Permit (181) CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Permit#: PLM2018-00391
TIG It D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/16/2018
,
Parcel: 1 S 134DC03001
Jurisdiction: Tigard
Site address: 11130 SW TIGARD ST
Project: Dirksen Nature Park Subdivision: CHERRY HILL ACRE TRACTS Lot: 6
Project Description: Plumbing site utilities for a new 1,465 restroom facility,includes water,storm and sanitary sewer,manholes and
pressure reduce valve.
Contractor: COLUMBIA CONSTRUCTION INC Owner: TIGARD, CITY OF
28170 BOBERG RD 13125 SW HALL BLVD
WILSONVILLE, OR 97070 TIGARD, OR 97223
PHONE: 503-427-0304 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Manholes 08/16/2018 $56.28
Specifics: g If Sanitary Sewer 08/16/2018 $62.54
342 If Storm Sewer 08/16/2018 $175.10
Type of Use: COM 628 If Water Service 08/16/2018 $287.66
Class of Work: NEW 25 Misc Other Fee 08/16/2018 $25.02
Type of Const: 1 12%State Surcharge- 08/16/2018 $72.79
Occupancy Grp: Plumbing
Stories:
Total $679.39
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: Let...„/„6„ Permittee Signature: 1 iii, daillo
,IIS
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 Aaalicatia a f�;.' l
Site Utilities 1 U It O I I I( 1 I .I 1 1.1 1
AUG IL b 201
City of Tigard F/51# ' ;,;r , .•1 No 'c'!:/7-2l,/1'G7a.37/
13125 SW Hail Blvd.,Tigard,OR 9 w w' , /'
4+/ .-1 -' S -, - Pon risy. Other Permit
Phone: 503.7182439 Fax: 503.5 � g , / rt;�F �epeWgy: �/%�/Q''0(JL�ola�..
Inspection Lint: 503.639.4175 a l) €_,i r �� f -Dalt RcadY/BY: • B Ste Page 2 for
Internet: www.tigard-or.gov NotifedfMe hod:O /C-% lir /44at ldarmano.
.: : - Z-1,,„7.,„,;:- i` r ` • d._ - -
-,-,
®New construction 0 Demolition
For special iwjorw.dow use eheckl&
Description I Qty. I Fa. I Total
❑Addition/alteration/replacernent ❑Other: New 1-24amily dwellings(includes 100 ft.for each utility connection)
tY R, SFR(1)bath 312.70
❑1-and 2-family dwelling ®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 0 Other: Fire sprinkler(____sq.ft.) Page 2
r i. �., , ,,, `_, 1 .C: 1 ,. , `i .;i. Site utilities:
Job site address:11130 SWC T/ fZ� �- Catch basin or arca drain 18.76
City/State/ZIP:TIGARD,OIL 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:N/A I Project name:DIRKSEN RESTROOM/NAT PLAY manufactured home utilities 50.03
Cross street/directions to job site:TIGARD ST AT SW TWIN PARK PLACE Manholes 3 18.76 56.28
ENTER DIRKSEN NATURE PARK AT TIGARD ST/FANNO CRI.TRAILHEAD Rain drain connector 18.76
WEST OF TIGARD ST.BRIDGE.RESTROOM/NATURE PLAY IMPROVEMENTS Sanitary sewer(no.linear ft.:P 1 Page 2 62.54
Storm sewer(no.linear ft.:ia) 4 Page 2 175.10
SITED JUST NORTH OF EXISTING SPORTS FIELD. Water service(no.linear ft.:fair 7 Page 2 287.66
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.:1S134DD01000 Backflow preventer 31.27 31.27
Backwater valve 12.51
a
Clothes washer 25.02
6"SEWERLINE FROM MANHOLE TO RESTROOM Dishwasher 25.02
2"WATERLINE FROM TIGARD ST TO RESTROOM f s,✓leCra7r- Drinking fountain 25.02
4"PVC PIPE FROM NATURE PLAY TO DISHARGE Ejectors/sump 25.02
t:::::-:1:2)
.,._ <f )`.0 e'_ , Expanswn tank 12.51
Name:CITY OF TIGRAD Fu 's cap 25.02
Floor drain/floor sink/hub 25.02
Address:13125 SW HALL BLVD
- Garbage disposal - 25.02
City/State/ZIP:TIGARD,OR.97223 Hose bib 25.02
Phone:(503)718-2466 Fax:( ) ke maker 12.51
Interceptor/grease trap 25.02
Business name:CITY OF TIGARD Medical gas(value:S_) Page 2
Primer 12.51
Contact name:JEFF PECK
Roof drain(commercial) 12.51
Address:13125 SW HALL BLVD Sink/basin/lavatory 25.02
City/State/ZIP:TIGARD,OIL 97223 Solar units(potable water) 62.54
Phone:(503)718-2466 Fax::( ) Tub/shower/shower pan 12.51
E-mail:jeffp@dgard-or.gov Urinal 25.02
Water closet 25.02
Water heater 37.52
Business name: Co 10 rN b;t Cp,et}Sw-ei--M Z d: Water piping/DWV 56.29
Address: (07'(q 0 a s f 06 Other: 4 suns,-cOci.c, g- / 25.02
City/State/ZIP: DtM w l of a 670x co r6LiY� Subtotal
Phone:(QCR) 503-k 77- ',log Fax:(co;) 774-gfg9 Minimum permit fee: $72.50-rej:a::43(7,;
CCB Lic.: i9!1 G3 Plumbing Lic.no.: V PB /400 Plan review (25%of permit fee)
Authorized signatu �-� ��� , Slate surcharge(12%of permit fee) 7 , 7�
Print name: 4-.:G. (>1 /S g .1,0../w ) TOTAL PERMIT FEE ,7�Lt�c�i
�' r� IY Date: treearit appilatla motive If.permit k sot tbhl.ed within 180 days
after k has been accepted m complete.
