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Permit CITY OF TIGARD PLUMBING PERMIT " COMMUNITY DEVELOPMENT t Permit#: PLM2023-00231 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/26/2023 Parcel: 2S103CB00700 Jurisdiction: Tigard Site address: 12235 SW JAMES ST Project: Erickson Subdivision: None Lot: None Project Description: New connection to sewer. Contractor: SUBCOM EXCAVATION & UTILITIES LLC Owner: ERICKSON, RICHARD PO BOX 4055 12235 SW JAMES ST HILLSBORO, OR 2022 TIGARD, OR 97223 PHONE: 503-648-9310 PHONE: FAX: FEES Quantity Description Date Amount 100 If Sanitary Sewer 06/26/2023 $62.54 Specifics: 1 12%State Surcharge- 06/26/2023 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 06/26/2023 $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: �/A�"I l �}-y 503.639.4175Call by 7:00 a.m.for the next available inspection date. iel y1 `sl" 11 o?7z. 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 - 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 Sewer-1st 100' 62.54 �Z,S� 3,601 to 7,200 $233.20 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 62.54 Water Service-each additional 100' 37.52 Medical Gas Systems: Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $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 andInspection of existing plumbing or for $148.50 including the first$10,000.00. which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 each a for first$10,000.00 and$1.54 for (minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to Inspections outside of normal business 90.00/hr and including 0.00. $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 90.00du 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$120 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*. Fixture Type for Quantity by Fixture Type Plan Review for Plumbing Installations Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. 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" Car Wash Drain Isometric or Riser Diagram Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice MachlRefrig.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 Pool Filter Washer-Clothes *Note: If the fixture work under this permit results in an 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. I:\Building\Permits\PLMU_PermitApp.doc 2 Plunnbin2 Permit Application Site utilities RECE17. 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