Permit Support Document CITY OF TIGARD PLUMBING PERMIT
{'! 11 COMMUNITY DEVELOPMENT � ,1
Permit#: PLM2020-00484
T13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 /zJff/2E.' K�} Date Issued: 12/3/2020
t Cs,1 R O Parcel: 2S 101 BB01400
Jurisdiction: Tigard
Site address: 12116 SW GARDEN PL
Project: AFS Subdivision: CROW PARK 217 Lot: 2
Project Description: Interior plumbing:Capping(1)service sink; Replacing(1)dishwasher and(1)sink. 12/17/2020: REPRINT to add
(1)2"hub drain, (1)primer and reroute (2)primers.
Contractor: POWER PLUMBING CO Owner: BKM PARK BC 252 LLC
PO BOX 19418 1701 QUAIL ST STE 100
PORTLAND, OR 97280 NEWPORT BEACH, CA 92660
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Dishwasher 12/03/2020 $25.02
Specifics: 1 ea Fixture/Sewer Cap 12/03/2020 $25.02
1 ea Lavatories 12/03/2020 $25.02
Type of Use: COM 1 12%State Surcharge- 12/03/2020 $9.01
Class of Work: ALT Plumbing
Type of Const: ea Floor Drain/Floor Sink/Hub 12/18/2020 $25.02
Occupancy Grp: 3 ea Primer 12/18/2020 $37.53
Stories: 0 12% State Surcharge- 12/18/2020 $7.50
Plumbing
Total $154.12
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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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 E, - 1211i 120
Building Fixtures RECEIVE
Cl of Tigard CCCBy: Pmm l
13125 SW Hall Blvd.,Tigard,OR 97223 DatelBy: 1 Z 1?1'7,C2 4d "P[.-!') lc 7.0.'DO`�e1
Phone: 503.718.2439 Fax: 503.598.1960 DEC 0 4 2D20 Plan Review Other Permit No.:
Inspection Line: 503.639.4175 Date Ree
l Date Read B n Jam. ® See Pe e 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/xlethod�2'�t7/ N�'' 'n C� Supplemental Information
TYPE OF WORK
3UILDING DIVISION fjLti„- /C.f'j,(S-n FEE° SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. f Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes I00 ft,for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler sq.ft.) Page 2
tf -11 ( JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 'SW GARDEN PLACE 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.: Project name:20-297 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.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
ADD TO PERMIT PLM2020-00484 Dishwasher 25.02
ADD 1 HUB/PRIMER, REROUTE 2 PRIMERS 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 1 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:POWER PLUMBING CO. Medical gas(value:$_) Page 2
Primer 3 12.51
Contact name: JOSH CRUME Roof drain(commercial) 12.51
Address: P.O. BOX 19418 Sink/basin/lavatory 25.02
City/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62.54
Phone:( 503-244-1900 Fax: :( 5031-244-8825 Tub/shower/shower pan 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:POWER PLUMBING CO. Waterpiping/DWV 56.29
Address:6611 SW MULTNOMAH BLVD Other: 25.02
City/State/ZIP:PORTLAND, OR 97223 Subtotal
Phone:( 503-244-1900 Fax,( 503)-244-8825 Minimum permit fee: $72.50
CCB Lic.:52878 Plumbing Lic.no: 34-15OPB Plan review (25%of permit fee)
surcharge(12%of permPERMiTit fFEEee)
90 ,QS
Authorized signature: l 'pe-rC TOTAI.
Print name:KRISTIE RA W State WELL Date:12 4-2020 This permit application expires if a permit is not obtained within l80 days
after it has been accepted as complete.
•Fee methodology set by Tri-County Building Industry Service Board.
1-\Building/PemnsIPLMU-PernulApp.doc )O101/09 440-46161110102rCOM/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-I"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 S233.20 •
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-Ist 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$7250
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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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 S100.00 or fraction thereof,to
(minimum charge—I/2 hour) and including S25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 S379.50 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$120 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*. Plan Review for Plumbing Installations
Qwnty 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 engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thu./ ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial ❑ Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain
ej
Eye Wash C.fl Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2" 1 am Epkt 1,j t (� JO l
3,. r }�r71// 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&Drains food related
rig.Ice MachifefDrain Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station PLEASE CALL JOSH CRUME WITH QUESTIONS 503-936-5669
Shower: -Gang
-Stall
Sink: -Lav/Bar 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-Toiletplumbing permit can be issued.
Urinal
Other Fixtures: 1 primer 2 pitmen
l:lBuilding\Permits\PLMF_PermitApp.doc 08/04/2011 2