Permit (52) CITY OF TIGARD PLUMBING PERMIT
II COMMUNITY DEVELOPMENT #. u, . ik
p Permit#: PLM2018-00065
13125 SW Hall Blvd.,Tigard OR 97223 503.718 2 ? 1 Date Issued: 02/20/2018
T i� A 1=.f', g Parcel: 2S103AB02400
Jurisdiction: Tigard
Site address: 11340 SW WALNUT ST
Project: MCLEOD Subdivision: None Lot: None
Project Description: Relocating(1)clothes washer,(1)kitchen sink,(1)dishwasher,and adding(2)sinks. 9/17/18:REPRINT to add ice
maker. 2/21/19: REPRINT to add(1)show pan.
Contractor: OWNER Owner: MCLEOD, MIKAYLA A&STUART J
STUART MCLEOD 11340 SW WALNUT ST
11340 SW WALNUT ST TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 971-246-1516 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 02/20/2018 $25.02
Specifics: 1 ea Dishwasher 02/20/2018 $25.02
3 ea Sink 02/20/2018 $75.06
Type of Use: SF 1 12%State Surcharge- 02/20/2018 $15.01
Class of Work: ALT Plumbing
Type of Const: 1 ea Ice Maker 09/17/2018 $12.51
Occupancy Grp: 0 12%State Surcharge- 09/17/2018 $1.50
Plumbing
Stories:
ea Tub/Shower/Shower Pan 02/21/2019 $12.51
0 12%State Surcharge- 02/21/2019 $1.50
Plumbing
Total $168.13
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. 2.1987 or 1.800.332.2344.
1
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection tlbTe.
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 RECEIVE
Building Fixtures FOR OFFICE U,SE�O\11..\" �/� �,�
City of Tigard FEB 212019 Received
Date/By: i /21 T /,, Permit]°�//�ls`ti rr 6
II II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /
_ Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGARD to/By. Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 BUILDING DIVISIO ate Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
itcadition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
Eand 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building 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: / /3 S�) (.�ti In S1-- Catch basin or area drain 18.76
t `7 Drywell,leach line,or trench drain 18.76
-
City/State/ZIP: Q!Z 97223
� 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.: ) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
/� m$„w' " Clothes washer 25.02
U ,-,- )461_,,e,-, ,,,i1 `C7 6 tL4eNtt 'Qrlit/tr Dishwasher 25.02
gr 7.0(S* O 2 6 5 I Drinking fountain 25.02
Ejectors/sump 25.02
G.PIlr6PERTY OW TEA Q," NANT 4 Expansion tank 12.51
Name: 4 i-1- Pi 6-(42t4
Fixture/sewer cap 25.02
//� 99 Floor drain/floor sink/hub 25.02
Address:
/3 L/O S� )a,�r-,i,y Garbage disposal 25.02
City/State/ZIP: j i y ''�
Ltit Z Z
(�� q 7 Hose bib 25.02
Phone:(" 71) 2'96
1516
Fax:( ) Ice maker 12.51
... Interceptor/grease 25.02
0 APPLICANT ❑ CONTAC)C PERSONtrap
Business name: Medical gas(value:$ ) Page 2
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 *- I/ 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: 0407,1,,,,,/-
/ Water piping/DWV 56.29
Address: �" Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:S{ C j This permit application expires if a permit is not obtained within 180 days
/14'LtFi C y' Date: �Z�/ 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(ea) Total Square Footage: ?ermit Fee:
Footing drain-Is'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: tern*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
r��.. .. Qty Feetea) Total each additional$100.00 or fraction thereof,to
1r'-Inspecti lr s 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.
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
moi: w :... � ..: ,. .
accurately report fixtures could result in increased sewer fees*. Plan R64*for Plumbing Insulations
QuanBq by Fixture Type' Plan review is required for any of the following.
FixtureTypefor x= Replace/ Please check all that apply.
Work Performed: Capped : Relocate 0 Any new commercial building with water service 2"and
Baptistry/Font 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 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"
P\. H :--- (.. ...:
4 ❑ 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:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
CITY OF TIGARD PLUMBING PERMIT
II COMMUNITY DEVELOPMENT Permit#: PLM2018-00065
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2018
f c;.1 It.T� g Parcel: 2S103AB02400
Jurisdiction: Tigard
Site address: 11340 SW WALNUT ST
Project: MCLEOD Subdivision: None Lot: None
Project Description: Relocating(1)clothes washer,(1)kitchen sink,(1)dishwasher,and adding(2)sinks. 9/17/18:REPRINT to add ice
maker.
