Permit y n
CITY OF TIGARD PLUMBING PERMIT
II COMMUNITY DEVELOPMENT Permit#: PLM2015-00289
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/01/2015
Parcel: 1 S136AD06100
Jurisdiction: Tigard
Site address: 11419 SW PACIFIC HWY
Project: Buster's BBQ Subdivision: VILLA RIDGE Lot: 2
Project Description: 55 ft.of new sanitary sewer from parking lot to street.
Contractor: ROTO ROOTER SERVICE& PLUMBING CO Owner: SCHOLIBO, GEORGE E JR&
23311 MADERO ST SCHOLIBO, STEPHEN A
MISSION VIEJO, CA 92691 12241 SW TERWILLIGER BLVD
PORTLAND,OR 97219
PHONE: 503-682-9774
PHONE:
FAX: 503-685-9754
FEES
Quantity Description Date Amount
55 If Sanitary Sewer 09/01/2015 $62.54
Specifics: 1 12%State Surcharge- 09/01/2015 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 09/01/2015 $9.96
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 1.800.332.2344.
Issued By: Permittee Signature:
/Py
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
Received n
City of Tigard ��C��v Date/By: 6//11 S"tf T Permit No.: /'/,n�1A,S crap?
itil • 13125 SW Hall Blvd.,Tigard,OR 972 3 Plan Review !! �-i/�ID[
I: Phone: 503.718.2439 Fax: 503.598.1960 SEP Date/By: Other Permit No.:
Inspection Line: 503.639.4175 LP Date Read /B Juris: ® See Page 2 for
TIGARD Ready/By: >
Internet: www.tigard-or.gov `.L�(BD Notified/Method: i� Supplemental Information
TYPE OF WORK C1( t1'4#S1C1 FEE* SCHEDULE
❑New construction ❑ DemblTiiton For special information use checklist.
Description I Qty. I Ea. I Total
A Addition/alteration/replacement I ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ommercial/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.) i Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11 4 IA P P" Ir`"__f N/S01 Catch basin or area drain 18.76
� Drywell,leach line,or trench drain 18.76
City/State/ZIP: 115 W d`�? 4 7 ac,vj Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: ei (- , - Ciq• Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:85A / Page 2 6,2_,Sy
Storm sewer(no.linear ft.:_1 Page 2 /
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
+ Clothes washer 25.02
v/ .iJ�' � W SP t' it /G1 Dishwasher 25.02
I� - -Im> Drinking fountain 25.02
Ejectors/sump 25.02
IR PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: �� -5 ?...) -?(11... Fixture/sewer cap 25.02
Address: q� ( r Floor drain/floor sink/hub 25.02
I ( 141 1 � c_c) fC rll c.A-`/ Garbage disposal 25.02
City/State/ZIP: (:3(.4 j 0a. 1 /old Hose bib 25.02
Phone:( 1 Fax:( ) Ice maker 12.51
cir APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
20 _ n 1 Medical gas(value:$ ) Page 2
Business name: l� e -C
Contact name::5�o a, 6 G� I Primer 12.51
�1 J Roof drain(commercial) 12.51
Address: g( 5j 5 6 L) L 4-1 ed Sink/basin/lavatory 25.02
City/State/ZIP: Gyt`.boiwI I( CA t'10-175 Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
f E-mail: Urinal 25.02
(; CONTRACTOR Water closet 25.02
��11 Water heater 37.52
Business name: 2.A-. - Water piping/DWV 56.29 Zook
Address: ,)isc,5 S st.a Q
oRa.s r, F`-� Other 25.02
9 f-'tr _
City/State/ZIP: W.A,serlW i�,tRi O.2 9 70'1 o Subtotal ,,
Phone:( ) Fax:( ) Minimum permit fee: $72.50 --IA.�
Plan review (25%of permit fee)
CCB Lic.: j ' i Plumbing Lic.no.: _76 P/�
V _ State surcharge(12%of permit fee) y-
Authorized signature: TOTAL PERMIT FEE
Print name:�r, • c'stL. e_ I Date:l!I `>rj This permit application expires ifs permit is not obtained within 180 days
` after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building'Prnnits\PLMU-PermitApp.doc 10,01,09 440-4616T(l0/02/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- I" I00 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
62.54 3,601 to 7,200 $233.20
Sewer-1st 100'
1 ee.),_5---t4 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 Valua Dn• Permit Fee:
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional I00' 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 1/2/2 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 ldded Relocate
❑ Any new commercial building with water service 2"and
Baptistry/Fun i
Bath: -Tub/Shower greater,except systems designed and stamped by licensed
engineer.
-Jacuzzi/Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall
Drive Thru as defined in OAR918-780-0040.
CI Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Commercial CI Any multipurpose fire sprinkler system.
Dishwasher:
Commeic CI 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 RisDiagram
Cl 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
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_Per'mitApp.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
11419 SW PACIFIC HWY, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2015-00289
George Heimos
Violation Summary:
Inspector Contractor