Permit (165) ..F
CITY OF TIGARD PLUMBING PERMIT
11111 ' COMMUNITY DEVELOPMENT
Permit#: PLM2019-00130
13125 SW Hall Blvd.,Ti and OR 97223 503.718.2439 Date Issued: 04/01/2019
T l -'A u �' g Parcel: 1S135CD01600
Jurisdiction: Tigard
Site address: 9794 SW WINDSWEPT PL
Project: Canyon Court Subdivision: CANYON COURT Lot:
Project Description: installation of private water lines to homes,Lots 1-8,(9794,9784,9774,9754,9744,9734,9724,&9714)from
banked meter locations.
Contractor: EDWARD MULLEN PLUMBING Owner: SB LAND DEVELOPMENT LLC
1601 SE RIVER RD 1815 NW 169TH PL STE 1040
HILLSBORO, OR 97123 BEAVERTON, OR 97006
PHONE: 503-969-8298
503-640-0113
FAX: 503-640-4483
FEES
Quantity Description Date Amount
1675 If Water Service 04/01/2019 $662.86
Specifics: 1 12%State Surcharge- 04/01/2019 $79.54
Plumbing
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $742.40
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: i��/�`'�%!; / Permittee Signature: ��r/ ..---
Call
0,00,a‘"..-"'....
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 Applicatio t
Site Utilities _ .i � � FOR OFFICE USE ONLY
RCity of Tigard Receives /ems cf l3
■ 13125 SW Hall Blvd.,Tigard,OR 97223CDate/By:• / (. l /� e� tpZU` ��j
illh = Phone: 503.718.2439 Fax: 503.598..'.'rA i . 16 g� Plan Review
�:i, - Lsi v i3 vt� RecDateiver
Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
OE WORK , , F1t*. ut > .,
®New construction ❑Demolition For special information use checklist
Description Qty. Ea. Total
O Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGOR OI+ t"+* u(i torq SFR(1)bath 312.70
® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ['Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB ,SITE INEORMA'T )N vo tot,AiltiS,, Site utilities:
Job site address:4L6UU 98th C77 Ai 5W ����.� Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Canyon Court Manufactured home utilities 50.03
Cross street/directions to job site:SW Greenberg Road 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.:1675) Page 2
Subdivision:Canyon Court 1 Lot no.: Fixture or item:
Tax map/parcel no.:1S135CD01600 Backflow preventer 31.27
F: Backwater valve 12.51
�CRIPUOI? O2 WORK
Clothes washer 25.02
Installation of private water lines to 8 homes from banked meter location
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
�e PROPERTY,OWNER ❑ TtNA14 Expansion tank 12.51
Name:Sage Built Homes,LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:1815 NW 169'Place,Suite#1040 Garbage disposal 25.02
City/State/ZIP:Beaverton,OR 97006 Hose bib 25.02
Phone:(503)969-8298 Fax:( ) Ice maker 12.51
iNTAcT pt„RsoN Interceptor/grease trap 25.02
Medical gas(value:$ ) Page 2
Business name:Same as owner
Primer 12.51
DoneyContact name:Cale
Roof drain(commercial) 12.51
Sink/basin/lavatory 25.02
Solar units(potable water) 62.54
Phone:(503)969-8298 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:caled@sagebuilthomesllc.com Urinal 25.02
Water closet 25.02
CONTRACTOR Water heater 37.52
Business name:Edward Mullen Plumbing
WaterPtPing/D WV 56.29
Address:1601A SE River Road Other: 25.02
City/State/ZIP:Hillsboro,OR 97123 Subtotal
Phone:(503)640-0113 Fax:( ) Minimum permit fee: $72.50
CCB Lie.:92689 Plumbing Lic.no.:34-260PB Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: ��'. TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days
Print name:Cale Doney Date:4/1/20191 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.d°c 10/01/09 440-4616T(10/02/COM/WEB)
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression S stems:
` '''� - a,.i #]moi� �*" s x�, t - a It S tz'x�%A � ''' +' ro
. r:s..Y..� "3r. L,.d.� t`„. ...,« x gp<, = - (,line.",444 .,_ E 6 $ �-,,,,` , ,-`,'ems`""43':j+ ?..
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 S stems:
Water Service-each additional 100' 37.52 1 ) etiii eiti1 a;°s 11 `F,fi k L'• x ". '
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
.41 iY N° ° °� ts f p-<, . ., r; and includinl $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 char_e-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 char•e-2 hours each additional$100.00 or fraction thereof,to
Reinspection Fees _ 90.00/lu and includin:$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 char:a-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*.
a a F ° 3 u ` 1tsAa-f , ez r'6 ( 4 E
;art tv y � x 1.74;:v.,-3r5,0.4' r "I:. ,.i d .v.�;i a, . ,, . F [t - ' 3
for ke Plan review is required for any of the following.
-MO ' ukjnied Pis , __ ..
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 ❑ 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.
-3"
a 2 7 o f g
Car Wash Drain ',..s.."...-4-1;-',. ° .°° ' ° 6 ° 4 ` . ,. E 1 k,-' ;!:.
Garbage -Domestic-non-food 0T Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the •ualifications 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 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:
I:\Building\Permits\PLMU_PermitApp.doc 2