Permit (103) CITY OF TIGARD PLUMBING PERMIT
IICOMMUNITY DEVELOPMENT Permit#: PLM2017-00531
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/20/2017
Parcel: 1 S 134AD02000
Jurisdiction: Tigard
Site address: 11367 SW LAKEWOOD CT
Project: Hij Subdivision: ENGLEWOOD Lot: 60
Project Description: Remodeling(2)bathrooms and kitchen:(1)clothes washer,(1)dishwasher,(1)hose bib,(2)sinks,(2)tub/showers,
(2)water closets.
Contractor: IRONMAN PLUMBING CONTRACTORS Owner: IONEL HIJ
12042 SE SUNNYSIDE RD#544 16933 SE FOSTER RD
CLACKAMAS, OR 97015 GRESHAM, OR 97080
PHONE: 503-674-7581
PHONE: 503-998-0276
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 12/20/2017 $25.02
Specifics: 1 ea Dishwasher 12/20/2017 $25.02
1 ea Hose Bib 12/20/2017 $25.02
Type of Use: COM 2 ea Sink 12/20/2017 $50.04
Class of Work: ALT 2 ea Tub/Shower/Shower Pan 12/20/2017 $25.02
Type of Const: 2 ea Water Closet 12/20/2017 $50.04
Occupancy Grp: 1 12%State Surcharge- 12/20/2017 $24.02
Stories: Plumbing
Total $224.18
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: Pe-rmittee Signature: C6044.1.___. 71
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 '
City of Tigard t ''
Li a Received
lli 1111 13125 SW Hall Blvd.,Tigard,OR 9 '' Date/By: la16/17 - Permit No.: /7-00,5:'?/*
i Plan Review /
Phone: 503.718.2439 Fax: 503.598.1960 c f� ,?T"(
Inspection Line: 503.639.4175 1�C t �i Date/By: Other Permit No.: g'J/'"for i 7,_.a wt.,
l 1 G A R[) -0-,c Date Ready/By: "" 7
Internet: www.tigard-or.gov � Jure ® See Page 2
4 t;7 A'i," otified/Method:
��' + "� �.� Supplemental Information
TYPE OF WORx l t".I6 91° J -
III
��1r � �; �. �� FEE* SCHEDULE '�
❑New construction o i ion For special information use checklist
Description
Addition/alteration/replacement �]Other: � Qty. I Ea. I Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
,. CATEGORY.Of CONSTRUCTION SFR(1)bath 312.70
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
IDAccessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
• Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATIONAND LOCATION - Site utilities:
Job site address: 1 I?6',-) L. �000 Catch basin or area drain 18 76
City/State/ZIP: " -i(,\ct,r d 0`n Ci 1 n/� Drywell,leach line,or trench drain 18.76
Suite/bldg./apt.no.: _J I Project name:
l� ") d d- Footing drain(no.linear ft.:_) Page 2
Manufactured home utilities 50.03
Cross street/directions to job site: •r-on W Lme Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: Water service(no.linear ft.: ) Page 2
I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIYI'" OF; -VOR - Backwater valve 12.51
-, ,. - Clothes washer
\YooV,'\ -1 N.
0 25.02 .t:
Dishwasher / 25.02 t
Drinking fountain 1
25.02
Ejectors/sump 25.02
0,PROPERTY OWNER ] TENANT' : Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
City/State/ZIP: Garbage disposal 25.02
Phone:( ) Hose bib / 25.02 4,2 5.,:,,,
Fax ( ) Ice maker 12.51
't A>PPUC 0 CONTACT,PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer
Contact name: *r e.( 1 12.51
E �C (� ( Roof drain(commercial) 12.51
Address: I(pin t
J FCL Sink/basin/lavatory 25.02 i
City/State/ZIP: &f,QJ i C) 9-70'WO
"� f L
(� ^�-� '1�-- / / Solar units(potable water) 62.54
Phone:(CD3) 7�!$'-CID /(�., Fax::( ) Tub/shower/shower pan 12.51 &X,
E-mail: `� Urinal
25.02
CpNTRACTOR - Water closet 9. 25.02
x Water heater
37.52Business name:49,1Mt l‘ f/ J L Cctfrac, -0(5 Water piping/DWV 55.02Address: /L Z Sc_. S u��Sr d�- � Other:
25.02
City/State/ZIP: C14.c.1Q-.M..5 0� G 7 DCS- Subtotal
v 1
Phone:(503 )(,7-75-g t / Fax: 22,e)
� �_
( ) Minimum permit fee: $72.50
CCB Lic.: /71 1 Q Plumbing Lic.no.: 178 3 0 Plan review (25%of permit fee)
Authorized signature: ciin ve /y,,
,, State surcharge(12%of permit fee) )-', (-
, - ' � ,r _ TOTAL PERMIT FEE�'9-�, i`�
Print name: �)ne( t-i• �, )ate' �� ��1�� This permit application expires if a permit is not obtained within 180 days
Jam--
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:
Qty. Fee(ea), Total Square�Faotage; Permit Fee: .>p
its utilities � oto 2,000 � $121.90
Footing drain-15`100' 50.03
37.52 2,001 to 3,600 $169.69
Footing drain-each additional 100' 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: 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
Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees ' 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.
$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
Additional plan review for revisions 90.00/hr 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*. flan Review dor 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 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
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 Comments regarding fixture work:
Ice Mach./Refrig.Drains
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 plumbing permit can be issued.
Water Closet-Toilet
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:
11367 SW LAKEWOOD CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2017-00531
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor