Permit CITY OF TIGARD PLUMBING PERMIT
. COMMUNITY DEVELOPMENT Permit#: PLM2022-00240
Date Issued: 7/7/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 110
Project: Oregon Dairy Council Subdivision: None Lot: None
Project Description: Installing(1)sink and(1)domestic dishwasher
Contractor: SR JOHNSON PLUMBING INC Owner: 72ND CORPORATE CENTER LLC
181 N GRANT ST#209 4949 SW MEADOWS RD STE 330
CANBY, OR 97013 LAKE OSWEGO, OR 97035
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 07/02/2022 $25.02
Specifics: 1 ea Sink 07/02/2022 $25.02
1 12%State Surcharge- 07/02/2022 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 07/02/2022 $22.46
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. , Permittee Signature: ? ai
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 Applicatid C IVEr
ligb
Building Fixtures JUN 16 2022 ' "'t t)' ' '' I ( ,,r t)\l ,
- City of Tigard Received R a d -OC C
Da1elBy: / �. Permit No.: G
13125SW Nall Blvd., OR 9722y� Y Of- �UhFiV
Phone: 503.718.2439 Fax: 503.59 Plan Review
U .DING DIVISION Dale/I3y: Other Permit No.S '3.9 '000.
TIGARD Inspection Line: 503.639.4175 Date Ready/Fly: L Jr
L Internet: www.tigard-or.gov � See Pent 2 for
Notified/Method: Supplemental Information
TYPE OF WORK e mai Lzoie7/-.,]/ , * SCHEDULE
ti ❑New construction ❑Demolition - Description For s eclat information use checklist
Qty. Ea. Total
_Addition/alteration/replacement ❑Other:
New 1-2-family dwellings(includes 100 ft.for each utility connection)
1 CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
)
El -and 2-family dwelling Commercial/industrial SFR(2)bath 437 7S -
SFR(3)bath 500.32
1 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.tl.) Page 2
JOB SITE INFORMATION AND�J LOCATION Site utilities:
I Job site address: 136 36 S W IA At C Catch basin or area drain t g.76
Vt ila
J City/State/ZIP: -1 t ,I i J � q1 4 1� I Doting leach line,or trench drain 1ge 2
+ O� �w,- Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name. 1i01�{ - Manufactured home utilities 50.03
Cross street/directions to job site: L Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
J --- Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.:
Fixture or item:
l Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
((/f A �� Clothes washer 25.02
,� DishwasherI 25.02 06 pp
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER .STENANT Expansion tank 12.51
�QiMA' �, � i i) Fixture/sewer
Name: aft. /► ,^ cap 25.02
C V1A(i Floor drain/floor sink/hub 25.02
Address: 61 /I► ,II► A , I��
/►/1) n +�q Garbage disposal 25.02
f City/State//IP. S1[Lr ,/ CYJ - - -- Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT I ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$_) Page 2
•
Primer 12.51
Contact name. txt ,/
U ". "11 Roof drain(commercial) 12.51
Addressb l Sink/basin/lavatory ' 25.02 .bD
City/State/ZIP: otjgbil/{ at 41)6i 3 Solar units(potable water) 62.54
Phone:( ) Jill,. ` _-5' J Fax::( ) Tub/shower,/shower pan 12.51
E-mail C i litjb I-„I` /10 ��` e Urinal 25.02
V ��(�y�_V 1 r
CONTRACT Water closet 25.02
Water heater 37.52
Business name: `G��j�nLa �i„ �`,. -
n ) `•-�M--ts�_- 1111I - _ Waterpiping/DWV 56.29
Address:,,4 b m/ lD h _ Other: 25.02
City/State/ZIP: "J� v Subtotal 6D.bi4
Phone: ') "fitly•• S'C Fax:( ) Minimum permit fee: $72.50 "2.5b
CCB Lic-: 5 y1a,2to J 3 Plan review (25%of permit fee)
J Plumbing Lk.no.: -toot* --- .�
State surcharge(12%of penult fee)
Authorized signature: �/�J,�,� ,/!' ��. �G
n� ��y"1'ti- Y'�� TOTAL.PERMIT FF,F, 7
Print name:1,�Q4. pi UL h,� Date: �1lIf l'/, This permit application expires if a permit is not obtained within 180 days
T� + o after it has been accepted as complete.
`Fee methodology set by Tri-County Building Industry Service Board.
1:1i)uiklingtPcrmitsti'L.MU-PemtitApp.doe lorni O9 440-4616T(la'O2COM'WEtr)
,‘-S- e.S O• ` ) Chu
I, IaS
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 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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 S50,000.00.
Additional plan review for revisions 90.00/hr S50,001.00 and up S742.00 for the first S50,000.00 and$1.20 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
Quantity 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
❑ Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -TubiShower engineer.
-Jacu2zi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
-Domestic Q' , ❑ 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 that meet the qualifications above.
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
lee Maeh./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -lav/Bar non-food related l
-Bradley
-Com/Serv/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 plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
L:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Branden Taggart
From: Branden Taggart
Sent: Thursday, July 7, 2022 4:44 PM
To: srjohnsonplumbing@gmail.com
Subject: Oregon Dairy Council Permits: PLM2022-00240 & SWR2022-00082 - 13535 SW 72nd
Ave Suite 110
Attachments: Oregon Dairy Council Plumbing & Sewer Permits.pdf; Permit Action Form for Fee
Refund.pdf
Hello Terra,
Per our phone conversation today, I have issued the Plumbing and Sewer permits for Oregon Dairy Council, and they are
attached above. You may now schedule inspections online through our website: http://inspections.tigard-
or.Rov/WebOnlinelnspections. I will be mailing the blue Clean Water Services Sewer Use Information Card for you to
complete and return to them.
As we discussed, we will be issuing a $45.00 refund for the commercial Sewer Inspection fee as this fee was incorrectly
assessed. Since the inspection fee was paid online, we are not entirely sure who completed payment, and therefore
who should receive the refund. Typically the owner of the property pays the Sewer permit fees. I have attached our
Request for Permit Action form above for you to complete and return to us so that we know who to mail the$45.00
rufund check to. We apologize for this inconvenience.
Thank you,
Branden Taggart
' City of Tigard
■ Senior Permit Technician
Community Development
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandent@tigard-or.gov
1