Permit (152) CITY PLMBEM
COMMUNITY OFTIGARD DEVELOPMENT
Permit#: Up LM2018ING-00125PRIT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2018
Parcel: 2S110DA04200
Jurisdiction: Tigard
Site address: 10832 SW KABLE ST
Project: Alcantara Subdivision: ERICKSON HEIGHTS Lot: 3
Project Description: Replace existing plumbing fixtures: (1)dishwasher,(4)water closets,(6)lays,(1)tub and(1)water heater.
Contractor: TTT CONSTRUCTION&PLUMBING, INC Owner: G&B DEVELOPMENT 2 LLC
9210 SW EDGEWOOD ST 10220 SW GREENBURG RD#100
TIGARD, OR 97223 PORTLAND, OR 97223
PHONE: 503-358-7769 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 03/26/2018 $25.02
Specifics: 6 ea Lavatories 03/26/2018 $150.12
1 ea Tub/Shower/Shower Pan 03/26/2018 $12.51
Type of Use: SF 4 ea Water Closet 03/26/2018 $100.08
Class of Work: ALT 1 ea Water Heater 03/26/2018
$37.52
Type of Const: 1 12%State Surcharge- 03/26/2018 $39.03
Occupancy Grp: Plumbing
Stories:
Total $364.28
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: '� i „ r
Permittee Signature: �✓
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 FOR OFFICE USE ONLY
City of Tigard DReactee/iBveyd:
n/v^ 6 /" 44,v Pemit NX)1,y /cG omc
6 / 2�
13125 SW Hall Blvd.,Tigard,OR 97223 (Q� qU
,1111 ul Plan Review
C Phone: 503.718.2439 Fax: 503.598. t Date/B Other Permit No.:
Inspection Line: 503.639.4175 O h-' i 11.741C-11-;
y'
TI G A R U a aDate Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov 3U'ILFiNG 1 a RSI k Notified/Method: Supplemental Information
t-: TYPE OF WORK: EEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
V(Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
Y' = e tt CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
a1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
E Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB.SITE INFORMATION ANDCATION v ; Site utilities:
Job site address: /083 2.. _5?Iv K4 t3(e S'� Catch basin or area drain 18.76
City/State/ZIP: 71 p e 0' re cr 7 y Z Cf
Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 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
"` k D ScRIPTjO ® . WORI Backwater valve 12.51
� Clothes washer 25.02
v Pe pier e (1 K//C-- f 6 s�1 h $ / cti, ?cl r3Dishwasher ! 25.02 2 5, C9'j,
k >G e w 0 n e g Drinking fountain 25.02
Ejectors/sump 25.02
4j PROPERTY 0
�; ; � -� ❑ ;It�� Expansion tank 12.51
P Pi, Reer Z. e� - j e Pg P ) ,r eR / / c Fixture/sewer cap 25.02
Name: L f-(�' T/l/ L-G-
Floor drain/floor sink/hub 25.02
Address: 5'q 1.1,+-I
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:(3'03) Scq - 3 1 I L( Fax ( ) Ice maker 12.51
-' ' 0 APPLICANT CONT r14 'x RSQI Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
5 4 / /, Jorge?'
Primer 12.51
Contact name: Q V (�
1 Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 1._,4,,,.;',. 6 25.02 1501 IL
City/State/ZIP: Solar units(potable water) 4 62.54
Phone:(5C ) ce(3 , ( j ( Fax::( ) Tub/shower/shower pan ( 12.51 1, 5
E-mail: Urinal 25.02
'4, m.. '. ,�, - ski Water closet y 25.02 j 00 ,06
244M,; TRACTOR Water heater / 37.52 51 ,5 Z
Business name: T 7 eigri,A/S/ LC C ti o GY nal/n/147t�� Water piping/DWV 56.29
Address: 36 ei S g C>✓ 71 -r-PK' Other: 25.02
City/State/ZIP: pop FGifavt. Q( t",e '7 Z Z - Subtotal <.t-57g
.hone:(. ' ) L a - 21,(&q Fax:( ) Minimum permit fee: $72.50 '3,A5., 77
�Ailf CCB Lic.: /2,03 6 3 Plumbing Lic.no.:p/3 ,r/ C.., Plan review (25%of permit fee)
V State surcharge(12%of permit fee) 3 J,
Authorized signature:
TOTAL PERMIT FEE 34 y, ,
Print name:
Zi9 K i rT`� Date:d3."2v^`tt This permit application expires if a permit is not obtained within 180 days
` after it has been accepted as complete. !�g//�
*Fee methodology set by Tri-County Building Industry Service Board.4 tel
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 Y Qty. It(ea) Total?„: Square Footage; Permit Fee:
Footing drain-151 100' 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
Storm&Rain Drain-1st 100' 62.54 Val Il: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Stonn&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
each additional$100.00 or fraction thereof,to
Other Inspections or Fed Q� (ea) 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
accurately report fixtures could result in increased sewer fees*. ' "; Pla `Revikw for, robing 1nstallat t► , .',..w
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Alieppace/ 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
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic ❑ 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"
lmetric't ,t ex'ser Diagram
4„
D 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 be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
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