Permit 711 CITY OF TIGARD e� PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00042
Date Issued: 01/31/2019
f C.A 1.1 r 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 AidParcel: 2S110DD02900
/, Jurisdiction: Tigard
Site address: 10570 SW CENTURY OAK DR
Project: SCHEURICH Subdivision: SUMMERFIELD Lot: 36
Project Description: Installing new catch basin and adding 100 ft storm line. 2/21/19:REPRINT to add(1)sump pump. 2/21/19:
REPRINT to change contractor address.
Contractor: DRAINAGE MASTERS LLC Owner: SCHEURICH, MAUREEN
2801 E 5TH 10570 SW CENTURY OAK DR
VANCOUVER,WA 98061 TIGARD, OR 97224
360-694-5847
PHONE PHONE: 503-524-0576
FAX:
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 01/31/2019 $18.76
Specifics: 100 If Storm Sewer 01/31/2019 $62.54
1 12%State Surcharge- 01/31/2019 $9.76
Type of Use: SF Plumbing
Class of Work: ALT
1 ea Ejectors/Sump 02/21/2019 $25.02
Type of Const: 0 12%State Surcharge- 02/21/2019 $3.00
Plumbing
Occupancy Grp:
Stories:
Total $119.08
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: c_c_c_ ,09
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.
CITY OF TIGARD PLUMBING PERMIT
;714COMMUNITY DEVELOPMENT Permit#: PLM2019-00042
11l Date Issued: 01/31/2019
T"I C_;A l=:p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S110DD02900
Jurisdiction: Tigard
Site address: 10570 SW CENTURY OAK DR
Project: SCHEURICH Subdivision: SUMMERFIELD Lot: 36
Project Description: Installing new catch basin and adding 100 ft storm line. 2/21/19:REPRINT to add(1)sump pump.
Contractor: DRAINAGE MASTERS LLC Owner: SCHEURICH, MAUREEN
PO BOX 818 10570 SW CENTURY OAK DR
RIDGEFIELD,WA 98642 TIGARD, OR 97224
PHONE: 360-694-5847 PHONE: 503-524-0576
FAX:
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 01/31/2019 $18.76
Specifics: 100 If Storm Sewer 01/31/2019 $62.54
1 12%State Surcharge- 01/31/2019 $9.76
Type of Use: SF Plumbing
Class of Work: ALT 1 ea Ejectors/Sump 02/21/2019 $25.02
Type of Const: 0 12%State Surcharge- 02/21/2019 $3.00
Plumbing
Occupancy Grp:
Stories:
Total $119.08
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 b calling 503.23 .1987 or 1.800.332.2344.
Issued By: ii./ Permittee Signature: Sr,?— A 75a-.`
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.
4
Plumbing Permit Applicatio
Building Fixtures n'
p FOR OFFICE USE ONLY
City of Tigard / Received �f �/
;� 13125 SW Hall Blvd.,Tigard,OR 97223 2,319 Date/By: �( h 'ermit No/924620/9-D�J'J2.
Phone: 503.718.2439 Fax: 503.598.j960` Plan Review _/
Inspection Line: 503.639.4175 Date/By: Other Permit No.:
I'1 G A IZ D p t Date Ready/By:
Internet: www.tigard-or.gov lutir. I ®See Page 2 for
Notified/Methad: Supplemental Information
TYPE OF WORK
FEE* SCHEDULE
For special information use checklist
0 New construction ❑Demolition
(Addition/alteration/replacement 0 Other: Description Qty. Ea. Total
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
❑Accessory building SFR(3)bath 437 78
❑Multi-family 500.32
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
JOB SITE INFORMATION AND LOCATION Fire utisprlities:ler( sq.ft.) Page 2
Site utilities:
Job site address: 10c1-0 � Catch basin or area drain 18 76
LA) 021 fir.
City/State/ZIP: ec's\ 5 i-c\ O.ft-L., " 22q
Footing
1,leach line,or trench drain 18.76
r T Footing drain(no.linear ft.:
Suite/bldg./apt.no.: I Project name: � „1,�, ) Page 2
Pc vc-c_is 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.: ) Page 2
Subdivision: Water service(no.linear ft.: ) Page2
I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer
31.27
DESCRIPTION OF WORK Backwater valve
�e� 12.51
I/P
^u 0 Clotheshwwashere25.02
�/ Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 1 25.02 ZS-,U7..
