Permit (82) `ik
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018 00015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2018
Parcel: 2S104BC01200
Jurisdiction: Tigard
Site address: 14504 SW FERN ST
Project: KAUFER Subdivision: HILLSHIRE HOLLOW Lot: G
Project Description: (1)sink, (1)garbage disposal,and(2)floor drains for outdoor living space.
Contractor: OWNER Owner: KAUFER, GREGORY&VALERIE
GREG&VAL KAUFER 14504 SW FERN ST
14504 SW FERN ST PORTLAND, OR 97223
TIGARD, OR 97223
PHONE: 503-999-0983 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Floor Drain/Floor Sink/Hub 01/10/2018 $50.04
Specifics: 1 ea Garbage Disposal 01/10/2018 $25.02
1 ea Sink 01/10/2018 $25.02
Type of Use: SF 1 12%State Surcharge- 01/10/2018 $12.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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 folio the rules.__....ted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952 :• -5.!0. ou m. obt. a .o.' • the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r /r //
Issued By: • %,i ia���
e Signature: / ,/�qA�
f
Call 503.639.4175 by 7:00 a.m.for the next available inspect n date.
This permit card shall be kept in a conspicuous place on the job site unil completipi of the project.
Approved plans are required on the job site at the time of each inspec ion.
Plumbing Permit Application
Building Fixtures
Received
City of Tigard
q. V(I F.I V F I
Date/By: / wii) „opzi--- Permit No.:fidell,tiotr...ctc.),fc...-
III 13125 SW Hall Blvd.,Tigard,OR 97223 ,,
.111 Plan Review
11 Phone: 503.718.2439 Fax: 503.598.1960'''N 1 9 /._11 I 0
Date/By: Other Permit
Inspection Line: 503.639.4175
IIGAICD , , , ,.. „ n f, Date Ready/By: kris' 0 See Page 2 for
Internet: www.tigard-or.gov 1211''*/ 11!' 11 46,A irtv Notified/Method: -i.1,<, Supplemental Information
'ii. TYPE OF WItlen DING MINION FEE SCHEDUX
I__I
...,„
New construction U Demolition For special information use checklist
Description
Qty.
El<ddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.lEa
or eachutiTotallityicomiection)
' 1
CATEGORY OF CONSTRUCTION ei,:r.,..*, SFR(1)bath 312.70
.,j.,---
and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler(._sq.ft.) Page 2
JOB SITE INFORMATION AND LOCA1I7ON ; Site utilities:
Job site address: \LCatch basin or area drain 18.76
A SO 1.„,,
,..,,,, ‘tir-,' Drywell,leach line,or trench drain 18.76
City/State/ZIP:-77 , N. ,D,(- ,r`'N ,cNt. 2. .,..3 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: C.) 1 Project nam .) \S o.AA-V e.-\r" Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
\h)eez.,. -477y,„ A_r Sanitary sewer(no.linear ft.:_) Page 2
4,- c5-,.-., \---.'e_Ct-1'-‘ ...'N'° ''')VV1 ''''''''''''{'I' , 're\ Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Backflow preventer
Tax map/parcel no.: 231i.02571
,, )5,
:44. imscRwrioN 0 14(.. „,,i.,,,,tvi. Backwater valve
125
"-e14.z°41 Clothes washer
0 Lkit C,..C)b'C'-' ..1.x..)\.V\s\o ,St---)3,..C...9.. Dishwasher .02
Drinking fountain 25.02
\ \ \ CA c.,\ c, Ejectors/sump 1 2525.02
, Rooirry,,,o' f)u• ....7, Tsj Expansion tank 12.51
Fixture/sewer cap 25.02
Name: C",<- ,. 03\ Expansion
Floor drain/floor sink/hub OM 25.02 '', .ell
Address: 1 Lt40 Lk .3,\Ks --c.---7,--y-, ,.11--- Garbage disposal
City/State/ZIP:- -- (DV'aelts,0 v-‘1 Ct 1 2 2 -se,. Hose bib 25.02
I ''` ,
Phone:(503) 1 9 _0 9 g 3 v Fax:( ) Ice maker 12.51
APPLICST NMT PERSON
Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name: 0‘.,.\ N-V\\.'s\c-)V. Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02 3.51 e)
City/State/ZIP: Solar units(potable water) 62.54
Phone:(S)" ) '3\'' - 3., s-g Fax::( ) Tub/shower/shower pan 12.51
Urinal gi 25.02
E-mail:
, • Water closet
61;, ,,i,A41; r4ap r ' ' 25.02
-1"1 ' • . ,,:',.'"'L''",-- 7 7'7 ..'-.- - - Water heater 37.52 _
Business name: t-,
t_}L.or\e,C--* Water piping/DWV 56.29
Address:• 0-\C\'\„.,t_d 0-5 ,x0\0 '‘,1\--e..._ Other: 25.02
t.)
City/State/ZIP: C.J Subtotal iin) -
it, ...
Minimum permit fee: $72.50
Phone:( ) Fax:( )
Plan review (25%of permit fee)
CCB Lic.: P umbing Lic.no.:
\ State surcharge(12%of permit fee)
. .
Authorized signatur 1 Date: TOTAL PERMIT FEE i/
fr%•---,Th
This permit application expires if a permit is not obtained wit itn 180 days
Print name:-"Tr.'0.,1
ifiro el".
' `‘'' after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Budding\Permtts\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
pltf a iTt1 w es, µ. Square Footage n ; Permit ree• n• ry
Footing drain-Pt 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
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54x„
$1.00 to$5,000.00 Minimum fee$72.50i4
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; or Fees' each additional$100.00 or fraction thereof,to
Fee 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
(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
did si
accurately report fixtures could result in increased sewer fees*. Piy few for Plumbing E ations k.
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
Bath: Tub/Shower greater,except systems designed and stamped by licensed
-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 ❑ 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"
Isometric OEiagram
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 beaid before the
Water Extractor p
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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