Permit CITY OF TIGARD PLUMBING PERMIT
1111 C ,, - COMMUNITY DEVELOPMENT Permit#: PLM2013 00324
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/16/2013
Parcel: 25111 DC08400
Jurisdiction: Tigard
Site address: 15725 SW OAKHILL LN
Project: Vogel Subdivision: SUMMERFIELD NO 10 Lot: 573
Project Description: Replace soaking tub with tub/shower
Contractor: WESTERN PLUMBING Owner: VOGEL, JOHN A&SHARON P
9460 SW TIGARD AVE SUITE 101 15725 SW OAKHILL LN
TIGARD, OR 97223 TIGARD,OR 97224
PHONE: 503-639-6785
HONE: 503-639-5296
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Tub/Shower/Shower Pan 09/16/2013 $12 51
Specifics: 1 12%State Surcharge- 09/16/2013 $8.70
Plumbing
Type of Use SF 80 ea Minimum Fee Adjustment- 09/16/2013 $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 Not tion—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 di questions to OUNC by ng 503.232.1987 or 1 800.332.2344
slued By: . / Permittee Signature: 04/4.7 1
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
Building Fixtures RECEIVE':,\' FOR OFFICE USE ONLY
City of Tigard Received Q # /2 / Permit No.: ,Ciao/ _ ,�
n 13125 SW Hall Blvd.,Tigard,OR 97223■. Plan / J
0 Phone: 503.718.2439 Fax: 503.598.1960 6 Z 3 Plan Review Date/By: Other Permit No.:
Tl G A K D Inspection Line: 503.639.4175 Date Ready/By: Juris: 121 See Page 2 for
Internet: www.tigard-or.gov CITYOFTIGARD Notified/Method: Supplemental Information
TYPE OF WcILDING DIVISION FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement JOtherg 1,j New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
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:/,�7�s- .ç1, A'1l �G---ems Catch basin or area drain 18.76
City/State/ZIP: �/ ��//f Drywell,leach line,or trench drain 18.76
��� / l` �G���!r� n Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: V Q QO y?�Qe.�// Manufactured home utilities 50.03
Cross street/directions to job site: o 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.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: ( _ Fixture/sewer cap 25.02
t/V it h q4 S- �G1rBr'` V� Floor drain/floor sink/hub 25.02
Address: /
Jr-.) �� �//t/ ��/( / �`-� Garbage disposal -:25.02
City/State/ZIP: / i' 6,. _! /fk 9 7 02,9 Hose bib - 25.02
Phone:(RV) J/ 91.- 6� `71E_7-- Fax:( ___1___--- Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
r // 1-1-C- Medical gas(value:$ ) Page 2
Business name:/ ) �r ; �a„.42„
6/ I �'� f Primer 12.51
Contact name: 01, /. ,� Roof drain(commercial) 12.51
Address: ('bt) lya� �r� Sink/basin lavatory 25.02
City/State/ZIP:7i , "( t T2.).2 v Solar units(potable water) 62.54
Phone:(sb3) 6 , y3 v Fax: : 3) 6f-y_a9s-- Tub/shower/shower pan LA-Lit. V 12.51
E-mail: (4), �� /',/ r �ryt/�r/� ` Urinal 25.02
Water closet 25.02
CONT TOR
Water heater 37.52
Business name: �(f 3r- L,_H' 4t3 Water piping/DWV 56.29
Address: Other.•r •1 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( )
Minimum permit fee: $72.50 `72.CO
CCB Lic.: 'lumbing Lic.no.: Plan review (25%of permit fee)
��� State surcharge(12%of permit fee) g./
Authorized signature:/ (/v(i f TOTAL PERMIT FEE � ..?C)
Print name: i - D Date: This permit application expires if a permit is not obtained within 180 days
• *f/ 1t f 0 after it has been accepted as complete.
r *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)
•
Plumbin2.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-l'100' 50.03 0 to 2;000 _ $121.90
Footing drain-each additional 100' 37.52 2,001 to,3;600 $x69.69
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
Storm&Rain Drain-1st 100" 62.54 Valuation: Permit Fee:
$1.00 to'$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additiona1,100' 37.52 $5,001.00 to$10,000.00 $72.50-for the $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 fettle'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$50,600:00.
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
(minim um 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 El 'New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ My 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 that meet thequalifications above:,
Garbage -Domestic non-food •
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: -LavBar 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:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 •
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
15725 SW OAKHILL LN, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
2013-10-25 00:00:00
PLM2013-00324
PASS - No C of O
Violation Summary:
Inspector Contractor