Permit (31) MCI, CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2015-00430
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/28/2015
Parcel: 2S102BA01400
Jurisdiction: Tigard
Site address: 9685 SW JOHNSON ST 1
Project: Woodard Apartments Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 54
Project Description: Interior plumbing:Relocating(4)clothes washers,(1)2"floor drain,and(1)water heater.
Contractor: OASIS PLUMBING INC Owner: WESTLAND INVESTMENT CO
11177 S ALLEN CT SYLVAN HOLDINGS LLC
OREGON CITY, OR 97045 LEE,TIM ET AL
10220 SW GREENBURG RD#111
PORTLAND, OR 97223
PHONE: 503-351-0743 PHONE:
FAX: 503-212-0165
FEES
Quantity Description Date Amount
4 ea Clothes Washer 12/28/2015 $100.08
Specifics: 1 ea Floor Drain/Floor Sink/Hub 12/28/2015 $25.02
1 ea Water Heater 12/28/2015 $37.52
Type of Use: MF 1 12%Slate Surcharge- 12/28/2015 $19.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $182.13
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 th rule _ opted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y m obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.
Issued By: nature:
Call 503.639.4175 by 7:00 a.m.for the next available inspe ion date
This permit card shall be kept in a conspicuous place on the job site until comp) on of the project.
Approved plans are required on the job site at the time of eac pection.
Plumbing Permit Application
Building FixturesV10ReceivedFOR OF1710E USE ONLY
City of Tigard \h Date/By: 15-- Permit No.:
a 13125 SW Hall Blvd.,Tigard,W223 I
% Plan Review
Phone: 503.718.2439 Fax: 503.598.19��.% �nit Date/By: Other Permit No.: O`5
Inspection Line: 503.639.4175 O O®� Date Ready/13y: luris: ® Sec Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORo FEE* SCHEDULE
❑ New construction ❑ ton
For special information use checklist.
Descri tion Qty. Ea. I Total
Addition/alteration/replacement ❑Other: New I-2-fanlih,dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
,COA2- ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑ Accessory building �ulti-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: �f �� ��- Catch basin or area drain 18.76
l/� Dtywell,leach line,or trench drain 18.76
City/State/ZIP: TOv,.4 �_� cUu_
Footing drain(no.linear It:_) Page 2
Suite/bldg./apt.no.:(_.CA,)�� oject naanufacturcd]ionic utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear It.:_) Page 2
Stonn sewer(no.linear fi.:_) Page 2
Water service(no.linear It.:_) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
r
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Nance: 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 ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
_
Primer 12.51
Contact name: ��j QC_-"-
Rool'drain(commercial) 12.51
Address: I C-L Sink/basin/lavatory 25.02
City/Slate/ZIP: V �f-, (�_ 9 (7 Solar units(potable water) 62.54
Phone:(� ) - Fax: :( ) Tub/shower/shower pan 12.51
E-mail• Urinal 25.02
Water closet 25.02
CONTRAC OR
Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( )
Minimum permit fee: 572.50
Plan review (25%n of permit fee)
CCB Lic.: ' 6 e%( Plumbing Lic.no.: ktcl
State surcharge(12%of permit Ice)
Authorized signature: / TOTAL PERMIT FEE
me: � Date: This permit application expires if a permit is not obtained within 180 dacs '
Print naClti (2 2�
after it has been accepted as complete.
*I'ee methodology set by lYi-County Building Industry Service Board.
I:\13uilding\Permits\P1-\1U-PennitApp.doc 10101109 440-4616r(1&02/C0M1W1:13)
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- 1 st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100 37.52
Water Service- I st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1 st 100' 62.54 S 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 55,000.00 and S 1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and including 810,000.00.
Inspection of existing plumbing or for 510.001.00 to 525.000.00 5148.50 for the first 510,000.00 and 51.54 for
which no fee is specifically indicated 90.00!111• each additional$100.00 or traction thereof.to
(minimum charge-1/2 hour) and including 525,000.00.
Inspections outside of nornal business 90.00/111 $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 550,000.00.
Additional plan review for revisions 90.00/111' $50,001.00 and up $742.00 for the first 550,000.00 and 51.20 for
(minimum charge-I/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
Ba tisu /Font ❑ Any new commercial building with water service 2`'and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirl pool
Car Wash: -Each Stall El New exterior plumbing site utilities for any complex structure
Drivas defined in OAR918-780-0040.
Cuspidor/Water-Aspirator llu El Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial El Any multipurpose fire sprinkler system.
Domestic El 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: T' f
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 DuniStation
Shower: -Gang
-Stall
Sink: -Lav/Bar non-fbod related
-Bradley
-Com/Sery/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:
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