Contractor: OWNER '�I Owner: MCLEOD, MIKAYLA A&STUART J
STUART MCLEOD 11340 SW WALNUT ST
11340 SW WALNUT ST TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 971-246-1516 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 02/20/2018 $25.02
Specifics: 1 ea Dishwasher 02/20/2018 $25.02
3 ea Sink 02/20/2018 $75.06
Type of Use: SF 1 12%State Surcharge- 02/20/2018 $15.01
Class of Work: ALT Plumbing
Type of Const: 1 ea Ice Maker 09/17/2018 $12.51
Occupancy Grp: 0 12%State Surcharge- 09/17/2018 $1.50
Stories: Plumbing
Total $154.12
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: •
/'/ ermu ee Signature: w
Call 503.639.4175 by 7:00 a.m.for the next available inspect' ate.
This permit card shall be kept in a conspicuous place on the job siteit curtf ompletion 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 1VedAri- Permit xo.: ��y p k�
14 13125 SW Hall Blvd.,Tigard,OR 97223 E N Review
`� � "V a��V�'SP
Review
Phone: 503.718.2439 Fax: 503.598.1960 � Date/By: Other Permit No.:
Inspection Line: 503.639.4175 ate Ready/By: orris: See Page 2 for
IIC;ARD ft 2W
Internet: www.tigard•or.gov FEB 'A Notified/Method: 'WC Supplementatlnformation
TYPE OF WORK tiliiiyof TIGARD FEE* SCHEDULE❑New construction ❑DemQjDING DIM 1 k`fit~ For special information use checklist
jDescription , Qty. i Ea. f Total
ErAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)b,, 312.70
I31-and 2-family dwelling 0 Commercial/industrial 437.78
❑Accessorybuildingg1! s alit ' . 500.32
0 Multi-family
❑Master builder ❑Other: E'Fff , :i .ath/kitchen 25.02 ;
(sprinkler(__sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 1(3 1/0 S W uk l„,f,,,.i-- cf- Catch basin or area drain 18.76
City/State/ZIP: ' Drywell,leach line,or trench drain 18.76
Ci
ty t5r,r(2, . 0(� 9 7 Z 11 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.: ) Page 2
C1/i /7 2 a-P[044.4 l-l) l U (Y)of//.,s,� Storm sewer(no.linear ft.:___) Page 2
Water service(no.linear ft.:-,_,_, Page 2
Subdivision: ( Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valveINII 12.51
` ( i /L \\\ Clothes washer LmI
Motr,tl(tL' e-r t1,c(1I `4.i �,5 l ) c-' .
D�E� G S c(11‘. C l o t l, ) 44\12k, (1Q�.) 4 A�(K;4C a19 Drinking fountain 1
ta:L�h� r d(LX r Ejectors/sump 25.02 '
5 PROPERTY OWNER ' I 0 TENANT Expansion tank 12.51
Name: 54((kr4- M cLc.ce4,
Fixture/sewer cap 25.02
Address: t, p , _ �}� Floor drain/floor sink/hub 1
1I 4.0 S tw I.CM`� nv"' �� Garbage disposal 1
City/State/ZIP: 74 v„YO� 01- 9 ) 12 3 Hose bib t
Phone:(9 7 i ) /mg is 16 Fax:( ) Ice maker 1 12.51 /)_ >> I/7/,r
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25 t
Medical gas(value:$ ) Page 2
Business name: Seild as a
Primer 12.51
Contact name:
Roof drain(commercial) 12.51 I
Address: Sink/basin/lavatory 3 25.02cls —
City/State/ZIP: Solar unitg(potable water) 02,54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 ,
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: a114/ PP f�
Water in WV 56.29
.
Address: Other: 25.02
City/State/ZIP: Subtotal 1L5 1;) '
( )
Phone:( ) Fax: Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) /5,01
Authorized signature: '3" 'f. z��- TOTAL PERMIT FEE /di(),//
Print name: S-�c€r/-i 1 `L�_ea" Date: -y20/6'' 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.