PROPERTY OWNER I 0 TENANT Expansion tank
12.51
Name: rI „ �� �C + -QUI
;C Fixture/sewer cap 25.02
Address: t 'o 5 S ikaj ñ a a r IN
Floor drain floor sink/hub 25.02
City/State/ZIP: el e\--1K, �._!7 . q act
ct
Garbage disposal 25.02
Phone:(56S 5. y 0 S \'?�� Fax:( ) Hose maker 25.
�` Ice 12.51
'D`APPLICANT 0 CONTACT PERSON Interceptor/grease trap
�\ 25.02
Business name: 1 ) A �,(111A o 51.,,,_ r S C Cc Medical gas(value:$ ) Page 2
12.51
Contact name: 1 � YC i V�� 7�-",. Primer
Address: Z / G^-5- --..s.1-__. Roof drain(commercial) 12.51
City/State/ZIP: Sink/basin/lavatory 25.02
v��e'ck„A..Q_fi Solar unit
(A-14.- -dr,6s
Phone:('�6 1'Z-6 ) � (potable water) 62.54
le Is k {IFa::( ) '/1 - Tub/shower/shower pan 12.51
Email: ', �� Q0. P U\k.L4%�kN�r 1 I1 \ Q1+"nKa) r�_ (GyY Urinal 25.02
J CO CTOR Water closet 25.02
Business name: �/� ,+ Water heater 37.52
i ck:\�A V VIA
' a i s et-C.' Water piping/DWV 56.29
G-
Address: 2 cc„ S s 4._
Other: 25.02
City/State/ZIP;V-a 1,tC pV�,1 *I, 41( 6 /
Subtotal /���
Phone:(366) 6�y....,(5,._.(4...„--4. I Fax:( ) Minimum permit fee: $72.50
360 6 gY- �3Z
d
CCB Lie.: f ���! Plumbing Lic,no.: n 8 Z� �a Plan review (25%of permit fee)
Authorized signature f ! State surcharge(12%of permit fee) 3.
TOTAL PERMIT FEE 'oz
Print name: ikti, slit; r . t--a I Date: 2 Ii 9//91 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-PermitApp.doc 10/01!09
440.4616T(10l02JCOM/WEB)
tt
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-I'100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
Sewer-each additional 100' 7,201 and greater $327.54
37.52
Water Service-1st 100' 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
Storm&Rain Drain-each additional 100' $1.00 to$5,000.00 Minimum fee$72.50
37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00.
$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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
Inspections outside of normal business 90.00/hr and including$25,000.00.
hours(minimum charger 2 hours) $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
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:
Other Fixtures: I I I I
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*.
Quantity by Fixture Type
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan Review for Plumbing Installations
Baptistry/Font Plan review is required for any of the following.
Bath Tub/Shower Please check all that apply.
Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator 0 New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR9I8-780-0040.
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain 0 Any multipurpose fire sprinkler system.
Eye Wash 0 Any complex structure as defined in OAR9I8-780-0040.
Floor Drain/sink -2"
3' Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain
Garbage -Domestic-non-food Isometric or Riser Diagram
Disposal -Domestic-food related ❑ Isometric or riser diagram is required for new buildings
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall a'\ 6 C�r1 �(�p\ 1-e4C mea �
Sink/Lav -Non-food related Q �K Q t J in`, r eT t"‘1)1)n I C Ot rt
-Bradley Nip&ckVi-k. c$4 vi4!'1 t p.,(\1 t -
-Commercial-food related
-Service
Swimming Pool Filter
Washer-.Clothes
Water Extractor *Note: If the fixture work under this permit results in an
Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
C:\Users\HP ProDesk 600(I)-doc SFF1AppData\Local\Packages\Microsoft.Micro�9oftEdge_8wekyb3d8bbwe\TempState\Downloads\PLMF PetmitApp
CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit#: PLM2019-00042
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/31/2019
T I t;A R D g Parcel: 2S110DD02900
Jurisdiction: Tigard
Site address: 10570 SW CENTURY OAK DR
Project: SCHEURICH Subdivision: SUMMERFIELD Lot: 36
Project Description: Installing new catch basin and adding 100 ft storm line.
Contractor: DRAINAGE MASTERS LLC Owner: SCHEURICH, MAUREEN
PO BOX 818 10570 SW CENTURY OAK DR
RIDGEFIELD,WA 98642 TIGARD, OR 97224
PHONE: 503-524-0576
PHONE: 360-694-5847
FAX:
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 01/31/2019 $18.76
Specifics: 100 If Storm Sewer 01/31/2019 $62.54
1 12%State Surcharge- 01/31/2019 $9.76
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $91.06
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. 2.1987 or 1.800.332.2344.
