Permit (128) CITY OF TIGARD PLUMBING PERMIT
F :'• COMMUNITY DEVELOPMENT
Permit#: PLM2017-00417
T I CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2017
Parcel: 2S111AD01100
Jurisdiction: Tigard
Site address: 14585 SW 87TH AVE
Project: GARCIA Subdivision: PINEBROOK TERRACE Lot: 8
Project Description: Replacing 35 ft.of sanitary sewer.
Contractor: JTR PLUMBING INC Owner: GARCIA, ERIKA
4272 NE BEAUMEAD ST BARRON,JOSE LUIS OLEVARA
HILLSBORO, OR 97124 14585 SW 87TH AVE
TIGARD, OR 97224
PHONE: 503-209-4290 PHONE:
FAX:
FEES
Quantity Description Date Amount
35 If Sanitary Sewer 10/11/2017 $62.54
Specifics: 1 12%State Surcharge- 10/11/2017 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 10/11/2017 $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 - -
Issued By; }_ -e Signature:
Call 503.639.4175 by 7:00 a.m.for the next available insp tion 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 RECEIVE i'olz orrlcr. I_SI: ONLx
City of Tigard Received �/ - Permit No.:
lig
al 13125 SW Hall Blvd.,Tigard,OR 97223
Date/By: l ,�/ yj 7
_ Phone: 503.718.2439 Fax: 503.598.1960 0 C I 1�' 2 u I i Plan Review
i Other Permit No.: r
Date/By:
Inspection Line: 503.639.4175 CITY
rate Read/B Awls. H See Page 2 for
TIGARD cr 1 OFTLGAR�I Y Y
Internet: www.tigard-or.gov fl 1 otified/Method: Supplemental Information
TYPE OF WO $1 iatNG IDIVISI
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 COlsil RUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
buildingSFR(3)bath 500.32
❑Accessory 0 Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION,.;: Site utilities:
Job site address: 114 5 g 5' c rt.) D„ 4_ ,, �K ae
Catch basin or area drain 18.76
City/State/ZIP: O �j _ Drywell,leach line,or trench drain 18.76
T l 0 1 7a.2.k) - 5g C 3 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.:3r) / Page 2 4,,2,5
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
$. Backwater valve 12.51
DESCRIPTION OF WORK
'` Clothes washer 25.02
'
�01./✓ /7y� 4 �'��1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
[(PROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
cii c. r i��Q) 60 f f O S F- )-C:1.& C�.e 'r Floor drain/floor sink/hub 25.02
Address: 1 4 5&' p pp i t
S �% ��? � M-V,� Garbage disposal 25.02
City/State/ZIP: -n (lark 0 ye c. es l f_ 5 C'3 Hose bib 25.02
Phone:( ) I� 9
Fax:( � )) Ice maker 12.51
APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:
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
CONTRACTOR Water closet 25.02
/050.7.1 :9
Water heater 37.52
Business name: r7 p /0,� :9 Water piping/DWV 56.29
Address: y ,� e I `3` 140„9„4..) 2 Other: 25.02
City/State/ZIP: /47/S.�c)1 -0 y 97 /'. y Subtotal ,,zj'
Minimum permit fee: $72.50 7y) -571
Phone:(5c3) oL p G� j/„./ey Fax:( )
CCB Lic.: / Plumbing Lic.no.: �j (� q Plan review (25%of permit fee)
r -
�7���� �r L` State surcharge(12%of permit fee) ,pw 7;J
Authorized signature: • TOTAL PERMIT FEE 3Y/ s�
Print nam ' Gl v� g -V Date/ // . 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 tea) Total Square Footage: Permit Fee:
Footing drain-151 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' % 62.54 3,601 to 7,200 $233.20
l (p"�,.5 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 r�Fees " Fee(ea) o each additional$100.00 or fraction thereof,to
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
(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*. t:mlan 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 '
Baptistry/Font
0 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 tall 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 El 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 a;
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:
14585 SW 87TH AVE, TIGARD, OR, 97224 October 12, 2017 at 1 :53:27
PM
Record Type: Record ID:
Residential - Plumbing PLM2017-00417
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
4" sanitary under test with water.
Ok to remove test and cover.
Violation Summary:
Inspector Contractor