[:\BuldingTermits\PLMU-PermitApp.doc 10/01/09 440-4616T(l0/02/COM/WEB)
INCITY OF TIGARD PLUMBING PERMIT
` COMMUNITY DEVELOPMENT Permit#: PLM2018-00065
T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/20/2018
Parcel: 2S 103AB02400
Site address: 11340 SW WALNUT ST Jurisdiction: Tigard
Project: MCLEOD
vision:
Project Description: Relocating(1)clothes washer,(1)kitchen sink,(1)dishwasherr,,and adding(2)sinks. None Lot: None
Contractor: OWNER
STUART MCLEOD Owner: MCLEOD, MIKAYLA A&STUART J
11340 SW WALNUT ST 11340 SW WALNUT ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 971-246-1516 PHONE:
FAX:
FEES
Quantity Description Date
Amount
1 ea Clothes Washer 02/20/2018 $25.02
Specifics: 1 ea Dishwasher
02/20/2018 $25.02
Type of Use: SF 3 ea Sink 02/20/2018 $75.06
Class of Work: ALT 1 12%State Surcharge- 02/20/2018 $15.01
Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $140.11
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: • yr
Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection c;l.,
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; I SI 0y1.1
City of Tigard .iiierved
ll II 13125 SW Hall Blvd.,Tigard,OR 97223 I r� y Permit No.:�G• "4 -1 t ry 1� w e-
ll r7( `� (P O
I Phone: 503.718.2439 Fax: 503.598.1960 an Review
Inspection Line: 503.639.4175 Date/By: Other Permit No.:
7 I G A R D 2�i r late Ready/By:
Internet: www.tigard-or.gov 1.".:E9 4 'JurisC I S See Page 2l for
Notified/Method: Supplemental Information
TYPE OF WORK "IGARD . FEE* SCHEDULE
o New construction of 1y t) „il ji(�
❑Demoj> �NG For special information use checklist
ErAddition/alteration/replacement 0 Others Description IQty. I Ea. Total
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
[3 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath
437.78
❑Accessory 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 INFORMATION AND LOCATION Site utilities:
Job site address: I i 3 go S W W4,14(„,i-- cf-- Catch basin or area drain 18.76
City/State/ZIP: 1 i ie. 0�� 4'7 q Z? Drywell,leach line,or trench drain 18.76
G J Footing drain(no.linear ft.:
Suite/bldg./apt.no.: Project name: ) Page 2
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes
18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:) Page 2
Subdivision: I Water service(no.linear ft.: ) Page 2
Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
�11 } Clothes washer
MOW; (acid .1 nS \ 1 �lt9ty S'I\\kS ( i+k f rA) 1 25.02 `'
^��( _ L 11 ( Dishwasher 25.02 )„,Cr ‘
,J 1� Ione- �;1n_11( I�� P� eti n21.) S.n C� K,tG�Q() Drinking fountain 1 25.02 ��
0:5hc . r d(L .., I aatiJ Ejectors/sump 25.02
Er PROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name: 54 kq r-F M ti � Fixture/sewer cap 25.02
Address: I(i)yD SC) p _-ce I n ccFloor drain/floor sink/hub 25.02
City/State/ZIP: ( �•CI ` Garbage disposal 25.02
Tv 0 9 ) 223 Hose bib 25.02
Phone:(97 I ) 2_4 g dvir%(s 16 Fax:( )
Ice maker 12.51
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap
25.02
Business name: ,..i j Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
Address: Roof drain(commercial) 12.51
Sink/basin/lavatory 3 25.02 _cit,'
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
Business name: 0l.r ✓ Water heater 37.52
Address: Water piping/DWV 56.29
Other: 25.02
City/State/ZIP:
Subtotal is-5:/0
Minimum permit fee: $72.50
Phone:( ) Fax:( )
Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.:
Authorized signature: .. ,"- State surcharge(12%of permit fee) 15.01
�d� TOTAL PERMIT FEE
Print name: L Thispermit a r s
S-F�,,r r'- pil e I Date: 7.720 1 c I pplication expires if a permit is not obtained within 180 days
after it has peen accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Buuiklisg\PermitskPLMiJ-PermitApp.doc 10/01/09 440-4616T(10/02JCOM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11340 SW WALNUT ST, TIGARD, OR, 97223 February 21 , 2019 at
10:51 :30 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00065
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Add shower to permit as noted on shower pan inspection dated 4/6/18.
Plumbing final can be scheduled for approval after correction complete.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11340 SW WALNUT ST, TIGARD, OR, 97223 February 22, 2019 at
7:25:27 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00065
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor