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Permit (169)
IIIII II p p TIGARD City of Tigard June 24, 2019 Ken Leahy Construction PO Box 489 Cornelius, OR 97113 Re:Permit No. PLM2018-00146 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 7670 SW Hunziker Rd Project Name: The Fields Apartments Job No.: N/A Refund: ® Check#232414 in the amount of$132.22. ❑ Credit card "return"receipt in the amount of$ . ❑ Trust account"deposit"receipt in the amount of$ . Notes: Refund overpayment of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. g S\ & uvs aW�Lr AIM,erpaTigag4,Qregon 97223 • 503.639.4171 I:\Buildin Uo TTY Relay: 503.684.2772 • www.tigard-or.gov , IN - v City of Tigard T I G A R D Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Ken Leahy Construction DATE: 6/10/2019 PO Box 489 Cornelius, OR 97113 REQUESTED BY: Dianna Howse TRANSACTION INFORMATION: Receipt#: 423142 Case#: PLM2018-00146 Date: 4/29/2019 Address/Parcel: 7670 SW Hunziker Rd Pay Method: CreditCard Project Name: The Fields Apartments EXPLANATION: Refund 100%of overcharge. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount Plumbing Plan Review 230-0000-43109 $85.99 12%State surchage 100-0000-24001 46.23 TOTAL REFUND: $132.22 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff ' 4, If under$12,500 Division Manager If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY Case Refund Processed: Date: s 14/i/ By: 0) I:\Building\Refunds\RefundRequest.doc x 09/01/2010 CITY OF TIGARD RECEIPT l 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: The Fields Apartments Site Address: 7670 SW HUNZIKER RD Receipt Number: 434455 - 05/21/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2018-00146 $-46.23 Total: $-46.23 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 232414 DHOWSE 05/21/2021 $-46.23 Payor: Ken Leahy Construction Total Payments: $-46.23 Balance Due: $0.00 Page 1 of 1 CITY OF TIGARD RECEIPT ', 1111 g 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: The Fields Apartments Site Address: 7670 SW HUNZIKER RD Receipt Number: 434454 - 05/21/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2018-00146 $-85.99 Total: $-85.99 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 232414 DHOWSE 05/21/2021 $-85.99 Payor: Ken Leahy Construction Total Payments: $-85.99 Balance Due: $0.00 Pane 1 of 1 Iiii4 I CITY OF TIGARD RECEIPT • 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: The Fields Apartments Site Address: 7670 SW HUNZIKER RD Receipt Number: 423142 - 04/29/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2018-00146 Footing Drain 230-0000-43101 $50.03 PLM2018-00146 Manholes 230-0000-43101 $18.76 PLM2018-00146 Storm Sewer 230-0000-43101 $212.62 PLM2018-00146 Water Service 230-0000-43101 $62.54 PLM2018-00146 12%State Surcharge-Plumbing 100-0000-24001 $41.27 (manual) PLM2018-00146 Additional Plan Review 230-0000-43109 $85.99 PLM2018-00146 Plan Review 230-0000-43109 $85.99 PLM2018-00146 12%State Surcharge-Plumbing 100-0000-24001 $46.23 �" Total: $603.43 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 519253 PUBLICUSERO 04/29/2019 $603.43 Payor: Michael Shawn Ober Total Payments: $603.43 Balance Due: $0.00 Page 1 of 1 IliII CITY OF TIGARD RECEIPT 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: The Fields Apartments Site Address: 7670 SW HUNZIKER RD Receipt Number: 421746 - 02/26/2019 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PLM2018-00146 Catch Basin or Area Drain 230-0000-43101 $131.32 PLM2018-00146 Drywell, Leach Line or Trench Drain 230-0000-43101 $37.52 PLM2018-00146 Manholes 230-0000-43101 $75.04 PLM2018-00146 Rain Drain Connector 230-0000-43101 $187.60 PLM2018-00146 Sanitary Sewer 230-0000-43101 $625.34 PLM2018-00146 Storm Sewer 230-0000-43101 $1,263.18 PLM2018-00146 Water Service 230-0000-43101 $737.90 PLM2018-00146 Backflow Preventer 230-0000-43101 $31.27 PLM2018-00146 Misc Other Fee 230-0000-43101 $825.66 PLM2018-00146 Plan Review 230-0000-43109 $978.71 PLM2018-00146 12%State Surcharge-Plumbing 100-0000-24001 $469.78 Total: $5,363.32 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 216212 PUBLICUSERO 02/26/2019 $5,363.32 Payor: Slade R Leahy Total Payments: $5,363.32 Balance Due: $0.00 Page 1 of 1 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT Request for Permit Action T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD RECEIVED Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 APR 2 9 2019 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits n rd-or.gov (JI�I Y OF TIGARD FROM: ❑ Owner ❑ Applicant Contractor 09tIrk.MG DIVISION Check(✓)one REFUND OR Name: INVOICE TO: (Business or Individual) VEAJLitAl.he Ga.