Permit CITY OF TIGARD PLUMBING PERMIT
°�! COMMUNITY DEVELOPMENT Permit#: PLM2023-00396
Date Issued: 9/11/2023
TIGARLD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S136DD01300
Jurisdiction: Tigard
Site address: 6855 SW BAYLOR ST
Project: Kruse Woods Financial Partners Subdivision: WEST PORTLAND HEIGHTS Lot: 18
Project Description: Interior plumbing for TI:Adding(1)sink;Replacing(5)sinks and (4)water closets.
Contractor: LOCAL PLUMBING COMPANY Owner: DSM PROPERTIES LLC
20833 SW OLDS PL 6855 SW BAYLOR ST
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503-642-2067 PHONE:
FAX: 503-642-5954
FEES
Quantity Description Date Amount
6 ea Sink 09/07/2023 $150.12
Specifics: 4 ea Water Closet 09/07/2023 $100.08
1 12%State Surcharge- 09/07/2023 $30.02
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $280.22
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. r�
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 6)23-
Building Fixtures
City of Tigard -•ved
1114
� g Permit No.: _
I3125SW Hall Blvd.,Tigard,OR97223 RECEIV:= °y' 5�'I� ' � 1�
Phone: 503.7181439 Fax: 503.598.1960 e`�e`v Other Permit No.:�y�
Inspection Line: 503.639.4175 Da<eBy. r'��a?-�1��
-r 11.A IL 1) AUG
f� gOe19Date ReadyBy: A- kris: H See Page 2 for
Internet: www.tigard-or.gov AUG 7 L L.1 Notified/t ethod: j,7T7-. �T" Supplemental Information
TYPE OF WORK tt�� t'. •
��,JJJ FEE* SCHEDULE
❑New construction ❑Dem CITY OF TIGARD For special information use checklist.
e�UILDING DIVISION Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑Other: New 1-2-famil y dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ 1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437.78
❑Accessory buildingSFR(3)bath 500.32 .
❑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:6855 SW Baylor St.
Catch basin or area drain 18.76
City/State/ZIP:Tigard, OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:___) Page 2
Suite/bldg./apt.no.: I Project name:Kruze Woods Financial Planners 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: I Lot no.: Fixture or item:
Tax map/parcel no,: i <j)�floor 2 d) 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
❑ PROPERTY OWNER I 0 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
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Local Plumbing Co. Medical gas(value:S_) Page 2
Primer 12.51
Contact name:Brandy Solano Roof drain(commercial) 12.51
Address:20833 SW Olds Place Sink/basin/lavatory 6 25.02 150.12
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
Water closet 4 25.02 100.08
CONTRACTOR
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 250.20
Phone:(503)642-2067 Fax:(503)642-5954 Minimum permit fee: S72.50
Plan review (25%of permit fee)
CCB Lie.: 72253 !q'y f Y11 Plumbing�t Lie.no.:34-197PB 7l►,b(j State surcharge(12%of permit fee) 30.02
Authorized signature: I Cs Y_ TOTAL PERMIT FEE 280.22
Print name:Brandy Solano
J���"' i��f ff���UJI Date:9/5/2023 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Id-County Building Industry Service Board.
I:\Building\Permits/PLMU-PmnitApp.doc 10/01/09 440.46161110/02/COM/WEB)
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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 S I21.90
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 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$1.20 for
(minimum charge-1/2 hour) each additional$I00.00 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 ❑ New exterior plumbing site utilities for any complex structure
Drive Thm as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 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
4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above. B
Garbage -Domestic non-food
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Being.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related J 4
-Bradley
-Com/Serv/Util food related t� 1
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet 4 plumbing permit can be issued.
Urinal
Other Fixtures:
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