Permit (114) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00009
TCC.;1 h.D13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/10/2018
Parcel: 2S 110AA01100
Jurisdiction: Tigard
Site address: 14240 SW PACIFIC HWY
Project: The Gardener's Choice Subdivision: None Lot: None
Project Description: Adding backflow preventer located outside,closest hotbox to the meter inside fence.
Contractor: MP PLUMBING CO Owner: BATES, STEPHEN C&JODETTE S
PO BOX 393 10430 SW VIEW TER
CLACKAMAS, OR 97015 TIGARD, OR 97224
PHONE: 503-655-9161 PHONE:
FAX: 503-655-1726
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 01/10/2018 $31.27
Specifics: 1 12%State Surcharge- 01/10/2018 $8.70
Plumbing
Type of Use: COM 41 ea Minimum Fee Adjustment- 01/10/2018 $41.23
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 1.800.332.2344.
Issued By: � / for .ermittee Signature:
- '2/14 ICA,
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 ADD'kat
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Building Fixtures
1.0R ()Hi( 1 l S1: O\11
City of Tigard I 0 4 ?U 1 iReecived
;� 13125 SW Hall Blvd.,Tigard,OR 97223 Duda : ���� i,
Phone: 503.718.2439 Fu: 503.598'i ' ' i ' x 'i` Alan Review — ���' _�
i r r.,,vr.r r Inspection Line: 503.639"4175 °..3� 3_�r `' t�'`) : Other Permit No.:
Internet: www.tigard-orgov �(i A ����;"t �i\`/°�. �"��Due Ready'By: iiIIIERM
TYPE OF WORK e iF ( i Noli-ried/Method:
❑New construction FEE* SCHEDULE
❑Demolition
0 dditiontalteration/replacementDescri 'on
0 Other IMIII Ea. Total
7. CATEGORY OF CONSTRUCTION New I-2-famil•dwellin. (includes 100 R.for each unlit connection)
❑I-and 2-family dwelling ire 312.70 M.
ommercial/industrial _��
❑Accessory building
0 Multi-family IMEMIJMIIIIMIIMIIIIIIII500.32
❑Master builder 0 Other: Each additional bath/kitchen _
25.02 —
JOB SITE INFORMATION AND LOCATION
Job site address: - •
1 1 , Catch basin or arra drain ENE 18.7b
I 1 1 _ Drywall,leach line,or trench drain 18.76
5uite/bldgJapt.no.: Project name: Footing drain(no.linear R.: _) Page 2 M
r,- s r,. I i - ' 0 '
MN
Cross street/directions to job site: - 50.03
Manholes =®—
Rain drain connector
Sanitary sewer(no.linear R.:_ ) Page 2
MEM
Storm sewer(no.linear R.: )
Subdivision: Water service(no.linear R.:,�) Page 2
Lot no.:
Tax map/parcel no.:
Backflow ptevcntec ®
DESCRIPTION OF WORK _111111111E31111111111111
- • k" ' Ate:. 6, .� 41 cher r 25.02
wasr. . w . - .> . ti►r/ , r 25.02 ME�ll a_ Drinking fountain
* • � i ' � 25.D2
Ejectois/sump
❑ PROPERTY OWNER 25.02
El TENANT Expansion tank 12.5!51
Fixture/sewercap 111111 25.02
Mill
Adm: Floor drain/floor sink/hub
25.02 _
Garbage disposal 25.02
MEI
Phone:( ) Hose bib IIIIII 25.02
MEM
❑ APPLICANTIce maker
0 CONTACT.PERSON Interceptor/grease trap =®_
: - mom
contact zs.a_
natni
Medical gas(value:S ) —
IMMIllin
Roof drain(commercial) 11MEM®�
Sink/basin/lavatory 1111125.02
M.
Phone:( ) Solar units(potable water) 111111 62.54Mailliiiillim
Tub/shower./showerpan '®—
Urinal MN 25.02
CONTRACTOR Wafer closet 25.02
MN
) 1 p I. ti _®
Address: • s �, Water piping/DWv 56 29 11111111
• . Other
•C r r Mil25-02
Phone: 1 ) , I (Q% Fax:60 ) • A -
` • Minimum permit fee: 572.50
Plan (25%ofpennit fee) 111.111
co• Plumbing Lic,no.: 3
Authorized signature: t , 1 12 _y�, igigni State surcharge(12%of permit fee) `AM
® � ENE glom TOTAL PERMIT FEE MUM w
1 ' Date:1 Tlds permit applie het:spires Ira permit Isar:obtaia:d Wilde ria days
after It hu been accepted mpkle.
•Fee methodology yet by Tri-County Building industry Service Guard
I Budding Permits Pt.MU-P inirApp.doc 1001.09
4404616Th 0 02,C07t WEBI
Plumbing Permit Application - City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities" _ .r v _ < ` "Qty',, 'Fti c ) Total- Square Footage: ' Permit Fee:
Footing drain 1*100' 50.03r 0 to 2,000 S 121.90
2,001 to 3,600 516969
Footing drain-each additional 100' 37.52 3.601 to 7,200 5233.20
Sewer-1st 100' 62.54 7,201 and greater S327.54
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::.
Stone&Rain Drain-I st 100' 62.54 S1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to S10,000.00 S72.50 for the first S5,000.00 and$1.52 for
Fee(ea) Total each additional S100.00 or fraction thereof,to
OtherInspections'or Fees • and including SI0,000.00.
Inspection of existing plumbing or for 510,001.00 to$25,000.00 S148.50 for the first 510,000.00 and 51.54 for
which no fee is specifically indicated 90.00/hr each additional 5100.00 or fraction thereof,to
(minimum charge .1/2 hour) ,...and including$25000.00.
Inspections outside of normal business ^90.00/hr $25,001.00 to S50,000.00 5379.50 for the first 525,00000 and$1.45 for
hours(minimum charge-2 hours) each additional 5100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and includi ,S50000.00•
Additional plan review for revisions 90.00/hr $50,001.00 and up 5742.00 for the first S50,000.00 and SI.20 for
each additional 5100.00 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*.
- - -Oul ti tbyFixture,TynePlan Review for Plumbing InstaHations
Fixture Type for review is required for any of the following.
;
Work Performed: x -,n Capped Added' Relocate Please check all that apply.
Baptistry/Font
0 Any new commercial building with water service 2"and
Bath -Tub/Sh
-Jacuzzi/
wer greater,except systems designed and stamped by licensed
-Iac-Jacuzzi/Whirlpoolengineer,
Car Wash -Each Stall
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
-Cuspndot Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
_ - 'Isometric or Riser Diagram ,
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic non-food - that meet the qualifications above.
Disposal -Domestic iooti
foul related
-Commerr:ial food related _
-Industrial-food related
Ice MachJRefrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall -
Sink/Lav -Non-food related
-Bradley
-Commercial-food related ,
-Service
_Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet
Urinal plumbing permit can be issued.
Other Fixtures:
httpliwww,tigard-or.govfdocument center/Building/PLMF PcrmitApp.dip