Permit (9) CITY OF TIGARD PLUMBING PERMIT
111
COMMUNITY DEVELOPMENT Permit#: PLM2017-00217
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 06/06/2017
TEttft.0 9
Parcel: 2S 111 DA 18900
Jurisdiction: Tigard
Site address: 8705 SW SCHMIDT LOOP
Project: Heritage Crossing, Lot 8 Subdivision: HERITAGE CROSSING Lot: 8
Project Description: Installation of residential backflow preventer for irrigation
Contractor: TRADEMARK LANDSCAPES INC Owner: DR HORTON INC-PORTLAND
PO BOX 2410 4380 SW MACADAM AVE STE 100
OREGON CITY, OR 97006 PORTLAND, OR 97239
PHONE: 503-631-3893 PHONE: 503-222-4151
FAX: 503-631-4737
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 06/06/2017 $31.27
Specifics: 1 12%State Surcharge- 06/06/2017 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 06/06/2017 $41.23
Class of Work: OTR Plumbing
Type of Const:
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 Notifi - 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 din- questions to •.NC b -ling 503.232.1987 or 1.800.332.2344.
Iss ed By: �1 i / Permittee Signature:
/1
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 Applica
BuildingKELLIVE1)
Fixtures FOR OFFICE
USE ONEX
City of Tigard . Received /^ (J�
�} Date/By: Z,(9 ( / , Permit No.: .. / /
II gi 13125 SW Hall Blvd.,Tigard,OR 9J7 6(i�j �`�
Plan Review
Phone: 503.718.2439 Fax: 5 9 By: Other Permit No.: V`15
T I G/+RD Inspection Line: 503.639.4175 , I VITIGA DatsDate/Ready/By: 7uris: ® See Page 2 for /4 w 77
Internet: vs,www.tigard-or.g°16u7a D r Notified/Method: Supplemental Information
TYPE IIO��FWIORK FEE* SCHEDULE
For special information use checklist
KNew construction 0 Demolition
Description Qty. Ea. Total
❑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
1-and 2-famil y dwelling SFR(2)bath 437.78
0Commercial/industrial
❑Accessory building 0 Multi-family SFR(3)bath 500.32
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: 1105 5.LA) �(,t r_4 c1# Loop
Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: `& wt.O 012_ 97 22'4 / Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 Project name: Fte2I 7,46-€ Croy S i'..,3 Manufactured home utilities 50.03
Cross street/directions to job site: S.1.,)J 'Apple wo
oC.l e,-LANManholes 18.76
f 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: Htrt1Tt4cre, Geo S 5 t✓►J I Lot no.: Lar$ Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
,„ . .-. DESCRIPTIO '^DF WORK
_4.1..' Backwater valve 12.51
f, -COS ; . .3. Y Clothes washer 25.02
(3Ack-f l ow FR. '5?r i..‘k ter S 1S'1ty✓1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
:Iv, .PROPE TY OWNER :T ❑ 'ENANT ,, p 12.51
,,, Expansion tank
Name: p,fl._ }..(v0.1.0 Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: `43134; 6,GJ W(.+-c.t p.rw) p}v,C
Garbage disposal 25.02
City/State/ZIP: Po g-Tv4W 13 r d ft Cj 7 237 Hose bib 25.02
Phone:(So ) 222 -L4 1$,1 Fax:( ) Ice maker 12.51
_' W.►• ‘47,11Lih : ,i ‘4,/ jE'z tl N Interceptor/grease trap 25.02
Business name:'-F,,xpoe Wt•442.14rDscnjares �C Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: STEDu E. ELt:is
Roof drain(commercial) 12.51
Address: p,a 40 L LH I0 Sink/basin/lavatory 25.02
City/State/ZIP: 012E(.ot4 Gi_ r 1 02 /7O95 Solar units(potable water) 62.54
Phone:(5o3)�2- 65 t`) Fax::( ) Tub/shower/shower pan 12.51
E-mail: L j 5• STC'Je Urinal 25.02
yy �. yartoo ,co&A
C(1tNTRACTOR N .z. Water closet 25.02
/ A'' : ` ' "` Water heater 37.52
Business name: Ty1AAE�� L-��.Ne 5o S K. WaterP €/
ip to DWV 56.29
Address: P,0 3 o x 24(0 Other: 25.02
City/State/ZIP: 0 itc645,4 C 1 -), t oQ 970 Lis Subtotal
Phone:(�j(j3 ) Z _03tq Fax:( ) Minimum permit fee: $72.50 7A'S7�
CCB Lic.: �'-)9� Plumbing Lic.no.:
Plan review (25%of permit fee)
State surcharge(12%of permit fee) K.a-v
Authorized signature: TOTAL PERMIT FEE g'/, O 0
-17 This permit application expires if a permit is not obtained within 180 days
Print name: STE0E- c. CLL j5 Date: ,6..
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-15t 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
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.
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 PlunnbingInsta atio s.
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 Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
El al Any multipurpose fire sprinkler system.
Dishwasher: -Commercial
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"
.r o lc Gr RiseTD a F' , :�:
�t.
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
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
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8705 SW SCHMIDT LOOP, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2017-00217
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
1 " irrigation backflow device Febco model 850 ser# HE27016 approved with test report
Violation Summary:
Inspector Contractor