Permit (140) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00072
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13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/27/2018
TIGARDParcel: 2S 111 ACO2901
Jurisdiction: Tigard
Site address: 9500 SW MURDOCK ST
Project: Templeton Elementary School Subdivision: None Lot: None
Project Description: Site utilities for a new 2-story,80,000 sq.ft.elementary school:(26)catch basins,2,125 ft.of footing drain,(21)
manholes,(16)rain drain connectors,527 ft.of sanitary sewer,4,829 ft.of storm sewer,227 ft.of water service,2
backflow preventers,(4)backwater valves,and(1)grease trap.
Contractor: CALIBER PLUMBING&MECHANICAL INC Owner: TIGARD-TUALATIN SCHOOL
6036 N CUTTER CIRCLE, SUITE 360 DISTRICT 23J
PORTLAND, OR 97217 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 971-563-1672 PHONE:
FAX:
FEES
Quantity Description Date Amount
26 ea Catch Basin or Area Drain 06/27/2018 $487.76
Specifics: 21 ea Manholes 06/27/2018 $393.96
16 ea Rain Drain Connector 06/27/2018 $300.16
Type of Use: COM 2 ea Backflow Preventer 06/27/2018 $62.54
Class of Work: NEW 4 ea Backwater Valve 06/27/2018 $50.04
Type of Const: 1 ea Interceptor/Grease Trap 06/27/2018 $25.02
Occupancy Grp: 1 Plan Review 06/27/2018 $1,102.16
Stories: 1 12%State Surcharge- 06/27/2018 $529.04
Plumbing
2125 If Footing Drain 06/27/2018 $837.95
527 If Sanitary Sewer 06/27/2018 $250.14
4829 If Storm Sewer 06/27/2018 $1,863.50
227 If Water Service 06/27/2018 $137.58
Total $6,039.85
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 rfiobtain a copy of the rules
or direct questions to OUNC by calling 503.232.19 00.332.2344.
Issued By: Rermittee Signature:
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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.
, IPlOmbin2 Permit Application
Site Utilities RECEIVED FOR OFFI( F I sl. ON 1.1
i� Received
City of Tigard /�y;� �,,._ Permit No./.24.11726)/T* ,o�7i
III II 13125 SW Hall Blvd.,Tigard,OR 97223kA�A 10 Date/By:nRera�l✓��L
Phone: 503.718.2439 Fax: 503.598.19gd` 2018Date/By:Plan Review
� R Other Permit No.: ��,f
4,_�,g..(� ,� t�r�crUf
I[('ARD Inspection Line: 503.639.4175 CITYeI ARD Date Ready/By: Y orris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method:7 #1. iii 0 s Supplemental Information
TYPE c� o f NG DIVISION cgp l .c ,�� ;. FEE; D
®New construction ❑Demolition i I u For special information use checklist
�(4- "►star' Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: O'f‘�` ,� �i It New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONS'iitUCTION. ,r 1'.T^ SFR(1)bath 312.70
❑ 1-and 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 ®Other:Elem School Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities: _
Job site address:9500 SW Murdock Street Catch basin or area drain Es 18.76 g 9,76
Drywell,leach line,or trench drain 0 18.76 -
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.:2125) 22 Page 2 T?7.415
Suite/bldg./apt.no.: Project name:Templeton Elementary Scho Manufactured home utilities 0 50.03
Cross street/directions to job site:96th&Murdock Manholes i 18.76 ,96
All site utlity work required to construct a new 2-story 80,000 SF Elementary Rain drain connector 16 18.76 10 . /(i
School Building,including storm,sanitory sewer,fire protectionm,wanter Sanitary sewer(no.linear ft 5x2'1 6 Page 2 B,l5e)/tj
Storm sewer(no.linear ft Q-9 a9 `i 9 1 Page 2 I.,66150'
and natural gas lines,connections and terminations.
Water service(no.linear ft 2;17 1 3 Page 2 /37,S8 I
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.:2S111ACO2901 Backflow preventer ,. 31.27 6c9 B54
,-, . Backwater valve 4 12.51 ga 04
�( s Y '.- DESCRIPTION OF- WORK B
Clothes washer 25.02
Construction of new 2-story 80,000 SF Elementary School Dishwasher 25.02
.�•7 Drinking fountain 25.02
Ejectors/sump 25.02
.1Si PROPERTY OWNER ( r CJ TENANT
Expansion tank 12.51
Name:Tigard Tualatin School District Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:6960 SW Sandburg Road
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97224 Hose bib 25.02
Phone:(503)523-8103 Fax:( ) Ice maker 12.51
2 i'A1*P,ICANT 0 CONTACT PERSON Interceptor/grease trap / 25.02 ,a5,0'),
Business name:Day CPM Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Angela Caffrey
Roof drain(commercial) 12.51
Address:6960 SW Sandburg Road Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97224 Solar units(potable water) 62.54
Phone:(503)523-8103 Fax::( ) Tub/shower/shower pan 12.51
E-mail:acaffrey@daycpm.com Urinal 25.02
Water closet 25.02
CONTRACTOR
/ Water heater 37.52
Business name:TBD
Air. '
I fiber F2/i, i17, q 1 etp!.,171 4 i Water piping/DWV 56.29
Address: 40 /If 0`,.t.r.e. 6•rii f& 51>,4E,3 4() Other: 25.02
City/State/ZIP: riAfi�� �0 R. 7 7-z i Subtotal 4,q®8,is
"[[ Minimum permit fee: $72.50 7
Phone:(„5-03) c/7 5 �' Fax:( ) - Plan review (25%of permit fee) //Q i6
I� 1 B
CCB Lic.: , tiL,.-- Plumbing Lic.no.: g
State surcharge(12%of permit fee) 5,261,64
Authorized signature: C�`
gn TOTAL PERMIT FEE g,031,VS
Print name: Z( `Z Date: ' This permit application expires if a permit is not obtained within 480 days
i�1h..1(V C s 1 '( /i r , after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Peamas\PLMU-PermitApp.doc 10/01/09 440-4616T(IO/02/COM/WEB)
J
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Fee(ea) Total ,
Site Utilities ' Square Footage: Permit Fee:
Footing drain-14 100' •2.101) 1 50.03 5--e L 3 0 to 2,000 $121.90
Footing drain-each additional 100' 21 37.52 717 fa 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' S.2 rj t 1 62.54 6).5-4 7,201 and greater $327.54
Sewer-each additional 100' 5 37.52 177 40
Water Service-1st 100' r)' 1 62.54 4),5-ti Medical Gas Systems:
Water Service-each additional 100' a. 37.52 ri5,04
Storm&Rain Drain-1st 100' Q,Zq� 1 62.54 Valuation: Permit Fee:
(!,;Z•S y $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 4% 37.52 1800,q $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
eacOther Inspections or Fees Qty.- Fe(e11) Total and
includingi $10,$100.000. or fraction thereof,to
and $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: ��9 17 7
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*.
Quantity by Fixture Type Phui Review for Plumbing Installations
Fixture Type for Replace/ ' Plan review is required for anyof the following.
Work Performed: Capped Added Relocate 4
BaptistrylFont Please check all that apply.
Bath -Tub/Shower ® Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ® Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
Car Wash Drain Isometric or Riser Diagram
Garbage Domestic-non-food ® Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
https://daycpm-my.sharepoint.com/personal/schristensen daycpm_com/Documents/Documents/Permitting/FINAL/TMP Plumb Site App-Rev 1.doc