Permit (63) CITY OF TIGARD PLUMBING PERMIT
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I COMMUNITY DEVELOPMENT Permit#: PLM2016-00236
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/27/2016
TIG.h I?I) g Parcel: 2S104AC10900
Jurisdiction: Tigard
Site address: 13320 SW WALNUT ST
Project: Walnut Ridge Subdivision: HANDY ACRES Lot: 34
Project Description: Installing(500)ft.of water service to future lots 8,9,and 10. Installing(100)ft.of storm sewer to future lot 1.
Contractor: H&H MECHANICAL Owner: ZECHMANN, BARBARA JUNE&TERRY L
5757 SE WILLOW LN LEARY, KATHLEEN JOAN
MILWAUKIE, OR 97267 LEARY, KATHLEEN J&DAVID L
13320 SW WALNUT ST
TIGARD, OR 97224
PHONE: 503-975-9787 PHONE:
FAX: 503-659-2979
FEES
Quantity Description Date Amount
100 If Storm Sewer 04/27/2016 $62.54
Specifics: 500 If Water Service 04/27/2016 $212.62
1 12%State Surcharge- 04/27/2016 $33.02
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $308.18
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 require , follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OA'`.1• 090. may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.3 44. ��
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection da
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
Site Utilities; ,,,W 1 V
City of Tigard V44-;
' Received `_ „ jL Permit No.: in /r,�az �/�
ill 13125 SW Hall Blvd.,Tigard,OR 9 Date/By. 6� pin l/lA^3Vi
Il `_ Plan Review E
Phone: 503.718.2439 Fax: 503.598.1960 q 2�1u Other Permit No.: 5/4812,0 I y- ])//
D Date/By:
1t 1 Inspection Line: 503.639.4175 PQ� kkV11 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov ,'t 1b 4,tified/Method: Le Supplemental Information
k, * A
®New construction ❑D r a i r �s For s ecial information use checklist
�� Description Qty. Ea. Total
0 Addition/alteration/replacement ❑0 er: New 1-2-family dwellings(includes 100 ft.for each utility connection)
SFR(1)bath 312.70
® m
1-and 2-family dwelling 0 Comercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
0 Accessory 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
' .. t.� fir, c •
, � Site utilities:
Job site address: '•�'i'.,W Walnut Street Catch basin or area drain 18.76
City/State/ZIP:Tigard OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Walnut Ridge i Manufactured home utilities 50.03
Cross street/directions to job site:SW 133rd Terrace Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:r ) / Page 2 (Al
Water service(no.linear ft.SeSki S, Page 2 (20,1n
Subdivision:SUB2014-00011 Walnut Ridge 1 Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:2S104AC10900
s �+ � _, Backwater valve 12.51
Clothes washer 25.02
Installing water service stubs to future lots 8,9 and 10. Installing storm
Dishwasher 25.02
stub to future lot 1. Drinking fountain 25.02
Ejectors/sump 25.02
@,,�; , .� , Expansion tank 12.51
I Name:*Riverside Homes LLC Fixture/sewer cap 25.02
Address:17933 NW Evergreen Parkway,Suite 370 Floor gedroor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Beaverton OR 97006 Hose bib 25.02
Phone:(503)645-0986 Fax:( ) Ice maker 12.51
,iti- .--4 � , - , 1 xb , t-,,:.%:>r i ;_ Interceptor/grease trap 25.02
Business name:Riverside Homes LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Niki Munson
Roof drain(commercial) 12.51
Address:17933 NW Evergreen Parkway,Suite 370
Sink/basin/lavatory 25.02
City/State/ZIP:Beaverton OR 97006 Solar units(potable water) 62.54
Phone:(503)645-0986 I Fax::( ) Tub/shower/shower pan 12.51
E-mail:nmunson@riversidehome.com Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name:H&H Mechanical Water piping/DWV 56.29
Address:5757 SE Willow Lane Other: 25.02
City/State/ZIP:Milwaukie OR 97267 Subtotal y, /(v
Phone:(503)975-9787 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:178122 Plumbing Lic.no.:PB414 Plan review (25%of permit fee) , J
State surcharge(12%of permit fee) ,j•U)-
Authorized signature: TOTAL PERMIT FEE _ r l D
Print name:Niki Munson Date:4/27/16 This permit application expires if a permit is not obtained wi in 1 days
- after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su• a ression S stems:
Footing drain-1st 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 i eater $327.54
Sewer-each additional 100' 37.52
.8•
Water Service-1st 100' y�i r
��� 62.54 cps, dical Gas S stems:
Water Service-each additional 100' V.41 37.52 `�1� 15pi ;
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
each additional$100.00 or fraction thereof,to
'`, , - _ s.• ";<< 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 char:e-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 char:e-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 char:e 1/2 hour) each additional$100.00 or fraction thereof.
Subtotal: -DM •
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 is required for any of the following.
Baptistry/Font ,
r•vota mato " " `" Please check all that apply.
Bath Tub/Shower
0 Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain s _ ` ` ,_ ,: X..»..1 4.1,..`. 4.1k �,
Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the •ualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\nmunson\Downloads\PLMU_PermitApp(1).doc 2
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Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. Er map&tax lot# S project name 41.site addresssuite number
[/r zoning ('applicant name 9.phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS-Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size, type of material, slope of piping, manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
1:\Building\Pennits\PLMF-PermitApp.doc 12/30/05