Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00076
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/05/2012
Parcel: 2S112AC00600
Jurisdiction: Tigard
Site address: 7440 SW BONITA RD
Project: Associated Business Systems Subdivision: GARDEN TRACT ADDITION Lot: PT 24 -21
Project Description: Cap urinal and add (1) toilet. No change in EDU's.
Contractor: PRO DRAIN & ROOTER SERVICE, INC Owner:• BEALES, ALAN K & SUSAN R TRUST
3300 NW 185TH AVE #213 BY BEALES, ALAN K & SUSAN R TRS
PORTLAND, OR 97229 2126 MAGELLAN DR
OAKLAND, CA 94611
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PHONE: 503 - 533 -0430 PHONE:
FAX: 503 - 296 -2419
FEES
Quantity Description Date Amount
1 ea Urinal 04 /05/2012 $25.02
Specifics: 1 ea Water Closet 04 /05/2012 $25.02
i 12% State Surcharge - 04/05/2012 $8.70
Type of Use: COM • Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment - 04/05/2012 $22.46
Type of Const: Plumbing
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 • •s suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notifi . ion Center. Those rule are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a cop of the rules
or direct q -stions to OUNC b calling 03.'32 !87 or 1.800.332.2344.
Issued B : / / _ Permittee Signature: i Aig
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
Building Fixtures p Received ( i�G/ /a40, '�8
City of Tigard oaway: ., S //9... ' Permit No.:
V 13125 SW Hall Blvd., Tigard, OR 97223
li g
l Plan Review
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Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
T I C A R t� Inspection Line: 503.639.4175 Date Ready/By: orris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
® Addition/alteration/replacement ❑ Other: New l- 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
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler _
p ( sq. ft.) Page 2
,JOB SITE INFORMATION AND LOCATION Site utilities:
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Job site address: 7440 SW Bonita Rd Catch basin or area drain 18.76
City/State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldgJapt. no.: I Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
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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.: Bacldlow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Remove urinal and install toilet.
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 1 25.02 25.02
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
® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: ProDrain and Rooter Service Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Lisa Bolke
• Roof drain (commercial) 12.51
Address: 3300 NW 185th, #213 Sink/basin/lavatory . 25.02
City/ State/ZIP: Portland, OR 97229 Solar units (potable water) 62.54
Phone: (503) 533 -0430. I Fax: : (503) 296 -2419 Tub /shower /shower pan - 12.51
E -mail: plumbing®ProDrainPDX.com Urinal 25.02
Water closet 1 25.02 25.02
CONTRACTOR
Water heater 37.52
Business name: ProDrain and Rooter Service Water piping/DWV 56.29
Address: 3300 NW 185th, N213 Other: 25.02 - -
City/ State/ZIP: Portland, OR 97229 Subtotal 50.04
Phone: (503) 533 -0430 Fax: (503) 296 -2419 Minimum permit fee: $72.50 72.50
CCB Lic.: 108504 -Lic. no.: 26 -776PB Plan review (25% of permit fee)
State surcharge (12% of permit fee) 8.70
Authorized signature: TOTAL PERMIT FEE 81.20
I Print name srtur,+a` � I Date: 4/4/12 I This permit application expires if a permit is not obtained within 180 days
% after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\ Building \Permits\PLMU- PermitApp.doc 10101n9 440- 4616T(10/02/COM/WEB)
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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 -1" 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 - I st 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 -
Storm & Rain Drain - 1st 100' 62.54 Valuation: . Permit Fee:
$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
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
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:
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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 * .
Quantity by Fixture Type Plan Review for Plumbing Installations.
Fixture Type for Replace/ Plan r eview is required for any of the following.
Work Performed: Capped Added Relocate �1 y g•
Baptistry/Font Please check all that apply.
Bath - Tub /Shower ❑ Any new commercial building with water service 2" and
Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure •
Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. .
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
-3"
- 4" Isometric or Riser Diagram
Car Wash Drain ❑ I or riser diagram is required for new buildings
Garbage - Domestic -non -food agcy s
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Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav - Non -food related
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet i fees assessed for the sewer increase must be paid before the
Urinal I plumbing permit can be issued.
Other Fixtures:
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