Permit (151) CITY OF TIGARD PLUMBING PERMIT
•' COMMUNITY DEVELOPMENT Permit#: PLM2018-00569
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/19/2018
T I c,;t k.D9 Parcel: 2S103AA00101
Jurisdiction: Tigard
Site address: 10865 SW WALNUT ST
Project: Fowler Middle School Subdivision: None Lot: None
Project Description: Replacing water heater.
Contractor: OWNER Owner: TIGARD-TUALATIN SCHOOL DISTRICT
FOWLER MIDDLE SCHOOL BY MAPLETHORPE, BONITA
6960 SW SANDBURG 6960 SW SANDBURG ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-367-0421
PHONE: 503-431-4000
FAX:
FEES
Quantity Description Date Amount
1 ea Water Heater 12/19/2018 $37.52
Specifics: 1 12%State Surcharge- 12/19/2018 $8.70
Plumbing
Type of Use: COM 35 ea Minimum Fee Adjustment- 12/19/2018 $34.98
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
I f• / W ZA
Or,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures RECUVED
1
DEC 1 2018 Received
City of Tigard /
/F r�t�t,�y.1 g.. �y�
41 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: / r7 � N[�ro� �U ��7 `�/
Plan Review /57�p 02 9,
11111 S Phone: 503.718.2439 Fax: 503.598.y . P
L'i�'� of:T�,��� Date/By: Pt
1 t ARD Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
For special information use checklist
❑New construction 0 Demolition
Description Qty. I Ea. Total
. ...Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
- JO$f k#''E INFORMATION AND tCATIO$ Site utilities:
Job site address: /0$65 G �. I k 10 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1 I e. t4 rz�
" �� Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: ` :�c 1 ✓L- �.
M. .ROC Manufactured home utilities 50.03
Cross street/directions to job site: ` mow k.e t2_ VvA.. �(�1.tlJo t Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
/s;% .DE's f';:71ION�'1N 1 Backwater valve 12.51
•
7 v✓ 12- E 4 T 1-2-E �� A
&c,G,1E,•,_--(✓� Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
2.�.., '. • �° ',.:D "DOWNER 4 :..• � TE `.. Expansion tank 12.51
`r- \ Fixture/sewer cap25.02
Name: l ( ►,c Y2._` ' "- 1 04 J,4+.,1.
Address:4 ® 6 SwyS� Floor gedroor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: 1't 414.,,,r7.__ (VPZ C- 7�3 Hose bib 25.02
Phone: bYj )_13 0(9> Fax:( ) Ice maker 12.51
4:,:.i.??,.„:„.' ❑ AP ' CANT. .coNT T PERSONInterceptor/grease trap 25.02
Med
Business name: ical gas(value:$ ) Page 2
A/N Primer 12.51
IT ,,tiz
Contact name: T / i, 't-i "'-1
Roof drain(commercial) 12.51
Address: ei 6 0 S wt, Sink/basin/lavatory 25.02
City/State/ZIP: 7 Q aez.._ Cr_ g .3 Solar units(potable water) 62.54
Phone:(50) 3 ea 0(.4 7 I Fax::( ) Tub/shower/shower pan 12.51
E-mail: t Urinal 25.02
Kt t tAitty a s.t.t 4-Lc- �7�%� c.,, L.l5 17-,CS C
,- Water closet 25.02
CONTRACTOR :x 1
Water heater I 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:(b03) 3 c,„.4._- Ct-12 ( Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: ll�ftt
ei 06<511 A' Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:
This permit application expires if a permit is not obtained within 180 days
r tilt{Q t/1s1+✓� l (1 Date:'Z- CV 1. after it has been accepted as complete.
V\ *Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PerimtApp.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:
Fee... � Total � s�..�.
. (e Square Footage: Permit Pei:
Site Utilities �:��.� � 3v
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
Valuation:n Per»it 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
each additional$100.00 or fraction thereof,to
Other InSpecQn5 or Fees 04'. 'Feegea) 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*. P yRevieW t P1uingR
Quantity by Fixture Type 's Plan review is required for any of the following.
Fixture Type for Replacee 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 engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator
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"
, Isometr"ie-or Riselr-DIagram
4„
0 Isometric or riser diagram is required for new buildings
-Car Wash Drain
that meet the qualifications above.
Garbage -Domestic non-food
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
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10865 SW WALNUT ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00569
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Replace existing water heater- Approved
Violation Summary:
Inspector Contractor