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Permit (63) IICITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2017-00370 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/11/2017 Parcel: 1 S 133AD04300 Jurisdiction: Tigard Site address: 10880 SW SUMMER LAKE DR Project: Kummerer Subdivision: AMART SUMMER LAKE Lot: 17 Project Description: (2)lays and(1)tile shower for bathroom remodel. Contractor: JTR PLUMBING INC Owner: KUMMERER, MARK R 4272 NE BEAUMEAD ST 10880 SW SUMMER LAKE DR HILLSBORO, OR 97124 TIGARD, OR 97223 PHONE: 503-209-4290 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Lavatories 09/11/2017 $50.04 Specifics: 1 ea Tub/Shower/Shower Pan 09/11/2017 $12.51 10 ea Minimum Fee Adjustment- 09/11/2017 $9.95 Type of Use: SF Plumbing Class of Work: ALT 1 12%State Surcharge- 09/11/2017 $8.70 Type of Const: Plumbing 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: �, Permittee Signature: 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 Applicatio - rittBuilding Fixtures • ' City of Tigard SEP 1 2 0 1 T Date/By:Received ! i�/ 'lk7`, Permit No.,Q iii 13125 SW Hall Blvd.,Tigard,OR 972213r,„.. Y / v /' "�©� �0 I -� 1 Plan Review Phone: 503.718.2439 Fax 503.51966 r i,, b i ""+'i. Date/By: Other Permit No.: Inspection Line: 503.639.4175 3 l i I( 1 1 i h i owls i Date Ready/By: TIC,ARD �r i �l ar rI7u�s H SeePa e2for Internet: www.tigard-or.gov 3 Notified/Method: Supplemental Information TYPE OF WORK FEE* SC ,DULE` ,,# 0 New construction For special information use checklist ❑Demolition Description I Qty. Ea. Total pfr Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CA' GOI ' OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 ', JOB SITE INFORMATION..~' 3 OC411ON A. Site utilities: Job site address: /0_0: R sw c '/ -e LC 0,r. Catch basin leachor line,e drain 18.76 City/State/ZIP: ',9C-Y�/ d 9 2 3' Drywall, or trench drain 18.76 J ` Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 " ESCRIPTION OF VORI5kms' Backwater valve 12.51 ��, Clothes washer 25.02 0 0 wlY /` gym / Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 CI PROPERTY OW ER N I . y ❑ TENANT ,"k• Expansion tank 12.51 Name: > 25.02 ��'ti.� �?/ /� /7/7 t'� _ Fixture/sewer cap Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT = C3 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan [ 12.51 E-mail: Urinal 25.02 s' Water closet 25.02 CONI'RACTO1 ° Water heater 37.52 Business name: .--.., -2.-,g_ 7 fav,j, 9 J 7 Water piping/DWV 56.29 Address: 92,72. 4,,e 23,,,..,„,,„„,,,,,is fl Other: 25.02 City/State/ZIP:/014S16 yo Q 2Y,2. 9 Subtotal Phone:(Ct a ) 2 b 9q % Fax:( ) Minimum permit fee: $72.50 s 0 CCB Lic.: !4J ,, 4a i f Plumbing Lic.no.: ?17,..7 Plan review (25%of permit fee) , �� / �/1 State surcharge(12%of pennit fee) tr 7O Authorized signature: �� 7//17C' `? TOTAL PERMIT FEE FA p"�l Print name:....."7--. / C. 141e.'<" Date: AIII 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. 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: Per nitI?ee:-, Footing dram-1 t 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 ; luation' '" x 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 each additional$100.00 or fraction thereof,to Other Inspections or Fees ' QtY' a( Y Total 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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 Plumbing Installations 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 ❑ New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water irator 0 Any multipurpose fire sprinkler system. -CommercialDomtic ❑ Any complex structure as defined in OAR918-780-0040. -DDrinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" - 4" 3" Isometric or Riser Diagram 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: 10880 SW SUMMER LAKE DR, TIGARD, December 26, 2017 at OR, 97223 10:52:30 AM Record Type: Record ID: Residential - Plumbing PLM2017-00370 Inspection Type: Inspector: 399 Plumbing final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor