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Permit (204) CITY OF TIGARD PLUMBING PERMIT 2 COMMUNITY DEVELOPMENT if t Permit#: PLM2018-00353 HallBlvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/18/2018 T[C���tz.L� 13125SW 9 Parcel: 25111 BA01600 Jurisdiction: Tigard Site address: 9744 SW VIEW TER Project: Adamamy Terrace Subdivision: Lot: Project Description: 100 ft.of sanitary sewer for relocation of sewer lateral. Contractor: OWNER Owner: MITCHELL, PATRICIA MICHAEL&PATRICIA MITCHELL 14325 SW 97TH AVE 14325 SW 97TH AVE TIGARD, OR 97224 TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 100 If Sanitary Sewer 07/18/2018 $62.54 Specifics: 1 12%State Surcharge- 07/18/2018 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 07/18/2018 $9.96 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � Permittee Signature: Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures E� , FOR OFFICE USE Ol\'L\ Cit of Tigard .19...! VE Received City g Permit No.: ill II 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: "7/�7/I �, 'jy ��17 i j�.. � 3 0 l7 2�, Date/By:Phone: 503.718.2439 Fax: 503.598.1 Plan Review Other Permit No.: 2 g g �i l Y OF-TIGAR Notified/Method Page l for ��� 1 1 tJ t jk(, �9 PP alai Information Inspection Juris: kJ See T 1 i,A f�.`4.� '''t TYPE OF-W t Date Read/B .,,.'. --. _.. .. s ecnon Line: Internet: www.tr and-or, ov Su leme it iS �S 0 ❑New c��.�t.,a .�. r, -- - z �A 1�1'S� �`'lrFEE*�$�'I�DULE '' r construction 1 n Fors ecial in ormation use checklist Description �� Qty. I Ea. I Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) t^ C%tEGORY OF CONS 1jt'd,(CTION F SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder Other: // 0 Fire sprinkler( sq.ft.) Page 2 r "4: .I' t STT FORMATI AND LOCM ION,' �,�j�'• M ;Q.�![ ,:a, Site utilities: Job site address: d F - Al Catch basin or area drain 18.76 ,,�! il Dryweli,leach line,or trench drain 18.76 City/State/ZIP: `'i U Z _ - /` �� ��_. .. _ - Fo g drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project nam : 1-6)/1'sy1 44,1 ry1 /e/ /let Manu ctured home utilities 50.03 Cross street/directions to job site: $_t, r 4�, 41 4- ,_3.,..,.-..•,,,,- --_. 1V1annholes 18.76 Air be/.4) _� Rain drain connector 18.76 • Sanitary sewer(no.linear ft.:/(,J C Page 2a-sl'( Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_ ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 F� is„ ai oON OF o r, Backwater valve 12.51 Clothes washer 25.02 Sew 4� :64.7-t, � ( 7/2 ?O t" Dishwasher 25.02 i-d-hi fir-ifcr v Drinking fountain 25.02 Ejectors/sump 25.02 n '"e1 , ) rR0js g E .�I. 1 `_) '6 . $ t'4:44:14;:- Expansion tank 12.51 Name: /i!e 1.747 ,2,-.6 ,-a,i fe'LZ- Fixture/sewer cap 25.02 � Floor drain/floor sink/hub 25.02 Address: /e.(1/0_ ^ S e,(/ c:! ,,c___ Garbage disposal 25.02 City/State/ZIP: /7 drlie__.t> o"/L. Hose bib 25.02 Phone:(9'7O 7 7 7 t. U C.73 Fax:( ) Ice maker 12.51 ,a 1 APPLICANT ,+,�/ �-CONTA b',t,f ; Interceptor/grease trap 25.02 Business name: r+ __ ..,...s- ,-Lan Medical gas(value:$ ) Page 2 '^e_ 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 �r T�i, Water closet 25.02 n-Ii4 , Vi!.' :; - . ,-xa, L ` ' r- °; ' Water heater 37.52 Business name: G�'^'�/1. f Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal (j,,-..91-1 Phone:( ) Fax:( ) Minimum permit fee: $72.50 7,131) CCB Lic.: '.Dumbing Lic,no.: Plan review (25%of permit fee) i4/,/( v" State surcharge(12%of permit fee) ..f:.7 0 Authorized signature. �� �Gr a TOTAL PERMIT FEE i Print name: / i e(1-1,k- / (ret �z,c ate: 7• /7- /( 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. 1:\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: it'e Utilities QtyFee tea) Total - �;.. uare Fo �tgl�.�`` ;,P:ertnit 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 -Lr 7,201 and greater $327.54 Sewer-each additional 100' 37.52 11 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 'f. r VaICriin; , - omit 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 "43ther Inspections'Or Fees Qt• F"(ea) Tot 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* 410 ReV ;t't'f . PI, lbing Quanfl�by l?ixture a:`- Plan review is required for any of the following. Fixture Type for Please check all that apply. Work Performed: Capped Added +� tocate Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -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 ❑ 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" y��! 4„ ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. 