Permit CITY OF TIGARD • PLUMBING PERMIT
g •W COMMUNITY DEVELOPMENT I Permit# PLM2014-00217
• Date Issued: 07/02/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993-078 PARTITION PLAT Lot: 2
Project Description: THS Stadium-Add(2)eye washes,(2)hose bibs,(1)mop sink, (1)water closet&(1)water heater. 11/18/14,
adding(1)lay,60'of water service and(1)double check valve.
Contractor: OWNER Owner: TIGARD-TUALATIN SCHOOL DISTRICT
TIGARD-TUALATIN SCHOOL DISTRICT 6960 SW SANDBURG ST
6960 SW SANDBURG RD TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-431-4017 PHONE:
FAX:
FEES
Quantity Description Date Amount
60 If Water Service 11/18/2014 $62.54
Specifics: 1 ea Backflow Preventer 11/18/2014 $31.27
1 ea Ejectors/Sump 07/02/2014 $25.02
Type of Use: COM 2 ea Hose Bib 07/02/2014 $50.04
Class of Work: ALT 1 ea Sink 07/02/2014 $25.02
Type of Const: 1 ea Lavatories 11/18/2014 $25.02
Occupancy Grp: 1 ea Water Closet 07/02/2014 $25.02
Stories: 1 ea Water Heater 07/02/2014 $37.52
50 Misc Other Fee 07/02/2014 $50.04
1 12%State Surcharge- 11/18/2014 $39.78
Plumbing
Total $371.27
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 scions to ••k C by c- -• 503.232.1987 or 1.800.332.2344.
Issu By: � Permittee Signature: "7? "7
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 `) I t Ili OFFICE 1 'NI: ONLI
1 City of Tigard - Date By / t/ 6c,4, Permit No.: L f f 4/4/-iD2/.7
jig • 13125 SW Hall Blvd.,Tigard,OR 9727�((�jj Plan Review
• Phone: 503.718.2439 Fax: 503.598. 1 8 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 CITY r� Date Ready/By: Juris: RI See Page 2 for
TIGARD) 1 lT � y g
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF MC-PM111010r1P FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
.12<ddition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El �
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: //am �+V 0 -Dv(0,‘(0,‘A Catch basin or area drain 18.76
City/State/ZIP: ` Drywell,leach line,or trench drain 18.76
Cit T
y n vq. , 1) d2. 7 i-Z 15 Footing drain(no.linear ft.: ) Page 2
Suite/bidg./apt.no.: U Project name:-r-; : - _ r a, Manufactured home utilities 50.03
Cross street/directions to job site: j Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:at3 Page 2 42,5-4
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 3/.i-7
DESCRIPTION OF WORK Backwater valve 12.51
, / / / s Clothes washer 25.02
• G� VI L 1 ' /S( uU I C. "-Ve` 1 (l.G�Gh_, Dishwasher 25.02
y (i /l+61---if Drinking fountain 25.02
Ejectors/sump 25.02
91-PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name: --r 7 S D Fixture/sewer cap 25.02
rl �l 1 � Flooradgrain/poor sink/hub 25.02
Address: V w C� ft?>J f,I - s'}
Garbage disposal 25.02
City/State/ZIP: �t p a 0 b IZ / 5''P 7 Z 3 Hose bib 25.02
Phone:(S63) _ '-3. - #lr Fax:( ) Ice maker 12.51
❑ APPLICANT is CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Contact name: L)A. -T k l Primer 12.51
I\I I Vl ,'�- (� ` Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 1 25.02 a510..)"
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) 3 cc. Out 2[ Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
��� � Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal ijs.33.
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: D c i ' Plan review (25%of permit fee) �yy
' State surcharge(12%of permit fee) i Z••1`SG
Authorized signature: jr; ��' _ TOTAL PERMIT FEE /2311
f
Print name: Date: _ This permit application expires if a permit is not obtained within 1S0 nays
Am as complete.
