Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit q: PLM2014-00016
Date Issued: 01/21/2014
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503 718.2439 parcel: 2S104B803000
Jurisdiction: Tigard
Site address: 14121 SW NORTHVIEW DR
Project: Mueller Subdivision: CASTLE HILL Lot: 37
Project Description: Convert soaking tub to shower. Cap old shower location.
Contractor: IDEAL CONSTRUCTION LLC Owner: MUELLER. ULRICH M &
1946 SW LAKE PL KAREN E
GRESHAM. OR 97080 14121 SW NORTHVIEW DR
TIGARD OR 97223
PHONE: 503-737-5994 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 01/21/2014 $25 02
Specifics: 1 ea Tub/Shower/Shower Pan 01/21/2014 $12.51
1 12%State Surcharge- 01/21/2014 $8 70
Type of Use: SF Plumbing
Class of Work: ALT 35 ea Minimum Fee Adjustment- 01/21/2014 $34.97
Plumbing
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 a ion Eater. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or d ct questions to OUNC b ng 503.232 1987 or 1 800.332.2344. _
lss ed 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 Avvlica CEIVEI�
Building Fixtures FOR OFFICE USU.. ONLY
City of Tigard Received /Dta B ai /I/ C.- Permit No.: )LHol , UD° /6
13125 SW Hall Blvd.,Tigard,OR OM 2 1 2014 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
Ili. \K r. Inspection Line: 503.639.4175 CITY OF'TICA R D Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov r Notified/Method: Supplemental Information
TYPE OFIkbl 'G DIVISION FEE* SCHEDULE
❑New construction ❑Demolition For s ecial in ormation use checklist
Description Qty. Ea. I Total
(Addition/alteration/replacement ❑Other: New t-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
crl-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ID Accessory building SFR(3)bath 500.32
g ❑Multi-family
Each additional bath/kitchen 25.02
E l Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCAT ON Site utilities:
1 j 1 t1 ty(-g ,(� _, , Catch basin or area drain 18.76
Job site address: l `� ,U '�'1. V`�1 �V ,
City/State/ZIP: Drywell,leach line,or trench drain 18.76
I l` 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
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: [ Lot no.: Fixture or item:
Tax map/parcel no.: Hackflow preventer 31.27
DESCRIPTION OF WORK
Backwater valve 12.51
L Clothes washer 25.02
°`"'r"-,.. � 4% /. -/G. Dishwasher 25.02
•\ o Str1,Qt.J,e ('. ' lQ 8(� • L Drinking fountain 25.02
c�-� ZS-i� / _Ejectors/sump 25.02
❑ PROPERTY OWNER l ❑ TENANT Expansion tank 12.51
Fixture/sewer cap I 25.02
Name:
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
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
Phone:( ) Fax::( ) Tub/shower/shower pan ' 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: £O [cam -1.-- ,,t p,ti L_t.-G--
Water piping/DWV 56.29
Address: 1 aI4b StJ 1.--k-c- Pi., Other: 25.02
City/State/ZIP: G yeq yK D pil D8S O Subtotal
Phone:(50 7) 131 -511.6L41' Fax:( ) 7/ /I y Minimum permit fee: $72.50 '7 2.5.
CCB Lic.: plc el 51_, e'I,/,Z//y Plumbing Lic.no.: f g ( (C 9 Plan review (25%of permit fee)
p<- State surcharge(l2%of permit fee) 5.`7d
Authorized signature: s-� J3 P TOTAL PERMIT FEE S
Print name: 1Lyi, 1)0,/vi cock_ Date: ,.-- This r- 11-i This permit application expires if a permit is not obtained within 130 days
after it his been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:1Building\Permits1PLMIJ-PermitAppdoc 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
Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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 includin $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
each(minimum charge-1/2 hour) I$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 engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru
C Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water
Dishwasher:pidor W Aspirator-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
4" ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications 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: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: lithe fixture work under this permit results in an
Swimming Pool Filler 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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