Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00097
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/26/2013
Parcel: 2S 104C D03700
Jurisdiction: Tigard
Site address: 13641 SW BENCHVIEW TER
Project: Baker Subdivision: HILLSHIRE ESTATES Lot: 37
Project Description: (2) lays, (1) tub, (1) shower pan and (1) water closet master bathroom remodel
Contractor: ROCKY MOUNTAIN PLUMBING LLC Owner: BAKER, TIM & LINDA
PO BOX 459 13641 SW BENCHVIEW TER
SANDY, OR 97055 TIGARD, OR 97223
PHONE: 503 - 668 -0805 PHONE:
FAX: 503 - 668 -0750
FEES
Quantity Description Date Amount
2 ea Lavatories 03/26/2013 $50.04
Specifics: 2 ea Tub /Shower /Shower Pan 03/26/2013 $25.02
1 ea Water Closet 03/26/2013 $25.02
Type of Use: SF 1 12% State Surcharge - 03/26/2013 $12.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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: /7 ( PI-PP&ccittvo LL..
UUU 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.
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1,11 City of Tigard MAR 2 6 2013 Received 3/iP47 ,3 sr o. - Permit Nn
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Inspection Line: 503.639.4175 CITY OFTIGARD Dniemy.
T t GA R D Date Ready/By: ru la See Pege 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified/Method e l f o Supplemental Information
❑ New construction ❑ Demolition For speelalInformation 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)
. . SFR (1) bath 312.70
, ',,, CATEGORY ;OF CONSTRUCTION '"
® 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78
El Accesso building SFR (3) bath 500.32
ry g ❑ Multi- family
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB sug,,INE'ORl)9ATION ;AND LOCATION Site utilities:
Job site address: 13641 SW Benchview Terrace Catch basin or area drain 18.76
City/State /ZIP: Tigard, OR 97223 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
Water service (no. linear ft.: _) Page 2
Subdivision: I Lot no.: Fixture or Item:
Tax man /parcel no.: Backflow preventer 31.27
- :. . - • - . - - dl wilt YC - . . -1 :
Clothes washer 13.02
Maxtor Bathroom Romoclol
Dishwasher 25.02
[Milking ibuiitaIn z3.0z
Ejectors/sump 25.02
•. ❑ PROPERTY OWNER.,. - . -. E
: ❑TENANT . :. Expansion tank 12.51
Name: 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: ( ) Fax ( ) Ice maker 12.51
®, APPLXCANT. , . ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: Rocky Mountain Plumbing LLC Medical gas (value: $ _ ) Page 2
Primer 12.51
Contact name: Eric or Lisa Busch
Roof drain (commercial) 12.51
Address: PO Box 459 Sink/basin/igif 2 25.02 50.04
City/State/ZIP: Sandy, OR 97055 Solar units (potable water) _ 62.54
Phone: (503) 668 -0805 Fax: : (503) 668 -0750 'show o r pan 2 12.51 25.02
E -mail: RMPLUMBINGLLC@AOL.COM Urinal 25.02
se 1
- - - -. Water co t 25.02 25.02
C ON 1 RI CTOR
.., .. _ Water heater 37.52
Business name: Rocky Mountain Plumbing LLC Water piping/DWV 56.29
Address: PO Box 459 Other: _ 25.02
City/State /ZIP: Sandy, OR 97055 Subtotal 100.08
Phone: (503) 668 -0805 Fax: (503) 668 -0750 Minimum permit fee: $72.50
1 I I ( I , Plan review (25% of permit fee)
CCB Lic.: 167585 1,}-�Q I 3 Plumbing Lic. no.: PB39 -1 Y
Authorized signature. State surcharge (12% of permit fee) 12.00
TOTAL PERMIT FEE 112.08
P r i n t name: Lisa Busch L - ' I Datc: 3/26/13 IRIS permit appncanon expires it apermu is not ootainea wnnm rao aays
after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
I\Building\Perm isPLMU- PemdApp doe 10/01/09 4404616T(10/02/COM/WEB) tiA.°
3/26/2013 7:55 AM FROM: Fax Rocky Mountain Plumbing LLC TO: 503 -598 -1960 PAGE: 003 OF 009
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
$tP 1 t�I�HPR ;:. Qt7� ,' �. ) n4aoo• °,
Footing drain - I 100' 50.03 0 to 2,000 5121.90
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 Sc 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 Ins cetiO71H or I OC3 Fee (ea Tnfat each additional $100.00 or fraction thereof, to
P and.inchtding $1.0,00[1.01)
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
hourc (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.
strorai:
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 Installatiun�l
• Elature:Type for .,Reptaie :;_
Wor Performed.::_ capped - Added Relocate Plan review is required for any of the following.
Baptistry /Font Please check all that apply. - -
Bath Tub /Shower
ID Any new commercial building with water service 2" and
-Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Eadi Stall engineer.
Drive �,,,, CI New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR918 780 - 0040.
Diahweahcr - Commercial El Me 1iral gas and vaomim Systems for health rare facilities
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
Eye Wash
flea, Drnun'aink - 2" Submit 2 sots of plans with any of tho above.
4.. Isometric iii Riacr l)i i :rum
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage - Domestic - non -food !'� s
4 g
Disposal - Domestic -fond related that meet the qualifications above.
- Commercial-food related
- Industrial -food related
Ice Mach./Refrig. Drains
Oil Separator (Cue 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 - Clothes
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: \Users \Owner\Desktop\Rocky Mountain Plumbing, LLC \Plu mbing Perl2it Apps \City of Tigard Plumbing PertnitApp.daccx
3/26/2013 7:55 Alf rnoff: Fax Pocky ?fountain Plumbing LLC TO: 503 500 1060 PAGE: 001 OF 004
1
Rn4' y. Mrointain Pliimhing I I
PO Box 459
Sandy, UK 9/U55
CCB #167585
To: City of Tigard
Fax number: 503- 598 -1960
From: Eric & Lisa Busch
Fax number: 503 - 668 -0750
Business phone: 503 - 668 - 0805
Date & Time: 3/26/2013 7:55:20 AM
Pages: 4
Re: Plumbing Permit Application
Please see the included forms for plumbing permit application at:
13(41 SW DeitL1Lview Tell Tigard VP
Please call me with any questions.
Thew you,
Lisa Busch
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
13641 SW BENCHVIEW TER, TIGARD, OR,
97223
Residential - Plumbing
399 Plumbing final
04/10/2013 00:00
PLM2013-00097
PASS - No C of O
Violation Summary:
Inspector Contractor