Permit u CITY OF TIGARD 3 PLUMBING PERMIT
:F. ''• COMMUNITY DEVELOPMENT Permit#: PLM2016-00149
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2016
TIGARD Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: None Lot: None
Project Description: Replace 50'of sanitary sewer line on west side of main building.3/23/16:Reprinted permit to include 80 ft.of
sanitary sewer.
Contractor: S&S SEARS INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
PO BOX 446 6960 SW SANDBURG ST
GLADSTONE, OR 97027 TIGARD, OR 97223
PHONE: 503-650-8200 PHONE:
FAX: 5023-650-8203
FEES
Quantity Description Date Amount
130 If Sanitary Sewer 03/23/2016 $100.06
Specifics: 1 12%State Surcharge- 03/23/2016 $12.01
Plumbing
Type of Use: COM
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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. Y. ay obtain/ copy of ti- ules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 092....... _ Permittee Signature:
..i_A doeivi01.11...r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. 1
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 \liSk
Building Fixtures ch�j
City of TigardW \CO Date/Bya 3 i� �� Permit No.:pi tja0`/,..,/t0h9
il 13125 SW Hall Blvd.,Tigard,OR 97223 D J l- '� ( xv v�.l I
i Plan Review
Phone: 503.718.2439 Fax: 503.598.1�t Date/By: Other Permit No.:
Inspection Line: 503.639.4175 \�`t\\ V�� IS Date Read /B )oris: ® See Page 2 for
I
Ic AI I) �� ���� Y y S
Internet: www ttgard or gov gi Notified/Method: Supplemental Information
.. .�.�4 . P�4F WOR ' FEE*1��lILE
�❑New construction tolition
For special information use checklist
Description Qty. I Ea. I Total
0ldition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
P Y ±4F`Ctlt f 'IbN
SFR(1)bath 312.70
ElI-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
(1d� �, Catch basin or area drain 18.76
Job site address: ``-'��
City/State/ZIP: �e �21-
-
9 Drywell,leach line,or trench drain 18.76
L� Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.8O) I Page 2
Stonn sewer(no.linear ft.:_) 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
C
5,4;f ! �''� L. Dishwasher 25.02
SC'r9"' Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER ❑ 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 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:S ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
..c - Water closet 25.02
^": ri `RAC'I OR
Water heater 37.52
Business name:5 4.- �"e__ Water piping/DWV 56.29
Address: pFos Other: 25.02
City/State/ZIP 6 , �� ? 7 Z 7 Subtotal
` Minimum permit fee: $72.50
Phone:( ) 65z), --e Fax:( )472.13 �
Plan review (25%of permit fee)
n
CCB Lic.: /503 Plumbing Lic.no.:/ 13
State surcharge(12%of permit fee) ,
Authorized signature: v(W. '�
TOTAL PERMIT FEE 66 vC/
Print name: f t� � Date: L,-/(� This permit application expires if a permit is not obtained withi 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:Building Permits.PLMU-PermitApp.doe 1001 09 440-46161(10 02 COM WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site illitles Qty. Fee tea) Total S afire +�otage: Permit Fees
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' may 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
$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 Qr Fees Qty. re04) Tiotat and incadluding
10,$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 nonnal 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 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
Baptistry/Font
0 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 I=1 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"
Isometric or Riser Diagram
4'
0 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:
1:ABuilding\Permits\PLMF_PennitApp.doc 08/04/2011 2
w CITY OF TIGARD PLUMBING PERMIT
to COMMUNITY DEVELOPMENT Permit#: PLM2016-00149
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/21/2016
Parcel: 2S 114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: None Lot: None
Project Description: Replace 50'of sanitary sewer line on west side of main building.
Contractor: S&S SEARS INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT
PO BOX 446 6960 SW SANDBURG ST
GLADSTONE, OR 97027 TIGARD, OR 97223
PHONE: 503-650-8200 PHONE:
FAX: 5023-650-8203
FEES
Quantity Description Date Amount
50 If Sanitary Sewer 03/21/2016 $62.54
Specifics: 1 12%State Surcharge- 03/21/2016 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 03/21/2016 $9.96
Plumbing
Class of Work: OTR
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: ; ;;Izire.5,..4c......., Permittee Signature:
/ora
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 Applicatio JECEI i'Efl
Building Fixtures Folz orrl( 1.. 1 SE oyI.v
City of Tigard MAR 21 2016 Received PermitNo.•
Date/By:.jot/��e ��D.' Z.,-/A0 , eery.
Ili 13125 SW Hall Blvd.,Tigard,OR 97 ,lig ��1�r ���1d =`Y
PlanDate/By:503.718.2439 Fax: 503.59 0 1 I ARD Other Permit No.:
Inspection Line: 503.639.4175 BUILDING DIVISION Date Read /B luris: ® See Page 2 for
I l l 1> Internet www.tigard-or.gov Ready/By:
Notified/Method: Supplemental Information
fiIlPE OF WORK FEES: 1DtJ� ` ' r
❑New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
&ddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
i- 4 , -CATEGORY OF CONsrRUCTION " SFR(l)bath 312.70
0 1-and 2-family dwelling [commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: `'j t�/
(�OO /� .Y h - Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: /Jer 7...."1._
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: Manufactured home utilities 50.03
Cross street/directions t,iiicAo job ite: Manholes 18.76��,
t 5 c n�
Rain drain connector 18.76
n/ Sanitary sewer(no.linear ft.: r / Page 2 6 Zt
�J :./..1." �'t� C 174-I� LL "� Storm sewer(no.linear ft.:_) Page 2
�Jy �- ACC C e._ '5 e 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
��tiC1577 061 `�-- ; <-,---C.4-- ...<-,---C.4-- ... DDishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER I 0 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 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Contact name: Primer 12.51
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
; te .2 TACTOR
Water heater 37.52
Business name: -.06-..:_` _, A. .4 `�,- ' ater i in DWV 56.29
' PP ��
Address: Pe4517 Other: 25.02
City/State/ZIP: v'\ 9 70 Z 7 Subtotal
Phone:( )to,5-7) .- j Ldz..2 Fax:( )( $20 3 Minimum permit fee: $72.50 2�s -5s0
CCB Lic.: 1 5-
6 3 Plumbing Lic.no.�B/3 7 Plan review (25%of permit fee)
��� State surcharge(12%of permit fee) P.,70
Authorized signature: TOTAL PERMIT FEE ftPrint name: S�Z„ .t2 5_4„,...7_ Ls Date: 3 -g r- This permit application expires if a permit is not obtained within 180 days
YYYY after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1 Building Permits PLMU-PermitApp.doc 100109 440-4616T(1002COM 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' LL!!2
i 62.54 /„ ,C7 C/ 7,201 and greater $327.54
Sewer-each additional 100' 37.52 t�
Water Service- I st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 ' ""' "' 'er 'itFee�
$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 Qt3' Fe"") T 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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
Baptistry/Font 0 Any new commercial building with water service 2-and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
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 0 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-
Isometric or Riser Diagram
4
0 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/Scry/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:
1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2