Issued By: •- ittee Signature: ' r
410.10
Call 503.639.4175 by 7:00 a.m.for the next available inspectionad fe.
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 Applicatio .�
Building Fixtures
JAN °' "
`
City of Tigard ReceivedDateBy' i/3/ ifft - PrsoVi G- t_-,Z-
IN D 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
• Phone: 503.718.2439 Fax: 503.5984M, _ , "4i Date/By: Other Permit No.:
T 1 t,A R O Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK M FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description Qty. I En. Total
'�"Addition/alteration/replacement 0 Other:
New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY QF CONSTRUC.11'4QN SFR(1)bath 312.70
fi-and 2-family dwelling 0 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
JOE"' XNFORMAIIO.N AND L TJON :3 Site utilities:
Job site address: ,Q 5-7-0 5 j i ( O ct K pY Catch basin or area drain ( 18.76
�/ Drywell,leach line,or trench drain 18.76
City/State/ZIP: 1-r,q ! Q T ZZ 4'/__ A Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: jtv ke�C)y t QJ t- Manufactured home utilities 50.03
Cross street/directions to job site: 5 c ) /v y " 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
„ DRSCRiPiION F WO � r - it, Backwater valve 12.51
µY., D
is
Clothes washer 25.02
Vlew-( CC4e-tt- lae a, n 0Y1 2ck-Q A- cViveAs 0 Y v-»�t� pccltlM1� \S Dishwasher 25.02
-e' ‘Y1 ave(' o W 6 4Z-181.51-: 4211.kk -c lk ,ko S1i-4,4 Drinking fountain 25.02
CIjl yt_. iASLW ale OA c.Ao V ki 1A-. f tNp,.,+tl hr67(% w k, Ejectors/sump 25.02
,,ktl PROPERTY 4,AYNER : 1 ❑ TENANT..,,, Expansion tank 12.51
�t,ry
Name: L�' j�-�,�, 5 c� - Fixture/sewer cap 25.02
rl C_A,. Floor drain/floor sink/hub 25.02
Address: /Q S" l /tj C11 4--c.,vy c)Q k .0 r. Garbage disposal 25.02
City/State/ZIP: -, 5ay d r 6l. q 1 22,ei Hose bib 25.02
Phone:(575 ) S 2,/.. p S Fax:( ) jd(J,4ti- Ice maker 12.51
!CANT ' i CONTA FJi.SON Interceptor/grease trap 25.02
Business name: Dy.c,4 i 1, /,< GGA v Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: 6 o e.I 12-o.e ' ' Roof drain(commercial) 12.51
Address: Zig,d / 6' S 54.
`� Sink/basin/lavatory 25.02
City/State/ZIP:\)alit c, Vo - W '. q%(�(o I Solar units(potable water) 62.54
Phone:(36,0 )-1--"}2 G2--' ( Fax::(566 ) 6Q 2f- 5 Z Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
0,-(k e � Dia WO5 eys-.cit m
Water closet 25.02
CONTRACTOR
- Water heater 37.52
Business name: `✓re(f .e //, I is """ ��, u C . Water piping/DWV 56.29
Address: ., 0 / G -Y Other: 25.02
City/State/ZIP:v ckstk G9 U ye ft (Ad✓k-. q'v G f Subtotal
Phone: / Fax: Minimum permit fee: $72.50
(�� )`n q�-S��� (���) ��J y, �� Z.
Plan review (25%of permit fee)
CCB Lic.: 1 l(�`K 4 3 lz 1K`/� Plumbing Lic.no.: P 6 b
l V t+ 6 State surcharge(12%of permit fee)
Authorized signa • e: 410 �� t1� TOTAL PERMIT FEE
Print name: This permit application expires if a permit is not obtained within 180 days
T. , c,�f-p� Date: 1 �� i after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1Burlding\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 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
luatiO n, :: Permit Fee:
Storm&Rain Drain-1st 100' i 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
OthQt7 (ta) Tidal v each additional$100.00 or fraction thereof,to
elr Inspections or Fees "; 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 Ii; liew forlin °.Ery Installations
Quanti by F uI'e Type Plan review is required for any of the following.
Fixture`Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font ❑ 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
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 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"
ra -
4"
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