Permit (94) CITY OF TIGARD PLUMBING PERMIT
1 . COMMUNITY DEVELOPMENT Permit#: PLM2018 00228
T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/15/2018
Parcel: 2S102CB01500
Jurisdiction: Tigard
Site address: 10425 SW PARK ST
Project: Durdel Subdivision: NORTH TIGARDVILLE ADDITION Lot: None
Project Description: Install 150'sanitary sewer line to connect existing house to public sewer.
Contractor: SANITECH LLC Owner: DURDEL, MARGO L
201 SHIRLEY ST 10425 SW PARK ST
MOLALLA, OR 97038 TIGARD, OR 97223
PHONE: 503-803-1207 PHONE:
FAX: 503-303-8238
FEES
Quantity Description Date Amount
150 If Sanitary Sewer 05/15/2018 $100.06
Specifics: 1 12%State Surcharge- 05/15/2018 $12.01
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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 y.. • follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0:1-06,0 You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. A
Issued By: `�� ,ee Signature:
Al
war
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 RECEIVED FOR OFFICE USE ONLY
City of Tigard Received
Date/By: //�� 1" r Permit NoP Gj� ®�.,
114 U 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 14 2018r�
C Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Other Permitui� �� '��
6.Date/By:Inspection Line: 503.639.4175 CITY OF T!GARITIGARD
Date Ready/By:
Internet: www.tigard-or.gov Jura. 2
BUILDING t�piISdt N Notified/Method: Page Supplemental
'," � Supplemental Information
v
`TYPE OF WORK
1 Y � , : FEE* SCIIEDIJLE'x i r<
0 New construction 0 Demolition For special information use checklist.
Description Qty. 1 Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
` . `` s,y CAT
EGORY OF:
F CONSTRUCTION. , SFR(1)bath 312.70
1 (1-and 2-family dwelling 0Commercial/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
IQt3 $,fTE£INFOR14AT1(ON AND LOC;ATI.ON,„ ,,. Site utilities:
Job site address: ID �� C;, 1 ih j�t , Catch basin or area drain 18.76
City/State/ZIP: �j lab J!�t,z___I 17 Z.Z.�j Drywell,leach line,or trench drain 18.76
7 l t Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.;.--- --r I 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
. Backwater valve
«� � � �� moi, , ' < 12.51
D.S flow
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
YEA t R $i I' ,,s °T N :w.,, Expansion tank
12.51
Name: m. / ia �! L
Fixture/sewer cap 25.02
Address: a(-)--- SvO j�a �� Floor drain/floor sink/hub 25.02
f Garbage disposal 25.02
City/State/ZIP: r. ' J Ie--'V"'- Hose bib 25.02
Phone:
($ ) (9,if 0--
117 Fax ( ) Ice maker
12.51
AP LI Ah ] CONTAT E3 o Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
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
re f>< ' r t'
ONT.RAc OIi" Water closet 25.02
^',. /: �. Water heater 37.52
Business name: • , ..v ikyyt p`' S-47.4/:./..e4, 1 Lc_
. L Water piping/DWV 56.29
Address: Fp ' Other: 25.02
City/State/ZIP: V A..olja(ti O ! y 7D 53 Subtotal
Phone:( ) l Fax:( ) Minimum permit fee: $72.50
f---7 V
CCB Lic.: 11.1„ J l '+- . v .'.. ic.no.: P'5 I l).\7?__ Plan review (25%of permit fee)
up
i State surcharge of permitfee)
Authorized signature. /
TOTT ALL PERMIT
FEE
Print name: Z Date: J / ' I This permit application expires if a permit is not obtained within 180 days
dere o I ,Sip0 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doe 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:
it Utilities ::,. .,,Qty: Fee(e ) " otat4square Footage,; , '1' r t, ee• . --
Footing
Footing drain-1"100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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 "1"-'3aluation. ermit 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
� Q#y Feeeaotal each additional$100.00 or fraction thereof,to
Other,Inspection,� s or Fees,- a ,f, T. e 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.
$50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
Additional plan review for revisions 90.00/hr
each additional$100.00 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*. lac n Revrevv.for Plumb g nsta„ t o
Quantity by 'ixture Type Plan review is required for any of the following.
Fiture Type for Repl*t Please check all that apply.
Work,Performed: , ., Capp Aided Relocate ❑ 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 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2" N P .
-3" ti Is metric or'Riser Diagra* .
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 Comments regarding fixture work:
Ice Mach./Refrig.Drains
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 plumbing permit can be issued.
Water Closet-Toilet
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:
10425 SW PARK ST, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2018-00228
Inspection Type: Inspector:
395 Misc. inspection Don Sylvester
Result:
PASS
Comments:
1 . Pump receipt and back fill for septic tank- approved
Violation Summary:
Inspector Contractor