�+1� 1. after it has been accepted a plete
I
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\P1.MU-PennitApp.doc 10/01/09 440-4616T(10/02ICOM/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-l'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
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
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ 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"
3" 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 fees assessed for the sewer increase must be paid before the
Water Extractor
WaterCloset-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
CITY OF TIGARD PLUMBING PERMIT
'.. COMMUNITY DEVELOPMENT Permit#: PLM2014-00217
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/02/2014
Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993-078 PARTITION PLAT Lot: 2
Project Description: THS Stadium-Add(2)eye washes,(2)hose bibs,(1)mop sink,(1)water closet&(1)water heater.
Contractor: OWNER Owner: TIGARD-TUALATIN SCHOOL DISTRICT
TIGARD-TUALATIN SCHOOL DISTRICT 6960 SW SANDBURG ST
6960 SW SANDBURG RD TIGARD,OR 97223
TIGARD, OR 97223
PHONE: 503-431-4017 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Ejectors/Sump 07/02/2014 $25.02
Specifics: 2 ea Hose Bib 07/02/2014 $50.04
1 ea Sink 07/02/2014 $25.02
Type of Use: COM ea Water Closet 07/02/2014 $25.02
Class of Work: ALT 1 ea Water Heater 07/02/2014 $37.52
Type of Const: 50 Misc Other Fee 07/02/2014 $50.04
Occupancy Grp: 1 12%State Surcharge- 07/02/2014 $25.52
Stories: Plumbing
Total $238.18
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 1 344.
Issued 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 Ann licatRECEIVED
Building Fixtures I (I l l 01 1I( 1 I SI ON' 1
Received 7
City of Tigard JUL 1 2014 Date/By: 7 / /y �l Permit No.: (/e.Q/ -fx}_2/ /
111111
• 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Reviewj034:94/(4600
O Phone: 503.718.2439 Fax: 5 Date/By: Other Permit No.:
Inspection Line: 503.639.417 �l r�"F i 1GI�I\D
I I c ;\I:1) UILD Date Ready/By: j Juris: 65 See Page 2 for
Internet: www.tigard-or.gov ING D►VISIpN Notified/Method: 7 r� l�Y} 6 Supplemental Information
TYPE OF WORK �- Ay ' (i0.41`` FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement la Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El I-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:
Catch basin or area drain 18.76
Job site address: _ u a r`, _ .._._.
Drywell,leach line,or trench drain 18.76
City/State/ZIP:I IA_Cep �` I�d2 ?
l ,w/ Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no. I Project name: 1 I cZ �T��lv� Manufactured home utilities 50.03
Cross street/directions to job site: T�5 �1't,4N tJ%A...L. Manholes 18.76
L Lj _, t /2 07 AV r- Rain drain connector 18.76
'�4 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.: a 6 1 / q f}( co/DO Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
_ ' r Clothes washer 25.02
M 1we C��E t,J45� i4- (1-k, t�C, L b x)S Dishwasher 25.02
(e:;, �j t� L LA-I)l ! Drinking fountain 25.02
I c //( - ��l< w E/e f X Ejectors/sump ` 25.02 as,c
PROPERTY OWNER J ❑ TENANT Expansion tank 12.51
T Fixture/sewer cap 25.02
Name: T' ��
Floor drain/floor sink/hub 25.02
Address: Ce tri ft 0 W 17 r, Garbage disposal 25.02
City/State/ZIP:77a A tZ� OIL T77 Hose bib 25.02 .41'
Phone:(510) 1{.. L(Oj2 Fax:( ) Ice maker 12.51
❑ APPLICANT ( ,,CONTACT PERSON Interceptor/grease trap 25.02
Business name:
Medical gas(value:$ ) Page 2
1,510:31/4.-r Primer 12.51
Contact name: K it,ti �'S„��1 1 (commercial)�V\ Roof drain commercial 12.51
Address: /' 7 (D £) �(.` lo J Sink/basin/lavatory I 25.02 ois,c'„
City/State/ZIP-1' ; Q �_ I"'�^'Z' Z. S. rL Solar units(potable water) 62.54
Phone: ') e>/�r�^/�c I a t I Fax: :( ) Tub/shower/shower pan 12.51
E-mail:®hay.y'�C V�"'1 `� ,- 1 k(2* ,U s Urinal 25.02 c
i1
CONTRACTOR
`, Water closet , 25.02 as
1 Water heater ` 37.52 3 7_S�-
Business name: a W i )Ll2- Water-pipiag D i lip 56.29
Address: Other: f ye 14),I5 H P. 25.02 -e.°il
City/State/ZIP: Subtotal o2t 2-6!
