Permit CITY OF TIGARD PLUMBING PERMIT
Permit #: PLM2011 -00009
B COMMUNITY DEVELOPMENT Date Issued: 01/12/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1 S125DD01000
Jurisdiction: Tigard
Site address: 6695 SW VENTURA PL
Project: Lof Subdivision:JASHINGTON SQUARE ESTATES NO. Lot: 30
Project Description: Install (2) bathtubs
Contractor: THE PLUMBERS INC. Owner: LOF, JOHN & NANCY
90 NW 150TH AVE 6695 SW VENTURA PL
BEAVERTON, OR 97006 PORTLAND, OR 97223
PHONE: 503 - 246 -6331
PHONE: 503 - 519 -6644
FAX: 503 - 469 -4540
FEES
Quantity Description Date Amount
2 ea Tub /Shower /Shower Pan 01/12/2011 $25.02
Specifics:
1 12% State Surcharge - 01/12/2011 $8.70
Plumbing
47 ea Minimum Fee Adjustment - 01/12/2011 $47.48
Type of Use SF Plumbing
Class of Work: ALT
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. 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: U eN , /Z.
/
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.
Jan 11 2011 6:45PM The Plumbers Inc. 5034694540 p.1
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Plumbing Permit Appl V � �'
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Building Fixtures FOR OFFl(I tS[ ONLY
JAN 1 2 2011 Received
14,„.. City of Tigard Date By: / A // ,.,, /l., "PermitNc/1Giya //- 1 7OO 9
13125 SW Hall Blvd., Tigard, OR 97223
.v. r • A� Plan Review
" Phone: 503.634,4171 Fax: 503:$58. �1R60T1`� in Other Permit No.:
Inspection Line: 503.639.41751 t G DIVISION R ® See Page 2 for
'I'ii;A1 {l7 I'' ! N 1
Internet www.tigard- or.gov �V c°® I iv, f w Notified/Method: • Su, .lemeaiul In f orm ation
Tn4 to r
€ r g lid. € '11' Irl itl it_d? s :4 �, t �� � ` .s'+e. i ,,, { { ,, .fi " r ,
❑ New construction ❑ Demolition For special information use checklist
Description J Qty. I Ea. f Total
Addition/alteration/replacernent ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
Pl.;,.. , � ;;,. Nl + z : I E 9t st €i i
t an , t 1 Fa t, � L. .m ` g E I .# , i 1 .s t ,
:4 v � JT G., 'G:3 '°' : :iri M� l 'Itt' i ✓' S W 2 � t : _ �... ., d. 'T �r`� SFR(1)bath 312.70
,!• - and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437/8
I] Accessory building ❑ Multi- family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler (__ sq. ft.) Page 2
I]g l 43naat uI y�� 9 ac - l k w; 1
e , _p �..�' € kl� h 011 ; a t:a la +° # r ,l ,? 4 a fJ � ' Site ut • e =.� � g a t�t�u�u �%�€ - to �� -,, i] "'.l
Job site address: 0(04C s 4v V v-a .1 A.C.-C. Catch basin or area drain 18.76
City/State/ZIP: -n (. e r de_ Ci 4 -a. -�
Footing 1. leach line, or trench drain 18.76
Footin drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
f € rIf 1 0.11 ` , r e f A. a E i ' Backwater valve 12.51
6-64,(1 2. a S Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
t I i 1 7 ' s ,I fir,t ,�i t r, z$ " 1 itl y -r I € r r �[ ,�' I .
