Permit (112) II - CITY OF TIGARD MASTER PERMIT
• COMMUNITY DEVELOPMENT Permit#: MST2018-00268
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2018
T r C,�I:r7 9 Parcel: 2S104CD10200
Jurisdiction: Tigard
Site address: 13611 SW TRACY PL
Subdivision: HILLSHIRE ESTATES NO.2 Lot: 101
Project: CERBONE
Project Description: Finish basement area started under MST2016-00271. Per customer 10/9/18, electrical permit will
be pulled separately.
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 1 First: 0 sf Basement: 817 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0
Detectors: Yes
Total: 817 sf Value: $96,773.65 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 1 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs/Showers: 1 Garbage Disp: 1 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 2 Clothes Dryers: 0
Heat Pump: Y Hoods: 0 Other Units: 0
Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3 817
Owner: Contractor:
CERBONE,ROBERT REVOCABLE LIVIN(OWNER Required Items and Reports(Conditions)
13611 SW TRACY PL ROBERT CERBONE
TIGARD,OR 97223 13611 SW TRACY PLACE
TIGARD,OR 97223
PHONE: 503-310-9300 PHONE: 503-310-9300
FAX:
Total Fees: $3,232.36
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 fo .w the rules adopted by the Oregon Utility Notification nter. Those rules are set forth in OAR
952-001-0010 through OAR 952-0: -.'•0. You may ob•a copy of th rules or direct questions to OUNC by calling 503 .1987 or 1.800.332.2344.
Issued By: thee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti n date.
This permit card shall be kept in a conspicuous place on the job site until mpletion of the project.
Approved plans are required on the job site at the time of each inspection.
i
"Iuilding Permit Application
Residential RECEIVED l OR 01 1 1( 1 LSI: O\1 1
City of Tigard Received it
DatP, .
III 13125 SW Hall Blvd.,Tigard,OR 97223 SEP 2 7 2018 Plan ReviewP' /�/ s �`���
1 Phone: 503.718.2439 Fax: 503.598.1960- Date/By: I 0 / 8 4/4- Other Permit:
T- �_A l� Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
CITYOF I+GARL�
Internet: www.tigard-or.gov Notified Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction El Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
igiAddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this apptication.gGir - . C,,„s
Valuation: $
��
Ni 1-and 2-family dwelling ElCommercial/industrial � ` UO
Accesso bNumber of bedrooms:
❑ ryuildin g ❑Multi-family
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: fl'3 ,0 U SL,3 1 -O- 7( CL New dwelling area: .. '/ square feet
City/State/ZIP: "T-Z6trecv..1) 0,C - 9-1;- .3 �-7
�.3- ..t Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Covered porch area: square feet
Cross street/directions to job site: .5 ' rn-Tr� - Deck area: square feet
t 1� Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: V}ZL\S * -� .. a I Lot no.: 101 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: L l7 1 LQ �(� Z v� Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
r''L1"ZSNtk (. .1- 11/Q..-Th-`c AV.., + j-6,.,:ck. Valuation: $
Existing building area: square feet
ellaj �4.-k plitC.f m 4.k b< ?J U , „ AF 4 New building area: square feet
Ir ,'ROPERTY OWNER 0 TENANT A Number of stories:
Name: a eta -c C -- Type of construction:
Address: 1.-2)L12 k, ) --ti-S&A_e-j €7-LA(e Occupancy groups:
City/State/ZIP: .---(---z_64\„4--)` A_ 1 .,:: .- -- Skjt Existing:
Phone:(45-t j .;t CA-'1 S.. - Fax:( ,) ` New:
V APPLICANT 0 CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedulee)
Business name:
Structural plan review fee(or deposit):
Contact name: 1(.?C Cis-1(`.(
FLS plan review fee(if applicable):
Address: i,e ,2 5 .•‘_ --Alk,ACI C Total fees due upon application:
City/State/ZIP: , Lp L c(`„ ci'��3..-.s "1
;y
Phone:(��3) '3[t—'e?� y Fax::
Amount received:
E-mail: `^ ! PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted Photo Voltaic Solar Panel System.
Business name: L � ..J1.-t.V.. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: Solar Installation Specialty Code checklist.
City/State/ZIP: Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( ) Fax:( )
State surcharge(12%of permit fee): $21.60
CCB lic.:
A______„ Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ( t<� C gv )Lf Date: 4"'2 -x� -o4 *Fee methodology set by Tri-County Building Industry
r �
Service Board.
