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Permit
CITY OF TIGARD PLUMBING PERMIT IN s COMMUNITY DEVELOPMENT Permit#: PLM2013 00413 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2013 Parcel: 1 S 136DA01000 Jurisdiction: Tigard Slte address: 11564 SW PACIFIC HWY Project: Martin's Auto Detailing Subdivision: FRUITLAND ACRES Lot: 5 Project Description: (1)sink and(1)water closet for bathroom addition. Sewer permit not required as property is on septic.Prior to final inspection,letter from Washington County Environmental Health is required. Contractor: WESTERN PLUMBING Owner: GREENLAND GROUP LLC 9460 SW TIGARD AVE SUITE 101 PO BOX 1008 TIGARD, OR 97223 NEWPORT,OR 97365 PHONE: 503-639-5296 PHONE: FAX: 503-684-9015 FEES Quantity Description Date Amount 1 ea Lavatories 11/18/2013 $25.02 Specifics: 1 ea Water Closet 11/18/2013 $25.02 1 12%State Surcharge- 11/18/2013 $8.70 Type of Use: COM Plumbing Class of Work: ALT 22 ea Minimum Fee Adjustment- 11/18/2013 $22.46 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 ■ • ''cation -• -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or ect questions to OU ► b -- 'ng 503.232.1987 or 1.800.332.2344. -sued By: C.a./.....e/ Permittee ignature: , S Call 503.639.4175 by 7:00 a.m.for the next available in-section 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 FOR OFFICE USE ONLY Received j City of Tigard ` DateBy: p i Kin Permit No.: / �� _ ,yak r,� n 13125 SW Hall Blvd.,Tigard,OR 972,,,.,. Plan Review / , r/�� H 0 Phone: 503.718.2439 Fax: 503.*: R•r•11 Date/By: Other Permit No.: /h M1D�13 Inspection Line: 503.639.4175 P V��� TI G n R D p k,,. - Q ^ 1'3 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov \' 1 Z7 LO Notified/Method: rb - Supplemental Information ' TYPE OF WORK Nw Y ' r A�TN .FEE* SCHEDULE. ❑New construction w.1 ,1\ 01 s For s r ecial information use checklist ❑DOpp�t1 �`',� Descri.tion WINE Ea. Total ❑Addition/alteration/replacement 14¢ q�`` GIC)r V 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 Accessory building SFR(3)bath 500.32 [� ry g ❑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: i '/ Catch basin or area drain 18.76 /5 . uJ ��,e- - -1 / 19 ' / 02 Drywell,leach line,or trench drain 18.76 City/State/ZIP: --1-v v.6( C�'2 o,/ '' 7 Zz4 9 tti Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name:hiker,t .15 ALA.TV�f i/}/Lick:, Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 -C g Rain drain connector 18.76 �t f t Sanitary sewer(no.linear ft.: ) Page 2 Lit ld.wr Aci ac e..t T tJ L){/1 i 4- c.g -' _ Storm sewer(no.linear ft.: ) Page 2 ( 1 S(ot-I S t.e) -Pa c p• i•i r�i l 1 j CL.. .( , OeE4 O a Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: /5/36, DA DD%O f r O/Ono Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 r Clothes washer 25.02 Pe„,r74 l T/�YH� ¶ /�/SpC2C T!/er > e3 t 144S 7l4//eel Dishwasher 25.02 /ye�l c_y Y 'S T 1 r o en Yl'\ Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I .0 TENANT Expansion tank 12.51 Name: �,p,E,,/,�Aid v a Fixture/sewer cap _ 25.02 Cs�v �P GLC'. Address: }�© ---, Floor drain/floor sink/hub 25.02 c�)C IODS Garbage disposal 25.02 City/State/ZIP: /1 ou)pd err D 2FGD h 7 7 6 35 Hose bib 25.02 Phone:(.54/) Z 6,5--74,OG Fax:( ) Ice maker 12.51 GrAPPI ICANT . [ CONTACT PERSON Interceptor/grease trap 25.02 Business name: ���M z..<:-__ Medical gas(value:$ ) Page 2 t�EALI / 0„,Roc)." L Primer 12.51 Contact name: 0/4`Eit,' E fq f1$ M Roof drain c cial) 12.51 Address: (a i gQ 5,,)J 6,,,,..,17 7,_/ GOc ? Sink/basi avatory I 25.02 City/State/ZIP: ' AU E e_-TO f..-/ I O QF4 C/,_/ Solar units(potable water) 62.54 Phone:($c3 ) e 6,-75`Z/ Fax(: :( ) Tub/shower/shower pan 12.51 E-mail: 34 l e IA @ a ro t^�!ti✓I V \ Jc L1 p i is ,Lp yvl Urinal 25.02 `1 5 , Water closet i 25.02 'CONTRACTOR . D ' Water heater 37.52 Business name: (AD£g t t�) 1 L.L4J 13 4, Water piping/DWV 56.29 Address: Other: , 25.02 City/State/ZIP: Subtotal Minimum permit fee: $72.50 •7 .� Phone:( ) Fax:( ) _ Plan review (25%of permit fee) CCB Lie.: Plumbing Lie,no.: State surcharge(12%of permit fee) g-70 Authorized signature: e../. 4c-A-Zes-rvi T OTAL PERMIT FEE g /.d) Print name:aA..L,„/ a,12 l-/}3 l✓l Date: `//46/3 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. 1:\Building\Permits\PLM1J-PermitApp.doc 10/01/09 440.4616T(10/02/COM/WEB) 1 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities 1 Qty. Fee(ea) Total ' Square Footage: Permit Fee: Footing drain-1'100' 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. 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 ❑ 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 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 -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: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 ... tv. 1 ' 7--', 1 , r I I -1,•' r , . 1 , 1• ,, , , ir ...„. .. : 1 . , , i ,•, ,, .Q,- ## .. . 0 , , I 1-, --.7, -.' ., " .§,,-;:: : •- I - I 1 . , .. I 11 I . . 1 . ,'...,.,,' 1 ...../ ..„. ,. ... . ., . , .. . 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