Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00085
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013
T [ G A.R D Parcel: 2S 102 DB05500
Jurisdiction: Tigard
Site address: 13244 SW CHELSEA LP
Project: Keys Subdivision: CHELSEA HILL Lot: 32
Project Description: (1) shower pan replace bathtub with tile shower enclosure
Contractor: JET PLUMBING Owner: KEYS, EDWARD MCCLELLAND &
PO BOX 2217 KEYS, ELIZABETH ALICE
PORTLAND, OR 97208 13244 SW CHELSEA LOOP
TIGARD, OR 97223
PHONE: 503 - 620 -9308
HONE: 503 - 358 -4370
FAX: 503 - 286 -6266
FEES
Quantity Description Date Amount
1 ea Tub /Shower /Shower Pan 03/18/2013 $12.51
Specifics: 1 12% State Surcharge - 03/18/2013 $8.70
Plumbing
Type of Use: SF 60 ea Minimum Fee Adjustment - 03/18/2013 $59.99
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:
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
RECEIVED
Building Fixtures FOR OFFICE USE ONLY
City of Tigard MAR 18 2013 Received
II
Date/By: 3 I k �0 3 Permit No. 7i 3- voo b 5
U 13125 SW Hall Blvd., Tigard, OR 97223 TIGARD � Of 1IGARD Date /By: Plan Review
Phone: 503.718.2439 Fax: 503.598. Other Permit No.:
D
Inspection Line: 503.639.4175 ace y y :
T I G A R D Internet: www.tigard -or.gov BUILDING DNISIONDote R d Byd: �, � El See Page 2 for
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 (I) bath 312.70
SFR (2) ath 437.78
® 1- and 2- family dwelling ❑ Commercial /industrial )
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
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:_ 13244 SW Chelsea Loop Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City/State /ZIP: Tigard, OR 97223
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Keys Bath Remodel Manufactured home utilities 50.03
Cross street/directions to job site: Omara 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.: 2S102DB05500 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
replace current bathtub with tile shower enclosure
Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: Edward Keys Fixture /sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 13244 SW Chelsea Loop
• Garbage disposal 25.02
City /State /ZIP: Tigard, OR 97223 Hose bib 25.02
Phone: (503)620 -9308 Fax: ( ) Ice maker 12.51
® APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: M. J. Turner Construction Co Medical gas (value: $ ) Page 2
Contact name: Don Russell
Primer 12.51
Roof drain (commercial) 12.51
Address: 16165 SW Colony Dr. Sink/basin/lavatory 25.02
City /State/ZIP: Tigard, OR 97224 Solar units (po 62.54
Phone: (503) 784 -5025 Fax: : (503) 579-6474 Tub /show r /shower pan I 12.51
E -mail: dcrussell @frontier.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: JET Plumbing Water piping/DWV 56.29
Address: PO Box 2217 Other 25.02
City / State/ZIP: Portland, OR 97208 Subtotal
Phone: (503) 358 -4370 Fax: (503) 286 -6266 Minimum permit fee: $72.50
CCB Lic.: 183562 010( (. Plumbing Lic. no.: PB996 -71( ( I I Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature: TOTAL PERMIT FEE ! . t&
Print name: Don Russell Date: 3 - 18 - 13 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 10/01/09 440 -4616T(10 /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 1-,, Square Footage: Permit Fee:
Footing drain - 1' 100' 50.03 ' " ` 0 to 2,000 $121.90
Footing drain - each additional 100' 37 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
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 * .
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following. Performed: Capped Added Relocate �l 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"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food ❑ 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 (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
washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor 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:
C:\Documents and Settings\All Users\Documents\M 1 Turner Constructioi Current Bids\Keys Bath Remodel \PLMF - PermitApp.doc
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13244 SW CHELSEA LP, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
04/09/2013 00:00
PLM2013-00085
PASS - No C of O
Violation Summary:
Inspector Contractor