Permit CITY OF TIGARD PLUMBING PERMIT
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COMMUNITY DEVELOPMENT Permit #: PLM2013 00068
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/26/2013
Parcel: 2S 102DC06400
Jurisdiction: TIGARD
Site address: 13878 SW 90TH AVE
Project: Gertz Homes at Edgewood No. 2, Lot 13 Subdivision:GERTZ HOMES AT EDGEWOOD NO.2 Lot: 13
Project Description: 4/8/13, reprinted to correct project description and add ASI information. Installation of residential backflow
preventer for irrigation.
Contractor: TERRA -SOL LANDSCAPING Owner: GERTZ CONSTRUCTION CO INC
21685 SW HEDGES DR 19200 SW 46TH AVE
TUALATIN, OR 97062 TUALATIN, OR 97062
PHONE: 503 - 691 -6105 PHONE: 503-692-3390
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/26/2013 $31.27
Specifics: 1 12% State Surcharge - 02/26/2013 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment - 02/26/2013 $41.23
Plumbing
Class of Work: OTR
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 scions to O . C by g 503.232.1987 or 1.800.332.2344.
Iss ed By: 0_11 1
/ Permittee S' ! •
1
Call 503.639.4175 by 7:00 a.m. for the next available insp• tion 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.
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00068
Date Issued: 02/26/2013
T [ G °AAD 13125 SW Hall Blvd., Tigard OR 97223 503718.2439
Parcel: 2S 102 DC06400
Jurisdiction: TIGARD
Site address: 13878 SW 90TH AVE
Project: Gertz Homes at Edgewood No. 2, Lot 13 Subdivision:GERTZ HOMES AT EDGEWOOD NO.2 Lot: 13
Project Description: New SF. DEMO CREDITS FROM BUP2011 -00156 APPLIED TO THIS PERMIT.
Contractor: TERRA -SOL LANDSCAPING Owner: GERTZ CONSTRUCTION CO INC
21685 SW HEDGES DR 19200 SW 46TH AVE
TUALATIN, OR 97062 TUALATIN, OR 97062
PHONE: 503 - 692 -3390
HONE: 503 - 691 -6105
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 02/26/2013 $31.27
Specifics: 1 12% State Surcharge - 02/26/2013 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 02/26/2013 $41.23
Type of Use Plumbing
Class of Work:
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, Sta e of pecialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work s not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires yo o • • the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-1'41-0090. you may obtain a copy of the rules
or dir- . • uestions to " UNC b ailing 503.232.1987 or 1.800.332.2344.
X
Is. ued By: I III-4/k_//42J Permittee Signature:
■ L
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 comple ' • oft • roject.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Ap cjih 1
Building Fixtures J
City of Tigard FEB 2 6 2013 DateBy: Received 414 , g
Permit No.: Q /3••dee4O
q 13125 SW Hall Blvd., Tigar 97 v � Plan Revi
C ' Phone: 503.718.2439 F a� 0.� 1961p�1 __Lj Date/By: eW Other Permit No.:1-/yT�a -Lb XI 7
TI G A R D Inspection Line: 503.63 l a1r
� DtVIS l, ,, Date Ready/By: luris ® See Page 2 for
Internet: www.tigard -or. i' 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 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
X I-1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I 9 D Q 7 W J Li.-) 9 0 t\ AAkk-- Catch basin or area drain 18.76
City /State /ZIP: Drywell, leach line, or trench drain 18.76
Footing 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
I Water service (no. linear ft.: ) Page 2
Subdivision: Lot no.:
Tax map /parcel no.: B ac k floo w p enter 31.27 1, y7
DESCRIPTION OF WORK Bac ater valve 12.51
/
...
- K).-W, �0 Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY OWN R I 12 TENANT Expansion tank 12.51
l �
Name: 1 k ( G , Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone:5b)� be 2..:2,30,0 Fax: ( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: t ( � '- I� bOS % N, Water piping/DWV 56.29
Address: a.,‘ (0 N gS C ` r, Other: 25.02
City /State /ZIP: `7 , 1 1 i l�°L K2_ Subtotal
Phone& ... J 1 - t,.I OS' Fax ( ) Minimum permit fee: $72.50
5O ` p� ' 4' I'4 Plan review (25% of permit fee)
CCB Lic.: Plumbing Lic. no.:
State surcharge (12% of permit fee)
Autho ' d signature: I � ' • .. TOTAL PERMIT FEE 8 1 .2-v
Print n e In m \ %C\ r v r v ��
� „� w' Date: • ' 13 This permit a 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 \PermitsWLMU- PermitApp.doc 10401109 440- 4616T00 /02/COM/WEB)
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 - I' 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 7,201 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
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 62.54 $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
P 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:
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
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate ❑ Any new commercial building with water service 2" and
Baptistry/Font greater, except systems designed and stamped by licensed
Bath: - Tub /Shower
- Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918- 780 -0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918 -780 -0040.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: - 2"
3" Isometric or Riser Diagram
❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non -food that meet the qualifications above.
Disposal: - Domestic food related
- Commercial food related
- Industrial food related
Ice Mach./Refrig. Drains Comments regarding fixture work:
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower: -Gang
-Stall
Sink: - Lav/Bar non -food related
- Bradley
- Com/Serv/Util food related
- Service *Note: If the fixture work under this permit results in an
Swimming Pool Filter increase of sewer EDUs, 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 plumbing permit can be issued.
Urinal
Other Fixtures:
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