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Permit (150) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2018-00040 Date Issued: 01/29/2018 TtGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S101BCO2401 Jurisdiction: Tigard Site address: 12650 SW HALL BLVD Project: Snyder Roofing Subdivision: None Lot: None Project Description: Interior plumbing for TI:Relocating(2)2"floor drains,(3)sinks,and(2)water closets. Contractor: RAYBORN'S PLUMBING INC Owner: JFK PROPERTIES OREGON LLC PO BOX 69 12650 SW HALL BLVD 19990 SW CIPOLE RD TIGARD, OR 97223 TUALATIN, OR 97062 PHONE: PHONE: 503-692-4139 FAX: 503-691-2328 FEES Quantity Description Date Amount 2 ea Floor Drain/Floor Sink/Hub 01/29/2018 $50.04 Specifics: 3 ea Sink 01/29/2018 $75.06 2 ea Water Closet 01/29/2018 $50.04 Type of Use: COM 1 12%State Surcharge- 01/29/2018 $25.52 Class of Work: ALT Plumbing 1 ea Water Heater 01/29/2018 $37.52 Type of Const: Occupancy Grp: Stories: Total $238.18 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: c Permittee Signature: / 740(5. Call 503.639.4175 by 7:00 a.m.for the next available inspe on 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. 1 Plumbing Permit Application ` Site Utilities \AIA City of Tigard A • r Received / 13125 SW Hall Blvd.,Tigard,OR 9723 '��1.` Date/By: t �t( (� (6-77-- Permit No.: p � ,� �y)ti� '� Phone: 503.639.4171 Fax: 503.598.1960 ' �+ Plan Review K CJ -- lit,:�It n Inspection Line: 503.639.4175 , Date/By: Permit No.: � � j ' t Ready/By: Auris: ® See Page 2 for Internet: www.tigard-or.gov . s lii: tied/Method: ] `j Supplemental Information TYPE OF WORK a% FEE* SCHEDULE 0 New construction 0°,' fin, For s eeial in ormation use checklist Description Qty. .'rAddition/alteration/replacement 0 Other: P t Total New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 j I-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JO S INFO ., �;, ,��, � � „.:.,. i�T101l1 AM) LOBATION Site utilities: - t7 7 V Catch basin or area drain 18,76 Job site address: /vq ,_<V/ l Rei it 8/vc,2 City/State/ZIP: �"„J (:)/f 9'7? Drywell,leach line,or trench drain 18.76 'l Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Ji(J '' � /7 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 i�'Vet -" - 7 /e3 r LV S .2- floor Arm,- Dishwasher 25.02 / \Ala/tir ue t,Mi-1 / /tk Of S r 4X Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Address: Floor drain/floor sink/hub .2.--- 25.02 Sv-csit Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: RetytOo r 1415 1L v 6 t Medical gas(value:$ ) Page 2 Contact name: j Primer 12 51 Address: s � .t��- // ��- Roof drain(commercial) 12.51 W Ct `Q- ``c.K._ Sink'basimlavatory _. 3 25.02 75-, Vol City/State/ZIP: l,,a `P...- g�OCZ Solar units(potable water) 62.54 Phone:(S03) 6yp. Lit q Fax::(_/03 ) 6ct Tub/shower/showerpan l S � ��.� 12.51 E-mail: Acclic €.504. ,i"� , . G © %A.- Urinal 25.02 CONTRACTOR Water closet 25.02 5V.04 Business name:RAYBORN'S PLUMBING INC Water heater L 37.52 1').S-1 Water piping/DWV 56.29 Address: P.O.Box 69 Other: 25.02 City/State/ZIP:Tualatin,OR 97062 Subtotal ? i Phone:(503)692-4139 Fax:(503)691-2328 Minimum permit fee: $72.50 CCB Lic.:87852 Plumbin ic.no.:34-166PB Plan review (25%of permit fee) Authorized signature: �/ State surcharge(12%of permit fee) j 5 S _, TOTAL PERMIT FEF '�i 39 Print name: �J� � ~f/ed/Y�///et I Date:',-aL�_ (v// I This permit application expires if a permit is not obtained witflin ISO days �/' after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. Plumbing Permit Application - City of Tigard P, ge 2 - Supplemental Information Fee Schedule: Residential Fire Su. g MR� y - � .� --. - ress><on S stems: Footing drain-1"100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69 Sewer-1st 100' 62 3,601 to 7,200 $233.20 Sewer-each additional 100' 7,201 and greater $327.54 37.52 Water Service-1st 100' 62.54 _ Water Service-each additional 100' 37.52 Medical Gas S stems: F�' ) Lt,, �'6 c ipi" r3f "� i� * -.- ,',..: Storm&Rain Drain-1st 100' 62.54 0_x- 1) .0 n .� ,„ r te �, Storm&Ram Drain-each additional 100' $1.00 to$5,000.00 Minimum fee$72 50 37 52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for re C�� ' � 4` Via I „ieach additional$100.00 or fraction thereof to Inspection of existing plumbing or for and including$10,000.00. which no fee is specifically indicated ■ 90.00/hr ■ $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for minimum chaz:e-1/2 hour) each additional$100.00 or fraction thereof,to Inspections outside of normal business - 90.00/hr and including$25,000.00. hours minimum char_•e-2 hours $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for 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 charl e-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*. ni ` -1t � a 6 -Ta 9a ;f 3s t k aee s ..._ fix} s. �Ct ?tn 151,1F"i1tlre:774)7:1P7'1.fpr � 10:1' ' . Plan review is required for any of the following. 1'+P � it Please check all that apply. Baptistry/Font ❑ 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 Thru as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ 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" 1 4„ , , r n I t t ' , t ti ;;:t t t ` .fir,.- '-• Car Wash Drain 0 Isometric or riser diagram is required for new buildings Garbage Domestic non-food that meet the •ualifications 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 2. -Bradley -Com/Serv/Util food related i -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 2- plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2