Permit PLUMBING PERMIT
CITY OF TIGARD •
•
1111 n 3 " COMMUNITY DEVELOPMENT d$�' Permit#: PLM2015 00219
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2015
Parcel: 2S102CC00700
Jurisdiction: Tigard
Site address: 13599 SW PACIFIC HWY
Project: Tigard Vet Clinic Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Relocate(2)sinks in beauty salon. 9/28/15:Reprinted permit to show project name correction from Nevaeh
Designs to Tigard Vet Clinic.
Contractor: UNITED PLUMBING Owner: HORTON, DENNIS M&ELISABETH A
PO BOX 971 19220 VIEW DR
FAIRVIEW, OR 97024 WEST LINN, OR 97068
PHONE: 503-752-8446 PHONE:
FAX: 503-491-8671
FEES
Quantity Description Date Amount
2 ea Sink 07/14/2015 $50.04
Specifics: 1 12%State Surcharge- 07/14/2015 $8.70
Plumbing
Type of Use: COM 22 ea Minimum Fee Adjustment- 07/14/2015 $22.46
Plumbing
Class of Work: ALT
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 obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.8�.
Issued ey: 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.
CITY OF TIGARD PLUMBING PERMIT
��
1111 ,
COMMUNITY DEVELOPMENT Permit#: PLM2015 00219
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2015
Parcel: 2S 102CC00700
Jurisdiction: Tigard
Site address: 13599 SW PACIFIC HWY
Project: Nevaeh Designs Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: Relocate(2)sinks in beauty salon.
Contractor: UNITED PLUMBING Owner: HORTON, DENNIS M & ELISABETH A
PO BOX 971 19220 VIEW DR
FAIRVIEW, OR 97024 WEST LINN, OR 97068
PHONE: 503-752-8446 PHONE:
FAX: 503-491-8671
FEES
Quantity Description Date Amount
2 ea Sink 07/14/2015 $50.04
Specifics: 1 12%State Surcharge- 07/14/2015 $8.70
Plumbing
Type of Use: COM 22 ea Minimum Fee Adjustment- 07/14/2015 $22.46
Plumbing
Class of Work: ALT
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 952 101-0090. You may_obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �/ rMi�`� Permittee Signature: 63/J071 l
or
Call 503.639.4175 by 7:00 a.m.for the next available inspe tion 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 RECEIVED
Building Fixtures FOR OFFICE USE ()NIA
JUL 14 2015 Received
City of Tigard Dae�By: /rf/�s 141'177 PermitNo��y�/5 -0,0, 1? 9
NI 13125 SW Hall Blvd.,Tigard,OR 97223 t,�TV!1�, ri/ Ap Y> / emu' ✓
CPI
Phone: 503.718.2439 Fax: 503.598.1989 1 1 V 1 V I�!<1 Pla"R°v' Other Permit No.:
Inspection Line: 503.639.4175 Date/By:
I I G A R D P BUILDING DIVISIO 1�)ate ReadyBy: luris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Su lemental Information
❑New construction 0 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)
SFR(1)bath 312.70 J
CI 1-and 2-family dwelling Er Commercial/industrial SFR(2)bath 437.78
❑Accessory building Multi-family
SFR(3)bath 500.32
❑Multi-famil
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
Site utilities:
�-` /� Catch basin or area drain 18.76
Job site address: 1 35'9 9 ‘5,,,_) PaL; F� C_ r14�/ '-
C17.2_2- Drywell,leach line,or trench drain 18.76
City/State/ZIP: `T' I, a,-,4 , 0 2 3 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: A/EV/167-1- I ES/G/JS 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 It.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
f� Clothes washer 25.02
r "°V e 5,- 4 k_3 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I i ❑ TENANT 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 12.51
APPLICANT i ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:V v,I Ted i v i,l,�10 ; Medical gas(value:$ ) Page 2
�_A� Primer 12.51
Contact name: Z O v'+ `-APT y-t/l 6
Roof drain(commercial) 12.51
Address: P O 0.ox 9'-7 I Sink/basin/lavatory 2 25.02 co4_o Li
City/State/ZIP: Fic ; r u I e.c.v/ O (Z Ct 702 t-f' Solar units(potable water) 62.54
Phone:(S03) 7.5- _ L1.& Fax::03) q ci�r g Io 7 Tub/shower/shower pan 12.51
tt Urinal 25.02
E-mail: I y ti) a ♦ 0 i -re e •1 0 M .i" i.L C , Co�-+ Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal - p.0`i
Phone:( ) / Fax:( ) Minimum permit fee: $72.50 72,5o
CCB Lic.: / s I f G /17 I / Plumbing Lic.no.: 12 6 S y Plan review (25%of permit fee)
f State surcharge(12%ofpermit fee) ei 70
Authorized signature: //'' TOTAL PERMIT FEE I v ,2() t/
Print name: �/-�S o t/1 L A/✓1 b PAC; Date: 7-1 4-i S
This permit application expires if a accepted is not obtained within 180 days
J after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01109 440-4616T(I0/02/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-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
Storm&Rain Drain-1st 100' 62.54 Valuation; germlt ce:
$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
WIT; 0119 x01' 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 Plumbin Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work,ltuformed: 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
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru 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"
4 ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the s ualifications 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: -LavBar 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 P
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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