Permit (2) CITY OF TIGARD PLUMBING PERMIT
'91 1 COMMUNITY DEVELOPMENT Permit#: PLM2020-00484
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/3/2020
Parcel: 25101 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.
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:
Occupancy Grp:
Stories:
Total $84.07
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: iliacu Cr�..� (�_ Permittee Signature: OYl a�^IIL,�
�CJJJ�( ,, \/0.CAaVll.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 Aaalpa ice' IVE D C- - (1/2a12,,
Building Fixtures NOV2 q q Fon oFFicu: USE oyl.ti
NOV V 0 2020 Received
City of Tigard Date/By: /L/.7/J J lay" Permit No.: ,e04// --ayi si
13125 SW Hall Blvd.,Tigar�7t2 �TIGARDPlan Review
✓ a c� / V!D `
Phone: 503.718.2439 ppRx. f [.9�98. 00 DIVISION+�}t Date/By: Other Permit No.:�/�lJ�ry �r' U
Inspection Line: 503.63`.®t7il!_.LJ fNI-�7 L1 V 1�."Iv1 Date Ready/By: ./� lle-ns: 21 See Page 2 f✓or~ %^'
Internet: r��nv.tigard-or.gov Notified/Method: f --/VIA '�'J'1� y A, Supplemental information
TYPE OF WORK <"tY:,it.e.r( k.r:f'/e FEE" SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 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
❑ 1-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
0 Master builder D Other: Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site add ess: 1
;�1 J t78$SVV GARDEN PLACE Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:TIGARD, OR 97223 Footing drain(no.linear fl.:_) Page 2
Suite/bldg./apt.no.: I Project name:20-297 !, G/y-Ye 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: l Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: S��l,?!�l]1LI Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
AFS TENANT IMPROVEMENT Dishwasher 1 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 1 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:POWER PLUMBING CO. Medical gas(value:$_) Page 2
Primer 12.51
Contact name: JOSH CRUME Roof drain(commercial) 12.51
Address: P.O. BOX 19418 Sink/basin/lavatory 1 25.02
City/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62.54
Phone:( 503-244-1900 Fax::( 503-244-8825 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. Water pipingDWY 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
Plan review (25%of permit fee)
CCB Lie.:62378 Plumbing Lie.no.: - OPB State surcharge(12%of permit fee)
% `
Authorized signature: � p C�1�kr� TOTAL PERMIT FEE
Print name:KRISTI BRAMWELL Date:11- 0-2020 This permit application expiresif a permit is not obtained within Igo days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
t'9uiidina\Permits0'LML'-PermitApp.doe 10/01/09 440-4616T(I O/OLCOM,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 $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
h 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
Re inspection 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$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
❑ 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
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator El Medical gas and vacuum systems for health care facilities.
DishCuspidor/washer: -Commercial t 0 Any multipurpose fire sprinkler system.
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit sets of plans with any of the above.
Floor Drain/sink: -2"
Isometric or Riser Diagram
-4" ❑ 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 PLEASE CALL JOSH CRUME WITH QUESTIONS 503-936-5669
Shower: -Gang
-Stall CAPPED FIXTURE IS MOP SINK
Sink: -Lav/Bar non-food related t
-Bradley
-Com/Serv/Util food related
-Service p *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
er
Other Fixtures:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/201 I 2
Branden Taggart
From: Branden Taggart
Sent: Thursday, December 3, 2020 2:07 PM
To: Kristie Bramwell
Subject: AFS Plumbing Permit: PLM2020-00484 - 12116 SW Garden PI.
Attachments: Invoice.pdf
Hi Kristie,
The Plumbing permit for AFS is ready to issue now. The balance due is $84.07, and I have attached an invoice above for
you to reference. The permit fees can be paid online through our
website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit number
(PLM2020-00484) in the Record Number field, and click Search. Once paid, please notify us at
TigardBuildingPermits@tigard-or.gov, and I will email the permit paperwork to you.
Thanks,
Branden Taggart
City of Tigard
Senior Permit Technician
Community Development
"CcRD.
13125 SW Hall Blvd
Tigard, OR 97223
(503}718-2449
brandent@tigard-or.gov
1
Accumulative Sewer Tally
74 ■
■ Tenant Name:AFS SWR# N/A
Site Address: 12116 SW GARDEN PI, P1,M# 2020-00484
11 CARD
Parcel#: 25101 BB01400
Fixture Value Previous Previous Credits Capped Fixture Pixture New New
# value count capped#s value count added# added value total#s total values
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 0
-Drive through 16 0 0 0 0 0
Cuspidor/Water Aspirator 1 0 0 0 0 0
Dishwasher: -Commercial 4 0 0 0 (1 0
-Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain/Sink: -2 inch 2 0 0 0 0 0
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 HP) 16 0 0 0 0 0
-Commercial(to 5 111'; 32 0 0 0 0 0
-Industrial(over 5 H1') 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 0 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lav/Bar-Non-Food Related 2 0 0 0 0 0
-Bradley 5 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 1 3 0 -1 -3
Swimming Pool Filter 1 0 0 0 0 0
Washer-Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
TOTALS 0 0 1 3 0 0 -1 -3
Current Fixture Value -3 divided by 16= -0.188 Current ISDC 1 EDU= $5,800.00
Previous Fixture Value 0 divided by 16= 0.000 Previous EDU
Change -3 divided by 16= -0.188 over (under) $ (1,102.00)
Enter EDU Change Here -0.190 *
*Round EDUs to the nearest 1/100th: a count ending in.005 shall be rounded up to.01,and a count ending in.014 or less shall be rounded down to.01.
Notes: ***CREDIT***
Authorized Name/Signature: BRANDEN TAGGART X2449 Date: 12/3/2020
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
1:\Building\Sewer Tally\Sewer IallySheet_5800_070119.xlsx