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Permit CITY OF TIGARD PLUMBING PERMIT 2 ' .' COMMUNITY DEVELOPMENT Permit#: PLM2016-00458 ;llTIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/29/2016 Parcel: 2S 104 BC07900 Jurisdiction: Tigard Site address: 14125 SW MITCHELL CT Project: HINDMAN Subdivision: HILLSHIRE CREST Lot: 1 Project Description: Kitchen renovation. Move sink and install ice maker. Contractor: TRUE BLUE PLUMBING LLC Owner: HINDMAN, GAVIN D 3300 NW 185TH AVE#311 14125 SW MITCHELL CT PORTLAND, OR 97229 TIGARD, OR 97223 PHONE: 503-747-9989 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Ice Maker 08/29/2016 $12.51 Specifics: 1 ea Sink 08/29/2016 $25.02 Type of Use: SF 1 12%State Surcharge- 08/29/2016 $8.70 Plumbing Class of Work: ALT 35 ea Minimum Fee Adjustment- 08/29/2016 $34.97 Type of Const: Plumbing 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 t+, Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You obtain a copy of the rules or 'rect questions to'UNC b ..fling 503.232.1987 or 1.800.332.2344. sued By: $ ,�� Permittee Signature: 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 completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Appli Building Fixtures q FOR OFFICE CSE ()NL) City of Tigard 4;22 Received (/ / LO a.0/ �c15► 111 13125 SW Hall Blvd.,Tigard,0 IN it4c)224 >i Date/By: } a� �� ) Permit No.: i /� _ Phone: 503.718.2439 Fax 50..3, D 598 196Q_ an Review t 7rj 6�ll0�d3 / : Date/By: Other Permit No.: t T I G A R D Inspectionspection Line: 503.639.4k°75( Y ' Date Read/B Internet: www.tigard-or.gq� r„ .a -, r, Ready/By: Juris: Supplemental See Page 2 Informationnr ° ,/.,� Notified/Method: "4lf>,$ta h"I-101k/rt/ ,. TYP > Oltx FEE* EcHEDviLE ' 0 New construction 0 Demolition For special information use checklist Descri.tion Q . Ea. Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ;.. CATE,,GORY OF CONSTRUC'T'ION SFR(1)bath 312.70 [)11-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE,INFORMATION ,1NB LOCATION Site utilities: Job site address: I q 1 'i L' S Ait`IL-614e 1 f C i. Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: "'r Jac-A 0K ,-7 ZZ Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 1 Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION O y1' Rh Backwater valve 12.51 Mode, klt`�C�neCs1 'tG� Clothes washer 25.02 � Dishwasher 25.02 ( N Cl"?1` .66 (e r Drinking fountain 25.02 Ejectors/sump 25.02 0 PROJ',ERTy OWNER ,.x x Expansion tank ��_. *� 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax: ( ) Ice maker 12.51 ❑'APPLICANT J] CO,N`�ACT PERSON Interceptor/grease trap 25.02 Business name: �`, ( T> � f % Medical gas(value:$ ) Page 2 J> !� �/ Contact name: c-1 RoofdPrimer 12.51 3�a�� drain(commercial) 12.51 Address: ©© /U j Ave. Sink/basin/lavatory / 25.02 City/State/ZIP: �of-1--H?ilk 0 . -7.2' _ 3 Solar units(potable water) 62.54 Phone:( )3) 7ct 7 -99-K9- Fax::( ) Tub/shower/shower pan 12.51 E-mail: 7 Urinal 25.02 CONTRACTOR Water closet 25.02 Business name: ,„� Water heater 37.52 ,,n Water piping/DWV 56.29 Address: P/"1Other 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 .. ) CCB Lic.: l ,7<�90 . umbing Lic.no.: ? b 1 Z � Plan review (25%of permit fee) /�- State surcharge(12%of permit fee) 70 Authorized signature: -�g//_ cam+. TOTAL PERMIT FEE ,f1.) r5 Print name: '3/ coyi C i,/ Date: - 9,16 This permit application expires if a 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\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-151 100' 50.03 0 to 2,000 $121.90 37.52 2,001 to 3,600 $169.69 Footing drain-each additional 100' 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 Qty. a Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections'or,Feesand 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 . . flan iew fur 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: ❑ buildingAny new Capped Added Relocate new commercial with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" , 3>, ISQTnetrie oI Riser Diagram 4" 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 Comments regarding fixture work: Ice Mach./Ref ig.Drains 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 plumbing permit can be issued. Water Closet-Toilet 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 14125 SW MITCHELL CT, TIGARD, OR, 97223 Residential - Plumbing 399 Plumbing ﬁnal PASS - No C of O PLM2016-00458 Don Sylvester Violation Summary: Inspector Contractor