Permit (143) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00333
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/11/2018
TIGARD Parcel: 2S 111 CA00400
Jurisdiction: Tigard
Site address: 15195 SW 98TH AVE
Project: Nelson Subdivision: ALDERBROOK FARM Lot: 10
Project Description: Add bathroom to basement with(1)shower,(1)water closet,(1)lay,and(1)backwater valve.
Contractor: THE PLUMBERS INC. Owner: NELSON, GARY&SANDRA
90 NW 150TH AVE NELSON, KEVIN ERIC
BEAVERTON, OR 97006 15671 SW SUMMERFIELD LN
TIGARD, OR 97224
PHONE: 503-519-6644 PHONE:
FAX: 503-684-1202
FEES
Quantity Description Date Amount
1 ea Backwater Valve 07/11/2018 $12.51
Specifics: 1 ea Lavatories 07/11/2018 $25.02
1 ea Tub/Shower/Shower Pan 07/11/2018 $12.51
Type of Use: SF 1 ea Water Closet 07/11/2018 $25.02
Class of Work: ALT 1 12%State Surcharge- 07/11/2018 $9.01
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $84.07
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 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: Kf:/)
i% %�/ Permittee Signature: A-1-4/-4L. )-1.•
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 � k
Building Fixtures FOR OFFICE USE ONLY
qq pp Received
Cl of Tigard JUL
2 I U Permit No
i 13125 SW HallllBlvd.,Tigard,OR 9722 Date/By: ���� ' PL/./ �/�'(�O33
3
a Plan Review
111 ligPhone: 503.718.2439 Fax: 503.598.1ii
T � � � Other Permi T;2►/ -6'O/rs
Date/By:
T I G A R D Inspection Line: 503.639.4175 BtAnING D,�1� S p 4 \-ate Ready/By: kris: Ea See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE O1 'ORK " 'PEE'*'SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
{ SFR(1)bath 312.70
� ', ` CATEGORY OF:CONSTRUCTION �' ......E •`��
1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
dOD SITE INFORMATION AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: % y�d d X72 yz V.
F- Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: 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 31.27T Backwater valve / 12.51
k,1 f CRS M. 14, OF WORK . t
:. Clothes washer 25.02
TCadel.41 ��-rftDishwasher 25.02
-t t er t 4.'li7'7✓061 i/YI Drinking fountain 25.02
Ejectors/sump 25.02
' " p-PROPERTY OWNER .�# n - Expansion tank 12.51
Name: 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 12.51
' i -Po1 '- ' CONTACT ON Interceptor/grease trap 25.02
,,,441816
Medical gas(value:$ ) Page 2
Business name:
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::( ) Tu- show./shower pan / 12.51
E-mail: Unna 25.02
,a - r s 1 Water closet / 25.02
CONTRACTOi ., . ' Water heater 37.52
Business name "Y14 Kllct/a --PI(' . Water piping/DWV 56.29
Address: 7) ,,) u) / 6) 'OA 4-"OIL- Other: 25.02
City/State/ZIP: j/,Qy ).--1 6,e, q-?OLl0/ Subtotal /S 0 k'
Phone:((jj 3) 479'r &64i- Fax:( < ) o '41- Minimum permit fee: $72.50
CCB Lic.: /9 7?-// Plumbing Lic.no.:17 v9, Plan review (25%of permit fee)
State surcharge(12%of permit fee) l 0/
Authorized signature: TOTAL PERMIT FEE ep / 97
Print name:. , / Date: ` This permit application expires if a permit is not obtained within 180 days
,4A11 J¢ /V/ -�S 6, .1 G-/r 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:
r Site Utilities Qty. Fee(ea) Total.4, Square,Footage: r`Permit Fee:
Footing drain-15`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 _7
'valuation k Permit eery.
Storm&Rain Drain-1st 100' 62.54 r'"
$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
Other Inspe l r Fees r Fee ea Toff, each additional$100.00 or fraction thereof,to
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*. for Plu. E o ° ustallationjs
Quilt# by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped ,ks 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
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall
0 New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 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"
3"
.4,140.n. Iso" {" :or Riser M g 'x „1„a�
4
0 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:
15195 SW 98TH AVE, TIGARD, OR, 97224 August 21 , 2018 at
12:24:07 PM
Record Type: Record ID:
Residential - Plumbing PLM2018-00333
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
No access for inspection, no one home. 12:23 pm
Left message with 1 hr notice for inspection as requested with Inspection.
Violation Summary:
Inspector Contractor