Permit q CITY OF TIGARD PLUMBING PERMIT
''1 = COMMUNITY DEVELOPMENT Permit#: PLM2015-00276
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2015
Parcel: 1 S135AD01900
Jurisdiction: Tigard
Site address: 8810 SW SPRUCE ST
Project: Spruce Village,Lot 5 Subdivision: GRAHAM ACRES Lot: 2
Project Description: Adding(1)hose bib,(1)lay,(1)water closet&(1)shower.
Contractor: ROME PLUMBING INC Owner: ANDERSON HOMES&CONSULTING LLC
17295 SW EDY RD 5357 LAKEVIEW BLVD
SHERWOOD, OR 97140 LAKE OSWEGO, OR 97035
PHONE: 503-625-1452 PHONE:
FAX: 503-625-1452
FEES
Quantity Description Date Amount
1 ea Hose Bib 08/20/2015 $25.02
Specifics: 1 ea Lavatories 08/20/2015 $25.02
1 ea Tub/Shower/Shower Pan 08/20/2015 $12.51
Type of Use: SF 1 ea Water Closet 08/20/2015 $25.02
Class of Work: ALT 1 12%State Surcharge- 08/20/2015 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $98.08
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 expire if work is not started within 180 days of
issuance, or if ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N ' cation Cen Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire questions to OUNC by - ' • 503.232.1987 or 1.800.332.2344.
Issue By: �t' __iIi 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 Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received ♦ f/ /S Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Datc/B `ai _
Date/By:Review Other Permit No.:
, Iiii I Phone: 503.718.2439 Fax: 503.598.1960 ateBy:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Jurir: 65 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
si 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)
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
ATIO Site utilities:
Job site address: gel b SL,} )pf t/cI Catch basin or area drain 18.76
/ Drywell,leach line,or trench drain 18.76
City/State/ZIP: pvA Q co 22 3
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: ''
Project 5>PiQUCfi 5� �/1.01-66 s 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
�P�vC� �r V'L( J
Water a or item:
service o.linear ft.: ) Page 2
Subdivision: Iw Lot no.: Fixture or im
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
(PROPERTY OWNER X i. ❑ TENANT Expansion tank 12.51
Name: Amp c N grm5 Fixture/sewer cap 25.02
Address: 5 391 ✓/fcw `-d✓J Floor drain floor sink/hub 25.02
a Garbage disposal 25.02
City/State/ZIP: �II-t, Os k.£6 B Oi"�Q�- 11O 3s Hose bib I 25.02
Phone:(613) c )--in LIG, Fax:( ) Ice maker 12.51
APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
----' Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory i 25.02
City/State/ZIP: Solar units(potable ter) 62.54
Phone:( ) Fax::( ) Tub/show /shower pan 1 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet f 25.02
- Water heater 37.52
Business name: I 1 014, 'i/U/H rll NG--- Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: 5}{f 244)o( f 0 Subtotal
Phone:( ) ''// Fax:( )
Minimum permit fee: $72.50
CCB Lic.: 24'3 T Plumbing Lic.no.: / 'O'Cp7/ Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE /6.-.0,-3-.
Print name: ie Date: �j -tl 0 r This permit application expires if a permit is not obtained within ISO days
��r/�f��-�/V i) after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:I BuildingTennitatPLMU-PermitApp.doc 10/01/09 440-4616T(l0/02/COM/WFB)
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: MIL.
Footing drain-151 100' 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 S stems:
Water Service-each additional 100' 37.52
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
{;
-ter each additional$100.00 or fraction thereof,to
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 Revie• for Plumbin i i 'tallatio
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work.P.c rmed: 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 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"
4
• Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the s ualifications above.
Garbage -Domestic non-food
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
WaterCloset-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\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
8810 SW SPRUCE ST, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00276
David Young
1" Wilkins model 350, serial # A473650
Violation Summary:
Inspector Contractor