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Permit (103) 71 CITY OF TIGARD PLUMBING PERMIT P . '3 COMMUNITY DEVELOPMENT Permit#: PLM2017-00485 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2017 Parcel: 2S102CA00210 Jurisdiction: Tigard Site address: 13235 SW ASH DR Project: POWERS Subdivision: VIEWCREST TERRACE Lot: 8 Project Description: Replacing sanitary sewer later from the home to street:60 ft.of sanitary sewer. Contractor: BLACK ROCK UNDERGROUND LLC Owner: POWERS,JASON&CASSANDRA 267 NE 34TH PLACE 13235 SW ASH DR HILLSBORO, OR 97124 TIGARD, OR 97223 PHONE: 503-747-9312 PHONE: FAX: 503-214-5886 FEES Quantity Description Date Amount 60 If Sanitary Sewer 11/20/2017 $62.54 Specifics: 1 12%State Surcharge- 11/20/2017 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 11/20/2017 $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 yo to o t e rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952- 1-00'I You may obtain a cs,py of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 4/1 Issued By: rmittee 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 Application Building Fixtures FOR OFFICE USE ONl.l City of Tigard Received ) g Date/By: /l��c�l .377-.- Plan � Permit No.:04,yn �a i 7 �y is...-+ lig13125 SW Hall Blvd.,Tigard,OR 97223 r rs . (fry 7 _ Plan Review Phone: 503.718.2439 Fax: 503.598.19' Other Permit No.: Date/By: Inspection Line: 503.639.4175 H See Page 2 for I 1 G A R D R Date Ready/By: Juris: Internet: www.tigard-or.gov rK0`� Notified/Method: Supplemental Information TYPE O _ VM +• FEE* SCHEDULE , 0 New construction ■`�emo q 4,s t` For special information use checklist Q�V® Descri.tion S . Ea. Total hp_ Addition/alteration/replacement R • '-•• ,� New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CO " ION SFR(1)bath 312.70 'tiaj and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ID Accessory buildingSFR(3)bath 500.32 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: 13 1.. 3 5 5c,...) 11\--6\1\ Catch basin or area drain 18.76 Q Dryting leach line,or trench drain ■ 18. 6 2 City/State/ZIP:--TT. , Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: !"L'e,-5 Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft. ) 1 Page 2 6.A,$'l/ 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 DESCRIPTI©N O Backwater valve 12.51 Clothes washer 25.02 -V1R2, Svc \ �A.fR.AL .;"S0.�t�•cn Stu Dishwasher 25.02 6,k cj \ . (---oti,.. :,,2 \NAvv.e 2•, --1-3\C(, )5 A a1 ) Drinking fountain 25.02 \, 1/4\n.e., 4r Ejectors/sump 25.02 0 PROPERTY OWNER ` ` I 0 TENANT Expansion tank 12.51 Ce,�„ .ri Fixture/sewer cap ■ 25.02 Name: `xt �� pc �� 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 .e .ACT P ON Interceptor/grease trap 25.02 Business name: 40_0 c).. 0 AKA, �, v o L� Medical gas(value:$ ) Page 2 Contact name: n Primer 12.51 c CAA '`^V ..c., � Roof drain(commercial) ■ 12.51 Address: Co 1 Sink/basin/lavatory 25.02 �G City/State/ZIP: \ .O . % Solar units(potable water) 62.54 Phone:(5a,) I"L% , 1-V1 C 0 Fax::( ) Tub/shower/shower pan 12.51 E-mail: t Into C:� 'a►t r41 C.v.„b1 Cts' /.OV tR c dVh Urinal 25.02 CONTRACTOR Water closet 25.02 --, Water heater 37.52 Business name: _ Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 6 2.,57r Phone:( ) Fax:( ) Minimum permit fee: $72.50 '11 CCB Lic.: 40 Plumbing Lic.no.' Plan review (25%of permit fee) State surcharge(12%of permit fee) , r, 70 Authorized signa _��L _...se-_,-..!--.... TOTAL PERMIT FEE _ ` This permit application expires if a permit is not obtained within 180 days Print name: ,. n' . after it has been accepted as complete. �} Date: ' �a *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Perntits\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: Fee(ea) Total g Site D1�11tlet �� = Qty. Fee �40tSige: Permit Fee: „. Footing drain-1'1 100' 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 0 A 47j 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 Storm&Rain Drain-1st 100' 62.54 Valuation:r" Permit:Fee: $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 Gthery Inspections or Fees Fee(ea) Total each additional$100.00 or fraction thereof,to p 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*. a Plan Review for Pluml g 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 ❑ 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 Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru 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 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