I:\Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
. Y
Building Permit Application Checklist ,
One- and Two-Family Dwelling ro lz (nu( 1 i. OM M.v
City of Tigard Received Permit No.:
Ili13125 SW Hall Blvd.,Tigard,OR 97223 a
g Associated permits:
■ Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 ❑ Electrical 0 Plumbing 0 Mechanical
TIG \12 D Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW les yo y'k
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ 0 0
3 Verification of approved plat/lot. 0 0 0
4 Fire district approval required. Name of district: • 0 0 00
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit. 0 0 0
7 Water district approval. 0 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ❑ 0 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 0 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 0 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing 0 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists 0 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 0 0
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 0 0 0
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". 0
24 Two(2)sets each are required for Items 16,19,20 and 22 above. 0 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. 0 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. 0 0 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
A
'Mechanical PermitApplication FOR OFFICE USE O;VLI'
Received
City of TigardREG Date/By: Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 S F P 2 7 2018
Date/By:
Other Permit:
Inspection Line: 503.639.4175
TIGARD Date Ready/By: Juris
® See Page 2 for
Internet: www.tigard-or.gov CITY Qt- fi�.� 1Notified/Method:
Supplemental Information
Bull DING DMS-1 ".
TOF WUtic
COMMERCIAL`F
YPEEE*SCHEDULE USE CKLIS ';
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
',,t1'47 CATEoR2 :-4 CC.'NSTRUCTION
= °: °" ... -. 'RESIDEl�ITIAL ('iIIPMEl `7s* .' .-
lif1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
'" Heating/cooling:
''''Iit,'714. JOB SITE INFORMATION AND LOCATION
Air conditioning 46.75
Job site address: LSA S 'fall\A-C`1 '. ,A(s Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: ,--N---L 20 * r_ ci'Ia3_ -1-CS-7s1 Furnace 100,000+BTU(ducts/vents) 54.91
t
vh Heat pump" j 61.06 61,Ma
Suite/bldg./apt.no.: Project name: Duct work 23.32
Cross street/directions to job site: ..s
"- Hydronic hot water system 23.32
b Z-SKV Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: , Zt�LS E . Lot no.: 1pl Other fuel appliances:
Tax map/parcel no.: c co ‘Qt-6 Water heater 23.32
x , �( j�;,, 0O ; Gas fireplace/insert 33.39
-: x.: " " .. m ,. zr tax",• .. -g-4 ,,
Sckv A _A . ?-V.-)
� -S
P a f reepp lue vent for water heater or gas
VT �,7,+ fireplace 23.32
4 `�.- '� Log lighter(gas) 23.32
\r i Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other:
{ 23.32
IF:• ft"< PROPER�& a ibriNER w . . r "' ANT:.1
Environmental exhaust and ventilation:
Name: ra -�Ci C----\I\.15..�.#. 0 Range hood/other kitchen
equipment 33.39
Address: -
1�� ` SL> ( LA-Q.1 (- Clothes dryer exhaust 33.39 ____qte 444(
City/State/ZIP: ---(7 Q(I� L 1 3 --, -0 Single-duct exhaust(bathrooms,
�V// C % toilet compartments,utility rooms) 1„,.. 23.32 IfeSSIII
Phone:(�,3 - 210--. " ,%,. Fax:( r ) *- Attic/crawlspace fans 23.32
" ,APPLICANT, .4...it''''''''' x66! -A , '*.ON at: Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: rL L &•...0 Furnace,etc.
Address: ��` S w \VN.,l�`fi e�v4t Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: z."-Z J,() ` C(`-t L p). - Water heater
Phone:(E5-N-21, ' 1, -- L Fax::( ..---) Fireplace
Range
E-mail: \,.. >7 () C „ Nei Barbecue
C.01,4ITRA ' i,l;I. Wim. Clothes dryer(gas)
Business name: / � tt � 4 ( C Other:
MECH4414 P3 ..:il FEES 'If,-
Address:
-
Address: \ --T j ‹�7 .�s� A/1&d , os Subtotal
City/State/ZIP: ^`-Z ? (\* i ��a� Minimum permit fee($90.00)
-1 a' Fax:( ) Plan review(25%of permit fee)
Phone:(
State surcharge(12%of permit fee)
CCB lic.: l 71(31 2. fU/2_11//r TOTAL PERMIT FEE
` This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: "'--- Date:a1 - rt
s
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard .
