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Permit CITY OF TIGARD PLUMBING PERMIT 3' COMMUNITY DEVELOPMENT Permit#: PLM201500080 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2015 Parcel: 2S110BA06600 Jurisdiction: Tigard Site address: 12102 SW WILDWOOD ST Project: Smith Subdivision: SHADOW HILLS NO.2 Lot: 49 Project Description: Remodel master bath and kitchen. Contractor: MCINNIS INDUSTRIES LLC Owner: SMITH,VISTON&SUSANN PO BOX 920 REVOCABLE LIVING TRUST BEAVERTON, OR 97075 BY VISTON/SUSANN SMITH TRS 12102 SW WILDWOOD ST TIGARD, OR 97224 PHONE: 503-319-3267 HONE: 971-226-4454 FAX: 503-643-6343 FEES Quantity Description Date Amount 1 ea Dishwasher 03/17/2015 $25.02 Specifics: 1 ea Garbage Disposal 03/17/2015 $25.02 1 ea Ice Maker 03/17/2015 $12.51 Type of Use: SF 1 ea Sink 03/17/2015 $25.02 Class of Work: ALT 2 ea Lavatories 03/17/2015 $50.04 Type of Const: 2 ea Water Closet 03/17/2015 $50.04 Occupancy Grp: 1 12%State Surcharge- 03/17/2015 $22.52 Stories: Plumbing Total $210.17 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 i not starte• hin 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fol:- th= rules ..opte• by the Oregon Utility N. ' .. enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-009.. You ay obt.in a 'opy of the rules or.• -ct questions to O• C by calling 503.232.1987 or 1.800.332.2344. 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 ApplicatiCE1VE1) Building Fixtures I till (H I ICE I SF: O\I.1 City of Tigard MAR 17 2015 Da ,j��nJl Permit No: )4_11,910/5_(:e g0 le 11111 13125 SW Hall Blvd.,Tigard,OR 97223 T Phone: 503.718.2439 Fax: 503 $ F l IVARD Plan Review Other Permit No.: Inspection Line: 503.639.4175� j Date/By. I 1('A I.I) g g p)IJA�hING DIVISION Date Ready/By: Juris ® See Page 2 for Internet: www.ti ard or. ov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction ❑ Demolition For special information use checklist Description I Qty_ I Ea. [ Total ®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ® I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 building SFR(3)bath 500.32 ❑Accessory 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: 12102 SW Wildwood St Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP:Tigard,OR 97224 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name:Smith Manufactured home utilities 50.03 Cross street/directions to job site:SW Bull Mt.Rd Manholes 18.76 Rain drain connector 1 8.76 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 Relocate master bath shower,tub,toilet,shift kitchen sink,disposal,add Dishwasher 1 25.02 25.02 kitchen bar sink,replace DW,add insta-hot Drinking fountain 25.02 Ejectors/sump 25.02 ® PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name:Vision&Susan Smith Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 12102 SW Wildwood St Garbage disposal I 25.02 25.02 City/State/ZIP:Tigard,OR 97224 Hose bib 25.02 Phone:(503)319-3267 Fax:( ) Ice maker I 12.51 12.51 ® APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name:McInnis Industries LL( Medical gas(value:S ) Page 2 Primer 12.51 Contact name:Gerry McInnis Roof drain(commercial) 12.51 Address:P.O.Box 920 Sink/basin/lavatory 3 25.02 75.06 City/State/ZIP:Beaverton,OR 97075 Solar units(potable water) 62.54 Phone:(971)226-4454 Fax: :( ) Tub/shower/shower pan 12.51 E-mail:gerrymcinnis@yahoo.com Urinal 25.02 Water closet 2 25.02 50.04 CONTRACTOR Water heater 37.52 Business name:same as applicant Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 187.65 lix:(. Minim um permit fee: $72.50 Phone:( ) )�J/C ; Plan review (25%of permit fee) CCB Lie.: 172340 �� umbng Lie.no.:34-417PB I r I O State surcharge(12%of permit fee) 22.5 Authorized signature:y I TOTAL PERMIT FEE • . This permit application expires if a permit is not obtained within 180 days Print name:Gerard McInnis Date: Mar. 16,2 after it has been accepted as complete. "Fee methodology set by Tn-County Building Industry Servt oar/ar d. /7 v( O 11Budding\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) C'`� 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- 1'1100' 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 Oa) 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 CI 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 Thru ❑ 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" Car Drain Isometric or Riser Diagram Garbage Domestic-non-food 12 Isometric or riser diagram is required for new buildings 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: lithe fixture work under this ermit 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: http://www.tigard-or.gov/document_center/Bui Iding/PLMF_PermitApp.dtt 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 12102 SW WILDWOOD ST, TIGARD, OR, 97224 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2015-00080 Don Sylvester Violation Summary: Inspector Contractor