Permit CITY OF TIGARD PLUMBING PERMIT
11111 S:. COMMUNITY DEVELOPMENT Permit#: PLM2013 00406
T t GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2013
Parcel: 2S 111 DB 11000
Jurisdiction: Tigard
Site address: 15345 SW OAKTREE LN
Project: OLTEAN Subdivision: SUMMERFIELD NO.10 Lot: 598
Project Description: (1)icemaker and(1)sink for kitchen remodel.
Contractor: ALL SCOPE PLUMBING&CONSTRUCTION LLC Owner: OLTEAN, STEPHEN V
18859 SW BUTTERNUT ST FLANAGAN, MAUREEN
BEAVERTON, OR 97007 15345 SW OAKTREE LN
TIGARD,OR 97224
PHONE: 503-927-0713 PHONE:
FAX:
FEES I
Quantity Description Date Amount
1 ea Ice Maker 11/13/2013 $12.51
Specifics: 1 ea Sink 11/13/2013 $25.02
1 12%State Surcharge- 11/13/2013 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 35 ea Minimum Fee Adjustment- 11/13/2013 $34.97
Type of Const: Plumbing
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.
Issued By: ` Permittee Signature:
L� _ri_
I
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 r'����� FOR OFFICE USE ONLY
�1,` Received J
City of Tigard "' Date/By: fi I3 /3 I Permit No.: naraa)3--uo Lev c4,
13125 SW Hall Blvd.,Tigard,OR 97223 13
III • Phone: 503.718.2439 Fax: 503.598.19600 1�20 DPlan ate/By:a Other Permit No.:
Inspection Line: 503.639.4175 \\►► Date Read B luris: ® See Page 2 for
TIGARD GkRD Ready/By: g
InterneC www.tigard-or.gov `' C 1V ottfied/Method: Supplemental Information
TYPE OF..WORK• CAI 11' (AVIS,' FEE* SCHEDULE ' .
❑New construction ❑ 1`a,e.,1 �n For special information use checklist.
Description I Qty. I Ea. I Total
zi•Addition/alterationireplacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
' • CATEGORY-OF.CONSTRUCTION ' - ' SFR(1)bath Itt-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: j s3 Li S S(r..J Qa� k�A Catch basin or area drain 18.76
City/State/ZIP: (( rA �Q �( Drywell,leach line,or trench drain 18.76
•1 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Oli,ch 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 map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK • Backwater valve 12.51
Clothes washer 25.02
�(
r`1 t-c�e.,-, a,00(I\ Dishwasher - 25.02
Drinking fountain 25.02
Ejectors/sump 25.02 '
' • , ® PROPERTY OWNER ❑'TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: .5`3(I$ S�✓ alit. /q Floor ge disposal sink/hub 25.02
-�- ��pp /y7 �° Garbage disposal 25.02
City/State/ZIP: i fe,ncAJ Cik "t! 2 t'1 Hose bib 25.02
Phone:(5c)�) 94. L7 S,. Fax:( ) Ice maker 1 12.51 h)...5 i
r, . •❑ APPLICANT... : . ]'CONTACT PERSON ' Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
12‘.,e,Business name: 'P r Ad
Primer 12.51
Contact name: Ti„' Lc 6 tr� Roof drain.(commercial) 12.51
Address: fb g6 /9 16 Sinklbasin/lavatory 1 25.02 ,S.0),
City/State/ZIP: 7j aJ 0 oP, Solar units(potable water) 62.54
Phone:(503 ) cryy , 27.6 3 Fax::( ) Tub/shower/shower pan 12.51
E-mail:1 Rer^^6 t0\ 0 u.,0` , t`0^' Urinal 25.02
' " +CON TRACTOR . Water closet 25.02
Water heater 37.52
Business name: A,, at6pC fthb\kj∎1..), Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50 7a,J-D
Plan review (25%of permit fee)
CCB Lic.: 10177z g Plumbing Lic.no.: j ZICI
State surcharge(12%of permit fee) cis---70
Authorized signature: TOTAL PERMIT FEE 7),
-77This permit application expires if a permit is not obtained within 180 days
,,,.
Print name: l��4lt� Date:
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\BuildingTermits\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-1S`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
Storm&Rain Drain-1st 100' 62.54 • Valuation: Permit Fee:
$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 Ins actions 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 i $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*. 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
-Jacuzzi/Whirlpool engineer.
Car Wash: -Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive tall 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" • Isometric'or'Riser•Diagram •
❑ 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 •V ,
-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 plumbing permit can be issued.
Urinal
Other Fixtures:
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