Permit (172) CITY OF TIGARD PLUMBING PERMIT
a 2. COMMUNITY DEVELOPMENT Permit#: PLM2018-00404
T t GA 9 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2018
Parcel: 2S102BD01600
Jurisdiction: Tigard
Site address: 9845 SW WALNUT PL
Project: Tigard United Methodist Church Subdivision: FREWING ORCHARD TRACTS Lot: I
Project Description: Site utilities:Repairing 10 ft.of storm sewer piping.
Contractor: SUNRISE LANDSCAPE SERVICES INC Owner: TIGARD UNITED METHODIST CHURCH
26085 SW CHEHALEM STA RD 9845 SW WALNUT PL
SHERWOOD, OR 97140 TIGARD, OR 97223
PHONE: 503-538-2386 PHONE:
FAX:
FEES
Quantity Description Date Amount
10 If Storm Sewer 08/23/2018 $62.54
Specifics: 1 12%State Surcharge- 08/23/2018 $8.70
Plumbing
Type of Use: COM 10 ea Minimum Fee Adjustment- 08/23/2018 $9.96
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.801
Issued By: -414111114- -- - -:
i 1
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Call 503.639.4175 by 7:00 a.m.for the next available inspection date. j
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLI'
Received t
City of Tigard a - Wl % f$' � Permit No.: f
tt
ill III13125 SW Hall Blvd.,Tigard,OR 97223 1, date/By. .�3 J )
S Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: j
Ins ection Line: 503.639.4175 �> ))80-....eiv �
T I G A R D p :0,, 2 ,, >��1 `g Date Ready/By: Jona: Pi See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
"," TYPE OF WORKOF I IGA FEE* SCHEDULE t-
.� w. ,:::,1''',,c,-,-,0,,
0 New construction ❑'Dettidli(iori For special information use checklist
Description I Qty. Ea. 1 Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
'CATEGORY OF CONSTRUCTION '''' i. SFR(1)bath 312.70
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFO 44:O AND IRCATION`` '143 x Site utilities:
!� Catch basin or area drain 18.76
Job site address: /' Celi J t{,;J A/ �(u
City/State/ZIP: ct-r,-G, (� 4"i 'Z2-2
J !PI Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: e l/ ,!f(V... 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.: P ) / Page 2 S-T'
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
. .... >. o r Backwater valve 12.51
r ttr
Clothes washer 25.02
P v - �q hof l 0-5 Dishwasher 25.02
d'/ ;45 camL
-' l but( r Drinking fountain 25.02
Ejectors/sump 25.02
ht 1 ¢TY OWNER . ".; 0 NANT w 5 N Expansion tank 12.51
aw ,l� icy / 1��y--72 c Fixture/sewer cap 25.02
Name: U �/ Itivi
Floor drain/floor sink/hub 25.02
Address:
1---/.1,3--6 ' ' eziA4v r` )i Garbage disposal 25.02
� c�
City/State/ZIP: G I(Cu.W e1 19 K L 7 7..7 Hose bib 25.02
Phone:(k5-4,4) 63 7 3 f/1 Fax:( ) Ice maker 12.51
APPL ' (yZ • `' [ CONT / ` �Q�N/y.'° Interceptor/grease trap 25.02
age 2
Business name:-f t 5 c A 4q a, j 5 V C,6.0/? 6 Medical gas(value:$ ) Per 12.51
Contact name: A v C k et:5 CO / Roof drain(commercial)
12.51
Address: (`t/4��' lis/-o/ i9--1,/ , Sink/basin/avatory 25.02
City/State/ZIP: L/ 01.. .- (9 A / ') - 2, Solar units(potable water) 62.54
Tub/shower/shower an 12.51
Phone:(� �J p Fax: :( ) P
, Urinal 25.02
E-mail: (4Q v i.C(' 1 "1 1/LL� //-
�S ,
y, ;. Water closet 25.02
r 1 'RACTOR
Water heater 37.52
Business name:,6"0 W }-1 j . 1,,,,-y,ij
sv)i_,�....r J<<.` Water piping/DWV 56.29
Address: 1> Q e A 0, A/)/ ,f t r 0,,,..c.,67,-„/ Other: 25.02
City/State/ZIP: 0 t21 9 1 I 1/0 Subtotal 6)„511
Phone:(1/4.5.:03,) ,r3 e., . 3 t'.6 Fax:( ) Minimum permit fee: $72.50 7.../.,57)
CCB Lic.: 6 / Plumbing Lic.no.: Plan review (25%of permit fee) --
`, State surcharge(12%of permit fee) 1 70
Authorized st .ture: r,,. ' TOTAL PERMIT FEES �1
This permit application expires if a permit is not obtained within 180 days
Print name: a(t l` t(,, ��B Date: �Z3�� 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:
Site Utilities Qty. Fee(ea) Total ;i Square Footage: Permit Fee:
Footing drain-151 100' 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
Valuation: "Permit Fee:
Storm&Rain Drain-1st 100' 62.54 "'
-�, $100 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
InSpectionS Or FeesQtY• Fee(ea) Total 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*.
