Permit (10) IiiiCITY OF TIGARD PLUMBING PERMIT
fC '' COMMUNITY DEVELOPMENT Permit#: PLM2016-00379
TR ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2016
Parcel: 2S103DC01400
Jurisdiction: Tigard
Site address: 11460 SW VIEWMOUNT LN
Project: Novelo Subdivision: VIEWMOUNT Lot: 2
Project Description: Replacing 7 water closets,(7)lavatories,(1)kitchen sink,and(2)shower valves.
Contractor: DOUBLE A PLUMBING LLC Owner: VICTOR&MYLENE NOVELO
4630 SE 75TH AVE 23831 139TH PL SE
PORTLAND, OR 97206 KENT,WA 98042
PHONE: 503-833-2764 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Sink 07/14/2016 $25.02
Specifics: 7 ea Lavatories 07/14/2016 $175.14
2 ea Tub/Shower/Shower Pan 07/14/2016 $25.02
Type of Use: SF 7 ea Water Closet 07/14/2016 $175.14
Class of Work: ALT 1 12%State Surcharge- 07/14/2016 $48.04
Type of Const: Plumbing
Occupancy Grp: 1 ea Investigation Fee 07/14/2016 $90.00
Stories: 1 ea Investigation 12%State 07/14/2016 $10.80
Surcharge
Total $549.16
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: - - ature:
.,_
_....
Call 503.639.4175 by 7:00 a.m.for the next available in .p ion 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
City of Tigard RDate/Beceived /' Permit No.: ,
III li 13125 SW Hall Blvd.,Tigard,O7223 y pN' )16,....700•37q
6 0'3 7q
_ R`9Plan Review
Phone: 503.718.2439 Fax 503.598.1960 t. Date/By: Other Permit No.:/ilrL p``t(0,,,.abet/
Inspection Line: 503.639.4175 ;`•` Y
T I G A R U Date Ready/By: Jmis: H See Page 2 for
Internet: www.tigard-or.gov ." .., Notified/Method: -pry
/cs�,.s Supplemental Information
TYPE OF WORK 10 It 3 I,1'C t' s � Fhb* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description I Qty. Ea. I Total
p Addition/alteration/replacement (:,Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
IDAccessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder El Other:c.�� % 1. rry,e
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION -: - Site utilities:
W-u
Job site address: iCatch basin or area drain 18.76
i U Sw V. E u_...,fYlu1l un C Drywell,leach line,or trench drain 18.76
City/State/ZIP: -i-, c\.(X4,2
1 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I 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.:_) Page 2
Storm 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
r ' Backwater valve 12.5114 D IONOEWO 1
''. Clothes washer 25.02
4Ciet, 1 AC%\bit`) 1 ((. AC(C 1-- '\u,ok.c ,,,t`) ,Yr t(tt,k- Dishwasher 25.02
kNk-C..VAL( 5•.-1t-< i ri e(ut� Z.5r),.,,u.SE:( a)Ltl,kS Drinking fountain 25.02
Ejectors/sump 25.02
C] PROPERTY O` RTOOT' -4:rExpansion tank 12.51
Name: S j A ) 1 i\-00-V ( c,.0 Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
( 1 L1 0 <w U,c t,�,t1 .4i n k tt.t Ylb Garbage disposal 25.02
City/State/ZIP: "t, ,.�,X1 (3Q--- Hose bib 25.02
Phone:(5':)) 72 1 .- }-69 15 Fax:( ) Ice maker 12.51
iilAPPIxI CANT , Q 6NTACT PI soN i Interceptor/grease trap 25.02
Business name: A i Medical gas(value:$ ) Page 2
J Primer 12.51
Contact name: c9-uaACiS(' ) 1. (r ct Y u
Roof drain(commercial) 12.51
Address: L-1(„' ;� S G 7 S 4 h 6,U ' Sink/basin/lavatory < 25.02 ?IX).i y
City/State/ZIP: f c,I‘., 0(2 . C1 4 ZC-( Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 2 12.51 425. OA
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02 %.75;/1
Water heater 37.52
Business name:to L2\01(ti, 4 QL „n hi,-, LI.( Water piping/DWV 56.29
Address: LI(„,..z,„: `a 1.51 6 J I-E; Other: 25.02
City/State/ZIP: f of 4 , • lL cl '1 Z 0(.) Subtotal L/jd.32,
Phone:(5 ) I%,51iFax:( ) 1/7 Minimum permit fee: $72.50
CCB Lic.: 2J Cl H 5 5 ) C� Plumbing Lic.no �•-O ')/ Plan review (25%of permit fee)
(, j State surcharge(12%of permit fee) 1-1.t, (1:1;
Authorized signature: 1 ��I /' , > ] TOTAL PERMIT FEE Lill '.
Print name: �' .5 /tIsO�j Date: 7 j H /i !_ This permit application expires if a permit is not obtained within 180 days
(ti{n c v ! �l Y U t ►/ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
�10 "I.\Buldin\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 Suppression Systems:
,Site Utilities> Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-l'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 Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
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
Fee Total each additional$100.00 or fraction thereof,to
Other Inspections r Fees •. Qty ) 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 how) 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
0 Any new commercial building with water service 2"
and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thin
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
CW
C -Commercial
al El Any multipurpose fire sprinkler system.
Dishwasher:
Domestic EIAny 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 Riser Diagrams
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
that meet the qualifications 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: -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 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
11460 SW VIEWMOUNT LN, TIGARD, OR,
97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00379
Don Sylvester
Approved with correction , hot and cold water crossed on pedestal lav.
All other corrections complete
Violation Summary:
Inspector Contractor