Permit "''' PLUMBING PERMIT
v i,` ,5, CITY OF TIGARD
�° s q
�' �'�'' COMMUNITY DEVELOPMENT Permit #: PLM2010 -00131
Date Issued: 04/23/2010
T [ G /1RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S1 33CC80171
Jurisdiction: Tigard
Site address: 14166 SW BARROWS RD 1
Subdivision: SCHOLLS VILLAGE CONDOMINIUMS Lot: 17
Project: O'Neill
Project Description: Replace (2) sink/lav and (1) water closet
Owner: FEES
O'NEILL, BROOKE N Quantity Description Date Amount
14166 SW BARROWS RD 17 -1 1 ea Sink 04/23/2010 $25.02
TIGARD, OR 97223 1 ea Lavatories 04/23/2010 $25.02
PHONE. 1 ea Water Closet 04/23/2010 $25.02
1 12% State Surcharge - 04/23/2010 $9.01
Contractor: Plumbing
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062
PHONE: 503 - 691 -6166
FAX: — 69/ — 67 7/
Type of Use: MF
Class of Work: ALT 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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Perm ittee Signature: 11 ; y - ,9-/ L / � /
�/
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Apr.22. 2010r11'06AMt (Modern Plumbing No. 0406 P. 2 2/3
r 'n' r Lures RECEIVED l: o R 01:1:1(1: t .' 1:
City of Tigard Rea;vcd
r a 13125 SW Hall Blvd.. Tigard, OR 974P R 2 2 2010 og : 9'03.3 /d Perm" N° 6;1 /0 00/3/
: 1 ' Phone: 503,639.4171 Fax: 503.598.1960 Plan Review :
Date/)}y: Other Permit No.:
. , , Inspection Lint 503.639.4175 CITY OF TIGARD
Interact: www ttgard•or gov Date Ready/By. 1 t J S See Page 2 for
1 ► 11
d Supplemental Information
T Y P E OF: WORK' . : . .. /Mctho
FEIN" SCHED[Jlt
❑ Ncw construction ❑ Demolition For special Information use checkh,
Description Q . Ea. Total
Addition/alteration/re
laccment ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) • CA'1lGORY QF eQNSTRUC'`I'IDN r r SFR (1) bath 312.70
1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath _ 437.78
111 Accessory building ST Multi - family
SFR (3) bath 500,32
❑Master builder Each additional bath/kitchen 25,02
❑ Ot her
- r Fire sprinkler ( s . Q ft) Page 2
JOS: SxTE, INFORMATION AND LOCATION Site utilities:
Job site address: l q 1 ( PG 51), ) i-1' (A w S ,D d t ii t Catch basin or area drain 18.76
City/State/ZIP; r C) C ►� Drywall, leach line, or trench drain 18.76
—
Footing drain (no. linear ft.; __) Page 2
Suite/bldg. /apt. no.: Project name: 0 i L Manufactured home utilities
50.03
Cross street/dircctions to job site; Manholes 18 76 +
Il i ilIA t ' 4 - , 5-L( 3 Rain dram 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: Lot no.: Fixture or Item:
Tax map /parcel no.: Backflow preventer 31.27
:RE$ L Flrl 1*. ::VVQI[ .;;:_..: Backwater valve 12.51
kel I A -Q A J 51 t Clothes washer 25.02
A l 1 ,,- Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 P. RoP R OTIiNtYt'. ' ;. + r - + , . .r` Expansion tank
._ ....:_... _....,... TY ....__... ....:.:- -- _ .:.. :,.C!_:x�I�.tl�rr: ..,�;�..._.: p 1151
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City /State /ZIP: Garbage disposal 25,02
Hose bib 25.02
Phony ( ) Fax ( . ) 1cc maker 12.51
K 0 v ' q OQNTRGERS4N P f Interceptor /grease trap 25.02
Business name; Medical gas (value: $ ) Page 2
Contact name: Primer 12.52
Roof drain (commercial) 12.51
Address:
Sink/basin/lavatory 2 25.02 5D D
City /Slate/ZIP: Solar units (potable water) 62.54 y
Phone: ( ) Fax:: ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
F :. Water closet 0 '
. .
