Permit CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit#: PLM2014-00152
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/07/2014
T l G A u i_) 9 Parcel: 25111 DB09800
Jurisdiction: Tigard
Site address: 15515 SW OAKTREE LN
Project: Sacconaghi Subdivision: SUMMERFIELD NO.10 Lot: 586
Project Description: Bath remodel: move existing shower.
Contractor: G&B PLUMBING&SONS INC Owner: SACCONAGHI JOINT TRUST
PO BOX 92 15515 SW OAKTREE LN
ST PAUL,OR 97137 TIGARD, OR 97224
PHONE: 503-868-1417 PHONE: 503-620-3520
FAX: 503-925-1707
FEES
Quantity Description Date Amount
1 ea Tub/Shower/Shower Pan 05/07/2014 $12.51
Specifics: 1 ea Water Piping/DWV 05/07/2014 $56.29
1 12%State Surcharge- 05/07/2014 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 4 ea Minimum Fee Adjustment- 05/07/2014 $3.70
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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt.'n a copy of the rules
or direct questions to UNC by calling 503.232.1987 or 1.800.332.2344.
410 Issued By: Permittee Signature: / ��,' ��`11
f
Call 503.639.4175 by 7:00 a.m.for the next available inspecti•n
fit e.
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 RECEIVED
Building Fixtures MAY 7 2014 I `W ()' '' ' ' " `)" 1
City of Tigard RDeceat j/y .��;� ..it No.:Pziy fy �e/s
el 13125 SW Hall Blvd.,Tigard,OR 972239gITY OF TIGARD Plan Re.
Plan Review
Phone: 503.718.2439 Fax: 503.598.1 Aate/By: Other Permit No.:
r i .A I:1 i Inspection Line: 503.639.4175 BUILDING DIVISI I 's:e Ready/By: kris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
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 CCOSTRUCTION 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: 15515 SW OAKTREE LN Catch basin or area drain 18.76
City/State/ZIP:TIGARD,OR 97224 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:SACCONAGHI Manufactured home utilities 50.03
Cross street/directions to job site:DURHAM TO ALDERBROOK DR.HEAD Manholes 18.76
TO ALDERBRRO CIRCLE RIGHT TO OAKTREE LANE LEFT 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:SUMMERFIELD 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
DELETE EXISTING TUB,MOVE EXISTING SHOWER LOCATION, Dishwasher 25.02
SHOWER PAN. USING EXISTING WALLS Drinking fountain 25.02
Ejectors/sump 25.02
IN rnornrry OWNER I 0 room Expansion tank 12.51
Name:ROD SACCONAGHI Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:15515 SW OAKTREE LN
Garbage disposal 25.02
City/State/ZIP:TIGARD OR 97224 Hose bib 25.02
Phone:(503)620-3520 Fax:( ) Ice maker 12.51
2 APPLICANT , .4 CONTACT PERSON Interceptor/grease trap 25.02
Business name:BLACK DIAMOND 1 Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:JEFF BETTINELLI
Roof drain(commercial) 12.51
Address:15685 SW 116TH AVE.,SUITE 290 Sink/basin/lavatory 25.02
I OR Solar units
(potable water) 62.54
i 210-6304 i I Tub/shower/shower pan 1 12.51 12.51
BLACKDIAMONDHCIMES@COMCAST.NET Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:G&B PLUMBING AND SONS, Water piping/DWV / 56.29
• r t P.O.BOX Other: ,iir 25.02
City/State/ZIP:ST PAUL,OR 97137 Subtotal 12.51
Minimum permit fee: $72.50 72.50
Plan review (25%of permit fee) ..
=� w jn i State surcharge(12%of permit fee) 8.70
Authorized signature: �� /�I(wifi�11',.\ TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:JEFF BETTIN LI Date:5/7/14 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board,/, 6'
1:\Building\Permits\PLMU-PermitApp.doe 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:
Sits Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-I a 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- I st 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 ti Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof;to
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*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thm ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3'.
-4„ Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings-Domestic-non-food s
g q g
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes p
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\UsersVeff Bettinelli\Downloads\PLMF-PermitApp(1).doc 2
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Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15515 SW OAKTREE LN, TIGARD, OR, 97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00152
George Heimos
Violation Summary:
Inspector Contractor