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Permit (10) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00091 Date Issued: 03/16/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 3/16/2 603000 Jurisdiction: Tigard Site address: 9300 SW 74TH AVE Project: Bly Subdivision: BOULEVARD HEIGHTS Lot: 5 Project Description: Replace all plumbing fixtures:(1)dishwasher,(1)expansion tank,(1)ice maker,(1)sink,(2)lays,(1)tub/shower, (1)shower,(2)water closets and(1)water heater. Contractor: GAGLIASSO PLUMBING COMPANY LLC Owner: LEETE, KEISHA D 17182 SE JADE CT 3895 JASMINE DR MILWAUKIE, OR 97267 ALVIN,TX 77511 PHONE: PHONE: 503-866-7073 FAX: 503-659-1455 FEES Quantity Description Date Amount 1 ea Dishwasher 03/16/2017 $25.02 Specifics: 1 ea Expansion Tank 03/16/2017 $12.51 1 ea Ice Maker 03/16/2017 $12.51 Type of Use: SF 1 ea Sink 03/16/2017 $25.02 Class of Work: ALT 2 ea Lavatories 03/16/2017 $50.04 Type of Const: 2 ea Tub/Shower/Shower Pan 03/16/2017 $25.02 Occupancy Grp: 2 ea Water Closet 03/16/2017 $50.04 Stories: 1 ea Water Heater 03/16/2017 $37.52 1 12%State Surcharge- 03/16/2017 $28.52 Plumbing Total $266.20 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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y:r m..y obtain/a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: lel Permittee Signature: ,y '' 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 Building Fixtures 4,,i 4, i 'q. ; , 0 t Folz 0FFICL LSE o11.1 City of Tigard Received / j _ Permit No. ��7,_�© lig13125 SW Hall Blvd.,Tigard,OR 97223 t !: ? Date/By: e /w /7 V g ) I t I Plan Revie 0 Phone: 503.718.2439 Fax: 503.598.196d' ' Date/By: Other Permit No.: TI G A I D Inspection Line: 503.639.4175 y t`+ Date Ready/By: Juris: la See Page 2 for Internet: www.tigard-or.gov , Notified/Method: Supplemental Information .. t,.. . d......r„ .K.a s t 3 t�..d A : ..,, „,.. TYPE OF WORK FEE* SCHEDUE 0 New construction 0 Demolition For special information use checklist. Description I Qty. Ea. I Total N,Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 Al-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 130.0 .5. tO, 7'11:2-4 Catch basin or area drain 18.76 �' l Drywell,leach line,or trench drain 18.76 City/State/ZIP: I �s,4 R,v p(Z6 , '17,q 3Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: 7 yc g 4 7• 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 - 1 Backwater valve 12.51 r DESCRIPTIONOP'' 1tORK '44 \ Clothes washer 25.02 (��j 1�- L14t.7"leA /41-1_, Rx-rti1-r:7 (PLOYvt. t"14) Dishwasher ( 25.02 ac..02 _ '` � WM Drinking fountain 25.02 Ejectors/sump 25.02 �PROPERTY OR »1.� Expansion tank r 12.51 TENANTf 12 S Name: Kg,i, )-4 . t.y Fixture/sewer cap 25.02 � ' � ! Floor drain/floor sink/hub 25.02 Address: 300 ,110 `- Garbage disposal 25.02 City/State/ZIP: -176412? )d'{Z, 11 X,z3 Hose bib 25.02 Phone (a.Z 5� $L q�-- Fax:( j Ice maker _ / 12.51 wiX fl :4 7 a 4I'PLICANT ❑`',ONTACT Pgit*Ar` Interceptor/grease trap 25.02 Business name: L I C-0, L L e---- Medical gas(value:$ ) Page 2 L 11q�J0 Primer 12.51 Contact name: (:: ,4 1.114-4i42, (commercial)Roof drain com��m__ercial 12.51 Address: iii ex. dj - C* GT r Smk/basin/lav ry 3 25.02 /6: City/State/ZIP: Y•`)L q-t Jl<c - , e>12_.. . 111E107 Solar its(potable water)` 62.54 Phone:(0033)g 6212,..-7073 Fax::(spa) 4,r�7.(.-1 Li 4;-6- Tub shower/shower pan S 42 12.51 as- E-mail:.t�'g.TL`0•I PI-Or ,fE� pg ;.� . .NO,t L t �-/1/\ Urinal 25.02 _-! -C,5, Water closet 2.., 25.02 5-©(9.2_{ CONTRACTOR 1 Water heater 1 37.52 3/ 1.3- Business � Business name: y&LI/j.Lf�� L11Y s ti46. C . /i-t4'i .I..LL Water piping/DWV 56.29 Address: l--716. 5,,m , s-p4-'t - GT-t Other: 25.02 City/State/ZIP: M1 Lt0l4.I,K 1 F.- ekt,, 9 /2107 Subtotal a58 Phone:(4-613)8(9(Q-70-I.?) / Fax:(,2,3)(pcl- �y 5S' Minimum permit fee: $72.50 Plan review (25%of permit fee) CCB Lic.: < PlumbingLic.no.: State surcharge(12%of permit fee p`8 ao�gc�-r ��/� /- i Yd Authorized signatur �/ //, TOTAL PERMIT F o2(2,(D 3.11 Print name: /,/ / Date: (53/4//1 This permit application expires if a permit is not obtained thin 180 days r,f 4 after it has been accepted as complete. iil *Fee methodology set by Tri-County Building Industry Service Boar 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-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 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 Other Inspections or Fees qty• Fee; a) Total each additional$100.00 or fraction thereof,to 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 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*. Plan Review for Plumbing Installations Quantity ty'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 -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic 0 Any 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 Diagram 4 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. 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 Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9300 SW 74TH AVE, TIGARD, OR, 97223 Record Type: Record ID: Residential - Plumbing PLM2017-00091 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Corrections complete, plumbing final - approved Violation Summary: Inspector Contractor