Permit gi CITY OF TIGARD PLUMBING PERMIT
g COMMUNITY DEVELOPMENT
Permit PLM2013 0014 •
•
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/07/2013
Parcel: 25111 BCO2603 •
Jurisdiction: Tigard
Site address: 10310 SW CANTERBURY LN
Project: Heritage Park Modification Subdivision: TIGARDVILLE HEIGHTS Lot: 7
Project Description: Install (1) catch basin, 100' of footing drain, 156' of sanitary sewer, 25' of storm sewer, 104' of water service & (2)
backflow preventers. 5/8/13, reprinted to correct address from 13125 to 10310 SW Canterbury. 5/14/13, reprinted , •
to correct parcel information.
Contractor: DA NEAL CONSTRUCTION INC Owner: CITY OF TIGARD
36296 NE WILSONVILLE RD 13125 SW HALL BLVD
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 625 -6802 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea.. Catch Basin or Area Drain 05/07/2013 $18.76
Specifics: 100 If " Footing Drain 05/07/2013 $50.03
156 If Sewer Service 05/07/2013 $100.06
Type of Use: COM 25 If Storm and Rain Drain 05/07/2013 $62.54
Class of Work: ALT 104 If Water Service 05/07/2013 $100.06
Type of Const: 2 ea Backflow Preventer 05/07/2013 $62.54
Occupancy Grp: 1 12% State Surcharge - 05/07/2013 $47.28
Stories: Plumbing
Total $441.27
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 Signatur .
Call 503.639.4175 by 7:00 a.m. for the next available inspecti n 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
'1 ' -• COMMUNITY DEVELOPMENT Permit #: PLM2013 00143
4� Date Issued: 05/07/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.24 Parcel: 2S1116C
Jurisdiction:
Site address: 10310 SW CANTERBURY LN
Project: Heritage Park Modification Subdivision: Lot: 02603
Project Description: Install (1) catch basin, 100' of footing drain, 156' of sanitary sewer, 25' of storm sewer, 104' of water service & (2)
backflow preventers. 5/8/13, reprinted to correct address from 13125 to 10310 SW Canterbury.
Contractor: DA NEAL CONSTRUCTION INC Owner: CITY OF TIGARD
36296 NE WILSONVILLE RD 13125 SW HALL BLVD
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 625 -6802 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 05/07/2013 $18.76
Specifics: 100 If Footing Drain 05/07/2013 $50.03
156 If Sewer Service 05/07/2013 $100.06
Type of Use: COM 25 If Storm and Rain Drain 05/07/2013 $62.54
Class of Work: ALT 104 If Water Service 05/07/2013 $100.06
Type of Const: 2 ea Backflow Preventer 05/07/2013 $62.54
Occupancy Grp: 1 12% State Surcharge - 05/07/2013 $47.28
Stories: Plumbing
Total $441.27
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 Notific. '• • enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direc estions to O) C b calling 503.232.1987 or 1.800.332.2344.
Issu• • By: ,I Permittee Sign. vs. '
/
Call 503.639.4175 by 7:00 a.m. for the next available inspectio • ate.
This permit card shall be kept in a conspicuous place on the job site u • •mpletion of the project.
Approved plans are required on the job site at the time of each Inspection.
• q CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00143
T F GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/07/2013
Parcel: 25111 BC
Jurisdiction:
Site address: 13125 SW Canterbury LN
Project: Heritage Park Modification Subdivision: Lot: 02603
Project Description: Install (1) catch basin, 100' of footing drain, 156' of sanitary sewer, 25' of storm sewer, 104' of water service & (2)
backflow preventers.
Contractor: DA NEAL CONSTRUCTION INC Owner: CITY OF TIGARD
36296 NE WILSONVILLE RD 13125 SW HALL BLVD
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 625 -6802 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 05/07/2013 $18.76
Specifics: 100 If Footing Drain 05/07/2013 $50.03 .
156 If Sewer Service 05/07/2013 $100.06
Type of Use: COM 25 If Storm and Rain Drain 05/07/2013 $62.54
Class of Work: ALT 104 If Water Service 05/07/2013 $100.06
Type of Const: 2 ea Backflow Preventer 05/07/2013 $62.54
Occupancy Grp: 1 12% State Surcharge - 05/07/2013 $47.28
Stories: Plumbing
Total $441.27
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 ' work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you o Ilo •e rules adopted by the Oregon
Utility Notifi •- enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -1090. ay obtain a copy of the rules
or direct % estions to • • NC by calling 503.232.1987 or 1.800.332.2344.