► g-ie,:i o Ns' Mailing Address: Po &OX 4i,1 City/State/Zip: Coe_J-i t..‘0 S E t2- cl 71 ( 3 Phone No.: c o ' - 357 219 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): ❑ .ckNCEL/VOID PERMIT APPLICATION. REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). Permit #: APL`,/17(2U/ —COL,CO Site Address or Parcel#: -i 670 SL/ p%ev,,,iLGr F-M. Project Name: 7 ., 5 4VidrverSubdivision Name: Lot#: EXPLANATION: p?„2a) N, .1 J j ,-t- .f�' /`'` . 4,/i.:t.,, 4'es-4 ©t` it 'S`. r:nel .:S at b/.../- cia.."4-. Signature: Date: fifer,....K, /j1��r-/ tWl/,Jru Print Name: grA,-lni /in/44-.4w3040 Refund Policy r'C-✓a��-✓. 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: /S"' . • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ONLY Route to Sys Admin: Date 3,'+ 'el By .—;. Route to Records: Date�'t! l/ By 4r Refund Processed: Date 6ity /? B . j Invoice Processed: Date By Permit Canceled: Date ,v By a Parcel Tag Added: Date By I:\Building\Forms\RegPcrmitAction_120S18.doc Reu;seS, S .te_ (ttiIvikes Plumbing Permit Application Site Utilities FOR OFFICE USE O!SLI City of Tigard Received ^�m dOL8 r‘ Date/By: Permit No.:r+ [k 13125 SW Hall Blvd.,Tigard,OR 97223 I Plan Review Phone: 503.718.2439 Fax: 503.598.1960 of'/7_l Y 04 Other Permit No.: Date/By: Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for T I G A R D Internet: www.ti and-or. ov y o B g g Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEq$°r 'N-:. 14 New construction 0 Demolition For special information use checklist Description Qty. Ea. Total ❑Addition/alteration/replacement ❑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 commercial/industrial SFR(2)bath 437.78 ElAccessory building El Multi-family SFR(3)bath 500.32 ( - " Each additional bath/kitchen 25.02 ❑Master builder 0 Other: .' ' r. e Ajt , ' Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATI n .:..' 'V" Site utilities: Job site address: 9b ti U `,�, � ��2 i (t�a- _ �� Catch basin or area drain 18.76 C, �1 Drywell,leach line,or trench drain 18.76 City/State/ZIP: T(t rr� I QQ• 9 a�3 Footing drain(no.linear ft.:5 ) I Page 2 5(103 Suite/bldg./apt.no.: Project name: ff. [is lip aVt jvrl4 t Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 1 18.76 18,74 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:'3 7 5 Page 2 jU .(.a Water service(no.linear ft.:31 ) I Page 2 6?.$q Subdivision: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 - Clothes washer 25.02 RQVi4ei PCX.K. 4-csY- S a i-e utt IA i e s Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 ❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 - - '- 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 12.51 E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 343. 75 Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) IS, State surcharge(12%of permit fee) 4 I.2 Authorized signature: TOTAL PERMIT FEE 471.9.1 This permit application expires if a permit is not obtained within 180 days Print name: 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) i CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2018-00146 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/26/2019 T I �iz.P g Parcel: 2S1010001600 Jurisdiction: Tigard Site address: 7670 SW HUNZIKER RD Project: The Fields Apartments Subdivision: FIELDS APARTMENTS Lot: None Project Description: Plumbing site utility work for(5)new apartment buildings and(1)clubhouse. Contractor: KEN LEAHY CONSTRUCTION INC Owner: FIELDS, FRED W REVOCABLE LIVING PO BOX 489 111 SW 5TH AVE#3675 CORNELIUS, OR 97113 PORTLAND, OR 97204 PHONE: 503-357-2193 PHONE: FAX: 503-357-3649 FEES Quantity Description Date Amount 7 ea Catch Basin or Area Drain 02/26/2019 $131.32 Specifics: 2 ea Drywell,Leach Line or Trench 02/26/2019 $37.52 Drain 4 ea Manholes 02/26/2019 $75.04 Type of Use: MF Class of Work: NEW 10 ea Rain Drain Connector 02/26/2019 $187.60 Type of Const: 1589 If Sanitary Sewer 02/26/2019 $625.34 Occupancy Grp: 3277 If Storm Sewer 02/26/2019 $1,263.18 Stories: 1895 If Water Service 02/26/2019 $737.90 1 ea Backflow Preventer 02/26/2019 $31.27 826 Misc Other Fee 02/26/2019 $825.66 1 Plan Review 02/26/2019 $978.71 1 12%State Surcharge- 02/26/2019 $469.78 Plumbing Total $5,363.32 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 se •rth 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': or 1.800. 