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: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 IL CITY OF TIGARD PLUMBING PERMIT :' ` COMMUNITY DEVELOPMENT Permit#: PLM2018-00353 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/18/2018 T[ ai 4. Parcel: 25111 BA01600 Jurisdiction: Tigard Site address: 9744 SW VIEW TER Project: MITCHELL Subdivision: Lot: Project Description: 100 ft.of sanitary sewer for relocation of sewer lateral. Contractor: OWNER Owner: MITCHELL, PATRICIA MICHAEL&PATRICIA MITCHELL 14325 SW 97TH AVE 14325 SW 97TH AVE TIGARD, OR 97224 TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 100 If Sanitary Sewer 07/18/2018 $62.54 Specifics: 1 12%State Surcharge- 07/18/2018 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 07/18/2018 $9.96 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forthAR 95220N-Q010 through OAR 952-001-0 90. You may obtain a copy of t'-- rules or direct questions to OUNC by calling 503.232.1987 or 1.400.332.2344. Issued By . - • ee Signature: �" / Call 503.639.4175 by 7:00 a.m.for the next av '__ a inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures � IVD FOR OFFICE USE ONLY City of Tigard RECF ..._,...4 Received / Permit No.: f$ �" 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: ���7�� �'- J 3 C Plan Review Phone: 503.718.2439 Fax: 503.598.1 r Other Permit No.: n 17 2018 Date/By: Inspection Line: 503.639.4175 TICARDReady/By:Date Jur s: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: 779 Supplemental Information CITY O II GARI: / _ w._ 7 TYPE OF O FEE.... SCHEDULE ❑New construction ` l �r tIfinDIV1S1OT'T 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) C GORY OF CONS'II4j(JCTION SFR(1)bath 312.70 0 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 0 Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: .�tr1 / Fire sprinkler( sq.ft.) Page 2 7Y JOIE'SITE` NFORMATIQ.iN AND LOCATION; - Site utilities: Job site address: _ . - f Catch basin or area drain 18.76 .,! , Z Drywell,leach line,or trench drain 18.76 City/State/ZIP: / / 9 7 ! Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: IProject name: 41 i7i-Yyq 4-4,7 7e/6,Ulc'E Manufactured home utilities 50.03 Cross street/directions to job site: $_e fiG rA. 77/1.44-9G• i,, Manholes 18.76 LCs b40214-r_-_46 Rain drain connector 18.76 Ai Sanitary sewer(no.linear ft.:idv) C Page 2 6)......5-if Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 _ Backwater valve 12.51 _ Clothes washer 25.02 .5EG/e� -- het 6 �/264�7��� Dishwasher 25.02 " i-/i `y)-e", Drinking fountain 25.02 Ejectors/sump 25.02 n © PROPERTY NE I ::Or..0 fitN r f Expansion tank 12.51 Name: /t,/l d ii-ii,t(:._ rc l f 'e L Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: / '05 r S tAi ,j7 ?" .-c____, Garbage disposal 25.02 City/State/ZIP: 1-7 0/��t> e`/'c. Hose bib 25.02 Phone:(971) 7 7 7 V o (7 3 Fax:( ) Ice maker 12.51 {*-' ,APPLICANTR :vz t CON'I'AC• +rt . .4 Interceptor/grease trap 25.02 Business name: f'=,+ _ r,�� Medical gas(value:$ ) 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 CO e :ti-- Water closet 25.02 :,3, , f' ' = ' f Water heater 37.52 Business name: �J�/1"./ f- Water piping/DWV 56.29 Address: " Other: 25.02 City/State/ZIP: Subtotal 6,1.- 141 Phone:( ) Fax:( ) Minimum permit fee: $72.50 7)51) Plan review (25%of permit fee) "'-- CCB Lic.: / ,,,, ,// 'hum ,,Lic.no.: State surcharge(12%of permit fee) � 7(0,.� .4 Authorized signature. 6 1-ai.G . TOTAL PERMIT FEE el,a Print name: / i e 0,-,), ,e. / ( re«e-L, ate: 7, /7- /sv 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: ite Utilities Qty. Fee(ea) Totaliare Footi# te: Permit 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 62.54 r 3,601 to 7,200 $233.20 Sewer-1st 100' r 1014-9 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 Valid do n. hermit Fee' $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 ins ections or Fees �' Fee lea) TOA: each additional$100.00 or fraction thereof,to Pand 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 eyes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. an Review for Plumbing n $Jat a$s f Quantity by Fixture Type:' Plan review is required for any of the following. Fixture Type for 11.01rei Please check all that apply. Work Performed: capped Added Rllocake ❑ 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 ❑ 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" � �.tt Isome" OW .* x fir= 4>, 0 Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. 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: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2