Permit (30) CITY OF TIGARD PLUMBING PERMIT
711i: ' COMMUNITY DEVELOPMENT Permit#: PLM2017 00227
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2017
T[GAR L g Parcel: 2S 103AA00101
Jurisdiction: Tigard
Site address: 10865 SW WALNUT ST
Project: Fowler Middle School Subdivision: None Lot: None
Project Description: Installation of approximately 40'of sanitary sewer line in auditorium.
Contractor: ADVANCED TECHNOLOGY GROUP Owner: TIGARD-TUALATIN SCHOOL DISTRICT
455 SE 2ND AVE BY MAPLETHORPE, BONITA
HILLSBORO, OR 97123 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-693-9202 PHONE:
FAX: 503-640-4333
FEES
Quantity Description Date Amount
40 If Sanitary Sewer 06/08/2017 $62.54
Specifics: 1 12%State Surcharge- 06/08/2017 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 06/08/2017 $9.96
Plumbing
Class of Work: ALT
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 requi - you . •low the rules adopted by the Oregon
Utility Notifica • enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. may obtain a copy of the rules
or direct••estions to Ob. • c. lin. 503.232.1987 or 1.800.332.2344.
Issued By: AI g , i / Permittee Signatu : 4 % %
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
Site Utilities E/1E1VE n/ FOR OFFICE CS1. ()NIA
t� Received /„ 7I /1 pE,1t�/7 ag.7
City of Tigard Date/By: t-CPennitNo.:
13125 SW Hall Blvd.,Tigard,OR 97223 JUN p Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 C7 2017 Date/By: Other Permit No.:
l I(; 12 I) Inspection Line: 503.639.4175 CITY®F r Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov f iH • Notified/Method: Supplemental Information
s .. ,.,4.•�:.;s .� "';.a >K.`,r.M..i' "k"a, .::. l�'"sMur,�?a:ti.,� e. =. '�,a'a•... y ... �� ... �. : r� i4.�` '"� w��...rt`�=... ;'
O New construction ❑Demolition For special information use checklist.
Description I
Qty. Ea. I Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
.,r f,t ,altW .. 0 E� - 4 SFR(1)bath 312.70
1111-and 2-family dwelling ®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 ❑Other: Fire sprinkler( sq.ft.) Page 2
„a.. � .., Site utilities:
Job site address:10865 Walnut Street Catch basin or area drain 18.76
City/State/ZIP:Tigard,Oregon 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name:Fowler Middle Schhol 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
Clothes washer 25.02
Sanitary sewer connection at Auditorium area. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Expansion tank 12.51
Name:Fowler Middle School Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:10865 Walnut Street
Garbage disposal 25.02
City/State/ZIP:Tigard,Oregon 97223 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Interceptor/grease trap 25.02
Business name:Advanced Technology Group Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Daniel Talbott
Roof dram(commercial) 12.51
Address:455 SE 2°d Ave. Sink/basin/lavatory 25.02
City/State/ZIP:Hillsboro,Oregon 97123 Solar units(potable water) 62.54
Phone:(503)693-9202 Fax::(503)640-4333 Tub/shower/shower pan 12.51
E-mail:danielt@atgweb.com Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name:Advanced Technology Group Water piping/DWV 56.29
Address:455 SE 2nd Ave. Other: 25.02
City/State/ZIP:Hillsboro,Oregon 97123 Subtotal
Phone:(503)693-9202 Fax:(503)640-4333 7/jbC Minimum permit fee: $72.50 7,g„trot)
CCB Lic.:1303640#0Plumbing Lic.no.: 5(E- 34 9 6 Plan review (25%of permit fee)
State surcharge(12%of permit fee) &;70
Authorized signatur= h . n( TOTAL PERMIT FEE 8'1.2-e
Print name:Daniel albott Date:6/8/2017 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.
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