44. Issued By: 'e ' ' nature: 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. . lumbin� 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 s'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' 1 62.54 $62.54 7,201 and greater $327.54 Sewer-each additional 100' 15 37.52 $562.80 Water Service-1st 100' 1 62.54 $62.54 Medical Gas Systems: Water Service-each additional 100' 1 g 37.52 4q5,3t. Storm&Rain Drain- 1st 100' 1 62.54 $62.54 Valuation: Permit Fee: $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 3g 37.52 /,200.b4 $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 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: .96,16 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 Plan Review for Plumbing Installations Fixture Type for Replace/ Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water servicer 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 ❑ 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. Isometric or Riser Diagram Car Wash Drain Garbage Domestio-non-food ❑ Isometric or riser diagram is required for new buildings 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 Per separate building permit. All qtys Shower --Gang are for site utilities only. 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: L:AProject\17000\17052\Archives\Outgoing\City of Tigard\2018-04-02 Sits Utilitiies Permit\PLMU_PermitApp.doc tt Dianna Howse From: Dianna Howse Sent: Friday,June 1, 2018 3:31 PM To: 'Kyle Childers' Cc: 17052; #Building Permit Technicians Subject: RE: 17052- Fields Property Site Works, Site Utility- PLM2018-00146 Attachments: PLM2018-00146.pdf Hello Kyle, The plumbing site utilities permit has been reviewed and the balance due is$5,363.32 (see attached invoice). The fees can be paid online at https://aca.accela.com/TIGARD/Default.aspx by searching for the permit record number PLM2018-00146 or in person when you pick up the permit Monday-Thursday, 8:00 am to 4:00 pm. We are closed on Fridays. Please note that we must have a licensed plumbing contractor identified prior to permit issuance. Also, because the site work and building permits have not yet been released for issuance,the plumbing site utilities permit cannot be issued at this time. Thank you. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Dianna Howse Sent:Tuesday, May 29, 2018 5:31 PM To: 'Kyle Childers'<Kyle.Childers@otak.com> Cc: 17052 <17052@otak.com>; #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: 17052-Fields Property Site Works, Site Utility Hello Kyle, The plumbing permits are still pending review with the plumbing inspector, Don Sylvester. Please contact Don at 503- 718-2424 or email at donsPtigard-or.gov for an update. Thank you. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits 1 From: Kyle Childers<Kvle.Childers@otak.com> Sent: Friday, May 25, 2018 2:27 PM To: Dianna Howse<Dianna@tigard-or.gov> Cc: 17052 <17052@otak.com>;#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: 17052- Fields Property Site Works, Site Utility Dianna, Any word on the plumbing review. Please let me know timing of plan review so I can update our project schedules. Thanks. Kyle From: Dianna Howse [mailto:Dianna@tigard-or.gov] Sent: Monday, May 14, 2018 2:27 PM To: Kyle Childers<Kyle.Childers@otak.com> Cc: 17052 <17052@otak.com>; #Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: RE: 17052- Fields Property Site Works, Site Utility Hello Kyle, The plumbing inspector tells me that he will begin review of the plumbing site utilities sometime this week. The site work permit has been approved by the building plans examiner, however it has not been released by the permit