Permit (67) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2017-00386
T I GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2017
Parcel: 2S112CC14100
Jurisdiction: Tigard
Site address: 8077 SW CAROL ANN CT
Project: WICKER Subdivision: DURHAM SCHOOL PARK Lot: 3
Project Description: Relocate(1)dishwasher and(1)sink for kitchen remodel.
Contractor: OWNER Owner: WICKER, CAITLIN
CAITLIN WICKER 8077 SW CAROL ANN CT
8077 SW CAROL ANN CT TIGARD, OR 97224
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/25/2017 $25.02
Specifics: 1 ea Sink 09/25/2017 $25.02
1 12%State Surcharge- 09/25/2017 $8.70
Type of Use: SF Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 09/25/2017 $22.46
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: 0"
Adi
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 Apph�t
Building Fixtures
City of Tigard Received , ��j
Date/By: Permit No.: /
III13125 SW Hall Blvd.,Tigard OR(9y224" i r't + � � d/ Q(J3�j
Phone: 503.718.2439 Fa ;,1503.598 1960
Date/By:
Plan y. Other Permit No.:
�L r.,�a -��o�
Inspection Line: 503.639. > z o�j
TIL A R n Internet: www.tigard-o y hl ''z '11.3�t' Date Ready/By: Juris: ® See Page 2 for
I .1 Notified/Method: Supplemental Information
'.. I EeEellij �DIVISION FEE* SCHEDULE
❑ ew construction Demolition For special information use checklistDescription Qty. � Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CQNSTRU 'ION. ' ' i SFR(1)bath 312.70
Al-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builder - Each additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE,INFORMATION AND LOCATION Site utilities:
Job site address: b 0--)"2 514) ra pt.:,l /�y G Catch basin or area drain 18.76
ARi V Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1-1 JC rot.of (0 q 7� -.D- /
`� � Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
'1' $I)ESCRIPT:ON of'WORK r .'" `-y. Backwater valve 12.51
`b' Clothes washer 25.02
J / A I a 1 Ai,i 'IA III -i A -_ 1 Dishwasher 25.02
MOeil Drinking fountain 25.02
�f lJ�YJ Ejectors/sump 25.02
a PROPERTY'OW ER ❑ IVA, ' Expansion tank 12.51
Name: Cal A; Utd)i C�p/n . Fixture/sewer cap 25.02
C l 5 uu- }' yt\ y1 �� GFlrb drain/floor sosink/hub 25.02
Address: c ��•"7"1 v CO,
Garbage disposal 25.02
City/State/ZIP: •1/7•C4 0 a 1-2a3
7 d3 Li Hose bib 25.02
Phone:( ) J Fax:( ) Ice maker
12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name: c Medical gas(value:$ ) Page 2
:J1Y1,-.42 S G0 - Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory f 25.02 ~.
Q.
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR .• Water closet 25.02
Water heater 37.52
Business name: G1t.,QJ1 '- WaterDWV
I m
P�P� g/ 56.29
Address: Other:
25.02
City/State/ZIP: Subtotal 5V-eLI
Phone:( ) Fax:( ) Minimum permit fee: $72.50 7)` 1
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) �`�
State surcharge(12%of permit fee) y-,7O
Authorized signature: a� 11
'(� �` TOTAL PERMIT FEE s' )0
Print name• � jfi
Cr•e Date:Cf-- 17 This permit application expires if a permit is not obtained within 180 days
' • l 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 Unpins Qty Feet ) Total Square Footage: Permit Fee:
Footing drain-151100' 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. F+li ; r.
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
l:� each additional$100.00 or fraction thereof,to
Other Inspections or:Fees ' Y• � Totaand 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 InMI4StallJitions
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 0 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.
-CommercialDomec ❑ Any complex structure as defined in OAR918-780-0040.
-D
Drinking Fountain
Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
3" sol#1 tric orser11.,agram
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./Refit.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:
8077 SW CAROL ANN CT, TIGARD, OR, 97224 October 11 , 2017 at 1 :48:13
PM
Record Type: Record ID:
Residential - Plumbing PLM2017-00386
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Provide sink piping with smooth interior finish,
Corrugated piping not approved in Oregon per OPSC.
Provide AAV for sink vent under cabinet.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8077 SW CAROL ANN CT, TIGARD, OR, 97224 October 19, 2017 at
11 :56:32 AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00386
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Corrections complete.
Violation Summary:
Inspector Contractor