Permit CITY OF TIGARD PLUMBING PERMIT
IN • COMMUNITY DEVELOPMENT Permit#: PLM2013-00358
T FGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/15/2013
Parcel: 2S114BB16500
Jurisdiction: Tigard
Site address: 16270 SW 103RD AVE
Project: Snyder Subdivision: RIVERVIEW ESTATES Lot: 11
Project Description: Replace master shower,replace master tub valve and install(2)new lays.
Contractor: DAVID LOGGINS LLC Owner: SNYDER,GREGG L&MOLLY S
489 S 17TH ST 16270 SW 103RD AVE
ST HELENS,OR 97051 TIGARD,OR 97224
PHONE: 503-313-6351 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Lavatories 10/15/2013 $50.04
Specifics: 2 ea Tub/Shower/Shower Pan 10/15/2013 $25.02
1 12%State Surcharge- 10/15/2013 $9.01
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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 • is not started within 180 days of
issuance c +f w rk is suspended for more the 180 days. ATTENTION: Oregon law requires you t• olio the rules adop+ by the Oregon
Utili otification Ce Those rules are set forth in OAR 952-001-0010 through OAR 952-00 .090. Y•u may •: .in . op • the rules
or rect questions to OUN y ca ' g 5 3.2 2.1987 or 1.800.332.2344.
•
Is ued 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
Building Fixtures. 7 FOR. OFFICE USE ONLY .
Received A/4/e/City of Tigard (�
Date/By: /C�5 /1 PermitNo.: 4_GYM 3S`7
n 13125 SW Hall Blvd.,Tigard,OR 97229 CT 1 5 2013 Plan Review
M: Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
p CITY OF` IGARD Re
Inspection Line: 503.639.4175 Date Ready/By: Jana: El See Page 2 for
T I G A R D Internet: www.ti ard-or. ov y y S
g g �S!in P1IAI(`l�p,faCilllsl Notified/Method: Supplemental Information
e...a.,:�..
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(1)bath 312.70
la 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: /647o .w /034±--' Catch basin or area drain 18.76
City/State/ZIP: -�{ O/C 972Z'{ Drywell,leach line,or trench drain 18.76
/ Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: {Project name: Manufactured home utilities 50.03
Cross street/directions-to job site:" - Manholes - 18.76
,` A1c41 RA- 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
��J Clothes washer 25.02
/f PLAGe- /1i* T - S ftv[ _If 4�fic-c+ /613-/- Dishwasher 25.02
71.t6'y (/¢L-vtt ( .. '?-1.415 0t t_.r ,.•%ett/ 1/1/A-relt._ Drinking fountain 25.02
DA] At+t-s f4 c Ejectors/sump 25.02
. lir PROPERTY'OWNER I ❑ TENANT Expansion tank 12.51
Name: �OL1.y SA/t/peg_
Fixture/sewer cap 25.02
Imo`- Floor drain/floor sink/hub 25.02
Address: no 270 SW /o 3,!-'-°-- cf- Garbage disposal 25.02
City/State/ZIP: -7-74„/4'r_42 D 12. R 7 22-i( Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPLICANT ,❑--CONTACT'PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name: A�1. it• Lr�CU-/7.4-,LL�-
Contact name: ,l �T Primer 12.51
D/lifi h LO66 I� Roof drain(commercial) 12.51
Address: L-f 8Q S • i 7 S fr Sink/basin/lavatory 2 25.02 So t4
City/State/ZIP: S f. gGle,1/44 ff 1.10-sz Solar units(potable water) 62.54
Phone:(9j3) 3(3 6,3 S-/ Fax::( ) Tub/shower/shower pan 2 12.51 2 Sow
E-mail: plumb ie/•o 1 Q/AOt4l4-//r_cAI Urinal 25.02
Water closet 25.02
.CONTRACTOR
Water heater 37.52
Business name: ijf..m c e 1 Water piping/DWV 56.29
Address: Other: 25.02 D
City/State/ZIP: Subtotal 15
Phone:( ) ,_ Fax:( ) Minimum permit fee: $72.50
CCB Lic.: g 5-6 Z /%,4//r Plumbing Lic.no.: g 4Lo Plan review (25%of permit fee)
t� State surcharge(12%of permit fee) 9•p/
Authorized signature: TOTAL PERMIT FEE W.07
Print name: P'/) 14069 f Date: /0 S0/z This permit application expires if a permit is not obtained within 1S0 days
after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permils\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- I"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
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.
L 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
Baptistry/Font
El Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Stall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any 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" IsometriclorRiser Diagram
4" ❑ Isometric or riser diagram is,required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
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: -Lav/Bar 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 l plumbing permit can be issued.
Urinal
Other Fixtures:
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