coordinator,Albert Shields, who can be reached at 503-718-2426 or albert@tigard-or.gov for an update. Thank you. Dianna L. Howse Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits From: Kyle Childers<Kyle.Childers@otak.com> Sent: Monday, May 14, 2018 10:32 AM To: Dianna Howse<Dianna@tigard-or.gov> Cc: 17052 <17052@otak.com> Subject: 17052- Fields Property Site Works, Site Utility Good morning Dianna. I wanted to check-in on the status of the Site Works permit and site utility permits for the Fields Project. I submitted the plans about a month ago and I wanted to see how the review is going. Is there an anticipated date as to when the review will be complete. Thanks Kyle 2 k Ota Kyle Childers, PE I Project Manager 808 SW Third Ave., Suite 300 Portland, OR 97204 Direct:503.415.2408 Main: 503.287.6825 www.otak.com at Otak,we consider the environment before printing emails. The information transmitted in this e-mail message and attachments,if any,may contain confidential material,and is intended only for the use of the individual or entity named above.Distribution to,or review by,unauthorized persons is prohibited.In the event of the unauthorized use of any material in this transmission, neither Otak nor the sender shall have any liability and the recipient shall defend,indemnify and hold harmless the sender,Otak and its principals,agents, employees and subconsultants from all related claims and damages.The recipient understands and agrees that any use or distribution of the material in this transmission is conditioned upon the acceptance of the terms stated in this disclaimer.If you have received this transmission in error,immediately notify the sender and permanently delete this transmission including attachments,if any. DISCLAIMER E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule." 3 Plumbing Permit Application Reu seri. S L€ (J�t;1 e s Site Utilities FOR OFFICE LSE ONI.1 /v.` City of Tigard Received Permit No.: Date PLM aOL8 -co 14C U 13125 SW Hall Blvd.,Tigard,OR 97223 Re 11 Phone: 503.718.2439 Fax: 503.598.1960 Plan Review +���I /�I Other Permit No.: • Date/By: IC1 T I G A R p Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov Notified/Method: Supplemental Information s. .m.: - TYPE 7 WORK 1F'EE".SCHEDULE -;.i`; New construction ❑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 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family '; Each additional bath/kitchen 25.02 ❑Master builder 0 Other: 7 i'' • •I Fire •sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATI a '' 4 V+� Site utilities: Job site address: I Catch basin or area drain 18.76 aa� �' 1 ��2 i (�v� Drywell,leach line,or trench drain 18.76 City/State/ZIP: 'T1 c�1rt7L 1 OR, qr.)p� Footing drain(no.linear ft.: c9) / Page 2 TO,03 Suite/bldg./apt.no.: Project name: F; J Q c flP exit kv1 f Manufactured home utilities 50.03 Cross street/directions to job site: 1 Manholes [ 18.76 /9,q6 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_) Page 2 Storm sewer(no.linear ft.:41S? 5 Page 2 Ala.62 Water service(no.linear ft.:31 ) C Page 2 (a.5e( Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 ,i x: . Backwater valve 12.51 DESCRII'IION OF WORI�1, ; x H i Clothes washer 25.02 R4+Ji.Sec_ PCILIA iCAi- S:i'fQ Lt+ i tL'I it S Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0`PROPERTY OWNER.:* ( ;`;k', 0 T-17 ' Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) I Fax ( ) Ice maker 12.51 ''.. 0 APPLICANT , ElCQNTACT E SON , Interceptor/grease trap 25.02 xx Business name: Medical gas(value:$ ) Page 2 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 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR % " Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal 343, 75 Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) a S.q t State surcharge(12%of permit fee) 41,`.Z ri Authorized signature: TOTAL PERMIT FEE 471,,at Print name: Date: 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(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Fee{ea) Total. Site Utilities _ _ : ()Or* Sgluare Footage. F;x�`e Permit Fez :. Footing drain-l'100' 50.03 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 6 2..54 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: - . Permit Fee- Storm&Rain Drain-1st 100' / 62.54 0,0 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 4 37.52 150.08 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Qty: Fee(ea) Tota each additional$100.00 or fraction thereof,to Other 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$100.00 or fraction thereof. Subtotal: 3)5.19 Commercial Fixture Work: Are you capping,adding or replacing fixtures? If"yes", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbing Installations FIXture Type for Replace/ - Work Performed: Capped Added Relocate Plan review is required for any of the following. Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water service 2"and Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru 0 New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. - Car Wash Drain I$i ti C or Riser,Diagram Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings 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 thisermit results in an Washer-Clothes p 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: I:\Building\Permits\PLMU PermitApp.doe 2 1111 Site Utilities — Plumbing Permit Application Plan Submittal Requirements TIGARD A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. 1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn to scale) labeled with: A. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads with project location. 2. PLUMBING PLANS -Two (2) complete sets, civil only. All details listed below shall be incorporated into the plumbing plans: A. Storm drainage plan showing: 1) Finish elevations throughout the developed site. 2) Grade breaks determining area serving each catch basin. 3) Location of catch basins. 4) Pipe size. 5) Type of material. 6) Slope of piping. 7) Manholes and field drains. 8) Cleanouts provided for each 100 feet or fraction thereof. 9) Roof drain laterals specifying cleanouts at each upper terminal. 10) Location of existing or proposed connection to a public sewer line. B. Utilities plan showing: 1) Sanitary sewer line location,pipe size,type of material, slope of piping,manholes and cleanouts provided as required for storm. 2) Size and location of domestic water piping and drainage. 3) Proposed location of connection to a public water or sanitary sewer line. I:\Building\Permits\PLMF-PermitApp.doc 12/30/05 OtakRECEIVED FEB 2 7 2019 CITY OF TIGARD BUILDING DIVISION Letter of Transmittal Transmitted By: Date: 2/27/2019 Project No.: 17057.001.003.200 ❑ Mail Project: Fields Apartment Project ▪ Courier To: Dianna H. Hours: 4 City of Tigard ❑ Will Call Address: 13125 SW Hall Blvd. Tigard, OR 97223 We Are Sending You: Transmitted: ❑x Plans/Drawings ❑ For Approval ❑ Specifications D As Requested Cl Samples ❑ For Your Use ❑ Other ❑ For Comment Copies: Description: 3 PVT Storm Drain Modifications Remarks: From: Kyle Childers 503.415.2408 cc: document1 808 SW Third Avenue, Suite 300, Portland, OR 97204 • Phone (503) 287-6825 Fax (503) 415-2304 otak.com FOR OFFICE USE ONLY— SITE ADDRESS: This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard ' COMMUNITY DEVELOPMENT DEPARTMENT Transmittal Letter : 1 a TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: DEQ 0 H}p, 4awSF... DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED FEB 2 7 2019 FROM: Kyle Childers, PE CITY OF TIGARD COMPANY: OTAK BUILDING DIVISION PHONE: (503)415-2408 $2 Pr RE: 7670 SW Hunziker PLM 2018-00146 (Site Address) (Permit Number) Fields Apartment Project (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. 3 Revisions: PVT Storm Drain Modifications Cross section(s) and details. Wall bracing and/or lateral analysis. Floor/roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other(explain): REMARKS: Revised Private Site Plumbing Permit Plans for the Fields Apartment Project PLE .Pec a, FEEL Fii . To CALL K>. , (GYLE, (S-b3) 4/5"-- 2400 FOR OFFICE USE ONLY Routed to Permit TThnician: Date: r/7i'7/7 Initials: t / Fees Due: 's n No Fee Description: j;it Lil b h c.j Asi..i. yjj Amount Due: $ it 7/ 4/ $ $ $ Special Instructions: Reprint Permit (per PE): es fl No Done Applicant Notified: 2-- Date: k7/".6fri Initials: j'.. I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012