by Fixture Type r. g :;
� Quantiy yp �an Review for Plu �ii�►g Installations
F. reType,for Replace/ Plan review is required for anyof the following.
Performed: Capped Added,w Relocate q
Baptistry/Font Please check all that apply.
Bath Tub/Shower CI 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 Tluu 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic El Any multipurpose fire sprinkler system.
Drinking Fountain ❑ 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.
-3"
Car Wash Drain ISometC or Riser Diagram
Garbage Domestic-non-food
0 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:
I:\Building\Permits\PLMU PermitApp.doe 2
Site Work Permit Application
Plan Submittal Requirements
TI G A R D Commercial, Multi-Family and One- &Two-Family Dwellings
A site work permit is required for all commercial projects including new buildings, additions,
accessory buildings larger than 120 square feet, modular structures and multi-family R-1
occupancies. A site work permit is required for excavation, fill,grading,paving,retaining walls,
fire hydrants and fire department access on private property for work on individual lots not
covered under the subdivision development.
Note: A separate "plumbing" permit for site utility plumbing work is required for sanitary
sewer, storm sewer and potable water systems on private property. Please see the Site
Utilities - Plumbing Permit Application for plan submittal requirements.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with:
A. ❑ map &tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ applicant phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads (drawn to scale) with project location.
2. BUILDING PLAN submittal requirement: Three (3) complete sets, Civil only.
All details listed below shall be incorporated into the plans:
A. Site plan showing:
1) Required parking spaces and driveways.
2) A route, accessible to persons with disability,leading from the public way to an
accessible building entrance.
3) Accessible parking spaces and adjacent access aisle connecting with the accessible
route.
4) Curb ramps along the accessible route, curb, sidewalk and gutter.
5) Finish grade elevations along the accessible route.
B. Topographic survey plan showing grade elevations crossing the entire site.
C. Overall grading plan.
D. Utilities plan showing:
1) Fire hydrant location and pipe size if on private property.
2) If the building is to be protected with an automatic fire sprinkler system, show
location of the water service vault and the fire depaittuent connection (FDC)
within 70 feet of a fire hydrant.
3) Size of underground water service for the sprinkler system.
E. Erosion control plan complying with the requirements of the Clean Water Services
(CWS) agency showing:
1) Silt fence locations.
2) Bio-filter bags/other approved barrier material surrounding catch basins.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 3
3) Illustrations detailing the correct installation of the silt fencing and catch basin
protection.
4) Any other measures to ensure compliance with CWS standards.
F. Landscaping plan.
3. ADDITIONAL REQUIREMENTS:
A. Soils (geotechnical) report. A soils report is required for new buildings and additions
to contain the following:
1) The report shall address the potential of soil liquefaction and instability (OSSC
Sec. 1804.2).
2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1).
3) Foundation and lateral pressures exceeding 1,500 lb./sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
I:\Building\Permits\SIT-PermitApp.doc 08/02/2016 4
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9845 SW WALNUT PL, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00404
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor