ) W-- J?M Fax: :( ) Tub/shower/shower pan 12.51 y ^ E mail:� � � I�Iv IT Gt?�\ Urinal 25.02 CONT,I .. R�" x 1 11 Water closet 25.02 Water heater 37.52 Business name: �rL k L Water piping/DWV 56.29 Address: 0 '�-O Other: 25.02 City/State/ZIP: PCYA-T ?�j Subtotal Phone:(503 ) 7 3').&j Fax:( ) Minimum permit fee: $72.50 CCB Lic.: ass O Plumbing Lic.no.: 6-77 3 Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Qp A - ,/ ��? 2� This permit application expires if a permit is not obtained within 180 days Print name: I�Ivr /1/ Date: after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. -\Building\Permits\PLMU-PermitApp-doc 10/01/09 440-4616T(10/02/C0M/WEB) Plumbing Permit Application - City of Tigard Page 2 -,Supplemental Information Fee Schedule: Residential Fire Suppression S stems: a t ,r hl`y.,.. '"` 1 '•�w� �� Vee,le ,TUta1 .. Footing drain-I"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-I st 100' 62.54 3,601 to 7,200 $233.207,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Medical Gas S stems: Water Service-each additional 100' 37.52 'l Fee h Storm&Rain Drain-1st 100' 62.54 `lutlon� 3 $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 10 Cfty4 ', � each additional$100.00 or fraction thereof,to ,... E) .> ee ?''' ,g.. 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 a-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*. 01 '•r„'s r'- Uantl b i'ilIx, @ '? �c/ Ilan l + v>tew umbx., . tally .,nom . ZF to r ftp ReptaCef Plan review is required for an of the following. rkorrrieT�, Capped Adeted = Relocate 9 Y g• °` Please check all that apply. Ba tist /Font Bath -Tub/Shower ❑ Any new commercial building with water service 2"and -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 ❑ 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„ 4„ s R� >; Itmetric,`sir Miser Iiia ra>aa, ... Car wash Drain L1 isometric or riser diagram is required for new buildings Garbage -Domestic-non-food g 9 g Disposal -Domestic-food related that 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 -Commercial-food related -Service Swimming-Clothes Pool Filter Washer *Note: If the fixture work under this permit results in an Washer 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 s 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. L\Building\Permits\PLMF-PermitApp.doc 12/30/05