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Permit (95) CITY OF TIGARD PLUMBING PERMIT ' ' ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00261 Date Issued: 06/25/2019 T I(3 A IF.i) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S114BB10300 Jurisdiction: Tigard Site address: 10387 SW PICKS WAY Project: PADIA Subdivision: SWANSON'S GLEN Lot: 44 Project Description: Installing(1)garbage disposal,(1)sink,(2)lavatories,and(2)water closets. Contractor: OWNER Owner: PADIA,JENNIFER R JENNIFER PADIA 10387 SW PICK'S WAY 10387 SW PICKS WAY TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 503-267-9426 PHONE: 503-267-9426 FAX: FEES Quantity Description Date Amount 1 ea Garbage Disposal 06/25/2019 $25.02 Specifics: 1 ea Sink 06/25/2019 $25.02 2 ea Lavatories 06/25/2019 $50.04 Type of Use: SF 2 ea Water Closet 06/25/2019 $50.04 Class of Work: ALT 1 12%State Surcharge- 06/25/2019 $18.01 Type of Const: Plumbing Occupancy Grp: Stories: Total $168.13 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: ' . A / / Permittee Signature: } 4,,,,,� /ilii r A. .,AZ:// MI I Call 503.639.4175 by 7:00 a.m.for the next available inspectio date. This permit card shall be kept in a conspicuous place on the job site until • pletion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures k FOR OIFlCE ISI. o\l.1 City of Tigard ReceivedBW /�Lc--- -P�nL � ��-J / IN 11 13125 SW Hall Blvd.,Tigard,OR 97223 t j;19,I 0 r° ,w:-t i p Date/By: / +9 MI`!� %f II Phone: 503.718.2439 Fax: 503.598.19613 '� ''.} Plan Review Other Permit No.: Date/By: Inspection Line: 503.639.4175 T I G A R D Date Ready/By: Juris: gi See Page 2 for Internet www.tigard-or.gov h i ^.1 Notified/Method Supplemental Information f � �.. : tit . .. ..,.ttisv ‘,..-to., i,,t t ., ❑New construction 0 Demolition For special information use checklist Description I Qty. I Ea. I 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 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE IliFOTjON AND I.O(A N` Site utilities: Job site address: ‘,0`.2)13'-) `` Catch basin or area drain 18.76 J`R..) \�c s U-..)(kDrywell,leach line,or trench drain 18.76 City/State/ZIP: ei`` e 5-.-c0 qi 2 LJ Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03 Cross street/directions to job site: +i L f L 5 t,L3c.k,?r_ G 1 b(1, Manholes 18.76 1 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 1I/1� 1-ekQk Ca-C4 f/ ,i 7 fiC, j� Fixture or item: Ian, minim / .Backflow preventer 31.27 " " Backwater valve 12.51 Clothes washer 25.02 k VL 3 1.-c. V\-1/4- �+�k. G - ' --- e ._ r rr Dishwasher 25.02 t a1`)i�1..t( vL0 SS'‘„ 5 t A'c. `(. 0'1-V\} \ ,ct; `4r Drinking fountain 25.02 tit cQ • � "t'� ` _5 Ejectors/sump 25.02 ® J. t - 'NER 4St- A Expansion tank 12.51 Name: ' Fixture/sewer cap 25.02 i �p � C� Floor drain/floor sink/hub 25.02 Address: 1 b 5(C5 C-(,i e 1 C S j t Garbage disposal ' 25.02 ac;:t 2 City/State/ZIP: r 4 C , c{ ©►�_ Gi7,3-Z Com/ Hose bib 25.02 Phone:)3) i.��-?O C`.(Z co Y Fax:( ) Ice maker 12.51 h CANT ;. o NT 'kookInterceptor/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 3 25.02 75-, 1(I City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan te_ 12.51 ` $t b�, E-mail: Urinal 25.02 time, NIItA �,. Water closet 25.02 jO,C,t� ,, c ,:,, ". Water heater 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 DLI e{ City/State/ZIP: Subtotal Phone:( ) Fax;( ) Minimum permit fee: $72.50 CCB Lic.: �'lumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: -(�„p r)`, y- 10 ^�? Date: 69/9,,s---1)4 This permit application expires if a permit is not obtained within 180 days \J 4 (f(�l 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) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Qty, Feeea) Total S uare Footage:... "x Permit:Fee: Site Utilities t 9 Footing drain-15'100' 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' 6254 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit„ : 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 Qty. Fee(ea);.' Total 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: 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� : 1u r g n>t> Quantl 'by rioui4-rpe. Plan review is required for any of the following. Fixture Type for Please check all that apply. W perfor ped: CappedARelocate 0 Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thnt Cuspidor/Water 0 Medical gas and vacuum systems for health care facilities. Aspirator Dishwasher: ❑ Any multipurpose fire sprinkler system. Cpal 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" tfriticIgiltiagrapl .Q .... a_ 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food 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