Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT
Permit#: PLM2022-00359
Date Issued: 10/4/2022
T I C;A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110AB00400
Jurisdiction: Tigard
Site address: 14210 SW 112TH AVE
Project: The Ridge Apartments, Building D Subdivision: Lot: PTS 1-4
Project Description: Interior plumbing for building D: Replacing(1)hose bib, (16)sinks,(8)tub/showers,(8)water closets,and(8)
water heaters.
Contractor: ANDERSEN MECHANICAL Owner: HOUSING AUTHORITY OF WASHINGTON COON
16285 SW 85TH AVE#410 ATTN: HENRY ALVAREZ
TIGARD, OR 97224 111 NE LINCOLN STE#200L
HILLSBORO, OR 97124
PHONE: 503-992-6664 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Hose Bib 09/30/2022 $25.02
Specifics: 8 ea Sink 09/30/2022 $200.16
4 ea Tub/Shower/Shower Pan 09/30/2022 $50.04
Type of Use: MF 4 ea Water Closet 09/30/2022 $100.08
Class of Work: ALT 4 ea Water Heater 09/30/2022 $150.08
Type of Const: 1 12%State Surcharge- 09/30/2022 $63.05
Occupancy Grp: Plumbing
Stories:
Total $588.43
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: C � ; Ca� o V1
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
Building Fixtures FOR OFFICE USE ONLY
City of Tigard `' Received , �yt
g CE Y ED Date/By: 1/ '/Q - Permit No.: ( LI 'I (2Q) tu3.57
.111
� • 13125 SW Hall Blvd.,Tigard,OR 97E Plan Review
I Phone: 503.718.2439 Fax: 503.59 Date/By: Other Permit No.:
I I u A R u Inspection Line: 503.639.4175 1 Z022. Ready/By: Kris: ® See Page 2 for
Internet: www.tigard-or.gov AUG Date
Notified/Method: Supplemental Information
TYPE OF WORK --p'OF TIGARD FEE* SCHEDULE
❑New construction ❑ROAMING nIVISI a For special information use checklist
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(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building ®Multi-family SFR(3)bath 500.32
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:14210 SW 112th Ave Catch basin or area drain 18.76
City/State/ZIP:Tigard Oregon 97224 Drywell,leach line,or trench drain 18.76
,^ Footing drain(no.linear ft.:_) Page 2
_L)
Suite/bldg./apt.no.: I Project name:The Ridge Apartments Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Next to SW 112th Ave between SW Gaarde St 8 SW Pacific HWY Frontage Rd 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: I Lot no.: Fixture or item:
Tax map/parcel no.:2S 1 10AB00400 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Replace plumbing fixtures in 8 unit apartment complex Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name:HAWC AHP4 Limited Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:111 NE Lincolm Suite 200-L Garbage disposal 25.02
City/State/ZIP:Hillsboro Oregon 97124 Hose bib 1 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Andersen Mechanical Medical gas(value:$_) Page 2
Primer 12.51
Contact name:Charlie Chrisman
Roof drain(commercial) 12.51
Address:16285 SW 85th Ave Suite 410 Sink/basin/lavatory 1.6- - 25.02
City/State/ZIP:Tigard Oregon 97224 Solar units(potable water) 62.54
Phone:(503 )992-6664 Fax: :( ) Tub/shower/shower pan B--if 12.51
E-mail:challie@andersenmechanical.com Urinal 25.02
CONTRACTOR Water closet $ i f 25.02
Water heater 8-I-) 37.52
Business name:Andersen Mechanical Waterpiping/DWv 56.29
Address:16285 SW 85th Ave Suite 410 Other: 25.02
City/State/ZIP:Tigard Oregon 97224 Subtotal
Phone:(503 )992-6664 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: 217392 Plumbing Lic.no.:PB1978
State surcharge(12%of permit fee)
Authorized signature: (�A Citz;:htadz.. TOTAL PERMIT FEE
Print name:Charlie Chrisman Date:08/11/2022 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\Permtts1PLMU-PeemitApp.doc 10/01/09 440-46I6T(10/O2/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-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
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
(minimum charge-1/2 hour) and additional 2 ,$100.00. or fraction thereof,to
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 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
0 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 ❑ New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities.
Dishwasher: Commercial El 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 Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall 8
Sink: -LavBar non-food related 16
-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 8 plumbing permit can be issued.
Urinal
Other Fixtures:
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