Permit (90) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00545
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/28/2018
C� g Parcel: 2S104BA04100
Jurisdiction: Tigard
Site address: 12490 SW 141ST PL
Project: Mead Subdivision: CASTLE HILL NO.2 Lot: 74
Project Description: Replacing existing bathtub with new bathtub.
Contractor: OWNER Owner: MEAD, STEPHEN C&JENNIFER M
STEPHEN MEAD 12490 SW 141ST PL
12490 SW 141 TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 412-327-5723 PHONE: 412-327-5723
FAX:
FEES
Quantity Description Date Amount
1 ea Tub/Shower/Shower Pan 11/28/2018 $12.51
Specifics: 1 12%State Surcharge- 11/28/2018 $8.70
Plumbing
Type of Use: SF 60 ea Minimum Fee Adjustment- 11/28/2018 $59.99
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 503.232.1•/:7 or 1.800.332.2344.
Issued By: j A.,Ail 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 FOR OFFICE ESE ONLY
City of Tigard �j "" fi Received ��/t� /O44A&1 T )d -/CJ
- Qom,:,: . Date/By: Permit N
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960N Other Permit No.:
/�t' Date/By:
Inspection Line: 503.639.4175 u 2 8 2018
T I G A R D p Date Ready/By: loris ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
Gl 1 Y t t t AF
'7PE air lt . i4 t1� �;? .1
0 New construction 0 Demolition For special information use checklist
Description Qty. Ea. j 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
® I-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
JOB STIT INFORMATION ArtIO LOCATION ^` Site utilities:
Job site address:12490 SW 141"PL Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Bathtub Replacement Manufactured home utilities 50.03
Cross street/directions to job site:End of 141"Place,on left 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:Castle Hill No.2 1 Lot no.:74 Fixture or item:
Tax map/parcel no.:2S104BA04100 Backflow preventer 31.27
f h"t` 4W YORK Backwater valve B k 1 12.51
Clothes washer 25.02
Replace existing bathtub with new bathtub
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® v Ot 1 Expansion tank 12.51�
Fixture/sewer cap 25.02
Name:Stephen Mead
Floor drain/floor sink/hub 25.02
Address: 12490 SW 1415'PL
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(412)327-5723 Fax ( ) Ice maker 12.51
.f. �p>ta�T ,. rozc ms Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Primer 12.51
Contact name:Stephen Mead
Roof drain(commercial) 12.51
Address: 12490 SW 141"PL Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(412)327-5723 Fax: :( ) Tub/shower/shower pan ' 12.51
E-mail:stephenmeadc@gmail.com Urinal 25.02
ater c oset
Water heater 37.52
Business name: znumzev.--
Water piping/DW V 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) _ _ Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) ,
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: --c4/4?
This permit application expires if a permit is not obtained within 180 days
cde,vizt
n Mme! Date: / 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:
�
Site Utilities O` r t *
TOO
square Footage: Permit ` e*
Footing drain-1St 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
V l[uti400. I'emu
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
each additional$100.00 or fraction thereof,to
Other Inspections or Fees oty,, ) rota
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*.
Quantic by Fixture Type Plan.Resew for o
Fixture Type f°" Replace/ Plan review is required for anyof the following.
Work'Performed: Lapped added' Relocate
q
Baptistry/Font Please check all that apply.
Bath Tub/Shower El 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 Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic ❑ 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 ❑ Isometric or riser diagramisrequired for new buildings
Garbage -Domestic-non-food g
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:
C:\Users\smead\Documents\Personal\HOUSE\Tigard Plumbing Permit.do2
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12490 SW 141ST PL, TIGARD, OR, 97223 August 12, 2019 at
11 :18:06 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00545
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor