Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2022-00342
Date Issued: 9/8/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10130 SW NIMBUS AVE D1
Project: Spec Space Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 2
Project Description: Landlord work prior to TI:Adding(1)sink and (1)water closet; Relocating(1)sink and(1)water closet.
Contractor: LOCAL PLUMBING COMPANY Owner: DIETRICH, NANCY BISHOP
20833 SW OLDS PL ROBINSON, JERRY CHRISTOPHER TRUST
SHERWOOD, OR 97140 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-642-2067 PHONE:
FAX: 503-642-5954
FEES
Quantity Description Date Amount
2 ea Sink 08/31/2022 $50.04
Specifics: 2 ea Water Closet 08/31/2022 $50.04
1 12%State Surcharge- 08/31/2022 $12.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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.
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Plumbing Permit Application RECEIVED 1
Building Fixtures I'� RUG 2 5 2
City of Tigard TIC,P ea I Ui Yas/x^ Permit No.:kin aG11- /C+�
II • 13125 SW Hall Blvd.,Tigard,OR 97223 ITS( °F :%..1
ew
_ Phone: 50 Line: 3 Fax: 503.598.1960 G U`DI\I y, Other Permit No. G+ `a
T I G A R D Inspection Line: 503.639.4175 BUILDING Page 2 �a'
Date Ready/By: kris: See® Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
For special information use checklist❑New construction 0 Demolition
Description I Qty. I Ea. I Total _
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
El1-and 2-family dwelling ®Commerciallindustrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:10130 SW Nimbus 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 R: ) Page 2
Suite/bldg./apt.no.:D, Ste 1-2 Project name:Bldg. D TI Manufactured home utilities 50.03
Cross street/directions to job site: C t� 5 vlanholes 18.76
.1 P' - 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
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Plumbing for TI 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:Local Plumbing Co. Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Brandy Solano Roof drain(commercial) 12.51
Address:20833 SW Olds Place Sink/basin/lavatory ,2' 1 25.02 50.04
City/State/ZIP:Sherwood, OR 97140 Solar units(potable water) 62.54
Phone:(503)462-2067 Fax::(503 )642-5954 Tub/shower/shower pan 12.51
E-mail: brandys@localplumbingco.com Urinal 25.02
CONTRACTOR Water closet 1 25.02 50.04
Water heater 37.52
Business name:Local Plumbing Co. Waterpiping/DWV 56.29
Address:20833 SW Olds Place Other: 25.02
City/State/ZIP:Sherwood, OR 97140 Subtotal 100.08
Phone:(503)642-2067 Fax:(503)642-5954 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lie.: 72253 Plumbing Lic.no.:34-197PB
State surcharge(12%of permit fee) 12.01
Authorized signature: TOTAL PERMIT FEE 112.09
Print name:Brandy Solano Date:8/24/22 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PemdtApp.doc 10/01/09 440-4616T(10/02/COM/wEB)
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-I'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-Ist 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
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 nominal 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:
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: -Tub/Shower
-Jacuzzi/whirlpool engineer.
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
-Dr
Each Thru as defined in OAR918-780-0040.
ivCuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial ElAny multipurpose fire sprinkler system.
Domestic El 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"
Isometric or Riser Diagram
0 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
Ice Mach./Refrig.Drains Comments regarding fixture work: ,se,
Oil Separator(Gas Station) 5 -s3 r
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lay/Bar non-food related 1 1
-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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet t plumbing permit can be issued.
Urinal
Other Fixtures:
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