Permit CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Permit#: PLM2018 00101
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/13/2018
Parcel: 2S111AA11700
Jurisdiction: Tigard
Site address: 14466 SW 90TH AVE
Project: Greensward South, Lot 11 Subdivision: GREENSWARD SOUTH Lot: 11
Project Description: New SF.
Contractor: AUSTIN BROWN LANDSCAPE Owner: FOUR D CONSTRUCTION
PO BOX 14441 PO BOX 1577
PORTLAND, OR 97293 BEAVERTON, OR 97075
PHONE: 503-887-7795 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 03/13/2018 $31.27
Specifics: 1 12%State Surcharge- 03/13/2018 $8.70
Plumbing
Type of Use: SF 41 ea Minimum Fee Adjustment- 03/13/2018 $41.23
Class of Work: OTR 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 ad.?ed by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt a,copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,,..0.' / Permittee Signature:
aPIL—Are' ",
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 oft • proj. t.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
RECEIVE _�•.. Received //�
City of Tigard // l _.- Permit No.:f ryy o �,,,, i
1111
11 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: /, I�(J {
li Phone: 503.718.2439 Fax: 503.598.1960 MAR 13 2018 Date/By:an Review Other Permit No.:/nS`T 7-61lis(�
!7`Ci (A�/
Inspection Line: 503.639.4175 Date Ready/By: Atm: See Page 2 for
T 1 G A R D Internet: www.tl and-or. ov T / 1 HD Notified/Method: Supplemental Information
g g s�����i1i� r,�' �� `jt�.+ r pP
TYPE OF WO> J�LD�NG DIVISION " E* SCHEDULE
For special information use checklist.
New construction ❑Demolition Description Qty. Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
;CATEGOR OF CONSTRUCTION , SFR(1)bath 312.70
'511-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I kl t/theC 1X3 I 0+1-^ l - Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: ,el vt-2..-o CIL
� Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 1 Project name: 6)i2-& L Vry i 11 Manufactured home utilities 50.03
Cross street/directions to job site: e7ti- ,v .4- I&5 ?- 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: 3
Tax map/parcel no.: Backflow preventer l 31.27 JI.)-7
CRIPTI AT p-'\SORK Backwater valve 12.51
Jo,. �� t �`,' � � �` Clothes washer 25.02
Gi c-/ ` z t N57 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 1' 1QPERT ' OWNER '<: 0 TENANT' '4 1- . Expansion tank 12.51
Name: i't eCU 0 6-01'0V% Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51f Interceptor/grease 25.02
4 1:1 op' 'ANI` ;,...;.-i., ``��: ❑ 01 �'AGT PE� N� trap
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 12.51
E-mail: Urinal 25.02
; ., , CONT (R Water closet 25.02
" .,;.;; -. .. - Water heater 37.52
Business name: 1,41,4 /./A.) 6Oj/ ,1 3 1�} S6 /t\ Water piping/DWV 56.29
Address: L2b ( 4/1(( Other: 25.02
City/State/ZIP: p / M-` C)( - e I-1)-1S Subtotal
'3i 6)7
�,5-ePhone:(�7�) 9S-1- 9-?-- Fax:( ) Minimum permit fee: $72.50
2� Plan review (25%of permit fee) --
CCB Lic.: 1. ie.no.: State surcharge(12%of permit fee) t,-70
Authorized signature: TOTAL PERMIT FEE g i,_6
Print name: ', 1( / f..- l } ) Date: (,'? (" This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site,Utilities S . 'Vee(ea) f >< ;$quare Footage: , PPermit Fee:
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
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' 62.54 $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
Qty: Fee;Ca Total each additional$100.00 or fraction thereof,to
Otll # SpeCt1ons 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
msµ.., .
accurately report fixtures could result in increased sewer fees*. '.an R w for Plumbing I s illations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ ` Please check all that apply.
Work erformed: Capped Added Rell9cate
Baptistry/Font ❑ Any new commercial building with water service 2"and
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
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ 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"
Isometric or Riser Diagr
El 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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14466 SW 90TH AVE, TIGARD, OR, 97224 March 19, 2018 at 7:29:06 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00101
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
1 "Wilkins model 350, serial # A639666 located left side of driveway.
Violation Summary:
Inspector Contractor