Permit (77) INCITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016 00520
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/17/2016
Parcel: 1 S 134AC00600
Jurisdiction: Tigard
Site address: 11396 SW IRONWOOD LP
Project: MacDonald Subdivision: ENGLEWOOD Lot: 34
Project Description: Plumbing for master bedroom/bathroom addition: 100 ft.of rain drains,(1)backwater valve,(2)hose bibs,(2)
sinks,(2)tub/showers,and(1)water closet.
Contractor: CLASSIC PLUMBING LLC Owner: MACDONALD, JONI C
521 S BALINE ST 11396 SW IRONWOOD LOOP
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503-554-1605 PHONE: 503-260-6039
FAX: 503-538-8570
FEES
Quantity Description Date Amount
100 If Storm Sewer 10/17/2016 $62.54
Specifics: 1 ea Backwater Valve 10/17/2016 $12.51
2 ea Hose Bib 10/17/2016 $50.04
Type of Use: SF 2 ea Sink 10/17/2016 $50.04
Class of Work: ALT 2 ea Tub/Shower/Shower Pan 10/17/2016 $25.02
Type of Const: 1 ea Water Closet 10/17/2016 $25.02
Occupancy Grp: 1 12%State Surcharge- 10/17/2016 $27.02
Stories: Plumbing
Total $252.19
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: Permittee Signature: j �_—_
N
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 Application
wilding Fixtures FOR OFFICE USE ONLY
City of Tigard Received
13125 S W Hall Blvd.,Tigard,OR 97 Date/By: �L� /7 • *r..-
4* Permit No.: p _rl,t5-y_,
r Phone: 503.718.2439 Fax: 503.598. 0 PLOD Plan Review Ste✓ _1�J
U DateB Other Permit No.:
TIGARD Inspection Line: 503 639 4175 �� yNDate y /��� L'C)� '
Internet: www.tigard-or.gov ��c,� �'Nonfied/Met od
ady/By: Juns See Page 2 for
i o ,� �r r'::),,1",,,,
py°_� Supplemental Information
���t,� t�:='" a, E a ti ya -�.;-. iti �� s � �V i 4 ',.0„,", ,1'�Lx ro 4 ,_. �I � yi4
❑New construction 0 De 'i 1 olOci If For special information use checklist.
EKr / Description J Qty. Ea. 1 Total
ttton/alteration/replacement 0 Ott/ New 1-2-family dwellings(includes 100 ft.for each utility connection)
m� , �_r4 . a0 g? ,t , ,a ' - ;f SFR 1 bath 312.70
C -and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other.
si �J Fire sprinkler( sq.ft.) Page 2
i,Trio�` - ;:':',1,7,t; '� ,7 ` ` "tom er '-� „.f
�_ f... t ! i ' �7,�01 �� Site utilities:
Job site address: i 1'7�r-i'(� S 1 t2,Jr.i,AJQtj1 p Catch basin or area drain 18.76
City/State/ZIP: e47 i (� tz "in-7 Drywell,leach line,or trench drain 18.76
_�� v Footing drain(no.linear ft.: ) Pae 2
Suite/bldg./apt.no.: I Project name: /Yi/. tC _ g
r Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_J Page 2
Storm sewer(no.linear ft.: '00) i Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
�� � -,k141 ,-.' i� ' `. „ ` i, . * Backwater valve
a a...«' .ia r, � r r 1 12.51 I'Z _Si
OG1�� it `d `` Clothes washer 25.02
A b 7t i ice Dishwasher
25.02
Drinking fountain 25.02
Ejectors/sump 25.02
L,roj , ` t wf +. r '� tank
Expansion 12.51s } ` r � , Fixture/sewer cap 25.02Name: ...---- 1,...---- 1,4ANA ACl t--0
Address: it 3ei� i i7�„4 vYe.aD t, Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: 1�extz,i) t C: 12-- �,e� �` �
'T
Hose bib 1L. 25.02 25.02 .`*
Phone:
( ) 2G.G Fax ( ) Ice maker 12.51
n
ii*kti , ,r, ,+ ;. 6 6, o + ,, r( n;;;,..,4p Interceptor/grease trap 25.02
Business name: tei
-112..10 2_ vls�SS Medical gas(value:$ ) Page 2
Contact name: S 0.1›.-/ g C .vet=1Z Primer 12.51
Roof drain(commercial) 12.51
Address: 1-1 i-r S ik..1 13 f A4 L
Sink/basin/lavatory Z-- 25.02 So-GSI
City/State/ZIP: ‘74,.n• t (e i1 ZZ
4 Solar units(potable water) 62.54
Phone:(5<_,3) 141 3_..S 2.3 1 Fax::( a.3) `, _s85(� Tub/shower/shower pan 7__ 12.51j e)---_,�cry ra 1�JTCR�tZiZESi 15►tsk�S,C�►v, Urinal 25.02
ice_ ,y, or,Fir C 1 a � a k Water closet
= = t , s *_r � ; ,, ' 25.02 Z�_�+Z
5r 1 Water heater 37.52
Business name: c_...\a., 1/4..._ Vj
\�� Water piping/DWV 56.29
Address: c
7 \ - \�\Cyr' , \ Other:
� 25.02
City/State/ZIP: ` \�'>.�.J '1 S.
Subtotal
:.\
Phone: ` l S5�--\�� Fax:( 5 . ..,_5 Minimum permit fee: $72.50
CCB Lie.: \C\.2:(�(v Plumbing Lic.no.:---\--)-,7,
-� Plan review (25%of permit fee) J
\ \\,,, State surcharge(12%of permit fee) (,I,
Authorized signature: Z �.
`2,) ,'._ __ci, TOTAL PERMIT FEjPrint name: � 1 Is 0 1 /x � ate: \� This permit application expires if a permit is not obtained within 18 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(l0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
.. Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sup ression S stems:
r 0 _,�9 G'�, j j '� , ® t,,tm
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
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
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
Storm&Rain Drain-1st 100' i 62.54 tea-Sq k
Storm&Ram Drain each additional 100' 37.52 $1.00 to$5,000 00 Minimum fee$72.50
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Ve i ,, i; 1 each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
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 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*.
p i� i Qu n t�1iy FiXtu Tyj e , ' fi 7 g- . +,m:
')Fl tRliet�e a l�� 5 t {i $p� '``= ' r- j 1,.,J 1, I ,1 .0L‘, ,!..,_,,,,,,11.,,,,% 1 x -.. i
York I'ee 7rmed ,sem; k a1tp Ad 01 s Plan review is required for any of the following.
Baptistry/Font 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.
-4"
Car Wash Drain 6 w��t >l r 1,_, - i i
Garbage -Domestic-non-food Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications 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
Washer-Clothes *Note: If the fixture work under this permit results in an
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:
Macintosh HD:Users:Jody:Downloads:PLMF_PermitApp.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11396 SW IRONWOOD LOOP, TIGARD, OR, April 27, 2017 at 9:16:33 AM
97223
Record Type: Record ID:
Residential - Plumbing PLM2016-00520
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Stoppers at lays need adjusting.
Violation Summary:
Inspector Contractor