*Fee methodology set by Tri-County Building Industry Service Bard.
1:1BalidIIatPuadAPLMU-PremhApp.doe 10/01/09 4404616T(10/2/COM/WEB)
i and
Plumbing Permit Application-City of T g
Page 2-Supplemental Information
Fee Schedule: Residential Fire Su' 1 ression_S stems:
,,-;:,?,- -,-11-i7,1,s -1,,,,, t',; } '°i } 1 7 ,'''' 0 1 i.'-. ' t iiii !` - . p" ! ":
Footing dram-I"100' 50.03 0 to 2000 $121.90
Footing drain-each additional 100' _1122 001 to 3 600
111 to 7 00 523320
Sewer-1st 100' 1 62.54 62.54 7 01 and'r a $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' I 62.54 62.54 Medical Gas S stems:
Water Service-each additional 100' 6 37.52 225.12
Stone&Rain Drain-1st 100' IEEE 62.54 62.54 s1.o0 to$5 000.00 Minimum fee 572.50
Storm&Rain Drain each additional 100' 3 ® 112.56 $5,001.00 to$10,000.00 $72.50 for the fust$5,000.00 and$1.52 for
each additional S 100.00 or fraction theroof to
1 1 I 1 1 iJ , 10 ':< ,, ,
1. �- � � I�.`'yi�..�.u.� �� �:� .� n and incl sl0000.00.
Inspection of existing plumbing or for III $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 5100.00 or fraction thereof,to
minimum c..,.e-1/2hour and includin $25000.00.
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
bows minimum . . e-2 hours each additional$100.00 or fraction thereof,to
Reinspection Fos _ 90.001hr and includin $50,000.00.
Additional plan review for revisions - 90.00/1n - $50,001.00 and up $742.00 for the fust$50,000.00 and$120 for
minimum- c-1/2 hour each additional$100.00 or fraction thereof.
Subtotal: __
1 Other Fixtures: I I I I
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurate' . .rt fixtures could result in increased sewer fees*.
,..s - ' , �,
Wall --- Plan review is required for any of the following.
Bath -Tub/Shower _- Please check all that apply.
0 Any new commercial building with water service 2"and
Car Wash -Each Stall IMEN. greater,except systems designed and stamped by licensed
-Drive tam --- engineer.
ester --- 0 New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic --- 0 Medical gas and vacuum systems for health care facilities.
• :,, Fountain 0 Any multipurpose fire sprinider system.
Wash 0 Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2" ---
-3" Submit a sets of plans with any of the above.
-4" MINI��
Car Wash Dram
Garbage -Domestic-non-food ■ Isometric or riser diagram is required for new buildings
Disport -Domestic-food related
-Commercial-food related ---
that meet the ,ratifications above.
-Industrial-food related ---
Ice Mach./Refri Drains -
• for thong---
Rec.vehicle• ..Station . i1111111111111.1 Comments regarding fixture work:
Shower -Gang ---
-Stan MEMO��
Sink/lav -Non-food related -
--
-Bradly -
-Commercial-food related --IIIIIIIIMM
-Service -_MINN
Swimmin Pool Filter --NIINIIIIII
Washer-Clothes IIIIIIIIIM *Note: If the fixture work under this permit results in an
Water Extractor ---
Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and
Uri MOM fees assessed for the sewer increase must be paid before the
I:IENG'-Active Projects\92016-06 DNP Interpretive Shelter and RestroQm\PERMITTING\CITY OF TIGARD\Building Department\DNP-S1TE
UTILITIES-PLMU PemtitApp.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11130 SW TIGARD ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00391
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . 2" Watts DC model LF009 M1 QT, serial #046512, for irrigation,located by water meter
on Tigard St. - approved with test.
2. Correction is complete, plumbing final approved
Violation Summary:
Inspector Contractor