Permit q CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2022-00506
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/12/2022Parcel: 2S112CB10700
Jurisdiction: Tigard
Site address: 15427 SW KENTON DR
Project: MAXEY Subdivision: ASHFORD OAKS NO.2 Lot: 121
Project Description: Replacing 100 ft.of water service.
Contractor: BEST PRICE PLUMBING & DRAIN LLC Owner: MAXEY, CHARLES DAVID
4130 SW 117TH AVE 160 HATTON, KIMBERLY A
BEAVERTON, OR 97005 15427 SW KENTON DR
TIGARD, OR 97224
PHONE: 503-992-6249 PHONE:
FAX:
FEES
Quantity Description Date Amount
100 If Water Service 12/12/2022 $62.54
Specifics: 1 12%State Surcharge- 12/12/2022 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 12/12/2022 $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: /. '' mittee 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
Building Fixtures FOR OFFICE USE ONLY
�
City of Tigard Rceived Permit No.:■ 13125 SW Hall Blvd.,Tigard,OR 97223- Pate/By.
e.-u n 4 tin Review
Phone: 503.718.2439 Fax: 503.598.14 y " r ateBy: Other Permit No
Inspection Line: 503.639.4175 Date Ready/By runs- 19 see Pa-e 2 for
IntcmcC www_tigard-or.gov1 `]? Nonfied/Method: Supplcm cn tai Information
„.
it F. OF WORK � �� �IEI7LIiT
use checklist.
❑New construction ❑ DcnuoLtuxt ]or specialinformation,
Description I Qty. 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 ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2
Site utilities:
Job site address:
15427 Kenton Dr Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
CitylState/ZIP:Tigard, OR 97224 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Water Service Manufactured home utilities 50.03
Cross streetidirections to job site: Ashford St 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.<100) 1 Page 2 62.54
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backtiow preventer 3L27
Backwater valve 12,51
Nomm
Replace water"pipe from meter to house clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank 12.51
Name: Charles David Maxey and Kimberly Hatton F'ixture/sewercap 25.02
Address: 15427 SW Kenton Dr Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
city/state/zrP: Tigard, OR 97224 Hose bib 25.02
Phone:( ) 971-263-6763 Fax:( ) Ice maker 12.51
Inuffliffiaw"I" =0 Interceptor/grease trap 25.02
Business name: Medical gas(value:$_) Page 2
Contact name:
Charles David Maxey and Kimberly Hatton Primer 12.51
Roof drain(commercial) 12.51
Address:15427 SW Kenton Dr Sink/basin,/lavatory 25.02
City/State/ZIP: Tigard, OR 97224 Solar units(potable water) 62.54
Phone:(971) 263-6763 or 419-409-1877 Tub/shower/shower pan 12.51
E-mail: david@cdavidmaxey.com Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name: Best Price Plumbing and Drain LLC Waterpiping/DWV 56.29
Address: 4130 SW 117th Ave #427 Other: 25.02
City/State/Z,IP: Beaverton OR 97005 subtotal 62.54
Phone:( ) 503-443-9874 or 503-992-6249 Minimum permit fee: $72.50 72,50
CCB Lie.: 206235 Plumbing Lie.no.: P B 1587 Plan review (25%of permit fee
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE 3
Print name: YVl bEt� Date: /2 This permit application expires if a permit is not obtained within 190 days
KI y 2 Z
l� •` �
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
VBuilding\PermitsTLMU-PcmutApp.doe 10/01/09 440-4616T(10/O2/C0bI/wElu
PlumbinS Permit Aimlication - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression S stems:
Qty. Fec(ea)`
Footing drain-V 100' S0 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-Ist 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' j 62.54 62.54 Medical Gas S stems•
Water Service-each additional 100' 37.52 MONNOM
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 fust$5,000.00 and$1.52 for
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 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*.
uantitP bt Fixture'V• e t Plan review is required for any of the following.
Fixture Type for xephIC& Please check all that apply.
Work Performed; Capped Added Reluvate
Ba trst /Font El Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Stall ❑ New exterior plumbing site utilities for any complex structure
Car wash: -Each Stall
T as defined in OAR918-780-0040.
Cuspidor/Water idor/Water As i-Drive El Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial ElAny 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„
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
Ice Mach./Refri .Drains Comments regarding fixture work:
Oil Separator Gas Station)
Rea Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/fiar non-food related
-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 plumbing permit can be issued.
Urinal
Other Fixtures:
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