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Permit (44) CITY OF TIGARD PLUMBING PERMIT 'rli • COMMUNITY DEVELOPMENT Permit#: PLM2019-00023 Date Issued: 01/14/2019 T 1 i;Au 1-> 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 103BD06300 Jurisdiction: Tigard Site address: 12648 SW 116TH AVE Project: Newport Subdivision: HUNTER'S GLEN Lot: 19 Project Description: Replacing(1)tub/shower and(1)sink. Contractor: OWNER Owner: NEWPORT, DOUGLAS W&JANET M DOUG NEWPORT 12648 SW 116TH AVE 12648 SW 116TH AVENUE TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503-866-0697 PHONE: 503-566-0697 FAX: FEES Quantity Description Date Amount 1 ea Lavatories 01/14/2019 $25.02 Specifics: 1 ea Tub/Shower/Shower Pan 01/14/2019 $12.51 1 12%State Surcharge- 01/14/2019 $8.70 Type of Use: SF Plumbing Class of Work: ALT 35 ea Minimum Fee Adjustment- 01/14/2019 $34.97 Plumbing 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 32.1987 or 1.800.332.2344. Or �,,r♦ ii ttee Signature: \ Issued By: / _._ _. f dig 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 N ,,1 , r FOR oFFlcE USE oyl.v >.w,d Received �/��))�� 7 City of Tigard Date/By: / Cl: /"J/41 Permit Nod/ "tel /i/1 a?,3 III U 13125 SW Hall Blvd.,Tigard,OR 97223 JI,N 1 J. 9p c Plan Review` • Phone: 503.718.2439 Fax: 503.598.1960 t 1 i Date/By: Other Permit No.: T l G A R D Inspection Line: 503.639.4175 _ Date Ready/By: furls: ® See Page 2 for Internet: www.tigard-or.gov C ' Notified/Method: Supplemental Information TYPE OF WORK FEE* SCH 0 New construction 0 Demolition For special information use checklist Description I Qty. 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 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 u. JOB,'SIA" 'OR „w tON IANO AND LOCATION Site utilities: Job site address: 124,0(4 O 3_,.J -I,(©* Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: � Q cl7 2...23 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 1 L Vrtic C LY-J UQ.'A\f\-,J- ' 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: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 i :v' 1 Backwater valve 12.51 M x (n DESCRIPTION , "t- .. P. , Clothes washer 25.02 VW�i3 -`'�\\jki-Oh c`j.7 '`J�6 A-C/C ALAR c,, of\c,(__-- Dishwasher 25.02 FJ n �� r- &A c•- kc '�� c ole tz� (K 1/ \ L 5 Drinkingfountain 25.02 u� S �� ,, V c_E.r"j , Ejectors/sump 25.02 r�n r ' Ro RTY OWNER 1 ❑ TENANT Expansion tank 12.51 , Name: \)`v 'v.e w Q.,,i,--k---- Fixture/sewer cap 25.02 (� Floor drain/floor sink/hub 25.02 Address: \1(�y djt,;,.) 1 ((Q`1-'1^ A o1/4-- Garbage disposal 25.02 City/State/ZIP: 74 ,G,,`+ ) C.),2 0172 23 Hose bib 25.02 Phone:('S-0 ' sb -- d(p� Fax:( ) Ice maker 12.51 'APPLICINT x ,CONTACT.PERSON k<, Interceptor/grease trap 25.02 .... Medical gas(value:$ ) Page 2 Business name: Primer 12.51 Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory ( 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan -I 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 .:�. Water heater 37.52 Business name: (//�� Cj Water piping/DWV 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) g State surcharge(12%of permit fee) Authorized signature: , ' /l 1(//2 ( TOTAL PERMIT FEE Print name: Date: t This permit application expires if a permit is not obtained within 180 days cv t 201 Y after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Buildmg\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, F (ea) Total m&mita Footage: Permit Fee: Footing drain-l' 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: of"4 $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 ' spections or Fees:„ tr #eal Total each additional$100.00 or fraction thereof,to �. ..x 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 Revi , r lunabin ' s latl Quantity by Fixture Type .., Plan review is required for any of the following. Fixture Type for Reolare Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font 0 Any new commercial building with water service 2"and 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 Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic ❑ 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" 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/Bat 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