Permit 1 CITY OF TIGARD PLUMBING PERMIT
° = COMMUNITY DEVELOPMENT Permit #: PLM2013 -00227
Date Issued: 07/02/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S125DB01301
Jurisdiction: Tigard
Site address: 9055 SW 70TH AVE
Project: Dye Subdivision: SHADY DELL Lot: 13
Project Description: Replace 100' of water service.
Contractor: MP PLUMBING CO Owner: DYE, RALPH F & MARIBEL J
PO BOX 393 9055 SW 70TH AVE
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503 -655 -9161 PHONE:
FAX: 503 -655 -1726
FEES
Quantity Description Date Amount
100 If Water Service 07/02/2013 $62.54
Specifics: 1 12% State Surcharge - 07/02/2013 $8.70
Plumbing
Type of Use SF 10 ea Minimum Fee Adjustment - 07/02/2013 $9.96
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 6?—/C/31--/
Issued By: L� _ Permittee Signature: / e -7-7e „ v /
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 Applic ■
DIVED Building Fixtures 1,m ‘ II 1 1. I I N1 i I\ l ,
City of Tigard II i /. "'" ;t p r><,.:
13125 SW Hall Blvd., Tigard, OR 97? '''' II` 2U13 'LM�d /3 • /Q ,„ -
phone: 503.718.2439 Fax: 503.598.1960 R" "w cMha Permit nu.
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Inspection ne: Li 503.639.4175 Cin T`p
i � , • i . � Date Ready/By: ∎ yt" /a See Page 2 for
Internet: www.tigard- or.gov . t ,r G.
t,? l . Notified/Metbod: 1 -' Supplement■lInformation
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❑ New construction ❑ Demolition For special i',fom mtion use cheek/ire.
Description 1 Qty. 1 Ea. 1 Total
5, Addition/alteration/rcptaccment ❑ Other: New I- 2- family dwellings (includes 100 ft. for each utility connection)
g swAt•rcrc ;r i,i� i ; ;:: SFR (1)
?'`� l�.,�!. rtic rY, , { „1,_.,. �, :, --. ,• •,'••' .:,;aV, > •ctL6�: ts 7 . ir l st ; � .k,N,""0 bath 312.70
t; 1- and 2- family dwelling 0 Commercial/inductrial SFR (2) bath 437,78
SI''R (3) bath 500.32
0 Accessory building 0 Multi - family
Each additional bath/kitchen 25,02
❑ Master builder 0 Other: Fire sprinkler ( sq. ft.) Page 2
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;i ...d, ,. ..' ; •L' 1.. 1; �,. 1'.�:_ ;;l .�. ! 1,r4r,.,:,71'ICi Site utlllde3�
Job she address: IM -'rkn • 1 1 , Catch basin or area drain Mnal
- Drywc11, leach line, or trench drain 18.76 NM
City/State/ZIP: 'T
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1 hooting drain (no. linear it: __) MI Page 2
Suite/bldg. /apt. no.: Project name. g : 0_1 Ilk_ t , 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 R: Page 2
Water service (no. linear ft.:.) 1 Page 2 (p 9, $-1
Subdivision: f Lot no.: Fixture or Item:
fax map /parcel nth: Backflow prevcnter 31.27
k���:' w t + �,��.�` lv�s\,�: Backwater valve 12.51
�� ! ����. �^ / 9.bz. ��a�. - '��I !F5 �wil'1� �:+a'�•i ;;?',j:'�: ,G _...
Clothes washer 25.02
1 .X1 Q.., `C��I�C��N'\I.. ,' l� J\ JJ\ ) CL Dishwa her 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
7 We '` :A' .:t; ,M:,.1"4...a: R. F #.4.0 i(,'�,' 1oJ.s+t,,..' b, . It' . '...404,4 71,1 Expansion tank 12.51
Name: l kl- Vn Fixture/sewer cap 25.02
-
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City /State/Z1P: Hose bib 23.02
Phone: ( ) Fax: ( ) Ice maker 12.51
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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
Tub /shower /shower pan 12.51
Phone: ( ) Fax:: ( ) w
E-mail: ()rind 25.02
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.v�l /, 1,�,.�,t ;,It?t ( r,, , ,urn;' a • � . ti ,llifY.y'e; ^,.'a ,- .... ,,.,1 . ..',1; "' •in•. Water closet MI 25.02
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�>; ... • .• . - , .*. 1 i. .,14' ", ° ,�... Water heater 37.52
Business name: " I` . ] 1. Water piping/DWV Min 56.29
Address: . �� t Other: 25.02 -
City/State/ZIP: ,. • / '_ Subtotal MOM •
Phone: ( ' b ) -eft , i Fax: (saN (n -1 Zlf PE
Minimum permit fee: $ 72 . 50 WWI
CCB Lic.: ',� ,Plumbing Lic. no.: 31 ` 1 .411 P1 ao review (25° OF permit fee)
II; ���� I / /.` � StatesureharTOTA2 /oofRMIT FEE E� �. /
Authorized an store: ! i TOTAL PERMIT EE �� _ � ✓
'' , ��_� RM/ • Dale: ' M Ms permit application expires if a permit u not obtained within 180 days
��;� 1 after it Au been accepted it complete.
- Fee methodology an by Tti- County Building Industry Scrvicc Board.
'
I.\Buildi \ Permit*\PI.Ml1- PemlitApp.dac 10/01/09 44n- 46t6T(10m/l ;6M
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su ression S stems:
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Footing drain - I • 100' 50.03 0 to 2,000 $121,90
Footing drain - each additional 100' 37.52 2,001 l0 3,600 $ 169,69
3,601 to 7,200 5233.20
Sewer - 1st 100' 62.54 7,201 and 1Rtider $327.54 -
Sewer - each additional 100' 37.52
Water Service - 1st 100' , 62.54
(45 Medical Gas Systems:
Water Service - each additional 1 00'
17.52 SMg0** .i C cwCix;4='� Y
Stone bt Rain Drain -1st 100' 62.54 $ l.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
s` :F i t ,e each additional $100.00 or fraction thereof, to
cr 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 foc is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minunu -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 ho um) each additional $100.00 or fraction thereof, to
Rcinrtpection 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 S1.20 for
(minimum charge -1/2 hour) _ each additional $1 00.00 or fraction thereof.
Subtotal: l
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 *.
'i.L': -'t' r: e,. I.` •i. � : y ",}+ ?. >5 O001101 ribgitnre.1lype , .. .�, �ti
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'Wor1r;__ ___ ),Cappe ; , Via:, Plan review is required for any of the following.
13aptis5y/Font Please check all that apply.
Bath Tub/Showcr ❑ Any new commercial building with water service 2" and
- Jacurzi/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/Watcr Aspirator as defined in OAlt918 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.
Car Wash Drain
Garbage - Domestic- non -tool ❑ Isometric or riser diagram is required for new buildings
Disposal a)omestio - food related that meet the qualifications above.
-Commercial -food related
- Industrial -food related
Ice MachiRefrig. Drains
•
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink /I.av - Non -fired 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:
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