Permit CITY OF TIGARD MASTER PERMIT
III '4:„ COMMUNITY DEVELOPMENT Permit#: MST2022-00247
Date Issued: 08/02/2023
T I C;AB 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S133CD03600
Jurisdiction: Tigard
Site address: 13543 SW ASHBURY LN
Subdivision: COTSWALD MEADOWS Lot: 34 I
Project: ACHAMYELEH
Project Description: Convert garage to 2 bdrm, 1 bath. Elec and Mech to be pulled separately. WATER METER TO BE
UPSIZED TO 3/4"
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 2 First: 450 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Yes
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 450 sf Value: $30,000.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Drains: 0 Storm Sewer: 0
Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bcktlw Prevntr: 0
Footing Drain: 0 Ice Maker. 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furne100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Fum>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O SvclFdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amplvolt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 450
Owner: Contractor:
LIBASE,MISRAK Required Items and Reports(Conditions)
ACHAMYELEH,GAMACHIS
13543 SW ASHBURY LN
TIGARD,OR 97223
PHONE: PHONE:
FAX:
Total Fees: $977.58
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: on law requires you t follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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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.
' plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard RECEIVE I Received PlateDate/By: ' n/yam/ /'.'t/Ill //�/Lr``5 r 7Perm t No.: ��
1111 • 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
C Phone: 503.718.2439 Fax: Date,By.503.598.1960,UL 2 8 202� i Other Permit No.:
TIGARD Inspection Line: 503.639.4175 Date Ready/By kris ® See Page 2 for
Internet www.tlgard-orgov ,_,i.�, ... - Nolified'Method: (r Supplemental Information
.fit' I A„,. n..ar d""'
TYPE OF W0I(l..{� (tt'11�ls� e I.� FEE* SCHEDULE
❑Newconsffuction ❑7je'Lo('I�GDIVISION - For special information use checklist
Iition
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
El1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
['Accessory building ❑Multi-family
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: /3JC .. Vt..' /�/s .f-i t,- (� L f...( Catch basin or area drain •
18.76
-� � /` /.7-7'3/ Drywell,gdrain
(line,or trench drain 18. 6
City/State/ZIP: 7/( Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: /6 ,• / - Manufactured home utilities 50.03
Cross street/directions to job site: 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.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
(�� G(Z / (l "-- -- D' /7Hre/% fi. // isa warher 25.02
/ Dishwasher 25.02
/2/i/// !i ff J° 7/ Drinking fountain 25.02
t� f fV1L --J t C^^� Ejectors/sump 25.02
❑ PROP TY OWNER ❑ TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
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 ONTACT PERSON • Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
/�/ l L aA70 ! Primero 12.51
Contact name: �sI Roof drain(commercial) 12.51
Address: v,�/F�/3( flee /�/J� o (`� �J0//e Sink/basin/lavatory 1 25.02
City/State/ZIP: ` f/� TG/7�T S/ ®r �!�0✓ Solar units(potable water) 62.54
Phone:( �3 .%'✓ ,75 Fax::( ) Tub/shower/shower pan l 12.51
E-mail: /7I//.61 , // 1/. -. ./DIY' er- (7/1,7.9 C)'>7 Urinal 25.02
t Water closet / 25.02
CONTRACTOR
Water heater 37.52
Business name: </1.\.IZ✓1 Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax;( ) Minimum permit fee: $72.50
CCB Lic.: Plumbi g Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: T iI e Date: //////.18�/�J i� 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.
PVBaldingVPermits1PLMU-PermitApp_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- 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 51.54 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-la 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
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thr as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ 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
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:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -LavBar 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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures.
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Water Meter Fixture Unit Worksheet for Additions/Remodels/AD Us
RECEIVED
Please complete the following information:
Customer Name: <7,4 7 /C/(S /& ,,p--'7 4G6' f JUL 2 $ 2022
I.ITY OFl ItiAMiG
Service Address: Street/Suite#: /,5/ jv/ /15L//'C-' BUILDING DIVISION
City: //64¢,_/4 State: ( /Q-- Zip: 977 z 3
Phone Number: 5 3'"Va0—4-9 Email: /40 i✓l6/sAS(111�/17+G.1 60/#7
Please fill in the number of each fixture you currently have. Please fill in the number of fixtures you propose to add.