25, 2 a s0
" CONTRACTOR . .... i :;
� I Water heater 37,52
Business name: I W d for n 'P 1 lJ i 10 t
Water piping/DWV 56.29
Address: I �l� 5 U sl�.tsa 0--)2J/ Other 25,02
—
City /State/ZIP: 7 706 � Subt_otal
` 15.bt z
e one: ( �� Fes; 64 �.� . _ Minimum permit fee: $72,50
E Lic.: ' G' 6
Plumbing Lie. no.: 3 LiD 57D Fil Plan review (25% of permit fee)
State surcharge (12% of permit fen) 1 p
Authorized signat ' A _ J _ r I"1:t. I • ...a.t. TOTAL PERMIT FEE y, O7
Print name:h r / Date; m - Th is permit application expires if a permit is not obtained within 180 days
e �t /t� after it has been accepted ar complete v
*Fee methodology set by Tri- County Building Industry Service Board
RB uilding1PermitslpWO_permitApp.d°e 10/01/09 440 -4616T(10 /02 /COM/WBB)
Apr.22, 2010111.
06AM Modern Plumbi ng No. 0406 P. 3
�= Ap „ ��ull - u b ty of Tigard 3)
Page 2 Supplemental Information
Fee Schedule:
Residential Fire Si u r re
•
Qty, Fec (ea) Total
Footing drain • !" 100' Si Aare Foots e' p -
Slon SteIN18
50.03 0 to 2.000 erlmltt:Fee
Footing drain - each additional 100' �� $ 121.90
Sewer - 1st 100' 2 001 to 3 600 $169.69
1111111221.1.1 7,201 to 7 re $227.54
Sewer - each additional 100' 7 201 and _neater $327.54
37.52
Water Service - 1st 100'
Water Service - each additional 100' 62.54
Medical Gas S stems
Storm le Rath Drain - 1st 100' ___1111•111/111111 `!Vnlhatiolt
.,
M.
62.54 ;
Storm 4t Rath Drain -each additional 100'
$1.00 to $5 000.00
55,001.00 to $10,000.00
. erm>tt I�ee
Minimum fee 572,50
Other T s " a or Fees ~ 572.50 for the first 55 ,000.00 an
Qty. ' ` Fa e d $1.52 for
Inspection of existing plumbing or for ) Toil each additional $100.00 or fraction thereof, to
which no fee is specifically indicated and including $10.000.00.
minimum char :e –1/2 hour 90.00/hr 5 to 525,000.00 each 0 for the a dditional $100.00 or fraction first $ and thereof, for
Inspections outside of norms! each a i
business and mcludi ton thereof, to
hours minimum char: e – 2 hours 90.00/hr $25,001.00 to $50,000.00 5379,50 for the first $25,000.00 and 51.45 for
Rcinspcction Fees each additional $100,00 or fraction thereof, to
In 90.00/hr In
Additional plan review for revisions 90.00/hr $50,001:00 and up and inelud;n_ $50 000.00.
minimum char a –112 hour
Subtotal: 1.1111.11111111 p $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof
•
Commercial Fixture Work: 14, � . } t T rvl ■ \y ?
Are you capping, adding or replacing fixtures? If "yes"
please indicate work performed by fixture. Failure to "yes",
plan Review. fir an f t h e following,
n ' Installations
ore fixtures could result in increased sewer fees * - Plant review is required for any of the following
accurately re
Q txture Work Performed ❑ Any new commercial b Please check all that apply,
Fixture 1�p . buildin with water service 2" and
PM
.: Replace building h
Bastrs /Font 1.1.0:11
Existing greater, except systems designed and stamped by licensed
Bath - Tub /Shower
engineer. ❑ New exterior plumbing site utilities for any complex structure
Jacuzzi/Whirt • ool - as defined in OAR91$ -780 -0040.
Car Wash Each Stall �� � 111111 ❑ Medical gas and vacuum systems for health care facilities.
'Drive lin `��� ❑ Any multipurpose fire sprinkler system,
Cuspidor/WatcrAsvirator ❑ Any complex strtleture as defined in O
Dishwasher - commerd& co AR91$- 780 -0040.
- Domestic
Drinkin_ Fountain ~� Submit 2 lain ���� sets of plans with any of the above.
Floor Drain/sink . 2" ��MN 4::;!,:'',4
; :b'ir Ris:�x D��_�, nl!>q.`.
3.. ■ Isometric or riser diagram is required for new buildings
4 inn that meet the •ualifications above.
car Wash Drain —
Garbage Domestic __
[ Disposal - Commercial
Industrial ��� Comments regarding fixture work:
Ice Mach./Refri;. brains
Oil Seiarator Gas Station ��� a CO n
m. Station —
Shower -Gang ��
Rec. Vehicle Du o ! c k 7
- Stall
Sink - Bardavatory
-Bradley ��4
- Commercial �E�
service �� *Note: If the fixture work under this permit results in an
Swimming Pool Filter =MIMI increase of sewer Mils, 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 M
plumbing permit can be issued.
Other Fixtur linlillinill.
I' 1Bu i ldinglPermi ts\PLMF -Perm itApp, d o e
2