Phone:( ) Fax:( )
Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: t�f b452 Plan review (25%of permit fee)
State surcharge(12%of permit fee) AT-5"›.
Authorized signature: TOTAL PERMIT FEE -3 g.I g
Print name: 1 1
[ � 1/l Date: 1 This permit application expires if a permit is not obtained within 180 days
K ►,,�IM fl �� after it has been accepted as complete.
1 *Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Penults\PLMU-PermitApp.doe I0/01/09 440-4616T(10/09JCOM/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- 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
Quan�J' re Type Plan review is required for any of the following.
Fixture Type for 11 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
WaterCloset-Toilet j plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
c
Tenant Name: Tigard I ligh School Sewer Tally
SWR# 2014-00065
Site Addru . 9000 SW Durham Rd-'HIS Stadium PLM# 2013-00217
I':,reel 2S 114AA00100
Fixture \.,I„, I'rcvious Previous Credits Capped Fixture Fixture New New
# value count capped#s x clue town, added# added value total#s total valu..-
Baptisery/Font 4 0 0 0 0 0
Bath: -Tub/Shower 4 0 0 0 0 0
-Jacuzzi/Whirlpool 4 0 0 0 0 0
Car Wash: -Each Stall 6 0 0 0 0 II
-Drive through 16 0 0 0 0 (I
Cuspidor/Water Aspirator 1 0 0 0 0 (I
Dishwasher: -Commercial 4 0 0 0 0 LI
-Domestic 2 0 0 0 0 (I
Drinking Fountain I 0 0 0 0 0
Eye Wash I 0 0 2 2 2 2
Floor Drain/Sink: -2 inch 2 0 0 0 0 (I
-3 inch 5 0 0 0 0 0
-4 inch 6 0 0 0 0 0
-Car Wash 6 0 0 0 0 0
Garbage Disposal:
-Domestic(to 3/4 I lP) 16 0 0 0 0 0
-Commercial(to 5 HP) 32 0 0 0 0 0
-Industrial(over 5 HP) 42 0 0 0 0 0
Ice Machine/Refrigerator Drain 1 0 0 0 0 0
Living Unit 16 0 0 0 0 0
Oil Sep(Gas Station) 6 0 0 0 0 0
Rec.Vehicle Dump station 16 0 0 0 0 0
Shower: -Gang(per head) 1 0 II 0 0 0
-Stall 2 0 0 0 0 0
Sink:
-Lay/Bar-Non-Food Related 2 0 0 0 0 0
-Bradley � 0 0 0 0 0
-Com/Serv/Util-Food Related 3 0 0 1 3 1 3
Swimming Pool Filter I 0 0 0 0 0
Washer-Clothes c, 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet-Toilet 6 0 0 I 6 1 6
Urinal 6 0 0 0 0 0
Previous EDU (.nuns 0 0
Capped EDU Credit 0
TOTALS 0 0 _ 0 0 4 11 4 11
Current Fixture Value 11 dici,I,d by 16= 0.688 Current 11AI 1 1:1)1 = 54,900.00
Previous Fixture Value () divided by 16= 0.000 Previous EDU
Change I I divided by 16= 0.688 over (under) $ 3,381.00
Enter EDU Change Here 0.690
Notes:
Authorized Name/Signature: Debbie.\damski Date: 7/1/2014
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist,this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\Building\Sewer Tally\SewerTallySheet_4900._070114.xlsx