Permit (171) CITY OF TIGARD PLUMBING PERMIT
111
. COMMUNITY DEVELOPMENT Permit#: PLM2019-00076
p �� 7,-; Date Issued: 02/26/2019
'I ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 aParcel: 2S101 BC00301
tin= Jurisdiction: Tigard
Site address: 12360 SW KNOLL DR
Project: reed Subdivision: None Lot: None
Project Description: Repipe water throughout house. 3/6/19: REPRINTED permit to include 85 ft.of water service.
Contractor: RANDY ROGERS PLUMBING LLC Owner: WILLIAM REED
PO BOX 358 12360 SW KNOLL DRIVE
SANDY, OR 97055 TIGARD, OR 97223
PHONE: 503-668-0846 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 02/26/2019 $25.02
Specifics: 1 ea Dishwasher 02/26/2019 $25.02
3 ea Hose Bib 02/26/2019 $75.06
Type of Use: SF 2 ea Sink 02/26/2019 $50.04
Class of Work: ALT 4 ea Lavatories 02/26/2019 $100.08
Type of Const: 4 ea Tub/Shower/Shower Pan 02/26/2019 $50.04
Occupancy Grp: 1 ea Water Piping/DWV 02/26/2019 $56.29
Stories: 4 ea Water Closet 02/26/2019 $100.08
1 ea Water Heater 02/26/2019 $37.52
1 12%State Surcharge- 02/26/2019 $62.30
Plumbing
85 If Water Service 03/06/2019 $62.54
0 12%State Surcharge- 03/06/2019 $7.50
Plumbing
Total $651.49
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. ou 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:
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 th- .roject.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures rOR 01.11(-1. USE ONI.v
City of Tigard Received _
Date/By: _"VW/4'i 02- Permit No.:�//� J 1 a})
Y 13125 SW Hall Blvd.,Tigard,OR 92 1�/� I 1 l C J f
1 �4Plan Review
Phone: 503.718.2439 Fax: 503.598.1 6 2019 Date/By: Other Permit No.:
Inspection Line: 503.639.4175
1'1 C;A IZ I) Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: 77,..e„, Supplemental Information
TYPE OF wOUiLDING DIVISION FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description Qty. I Ea. I Total
►1 Addition/alteration/replacement 0 Other: ;<
•� :',A< New 1-2-family dwellings(includes 100 ft,for each utility connection)
CATEGORY OF CONSTRUCTIO � R�9 A. SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commerce:1/ind I. 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
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:12360 SW Knoll Catch basin or area drain 18.76
City/State/ZIP:Tigard Oregon Drywell,leach line,or trench drain 18.76
a 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:Hall Manholes 18.76
Hall to knoll Rain drain connector 18.76
' Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Subdivision: Lot no.: Water service(no.linear ft.:85) Page 2 62.54
Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
replace water service line Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
/l PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Name:William Reed Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:2300 sw 103rd Garbage disposal 25.02
City/State/ZIP:portland or 97225 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Contact name: Primer 12.51
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 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:rogers Plumbing Water piping/DWV 56.29
Address:po box 358 Sandy Or. Other: 25.02
City/State/ZIP:Sandy Or.97055 Subtotal 62.54
Phone:(971)506 0154 Fax:( ) Minimum permit fee: $72.50 X12.S(r
1:6 ^7r) Plan review (25%of permit fee)
CCB Lic.:168668 Plumbing Lic.no.: / a.
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:William Reedi)k Date:3/6/19 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete. 0*Fee methodology set by Tri-County Building Industry Service pard. `t
I:1BuildinglPermitslPLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) ���
CITY OF TIGARD PLUMBING PERMIT
111,,
COMMUNITY DEVELOPMENT
Permit#: PLM2019-00076
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/26/2019
g Parcel: 2S101 BC00301
Jurisdiction: Tigard
Site address: 12360 SW KNOLL DR
Project: reed Subdivision: None Lot: None
Project Description: Repipe water throughout house.
Contractor: RANDY ROGERS PLUMBING LLC Owner: WILLIAM REED
PO BOX 358 12360 SW KNOLL DRIVE
SANDY, OR 97055 TIGARD, OR 97223
PHONE: 503-668-0846 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 02/26/2019 $25.02
Specifics: 1 ea Dishwasher 02/26/2019 $25.02
3 ea Hose Bib 02/26/2019 $75.06
Type of Use: SF 2 ea Sink 02/26/2019 $50.04
Class of Work: ALT 4 ea Lavatories 02/26/2019 $100.08
Type of Const: 4 ea Tub/Shower/Shower Pan 02/26/2019 $50.04
Occupancy Grp: 1 ea Water Piping/DWV 02/26/2019 $56.29
Stories: 4 ea Water Closet 02/26/2019 $100.08
1 ea Water Heater 02/26/2019 $37.52
1 12%State Surcharge- 02/26/2019 $62.30
Plumbing
Total $581.45
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 503.23?.1987 o/ .800. 2.2344.
Issued By: Permittee Signature: iy.4
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 I;SF ()NI.)
Cityof Tigard _'. Received //�
g Date/By: P t;''oZUL 1-/X 7)7/
IIIII • 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 9 r -
■ Phone: 503.718.2439 Fax: 503.598.1960 'e�t`'- Plan Review
Date/By:
Inspection Line: 503.639.4175 - -
1 I G A R D Date Ready/By: Juris: I ® See Page 2 for
Internet: www.tigard-or.gov i ' , Notified/Method: Supplemental Information
TYPE OF WORK
; FEE* SCHEDULE '
0 New construction 0 Demolition For special information use checklist.
Description 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
Wr 1-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
JOB SITE INFORMATION:AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
J�.3 sem. ,r, l a�
Drywell,leach line,or trench drain 18.76
City/State/ZIP: �t �Q_ Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: W` Project name: 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
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
'bESC ON or WORK4, Backwater valve 12.51
Q Clothes washer ,. 25.02
1\ rtA# 40 C)CVS,11ii hiOAK Dishwasher f I 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER4, I 0 TENANT .a, , Expansion tank 12.51
Fixture/sewer cap 25.02
Name: k/i f f( eGrr K ..-Cdr
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib T 25.02
Phone:( ) Fax:( ) Ice maker 12.51
PLICANT ' 0 CONTACT PERSON Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:
Contact name: Primer 12.51
Roof drain(commercial) 12.51
Address:
Sink/basin lavatory ' 25.02
City/State/ZIP: Solar units(potable water) L 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan4 12.51
E-mail: Urinal I 25.02
CONTRACTOR Water closet I 25.02
' ' ' r. Water heater 37.52
Business name: 916 a,c
()J)
Water piping/DWV 1. 56.29
Address: , 3 S$ Other: I 25.02
City/State/ZIP: Se1i o J s Subtotal
Phone:(Ili1 ) 506-- O J S 1 ax:(SOi ) U -t)Sc . Minimum permit fee: $72.50
CCB Lic.: ' �R46 i pe, ' P umbing Lic.no.: I i ' Plan review (25%of permit fee)
v / 'v ••' • State surcharge(12%of permit fee)
Authorized signature:f► 0 ,. TOTAL PERMIT FEE
Print name: 4 _A Date: �-l+ This permit application expires if a permit is not obtained within 180 days
J�� / �' a a U , 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(l0/02/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-1s'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. Permit 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
Fee� ) Total each additional$100.00 or fraction thereof,to
Other.:Inspections 0,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 x i W for' 'lumbiflg Ins+••• a o tsF r
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Cameo;9 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"
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:
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