Permit CITY OF TIGARD PLUMBING PERMIT
• . COMMUNITY DEVELOPMENT Permit It: PLM2012 -00236
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2012
Parcel: 1 S 134CC01700
Jurisdiction: Tigard
Site address: 12325 SW KATHERINE ST
Project: Mary Woodward School Subdivision: MERESTONE Lot: 13
Project Description: (3) hose bibs installation
Contractor: BEAVERTON PLUMBING INC Owner: TIGARD - TUALATIN SCHOOL
13980 SW TV HWY DISTRICT 23J
BEAVERTON, OR 97005 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503 - 643 -7619 PHONE:
FAX: 503 - 643 -7620
FEES
Quantity Description Date Amount
3 ea Hose Bib 08/16/2012 $75.06
Specifics: 1 12% State Surcharge - 08/16/2012 $9.01
Plumbing
Type of Use: COM
Class of Work: OTR
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: A A T Permittee Signature: t^ � A ,77t �
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. /`%T?� C F7 1 / . ( 4 /'
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 Appli on... - R (a :4 4)
Building Fixtures � - . ek , ' V
City of Tigard pi al 4 2012 ,. 7 t s 12. T Permit No.: f [� �. 00 6
13125 SW hall Blvd., Tigard, OR Plan Review
. = • Phone: 503.718.2439 Fax 598.1,960 7:C.4/ it l Other Permit No.:
nspccliion .639.417 l ' r..'' : °•es'• Date 41:0 !S 9oe PaveZtar
i;: i, I Line: 503 R ,yr_rI i mod tl
Internet: wttrvtr.ttgardorgov ! , . ;.. N Ia1 tototwa oa
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❑ New construction ❑ Demolition For spedel Wonnalion user checklist
st
r Description I Qty. I Fa. I '1'ntal
El Addition/alteration/replacement ❑ Othcr: New 1 - family dwellings (includes 100 it. for each utility connection)
. • • , q,`,' a ' ., : : :' °.. SHR (1) had: 312.70
p 1- and 2 -fa dwelling 4 0 Commercial/industrial SFR (2) bath 437.78
❑ Accessory building 4 Multi- family SPR (3) bath 500.32 Each additional bathAdtchen 25.02
❑ Master builder ® Other. SCHOOL Hire sprinkler (_ sq. It) Page 2
fo i ii 1 . A::' . .,'' : :: 7 Site utilities:
Job site address: 12325 SW KATHERINE ST Catch basin or area drain 18.76
'1
City /StatefLIP: TIGARD, OREGON 97223 1)rywe11, leach line, UT trench drain 18.76
Footing drain (no. linear ft.: _) Page 2
Suite/bldgJapt. no.: I Project name: MARY WOODWARD SCHOOL Manufattnred home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 1176
- -.
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (nu. linear 11.: ) Page 2
Water service (no. linear It.: ) Pale 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no_: Backflow preventer 31.27
.,.� x,gr�; i '" •'- m ., . Backwater valve 12.51
J;'`'':'i'Y�!t7� + fir. z =:�;'
-.. Y, ia� K , s: :' :• lathes washer
25,02
INSTALL 3 HOSE BIBBS Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
k .:• x x. , :. 4:1 u,s•:: x : :• E tank 12.51
b
Name: TIGARD / TUALATIN SCHOOL DISTRICT' p / "er 25.02
Plow drain/floor sinkAlub 25.02
Address: Garbage disposal 25.02
City/StatetLlP: Huse bib 3 25.02
Phone: ( ) Fax ( ) Ice maker 12.51 •
.:.tt'{. -,� " M r "`�' ` : '' a'a - 1► �tS(J N; Interceptor/grease trap 25.02
' ,. ... . •... ...y.;. ..
Sliminess name: BEAVERTON PLUMBING, INC Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: CASEY
Roof drain (commercial) 12.51
Address: 139110 SW TUALATIN VALLEY HWY Sink/basin/avatory 25.02
City/State/71P: BEAVERTON, OREGON 97005 Solar units (potable water) 62.54
Phone: (503) 643.7619 I Fax: : (503) 643.7620 Tub/shower /shower pan 12,51
B -mail: Sue@beavertonplumbing.com Urinal 25.02
r Water closet 25.02
xs:. , ..., <. : :.i.'S S•.: .^.. Winer - cater 37.52
Business name: BEAVERTON PLUMBING, INC
Water piping/DWV 56.29
Address: 13980 SW TUALATIN VALLEY HWY Other. 25.02 _
City/Stale/7.TP: BEAVERTON, OREGON 97005 Subtotal 75.06
Phone: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72.51)
CB Lie.: 12889 Plumbing Lie. no.; 34-4PB Plan review (25% of permit fee)
State surcharge (12% of permit fee) 9.01 /
Authorized signature: TOTAL PERMIT FEE 84.07 J
Print name: SUSAN DEAN 1 Thtte• 8/14/12 This permit application expires if a permit is not obtained within 100 days
after it bas been accepted in complete -
•1 ee metMdtdogy mat by Tri Building Industry Service Board.
t:V Wilding \ramita\'I.U-Pemxtnpp.doc 1uNI/00 440.4616T(10/OVCOMMES)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems: T " e: o : _.. F r ' Fee:..
Footing drain - l" 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $l ti9.h9 -
Sewer - 1st 100' 62.54 3.601 to 7,200 $233.20
7,201 and greater $327.54
Sewer - eavh additional 100' 37.52
Water Service - 1st 100' G2.54 Medical Gas Systems:
water Scrvicx -each additional 100' 37.52 Valua ` Feirmit b ee:
Storm & Rain Drain - 1st 100' 62.54 $1.00 to $54810,00 Minimum toe $72.50
Storm & Rain Drain - each additional 100' 37.52 $55,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
, - 4._< each additional - .:. , ._ ,. .. (here o
:> ,....: $100.00 or fraction oli t
. < ) .. .
.` :. as.;; c:... < 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 thereat, 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 $1 m1,00 or traction 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 *.
(tuaaat�_byFixture Type
Fisiwe?I�jpe for 1 • Plan review is required for any of the following.
:Worlc�l4�focgrsd:.. • mo d >. ;:.
Please check all that apply.
y /F
Bath - 'I1lb/Showet ❑ Any new commercial building with water service 2" and
-1 acurzi/Wh irlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
- Drive ❑ Ncw exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator • as dcfincd in OAR9I8- 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"
a ^ •
so etric or. Riser i ram . • •
Car wash Drain
()mirage l>tomcstio noa_tooa ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestic-food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach /Refrig. Drains
Oil Separator (Gus Station) Comments regarding fixture work:
Rea, Vehicic Dump Station OUTSIDE 11OSE 13113135
Shower -Gang
-Stall -
Sink /I,av - Non -food related
- Bradley
- Commercial -food related
-Service
Swimming Pool Filter *Note: If the fixture work under this ermit results in an
Washer - Clothes p
Water Extratrrr increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
hupJ /www.tigard- or.gov/ city_ hall/dcpartmcnts /cd/docs/PLMF- PcmiitApedoc