Permit (49) 111 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00316
Tf-GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2017
Parcel: 1 S 134AB90282
Jurisdiction: Tigard
Site address: 11363 SW SPRINGWOOD DR
Project: Springwood Villiage Subdivision: SPRINGWOOD VILLAGE CONDO Lot: 28
Project Description: Bore in 160'of 1-1/2"water line in front of building 2 near parking structure P6,running south under driveway.
Contractor: LOVETT INC Owner: DANIEL, TESSA
PO BOX 86280 11363 SW SPRINGWOOD DR
PORTLAND, OR 97286 TIGARD, OR 97223
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
160 If Water Service 08/04/2017 $100.06
Specifics: 1 12%State Surcharge- 08/04/2017 $12.01
Plumbing
Type of Use: COM
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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 503.232J.1987 or 1.800.332.2344, . .
Issued By: A,,...4Permittee Signature:
3-,, .-_ /,,,ci,
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.
Aug. 2. 2017 10: 20AM Lovett Excavating No. 4838 P. 1
Plumbing Permit Applicatio ._Ef El VE"
Site Utilities iou c)i•l,i L IIsi: ONI,r'
City of Tigard A U 6 2 2017 ' '�d Permit x0 L
13I25 SW Hall Blvd.,Tigard,OR 97223 triort �7 �9�A/7 ? -3/
,ipiiPlan Review
0 Phone: 503.718.2439 Fax: 503,591OF T1(srti! I efBy. Other Permit No.:
Inspection Line: 503.639.4175
e 2 ter
L l t rl l'.D Internet: www.rigard-or.gov BUILDING DTVI°'' °1 ",'',am/method:Ready/By:
June. 3 pplemSee mto InfOrmdtion
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❑New construction ❑Demolition For special information use checklist
Description Qty. 1 Ea. I Total
IZI Addition/alteration/replacement 0 Other: New 1-2-fa mliy dwellings(includes 100 ft.for each utility connection) t
-,'''''''' ZIT :Yy1 r i5 ,7I.l ��''F!n1r.)u,rrrc 1,0'5' SFR(1)1) 312.70
1-and 2-familydwelling SFR(2)bath 437.78
❑ g ❑CommerciaUndustrial
SFR(3)bath 500.32
❑Accessory building 12 Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other Fire sprinkler( sq.ft) Page 2
, • t ;
sr rr711.m-Lis67y :::;:!.„,; ,y s ". •,:, ,, ,, ite utilities:
Job site address:11363 SWSpringwood Dr Catch basin or area drain 18.76
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR Footing drain(no,linear ft,: ) Page 2
Suite/bldg./apt.no.: Project name:221715213 Manufactured home utilities 50.03
Cross street/directions to job site;Scholls Ferry Rd Manholes 18.76
in front of building 2 near parking structure P6 running from building 2 South Rain drain connector 18.76
under driveway 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 preventcr 31.27
7777- 7 Pn L .,. r : ° tt Backwater valve 12.51
il .,,. roifi y.j.',L.La: / .1 a :s•,,..,.;;.AL.,c2 `
,c ..
C10thes washer 25.02
Bore in 160'of 1 1/2"main water line Dishwasher 25.02
Drinking fountain 25.02
Ejeerors/sump 25.02
7, t f� ',1 s �l to 1;' a 9 , 10 1.,.y ti k, �.a so°. Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/Stare/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
te. „<,,.n ,1�lr.-' 1 p r rl r rat ei R , "1 c�.W n�, :. T...
r ,�:ttr),.. -:'? .'.'�*>>. 4;24 ':, 44iV•r, lti „' YA�Fr�s dila gt , 17,)1 '@ gah k•: Interceptor/grease trap 25.02
Business name:Lovett,Inc Medical gas(value:$ ) Page 2
Primer 12.5I
Contact name:Dave Benson/Cindie Shatto Roof drain(commercial) 12.51
Address;PO Box 55580 Sin k/basin/layatory 25.02
Ci /State/ZIP:Portland,OR 97238
tySolar unit9Otab1C
cp water)) 6zsa
Phone;(971)804-1308 Fox:;(503)288-1630 Tib/shower/shower pan 12.51
E-mail:cindie.s%lovettservices.com Urinal 25.02
•" c . 1 ;1 1' 6. 1.,v Water closet atr:�,; x.;>".9,;, "• .W.ii ,i o i*p�pK1011a4S .b7�� i , ,MY 25.02
.re,e .!};:a.K4i a ,:•,?,7n;;g.r,l � .< r ',">. vdh, + Mi +Si •s, *?
',l
Water heater 37.52
Business name:Lovett,Inc Water piping/DWV 56.29
Address:PO Box 55580 Other: 25.02
City/Slate/ZIP:Portland,OR 97238 Subtotal jQ
Phone:(503)737-8423 Fax:0 Minimum permit fee: $72.50
GCB Lie.:125507 S � Plum sing Lie,no.:26-773FT1 � Plan review (25%of permit fee)
4 * State surcharge(12%of permit fee) , /02,a/
ArimmrAuthorized signature: f/1� /-J r1fFAra��' TOTAL PERMIT FEE l'/..2.,'7
Print name;Cindie L Shatto Date:8/1/2017Thispermit application expires If a permit is not obtained within 190 days
after it has been accepted as complete.
*Fee methodology ser by Tri-County Building Industry Service Board, '
t:uwaitngtrermanrt.yt0-PeneiiApo•aoe 10/01/09 440.4615T(1oro2/COnvWrsu)
Aug. 2. 2017 10:21AM Lovett Excavating No. 4838 P. 2
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Su cession S stems:
; i a �.m 4'�y, .� 17 F. ,a y-' 1ce
,11 1 1k i C 4. l.,w;Y,'+e r:ee i e e � .,,�: yR ♦'1 .at! I r °�.!C,%�;�.�.rt ti�1` 1 �` � .,1,. ...�,�J �t r i 7. .� Xn1Y Vhf "'k.,'q,`, •:y
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
S3,601 to 7,200 $233.20
Sewer 1St 100' 62.54
7 201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-tst 100' 100 62.54 Medical Gras S stems:
Water Service-each additional 100' 60 37.52 1 n i`i kj «i ) 11 ', 4 4'� e{':
Stone&Rain Drain•1st 100' 62.54 ,, K, ? r , . i. lt•: wa,
$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
each additional$100.00 or fraction thereof,to
•.a lw i Yl r�. fi.I K 1 '1
!AR- l er;I s.l �.J^t� u,f'`Qf' t'^�,, del � � •
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 112 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*,
" l` • >, ` Quantify by Ixtor€A Typ ', ' ' , ic[1
; "` " ys AB I.:PT
�A.,.ity. /.>�IQ
WoikkerOilli¢dti Capped Added Rcttept ° Plan review is required for any of the following.
Please check all that apply.
Baptistry/Pont
Bath Tub/Shower 0 Any new commercial building with water service 2"and
-Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash •Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-7S0-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health eare.facilitics.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAIL918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
+.0 7' RwAy,�tNt,t''..i'
Car Wash Drain ,,:t1P1,74,;4 afi'4z i91I 1) : ' .� t; ,` k!rcithi s.<<
Garbage -Domestic-non-food ElIsometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./R.efrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service _
Swimming Pool Filter _ *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
http://www.tigard-or,gov/document_center/Buidding/PLMU PermitApp,dgc