Permit CITY OF TIGARD PLUMBING PERMIT
III
s COMMUNITY DEVELOPMENT Permit#: PLM2014-00192
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2014
Parcel: 2S104AC00700
Jurisdiction: Tigard
Site address: 12975 SW 132ND AVE
Project: Subdivision: MORNING HILL NO.1 Lot: G
Project Description: Moving(1)water heater,(1)clothes washer and(1)kitchen sink,and installing(1)ice maker.
Contractor: TOM ALLENDER PLUMBING LLC Owner: WRIGHT, LARRY A&MAUREEN L
PO BOX 23753 12975 SW 132ND AVE
PORTLAND, OR 97223 TIGARD,OR 97223
PHONE: 971-219-9313 PHONE:
FAX: 503-213-5993
FEES
Quantity Description Date Amount
1 ea Clothes Washer 06/09/2014 $25.02
Specifics: 1 ea Ice Maker 06/09/2014 $12.51
1 ea Sink 06/09/2014 $25.02
Type of Use: SF 1 ea Water Heater 06/09/2014 $37.52
Class of Work: ALT 1 12%State Surcharge- 06/09/2014 $12.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $112.08
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 ex.ire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires y•u to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 0 4.
I
Issued By:v Perini Signature,
1`
Call 503.639.4175 by 7:00 a.m.for the next available inspection •ate.
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 O\I 1
City of Tigard Received
III g �a\ � DateB : •e ,, Permit No.: V iI4!
+ 13125 SW Hall Blvd.,Tigard,OR 97223 F
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 - �Q1�t
Date/By:
Other Permit No.:�STt I H '(ar-71
Inspection Line: 503.639.4175 ,a1 Date Ready/By: Luria: ® See Page 2 for
I WARD Internet: www.tigard-or.gov Notified/Method: -7-1....7 Supplemental Information
TYPE OF WORK • FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
1\ ddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
/�-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: 'Z el-3 5 SLi 132 Akre Catch basin or area drain 18.76
City/State/ZIP: g.9 I Drywell,leach line,or trench drain 18.76 J
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I 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: 1 Lot no.: Fixture or item: _
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer ( 25.02
Z5,6 2.
�/ UvL W1 1bt._ CpIL � p J7 ,& Dishwasher 25.02
WeE LT1tAAO �u (Vtl Drinking fountain , 25.02
KT-71--h-31"\A 51►I. OKAY. ‘17.E J4k1 . Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ NANT
Expansion tank 12.51
Name:
Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 1 12.51 V/ .5(
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: S�+�,1, 4 S C,.tn ) Medical gas(value:$ ) Page 2
Cam" °W Primer 12.51
Contact name: -
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 1 25.02 3. d 2
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
A' [}�( ,^� n (1, Water heater 1 37.52 -?�1 Si
Business name:�(v` ALOE'"Y2e( 1' LVM1/ L� Water i in WV 56.29
``null ' P P P�
Address:/23 Other: 25.02
City/State/ZIP: l it Cl i 2 g ' Subtotal !a0.c7
Phone:(qq-j) Doi •`C/313/ Fax:(563)2 13 •5(19 3 Minimum permit fee: $72.50
�!� 03 619 Plan review (25%of permit fee)
CCB Lic.: l C_l.P 13 Plumbing Lic.no.: 0'J 61 1 State surcharge(12%of permit fee) /d. L�I
Authorized signs re: /t /, TOTAL PERMIT FEE � , U Print name: ' b,^g I L �11 ` Date:(p 4 This permit application expires if a permit is not obtained within 1 0 days
1 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440-4616T(10/02/COM/WEB) .20
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.
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
Car Wash: Each Stall El 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"
Isometric or Riser 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
Water Extractor fees assessed for the sewer increase must be paid before the
WaterCloset-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12975 SW 132ND AVE, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
FAIL
PLM2014-00192
George Heimos
1. Dishwasher hose to be securely anchored to underside of cabinet top. 807.4
2. Recall inspection when corrections have been completed. Re-inspection required.
103.5.6.1
Violation Summary:
Inspector Contractor