Permit (88) CITY OF TIGARD PLUMBING PERMIT
. ` COMMUNITY DEVELOPMENT Permit#: PLM2017-00297
T FAR.O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2017
Parcel: 1S136AA01800
Jurisdiction: Tigard
Site address: 6817 SW OAK ST
Project: Shepard Subdivision: FUR VALLEY Lot: 3
Project Description: Replumb kitchen,washer lines&bath vanity.
Contractor: SHEPARD BROTHERS MANAGEMENT LLC Owner: SHEPARD,AMOS
2830 NW 29TH 2830 SW 29TH AVE
PORTLAND, OR 97210 PORTLAND, OR 97210
PHONE: 360-772-0355 PHONE: 360 772-6355
FAX:
FEES
Quantity Description Date Amount
90 Investigation Fee 07/25/2017 $90.00
Specifics: 11 Investigation Plumbing 12% 07/25/2017 $10.80
State Surcharge
Type of Use: SF 1 ea Clothes Washer 07/25/2017 $25.02
Class of Work: ALT 1 ea Dishwasher 07/25/2017 $25.02
Type of Const: 1 ea Garbage Disposal 07/25/2017 $25.02
Occupancy Grp: 1 ea Lavatories 07/25/2017 $25.02
Stories: 1 12%State Surcharge- 07/25/2017 $12.01
Plumbing
Total $212.89
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.
111Al
Issued By: � � - Permittee Signature: 1 f
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
City of Tigard REIV
Received ? ✓ l Permit No.:
/7.--66 `
13125 SW Hall Blvd.,Tigard,OR 97223
IN 0
Plan Review
Phone: 503.718.2439 Fax: 503.598.19 L 2 b 2017 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 Date Read/B Juris: ® See Page 2 for
TIGARD Ready/By:
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF 1IGARID.
TYPE OF DI '!DIVISJO FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
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
4 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family -
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler(_sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I Catch basin or area drain 18.76g i-� 5 OrAE2
Ci /State/ZIP: �"` Drywell,leach line,or trench drain 18.76
ty `�r,fi2 ) �'7 ZZ 1 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: 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
DESCRIPTION OF WORK p
Backwater valve 12.51
' Clothes washer 1 25.02
�`.L c)1 6 yci''�'cu-2-'t'`` (1)"k �4A Lt i Dishwasher 1 25.02
� Q l-1,:„.`it-, \fiek. .A;LV., Drinking fountain 25.02
j Ejectors/sump 25.02
PROPERTY OWNER 0 TENANT Expansion tank 12.51
�. � g Fixture/sewer cap 25.02
Name: A-s 3 .Zk
Floor drain/floor sink/hub 25.02
Address: C W l-7 ,S C-.L:. O I r� Garbage disposal + 25.02
\ City/State/ZIP: ` ,,, ,,_K Ora_ CtCt.-72 Z I Hose bib 25.02
J Phone:(36 p ) -7-7 2 t! S S c Fax:( ) Ice maker 12.51
� AI APPLICANT 0 CONTAC,TT_PE�RSON Interceptor/grease trap 25.02
`�n
U Business name. ✓V.u '! ,,,,„ _ rJ' Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: ,
/ Roof drain(commercial) 12.51
Address: l 15 3 c. A,t-,-) 2 ./(--- Sink/basin/lavatory I. 25.02
City/State/ZIP: PT\ 0 G 7 2-1 L Solar units(potable water) 62.54
Phone:(5o) 7-7 2_ _ / 3 S' Fax::( ) Tub/shower/shower pan 12.51
E-mail: U t J cam' 0_,,31_,-,,,„L poi L yt..., Urinal 25.02
it Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:
(_ (z: �% Y� x'_ ` �-
3Water piping/DWV 56.29
k. Address: JC..) 4 i eGy -
Other: 25.02
City/State/ZIP: P0-i. L - f 6/2_ "L .7 Z,I C) Subtotal
Minimum permit fee: $72.50
Fax:
Phone:( ,) ( ) Plan review (25%of permit fee)
CCB Lic.: i q 2 Z G S"- y---7 Plumbing Lic.no.: iV 1 1;5'
State surcharge(12%of permit fee)
Authorized signature: / 11111'41 TOTAL PERMIT FEE
Print name: A "'fff Date: This permit application expires if a permit is not obtained within 180 days
`l 5�` i/,-L( 2r �1 > 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-l'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(ea) Total each additional$100.00 or fraction thereof,to
hand 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*. $an Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixtureypc for Replace/ Please check all that apply.
Work Fes1'ormed: Capped . Added, Relocate i
Baptistry/Font ❑ Any new commercial building with water service 2"and
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 Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ 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 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:
6817 SW OAK ST, TIGARD, OR, 97223 October 6, 2017 at 9:10:21 AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00297
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
No plumbing rough in inspection done on this permit.
Rough in inspection approval required prior to cover.
Contractor or tenant to be present for inspection, no answer at door. 9:10 am.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6817 SW OAK ST, TIGARD, OR, 97223 October 13, 2017 at 9:32:49
AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00297
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Dishwasher hose to be secured to top of cabinet. 807.4
Partial waterlines covered prior to inspection, appear ok where visible.
Violation Summary:
Inspector Contractor