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Permit (7) CITY OF TIGARD PLUMBING PERMIT Ili It Permit#: PLM2022-00007 COMMUNITY DEVELOPMENT Tf GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/1/2022 Parcel: 2S101 BB01300 Jurisdiction: Tigard Site address: 11958 SW GARDEN PL Project: Zoom+Care Subdivision: CROW PARK 217 Lot: 1 Project Description: Interior plumbing for TI:Adding(1)sink and(1)water closet; Installing(1)icemaker and(1)water heater. Contractor: DP PLUMBING INC Owner: BKM PARK BC 252 LLC 15825 NE SPRINGBROOK BY SLK GLOBAL SOLUTIONS AMERICA NEWBERG, OR 97132 2727 LBJ FREEWAY STE 806 DALLAS, TX 75234 PHONE: 503-537-9492 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Ice Maker 03/01/2022 $12.51 Specifics: 1 ea Sink 03/01/2022 $25.02 1 ea Water Closet 03/01/2022 $25.02 Type of Use: COM 1 ea Water Heater 03/01/2022 $37.52 Class of Work: ALT 1 12%State Surcharge- 03/01/2022 $12.01 Type of Const: Plumbing Occupancy Grp: Stories: Total S112.08 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 therulesl Issued By: ..--.7 - Permittee Signature: '� B 'X 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 ECEIV 70II Building Fixtures DEC 2 7 202t Hip. firth' ' I �,F (t.l_, City of Tigard Received , ` /2 • 13125 SW Hall Blvd.,Tigard,OR 9722�I T Y OF 11GAR I Date EIT ! (jJr (� ]'' Perms No � ���_ CEO J`J'� Phone: 503.718.2439 Fax: 503.598 Plan Review /Y Other Permit No,: 1t // ! /&qf Inspection Line: 503.639.4175 -DING DIVISI N Uate/By: /'�' �✓ l./rD"e I I ci A P.U Datc Ready By: 777..�yy. /yam. .ttu�ryv�:, ® See Page 2 for Internet: www.tigard-or.gov Notifad/Metharl: //2/ 't/! ttC Supplemental Irlformotion TYPE OF WORK 1;1) / FEE* SCHEDULE ❑New construction 0 Demolition For apacral information use checklist. Description I Qty. I Ea. I Total tglAddition/alteratiorilreplacement ❑Other: New 1-2-famly dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION I SFR(1)bath 312.70 ❑ 1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ['Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION^AND J-4OCATION. ( Site utilities: Job site address: I I It S-g 5 w G-7„,-0•Ck P(Qi.t fI Catch basin oriarea rain 18.76 -rigDrywell,leach line,or trench drain 18.76 City/State/ZIP /gyp v^' : (+ gT Footing drain(no.linear ft.: Page 2 Suite/bldg./apt.no.. I Project name: Z y oolfn a. . v: • - Manufactured home utilities 50.03 Cross street/directions to job site: 2 '/j j L2✓��/'J?� Manholes ] 18.76 ✓ Rain drain co ector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 • Storm sewer(no.linear R.:_) Page_ 2 - ],, Water service(no.linear ft.: ) Page 2 Subdivision: 1)-510136©I30 I Lot Fixture oriten: Tax map/parcel no.. Backflow presenter 31.27 DESCRIPTION OF WORK • Backwater vat✓e 12.5] Qn r / I- f I L Clothes washer 25.02 l(lwh 6 f'CF t - 440114 T �I "L ekikli*y 1 re e- u 01 Dishwasher 25.02 I -' c 0 C't'�-t T !- t.v'� ii CUJGP Drinking foun:'n 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER ❑ TENANT! Expansion 12.51 Name: Fixture/sewer ap 25.02 Floor drain/11..r sink/hub 25.02 Address: Garbage dig,' al 25.02 City/State/ZIP hose bib 25.02 Phone:( ) Fax:( ) Ice maker gieStr 1 12.51 W idi 1 { 7 0• APPLICANT CONTACT PERSON Interceplor/grasetrap 25.02 Business name: Medical gas(.aloe:S_) Page 2 Printer 12.51 Contact name: Roof drain(c• ercial) 12.51 Address: • . Sink/basin/la :ory 1 25.02 „2,5.-,.tr), City/State/ZIP: Solar units(pe able water) 62.54 • Phone:( ) Fax::( ) Tub/shower/slower pan 12.51 E-mail • Urinal 25.02 CONTRACTOR Water closet I 25.02 025,0; ' l `'� Water heater 1 37.52 -7,Sr} Business name: PUIlM AQ 1jC. Water t m DWV 56.29 �I�FJP P P> Address: 1st Lc ttE' (.16� j'i Other: 25.02, City/State/ZIP: iId( ilel pl 1i34 , Subtotal too'C7 Phone:(tb;) 6-1 q.--i( 9 • Fax:( I ) Minimum permit fee: 572.50 CCB Lic.. rill 6 D Plumby�ng Lic.no.. Pe ,�� Plan review (25%ofpermitfee) 8 1 State surcharge 02"'o of permit fee)t. /)..0 Authorized si nature: 8 Q � P 'DOTAL PERM Fr FEE -/101.dg Print name: Dd.l'FA W p le.eCk Date: lily,/L This permil application expires if a permit is not obtained wit in 180 days 11 after h has been ateepted as romp/etc • •Pee methodology set by Tri-County Building Industry Service Board. IAiaiMu:gtProsa PLMt.-PamilApp Me 10/01/09 ji 44w461010/02✓cQM1Wea) , 5- rr10U J rr Plumbing Permit Application - City of Tigard Page 2- Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footag : Permit Fee: Footing drain- I' 100' 50.03 0 to 2,000 S121.90 Footing drain-each additional 100' 17.52 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' 7.52 Water Service-1st 100' 2.54 Medical Gas S stems: Water Service-each additional 100' 37.52 Valuation: I Permit Fee: Storm&Rain Drain•let 100' 62.54 $I.00 to$5,000.00 I 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 includingS10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.03 $148.50 fur 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$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 Quantly by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all thaw apply. Work Performed: Capped Added Relocate BaptistrylFont ❑ Any new com ercial building with water service 2"and greater,except stems 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 Thru as defined in R918-780-0040. CuspidodWater Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: -Commercial 0 Any multipurpose fire sprinkler system. -Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eve Wash Submit 21sets 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 ualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach.,72efrig.Drains Comments reg rding 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 Swinaning Pool Filter increase of sewer EDUs,a sewer permit will be issued and \1aalicr-Clothes fees assessed for the sewer increase must be paid before the _Water Extractor Water Closet-Toilet l plumbing P - can be issued. permit Urinal Other Fixtures: I:\Bullding\Permits\PLMF_PennitApp.doc 08/04/2011 2