Issued =y: dr r Permittee Signature:
r
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 AppliRy
E l
Site Utilities
�D
City of Tigard t A�V
2 0 � 3 ReceiveDateBy: d 7 / s3 ( i 6/1690/5- 4
a 131 SW Hall Blvd., Tigard, O 2 n 7 of -
Permit No.: ��
i ' Plan Review
Phone: 503.718.2439 Fax: IGARD Date/By: Other Permit No A � 3 -0e0/2--
T I G A R D Inspection Line: 503.639.417 �� �� �Y r Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard-or.go�UILDING DIVISION Notified/Method: Supplemental Information
// TYPE OF WORK FEE* SCHEDULE
Er ‘w 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
El I- and 2- family dwelling El 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: P4,21L Fire sprinkler (_ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Catch basin or area drain
/ �1 ! �, ^Z- L vL A ?�o
Job site address: 0 J (�W fJ 1 18.76 /�
City/State /ZIP: T /.0 t 2 2- 3 ' Drywell, leach line, or trench drain 18.76
�/ / d 2 Footing drain (no. linear ft.: ) /0 1 Page 2 ,t, p3
Suite/bldg. /apt. no.: I Project name: 8457" $ , yi ' 1.''s. Manufactured home utilities 50.03
Cross street/directions to job site: t-� / P41 Manholes 18.76
/.) , 4 f MLnvQ 9( s W . /0 34/ _� Rain drain connector 18.76
cJ r r /j+` Sanitary sewer (no. linear ft.: ) is t Page 2 AP, °tom
Storm sewer (no. linear ft.: ) 2$ 1 Page 2 61551
Water service (no. linear ft.: _) / Page 2 /Q?).*
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer L, 31.27 6,2,6y-
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
f/ /L ire A.1, _ 5- Dishwasher 25.02
Drinking fountain .. 25.02
,�,� Ejectors /sump 25.02
LrJ PROPERTY OWNER l ❑ TENANT Expansion tank 12.51
Name: C6'7 0y 7, v Fixture /sewer cap 25.02
Address: /3124" f, to, NALL $41/D Floor ge disposal siltic/ltub 25.02
Garbage disposal 25.02
City/State /ZIP: '4,i A. A.13 At. ¶7 213 Hose bib 25.02
Phone: (S0.3) 6 39 - L// 41 Fax: (03) 68Y- 27 57 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
DA , A /UKA eiwir2 s, pp p) .{�A.�G_ Medical gas (value: $ ) Page 2
Business name:
Primer 12.51
Contact name: »/9 V iD � , eajzies 0z
// Roof drain (commercial) 12.51
Address: 36 Z9 6 'J 1 Q. GV; is rl t� 1 llP l2 Sink/basin/lavatory 25.02
City /State /ZIP: Npiv b, / At 5'? / 3 2.- Solar units (potable water) 62.54
Phone: (f033) j 6 Z - 602, Fax: : (fp3 6 ZS - '2 05 6 Tub /shower /shower pan 12.51
E -mail: evlc• K 011 f it h u i e.. @ 9 M411I (Oh Urinal 25.02
o Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Daneal Construction, Inc_ Water piping/DWV 56.29
Address: 36296 N.E. Wilsonville Rd. Other: 25.02
City /State /ZIP: Newberg, OR 97132 Subtotal g3 . Y
Phone: (50j ) 6zS-- 4,6-o2_ Fax: (P3 g 2T -7-p U., Minimum permit fee: $72.50
CCB Lie.: y 766 g Plumbing Li no.: 3 - f(� S P� Plan review (25% of permit fee)
� State surcharge (12% of permit fee) y7. AS
Authorized signature: , : I S I t TOTAL PERMIT FEE 4/1/4 .2.7
Print name: XI 6,0 /0 , / 11/I (.. ..deNN Date: 51/43 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 Square Footage: Permit Fee:
Footing drain - 1 a 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
u 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 Q 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 ❑ Isometric or riser s
diagram is required for new buildings - Domestic - non -food g q g
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 Filer *Note: If the fixture work under this permit results in an
Washer - Clothes increase of sewer EDUs, a sewer permit will be issued and
Water Extractor
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMU- PermitApp.doc 2
I e..
Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. ❑ map & tax lot # ❑ project name El site address El suite number
El zoning El applicant name ❑ phone number ,
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS - Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location, pipe size, type of material, slope of piping, manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
1:\Building\Permits\PLMF- PermitApp.doc 12/30/05