Permit (43) IN
CITY OF TIGARD PLUMBING PERMIT
' COMMUNITY DEVELOPMENT Permit#: PLM2016 00513
Tf c,-,mz,D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2016
Parcel: 2S 110BC07500
Jurisdiction: Tigard
Site address: 12360 SW ASPEN RIDGE DR
Project: CANTRELL Subdivision: THORNWOOD Lot: 46
Project Description: Kitchen remodel completed without permits by previous owner. Investigative fee assessed for final inspection.
Contractor: OWNER Owner: CANTRELL, DONALD P&DENISE L
DONALD&DENISE CANTRELL 12360 SW ASPEN RIDGE DR
12360 SW ASPEN RIDGE DRIVE TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-298-9630 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Investigation Fee 10/13/2016 $90.00
Specifics: 1 ea Investigation 12%State 10/13/2016 $10.80
Surcharge
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $100.80
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 que 'oas . OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: / / Permittee Signature:
irluoilli
Call 503.639.4175 by 7:00 a.m.for the next available in ection 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 FOR OFFICE LSI. ONLI
City of Tigard 4 ; , ;ived
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 aate/By: Ai ii
/l�J Qf,,,.�j�)1 J�I
= Phone: 503.718.2439 Fax: 503.598.1960 Plan Revie / 1 w"'�
Date/By: Other Permit
' No.:V/L)01(p,..V yvInspection Line: 503 639.4175 ( C. fi 2 t ( Date Read/By' Jrs: See Page forTIGARD Internet: www.tigard-or.gov
Notified/Method: 7,PC> Supplemental
Information
TYPE OF WORK 1T a ` t�.A1R�) FEE* SCHEDULE
❑New construction 0 l i(9tdn , s For special information use checklist
-'`. Description
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes Qty• eaEa. Total
100 ft.for ch utilityconnection)
CATEGORY OF CONS RUCTION SFR(1)bath 312.70
c ti
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building ElMulti-familySFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND L1CATION Site utilities:
Job site address: j �, G; Aa Catch basin or area drain 18.76
/ Til47C)
City/State/ZIP: t ✓�1 C.).. --
-� �jy.�j -! Drywell,leach line,or trench drain 18.76
{-� t` . ._...a.,.
_` ) 'L Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project/name: :.--t..-t -� t 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.:_) 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
Backwater valve 12.51
,s RII T(QN 91: W9t :;
Cl
e. ` Clothes washer 25.02
+-L.-
14
�/�� `-'� ci Dishwasher 25.02
- 1(C9? / 1dyi- rA) V'C 'l &v- ✓� !j/,/ nking fountain 25.02
- 6(,k"f/®® Vr Vis. Ejectors/sump 25.02
0 PROPERTY 0 I R ,so (;TENANT Expansion tank 12.51
Name: �c%'Sit t Fixture/sewer cap 25.02
- Floor drain/floor sink/hub 25.02
Address: --2___-- /e„,-,2 ,9,,, ..., 7,, H"��' Garbage disposal 25.02
City/State/ZIP: f /
I`� -tel c+� �%`'(2___ / ?Z �� Hose bib 25.02
Phone:(,.;:irJ) 2 _ 7c 1p Fax:( ) Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON .• Interceptor/grease trap 25.02
Business name: ��� Medical gas(value:$ ) Page 2
5c01Q 4'4- R6t<S
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
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:
)•t,'l�ir- Water piping/DWV 56.29
Address:
Other: 25.02
City/State/ZIP: Subtotal YC)1-
Minimum permit fee: $72.50
Phone:( ) Fax:( )
Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.:
State surcharge(12%of permit fee) 44/0
Authorized signature: L .- - "-
e TOTAL PERMIT FEE 0/at
t A t--ve. l Date:i p..(( . This permit application expires if a permit is not obtained within 180 days
Print name: t
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:
Qty. Fee(ea) Total Square Footage: Permit Fee:
Site Utilities 9 g '
Footing drain-1"100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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. Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees 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.
$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
Additional plan review for revisions 90.00/hr
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
Quautity 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 ❑ 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 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 OAR918-780-004 .
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2>'
-3" Isometric or Riser,Diagram 5,,. 4
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./Refrig.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:
1:\Building\Permits\PLMFPermitApp.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
12360 SW ASPEN RIDGE DR, TIGARD, OR,
97224
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00513
Don Sylvester
Violation Summary:
Inspector Contractor