Permit (26) CITY OF TIGARD PLUMBING PERMIT
II, .
COMMUNITY DEVELOPMENT Permit#: PLM2017-00381
T-[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2017
Parcel: 25111 BD00600
Jurisdiction: Tigard
Site address: 9665 SW DARMEL CT
Project: STONE Subdivision: DARMEL NO.2 Lot: 33
Project Description: 100 ft.of sanitary sewer to connect existing home to sewer. Reimbursement District#27.
Contractor: SAKRISSON PLUMBING Owner: STONE, HELEN
PO BOX 821 RIDGEFIELD WA 98642 9665 SW DARMEL CT
RIDGEFIELD,WA 98642 TIGARD, OR 97224
PHONE: 503-440-7540 PHONE:
FAX:
FEES
Quantity Description Date Amount
100 If Sanitary Sewer 09/21/2017 $62.54
Specifics: 1 12%State Surcharge- 09/21/2017 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 09/21/2017 $9.96
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
f � _' C-- r Permittee Signature: �� ! !� 7��5
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. G%
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures Tori OFFICE: l si: ONL\
City of Tigard Received
Date/By: �j i Permit No.: A'
41 1111111 I 13125 SW Hall Blvd.,Tigard,OR 97223 ` // Nt40/7(01R
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No15444100,./q�n
T l G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Paggee22 for W/�
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
, TYPE OF WORK ~" ''FEE*E �SCS
REDUCE ,
❑New construction 0 Demolition For special information use checklist
Description IQty. I Ea. I Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION 'm , SFR(1)bath 312.70
( 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
/g❑'Accessory building 0 Multi-family SFR(3)bath 50032
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
? d0$ $TE INF`t'iJimAT!o 1 ANtr %JOCATIO111 Site utilities:
-
Job site address: 9 6 65-' s",cu DI '- �C•C C.� Catch basin or area drain I8.76
Ci /State/ZIP: T �j Drywell,leach line,or trench drain 18.76
ty �/ Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: /4)261/6 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:19Q� / Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
iESCIti,..„ Backwater valve 12.51
� N WORK ,
A
_ c,.Y- !� -' J Clothes washer 25.02
-�-x-1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
' PROPERTY OWNER I ' , 0 TENANT.. Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:
Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Al, CANT' IiiCONTACT PE Interc tor/ ease trap RSt),p7� eP gT 25.02
Business name: Medical gas(value:$ ) Page 2
PrimerContact name: A ,�lJ Ppm /e-r Roofd 12.51
((-��-'�"t 6a drain(commercial) 12.51
Address: S C L O S f iticsPoie 1_, roca Sink/basin/lavatory 25.02
City/State/ZIP: 6,---day t)A../ Q2 - Solar units(potable water) 62.54
Phone:( ,C9 ) d,...v...,- L‘trigf Fax::( /) /L Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR -`I Water closet 25.02
Water heater 37.52Business name: 54kr`S'i� 0 Ar /cJbfoWater piping/DWV 56.29
Address: P / pa'
�J Other: 25.02
City/State/ZIP: t b Az- 9g 6,9'�. Subtotal
Phone:( 51) (' ,S"I,/6 rax:( ) Minimum permit fee: $72.50
CCB Lic.: G 7 $ rr Q�8 ' r Plan review (25%of permit fee)
tr7 Plumbing Lic.no.: �,J
State surcharge(12%of permit fee)
Authorized signature: / /� TOTAL PERMIT FEE 3'� ,ZQ
Print name:/;��r�/ J. 1/ Date: 7,/,,./`7 This permit application expires if a permit is not obtained within 180 days
/ �`�'�/'2 7 Yr _c42&„„0„,....2.1 after it has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doe 10/01/09 440.46I6T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: w �. ..,
Residential Fire Suppression Systems:sthe � sQty.. Fee(eajTotal
r S. uare Foota e ,
Footing drain-1"100' q �' Permit1. 0Fee:.
50.03 0 to 2,000 _ $121.90
Footing drain-each additional 100' 37.42 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 _$233.20
7,201 and_greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 $lllalt)I1S ,, �ermitt.Fee;
Storm&Rain Drain-each additional 100' 37.52 $1.00 to$5,000.00 Minimum fee$72.50
P � � , Y5 Fee � £ � $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Ins ection or Fees (e� Totat> each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
$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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business 90,00 . and including$25,000.00.
hour (minimum charger 2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
Reinspection Fees 90.00/hr each in0 000 0 or fraction thereof,to
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
l
accuratey report fixtures could result in increased sewer fees*.
�;.:.;Plan Review'forllumbuig Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for " RePlrcei Please check all that apply.
P
Work
Work erformed: Capped Added Relocate
Peron 0 Any new commercial building with water service 2"and
Bath: Tub/Shower greater,except systems designed and stamped by licensed
-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
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
Car Wash Drain 0 Isometric or riser diagram is required for new buildings
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
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
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:
9665 SW DARMEL CT, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2017-00381
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Septic tank pump receipt has been received - plumbing final approved.
Violation Summary:
Inspector Contractor