t lrg a 6F . " r.': Y .. V . } :414341 -' Wing 1' Expansion tank 12 51
4 .e.: ,
-• Fixture/sewer cap 25.02
Name: p
Address: 0( c Si.") \ J " 6 / y q L - ' - Floor ge disposal sink/hub 25.02
Garbage disposal 25.02
City/ State/ZIP: 6 110 0 Ott - I ?-? ' Hose bib 25.02
Phone: Co 4 Fax: ( ) Ice maker 12.51
F� 3 i•�xR .° sa t l` c re
G'� : k ` ° ,4 lull Lai a d I l I I l tau ` '= Interceptor /grease tap 25.02
Business name: r V �.� �-�
."- Medical gas (value: S ) Page 2
Primer 12.51
Contact name: V / ex_ 1 CdM K-e S
r - , Roof drain (commercial) 12.51
Address: P5-4046 SW Op0dl'✓' r aeV elS{ '1. j f2.0,4-0 Sink/basin/lavatory 25.02
City/ State/ZIP: Let v , / 73 <- Solar units (potable water) 62.54
Phone: (5Q ` 51 CI CoCa � Fax: : ( j?) . (.0 >--- Tub /shower/shower pan Z,_.- 12.51
E - mall: _ -ie ., '� / (Ui�l_1/rt�vS (lnC,. h Urinal 25.02
ry e o T' r a r . t " . ; , s , Water closet 25.02
I { ( t f >�Y 7 aka r''`-t'
. ;. f° .ax x�s aiy j, t .W,,,ii W ater heater '
37.52
Business name: -- 1 - 1A41„,..- 1 , ..,w _i_.• C.-. Water piping/DWV 56.29
Address: / 5 O ' , S(A-1 U t & S e .. Other: 25.02
City / State/ZIP: 1.424. e-e Os tJJ V ' Or-- q ?6 2, c 'r Subtotal
one: ( �7 /: G.S. ax: ( ) Minimum permit fee: S 72.50 72 . 5"D
' r �� t ' Plan review (25% of permit fee)
CCB Lic.: ( 7 ( 3-` 0 Plumbing Lic. no.: P -� -• " State surcharge (12% of permit fee) i 7�1
Authorized si tore: ` `
A , I t/ TOTAL PERMIT FEE 17, a2 v
it
This permit application lication expires if a permit is not obtained within 180 days
Print name: AFR _ ~ � ►� _......-...m.... Date: ,--- after it has been accepted as complete.
/ "Fee methodology set by Tri-County Building Industry Service Board.
I:\ Building \Permits\Pt.MU- PermitApp.doe 10001/09 440- 4446T(]o102/COMMBn)
Jan 11 2011 6:45PM The Plumbers Inc. 5034694540 p.2
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su • • ression S stems:
.. " °i[.°° '� �' r = i trgn 1h' 7F r Tr .,; 't 'E t rr. s
" atel °` �' t � € W 1 S v,Y _+ . JINN 11_ 911 r
Footing drain - l' 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 7,20I and
greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54
Medical Gas S stems:
Water Service - each additiarai 100' 37.52 1 � y rg - 7
Storm & Rain Drain - 1st 100' 62.54'�� `a Cc� ', t �, ■ eirr
$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
,r € .21 1 � 3 p7¢►r t 1� : y s! . ' a� i t each additional $100.00 or fraction thereof, to
•� +yW � + and including $10,00(1.00.
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 char:e -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 chare -2 hours each additional $100.00 or fraction thereof, to
Reinspecti on 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 char:e - 1/2 hour each additional $100.00 or fraction thereof.
Subtotal: _
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", "_"1 ;1`, s W ,, ,+ a i;��� t }1
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurate] re .• 'rt. fixtures could result in increased sewer fees * . Please check all that apply.
oilJt ,,� ' i ' , s �, a 4 ,,Pf` ❑ Any new commercial budding with water service 2" and
greater, except systems designed and stamped by licensed
engineer.
Baptistry/Font
Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918 -780 -0040.
-Jacuzzi/Whirlpool ❑ Medical gas and vacuum systems for health care facilities.
Car Wash -Each Stall
Drive Tttru ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918 -780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain , - t1
E Wash � 1 1�. i n k ` t, i 1, i t % is t F � . rh:
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-4"
Car Wash Drain
Garbage - Domestic
Disposal -Commercial
- Industrial Comm ents regarding fixture work:
Ice Mach./Refrig. Drains
-
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
http : / /www.tigard- or.gov /city_hall/ departments /cd/docsfPLMF- PermitApp2,doc