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total yn tion; ..0 . Permit Fed
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
' " • Plumbing Permit ApplicationI
Building Fixtures
Cityan
Of Tigard SEP 2 ! 201 Received
g Permit No.:
Date
/By:U 13125 SW Hall Blvd.,Tigard,OR 97223 ,ITn(Rev
III
iewI Phone: 503.718.2439 Fax: 503.598.1960 C Limy OFfttAH Other Permit No.:
Inspection Line: 503.639.4175 BUILDING n"\fig 1ReaY.dy/By:1 1(;ARD Juris: a See
Page 2 forInternet: www.ti ard-or. Ov
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
/ CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
'46-
-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
ID_Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
_. JOB SITE INFORMATION AND LOCATION Site utilities:
--
Job site address: ` r�tl 5L05L0C Q L p Catch basin or area drain 18.76
L. ,s� Drywell,leach line,or trench drain 18.76
City/State/ZIP: cZ£�.k.J) °1 3.- �'"' � I
t. Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: _ Manufactured home utilities 50.03
Cross street/directions to job site: ' LJJ (-*N1\.--L `Nc-- t 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: t\----C1/41S -1,...-G- i�l'�j 7i�I Lot no.: tc,‘ Fixture or item:
Tax map/parcel no.: Q5 I C M;CO �O apt Backflow preventer 31.27
DESC 'HIP'TI0N Off,WORK Backwater valve 12.51
��V� - - � g iswasher 25.02
Dishwasher 25.02
D S.Z..)\c Drinking fountain 25.02
Ejectors/sump 25.02
pROPERTX OV4'NE,R . i TENANT Expansion tank 12.51
Name: (`�__� � C i � Fixture/sewer cap 25.02
= ^�-�nLt.' -(K Floor drain/floor sink/hub 25.02
Address: ``
\\ _' �� x1 eGarbage disposal ' 25.02
City/State/ZIP: ,-c-Z 1. 1/4, ,K. j11.�-'3 < 5.1.,, ' Hose bib 25.02
C.
Phone:(�j°,2j : Lt:,--9 3 Fax:4____,-- Ice maker 12.51
APPLICANT - CI CONTACT PERSON Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: (2N- ..;c C "
` ®L ! Roof drain(commercial) 12.51
Address:
--3 -e`� SL,a -\. -A L � Sink/basin/lavatory A 25.02
City/State/ZIP: �, ` t,(\-_ ci"i a.. . -'Sl'f.'l Solar units(potable water) 62.54
Phone:(S"\)". -..: t -9. c3 s Fax::(P- )"' Tub/shower/shower pan t 12.51
E-mail: L^ � cs C.ef'\e. ^e o t\,-....:* Urinal 25.02
Water closet t 25.02
CONTRACTORS
Water heater 37.52
Business name: e, ,,sr„,,,_
Waterpiping/DWV 56.29
Address: L- ,.k
( ' c 'ON-00 � €&U2 Other: 25.02
City/State/ZIP: 0c... (CAN.. ) t ('�. ` c1 ai.3 Subtotal
Phone: 4.44 --t 1 Fax:( ) 77//2 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.: 572.3? A ///2//9 Plumbing Lic.no.:311/3-0,0V V
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: 2_..67- :::>,....,. CE----1Date: Q.,--?^ - 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-PettnitApp.doc 10/01/09 440-4616T(10/02/CAM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage; 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
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
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit 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 Inspections;or FeesQty` F tom) 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*. Plan Review for plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped 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
engine
-Jacuzzi/Whirlpool
Car Wash: -Each Stall 0 New exxr.
terior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator ❑ 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" lac lnetr�c oriser Diagrr> >�Irl
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
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13611 SW TRACY PL, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00268
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13611 SW TRACY PL, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00268
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13611 SW TRACY PL, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00268
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13611 SW TRACY PL, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Master Permit MST2018-00268
Inspection Type: Inspector:
299 Final inspection David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13611 SW TRACY PL, TIGARD, OR, 97223 November 19, 2018 at
12:52:07 PM
Record Type: Record ID:
Residential - Master Permit MST2018-00268
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Mini split system ok.
Bath fans and timers not complete at this time.
Re call mechanical final when ready.
Violation Summary:
Inspector Contractor