Permit (9) CITY OF TIGARD PLUMBING PERMIT
.111
II COMMUNITY DEVELOPMENT Permit#: PLM2023-00351
Date Issued: 11/20/2023
T I i;A It 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DC20900
Jurisdiction: Tigard
Site address: 13904 SW 172ND AVE
Project: Riverside at Scholls Meadow,Lot 47 Subdivision: RIVERSIDE AT SCHOLLS MEADOW Lot: 47
Project Description: Backflow preventer for irrigation.
Contractor: TRUSCAPES Owner: RIVERSIDE HOMES LLC
21600 NW AMBERWOOD DR 15350 SW SEQUOIA PKWY STE 320
HILLSBORO, OR 97124 PORTLAND,OR 97224
PHONE: 503-707-0213 PHONE:
FAX: 503-352-4607
FEES
Quantity Description Date Amount
ea Backflow Preventer 11/20/2023 $31.27
Specifics: 1 12%State Surcharge- 11/20/2023 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 11/20/2023 $41.23
Class of Work: NEW Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. ose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: — Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection dat' e. Coo,t5l C '" oi
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4 Plumbing Permit Application
Building Fixtures roll OFFICI: (sI: ONI.y
City of Tigard Received
Date/B 1 � ) Permit No.:V' ( , + , '�
13125 SW Hall Blvd.,Tigard,OR 97223 y 1 °� .. 1 ,:, ?�i`,i x..
Plan Review �'
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date`Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov
. rst...t Notified/Method:
fV.. Supplemental
Sapple ental In
formation
.0 . +$ m # c # i . 1 AEtr' 11
.s =i
['New construction CIDemolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
VI, t"e ,f
' v4 - , W SFR(1)bath 312.70
❑✓ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building El Multi-familySFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
Vi ";1 , ... `.. i„, Site utilities:
r- taxa v
Job site address: 13904 SW 172nd Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers&Jean Louise Rd 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: Riverside at Scholls Meadow I Lot no.: 47 Fixture or item:
Tax map/parcel no.: WCTM 2S106DC21000 Backflowpreventer 1 31.27 31.27
r Backwater valve 12.51
Construction of single family detached residence Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
tors su Elec / mp 25.02
r +:-.:;, ,. # 4::,-j ( 7:4 Expansion tank 12.51
Name: Riverside Homes Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
15350 SW Sequoia Pkwy, Suite 320 Garbage disposal 25.02
City/State/ZIP: Portland, OR 97224 Hose bib
25.02
Phone:(971 ) 371-1310 Fax:( ) Ice maker 12.51
r „ Y F '.<{ a: rf Interceptor/grease trap 25.02
Business name: Riverside Homes Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
Jennifer Doty
Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink/basin/lavatory 25.02
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax::( ) Tub/shower/shower pan 12.51
E-mail: jdoty@riversidehome.com Urinal 25.02
. � .,_;'� . ... 1. 41" s :x Water closet 25.02
' 'IM , Water heater 37.52
Business name: Truscapes
Water piping/DWV 56.29
Address: 7800 NE Walker Road Other: 25.02
City/State/ZIP: Hillsboro/OR/97124 Subtotal
Phone:(503)531-9216 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: LCB #7962 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE 1,\lb
Print name: Jennifer Doty Date: 2/6/23 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\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(I 0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression S stems
:
r x x
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 S stems:
Water Service-each additional 100' 37.52 r ' ` 7 k
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
each additional$100.00 or fraction thereof,to
a 3 : r ),i € r t 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*.
uan T'lie
re Type fob w; '".0 .;, 401 �PPlan review is required for any of the following.
x 4'orkPorformedi, :;..; -
te
Please check all that apply.
Baptistry/Font
El Any new commercial building with water service 2"and
Bath -Tub/Showergreater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool
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.
ElDishwasher 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„ / s 4
Car Wash Drain � ..
ElIsometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal Domestic food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.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 *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
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
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