Multiply the quantity by the point value to arrive at the current Multiply the quantity by the point value to arrive at
total. the proposed total.
Fixture Unit Current Point Current Proposed Point Proposed
Quantity Value Total Addition Value Total
Bar sink x 1 = x 1 =
Bidet x 1 = x 1 —
Clothes washer ( x 4 = x 4
Dishwasher / x 1.5 = /, x 1.5 =
P'Outside Water Spigot / x 2.5 = �r S x 2.5 =
Water Spigot,each add'l / x 1 = x 1 —
Kitchen sink / x 1.5 =-/-„---
x 1.5 =
Laundry sink x 1.5 = x 1.5 =
Lavatory(bathroom sink) 1j x 1 = ( X I =
Water closet,1.6 GPF(toilet) v X 2.5 = u / x 2.5 = Z '�
Bathtub/whirlpool x 4 = x 4 =
Shower stall x 2 — . ( x 2 =
Bath/shower combo r x 4 = x 4 =
Current Points: /Z✓I5 Proposed Increase: r 5
Current Points +Proposed Increase= ;_'(_- _ =New Total Points =Required Meter Size /7
Meter Sizes: 1 to 30 points=5/8" 30.5 to 37 points=' " 37.5 and over points= 1"
3/4 16,094.00
New Meter Size Needed for New Total Points: Cost: $ (see page 1)
5/8 11,258.00
Current Meter Size per Utility Billing: Cost: $ (see page 1)
New Meter Size Cost minus Current Meter Size Cost= $ 4,836.00
(This is Your Cost to Increase Meter Size Due to Additional Fixture Units)
*************************************************************************************
FOR OFFICE USE ONLY Meter will need to be upsized to 3/4 inch.
Current Meter Size Confirmed with UB J Bentley 08/09/2022
Signature of UB Representative Date
I:/Building/Forms/WaterMeters_070121_Add.doCx Page 2
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
" Water Meter Fixture Unit Worksheet
TIGARD For Additions /Remodels /ADUs
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439• www.tigard-or.gov
LOCATION: City of Tigard—City Hall WATER METER SALES:
Utility Billing By Email Only. Please contact
13125 SW Hall Blvd. ubonlinepayga,tigard-or.gov
Tigard, OR 97223 to discuss sending documents and payment
METER: SIZE: FEE: - Pricing effective 07/01/2022
5/8" $11,258.00 Fee includes:
3/4" $16.094.00 water system development charge,
1" $29,588.00 - water meter, and
1-1/2" $87,787.00 meter installation fee.
2" $142,227.00
DETERMINING METER SIZE FOR RESIDENTIAL CUSTOMERS
City of Tigard Water Service Area uses the American Water Works Association Manual and the Oregon
Plumbing Specialty Code to determine the size of meter needed to adequately serve buildings. Due to the
variety of home sizes built in the Tigard area,we count the fixture units of all homes to determine the
appropriate meter size.
Use the worksheet on Page 2 to calculate the current number of fixture units compared to the proposed
increased number of fixture units,which will determine whether an increased meter size will be required.
Submit this signed worksheet with your building or plumbing permit application submittal.
DOCUMENTATION
Once you are ready to purchase the new meter,please provide the following items to the Utility Billing
counter:
• Completed water meter fixture unit worksheet for additions, remodels, ADUs, etc.(on back page).
• Copy of building or plumbing permit application date-stamped by building division.
• Copy of issued building or plumbing permit.
Your fixture count will be verified and your request will be processed upon receipt of these documents.
No exceptions.
INSTALLATION TIME
Once the upgraded meter size has been purchased, most meters are installed within 10-14 business days.
is/Building/Farms/WaterMeters_070121..Add.docx Page 1