Permit CITY OF TIGARD PLUMBING PERMIT
-�` Permit#: PLM2019-00062
• COMMUNITY DEVELOPMENT Date Issued: 07/30/2019
T I C_;A it f.7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Site utilities to rebuild 117,524 sq.ft.of the new school.
Contractor: CAT WORKS Owner: UNION HIGH SCHOOL DISTRICT
3501 THOMPSON AVE NO. 3 JT
VANCOUVER,WA 98660 00000
PHONE:
PHONE: 360-666-1113
FAX:
FEES
Quantity Description Date Amount
44 ea Catch Basin or Area Drain 07/30/2019 $825.44
Specifics: 3676 If Footing Drain 07/30/2019 $1,400.75
18 ea Manholes 07/30/2019 $337.68
Type of Use: COM 25 ea Rain Drain Connector 07/30/2019 $469.00
Class of Work: ALT 1023 If Sanitary Sewer 07/30/2019 $437.74
Type of Const:
4009 If Storm Sewer 07/30/2019 $1,563.34
Occupancy Grp: 64 If Water Service 07/30/2019 $62.54
Stories: 1 ea Backflow Preventer 07/30/2019 $31.27
5 ea Backwater Valve 07/30/2019 $62.55
1 ea Interceptor/Grease Trap 07/30/2019 $25.02
1 12%State Surcharge- 07/30/2019 $625.84
Plumbing
1 Plan Review 07/30/2019 $1,303.83
Total $7,145.00
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 dopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y.0 may o9 "in a copy of the rules
or direct questions to OUN by calling 50 232.1987 1.800.332.2344.
Issued By: / ,/ Permittee Signature:
AZ4161imairia11116 —1.1 .
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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 - City of Tigard
( Plge 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(es) Tea) Square Footage: Permit Fee:
Footing drain-1'100' 1 50.03 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 21 37.52 787.92 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' 1 37.52 37.52
Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 1 37.52 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 1 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 39 37.52 1463.2 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Fee(ea) Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees Q� 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*. _
Quantity by Fixture Type ,-„P44.Review for PlRtmbtill Installations
Fixture Type for Replace! Plan review is required for any of the following.
Added ed Relocate
Work Performed: Please check all that apply.
Baptistry/Font 0 Any new commercial building with water service 2"and
Bath -Tub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall
-Drive tall ❑ New exterior plumbing site utilities for any complex structure
Cas defined in OAR918-780-0040.
Dis
hwasher
s wa oirator
er -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 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 0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food that meet the qualifications above.
Disposal -Domestic-food related
Commercial-foo re ate ----1-
-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 increase of sewer EDUs,a sewer permit will be issued and
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet
Urinal plumbing permit can be issued.
Other Fixtures:
https://otakinc-my.sharepoint.cpm/personal/shawn_Christensen_otak_comtfpocuments/Documents/TMS Permitting/PLMU_PermitApp.doc
Plumbing]ermit Application
Site Utilities FOR OFFICE 1 SE ONL1
Received Permit No.: PI.IK�lC���{-(�G'C�G-„�
City of Tigard Date/By: f V /fg �J�1,
n 13125 SW Hall Blvd.,Tigard, 97223 Plan Review p
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 5--,`� -i l Jd Other Permit No.:
Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
T l G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑Demolition For special information use checklist
New
w construction Description I Qty. I Ea. I Total
0 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
SFR(2)bath 437.78
0 1-and 2-family dwelling ❑Commercial/industrial SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional bath kitchen 25.02
❑Master builder 11,4 Other: 5Other: Scitoe( Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities: �1
Catch basin or area drain 44 18.76 O$ 4
Job site address: 5 Sl, Drywell,leach line,or trench drain 18.76
City/State/ZIP: `�-4c I I OtS- q Pi a4 ] Footing drain(no.linear ft.:34i 39 Page 2 /SIQU.95
Suite/bldg./apt.no.: Project name: Twp( ! VL IICLlt s CYt cti( Manufactured home utilities 50.03
Cross street/directions to job site: Manholes /8 18.76 337.68
Rain drain connector a5 18.76 4G1.OO
Sanitary sewer(no.linear ft.:/pal) 1 I Page 2 '(39.74
Storm sewer(no.linear ft.:Wit y I Page 2 1563.34
Water service(no.linear ft.:64 ) I Page 2 4,2..5-4
Subdivision: Lot no.: Fixture or item:
Backflow preventer I 31.27 31..9
Tax map/parcel no.: 12.51 vt 5
Backwater valve
L
DESCRIPTION OF WORK Clothes washer 25.02
S 474- ( t'i I i`�+'tS Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER I 0
TENANT Expansion tank 12.51 Fixture/sewer cap 25.02
Name: 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 .05..❑ APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 ,'1S
Medical gas(value:$ ) Page 2
Business name: Primer 12.51
Contact name: Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
_City/State/7IP:_ Solar units(potable water) 62.54
Phone:( ) Fax: ( )
Tub/shower/shower pan
L _ 12T5-1-1-
Urinal 25.02
E-mail: Water closet 25.02
CONTRACTOR Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
CitylState/ZIP:
Subtotal 5115.33
Minimum permit fee: $72.50
Phone:( ) Fax:( ) Plan review (25%of permit fee) '303.83
CCB Lic.: Plumbing Lic.no.: •
State surcharge(12%of permit fee) (,25 84
Authorized signature: TOTAL PERMIT FEE rf 45.oO
Date: This permit application expires if a permit is not obtained within 480 days
Print name. 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:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1 100' / 50.03 s 0.03 0 to 2,000 $121.90
Footing drain-each additional 100' 36 37.52 x.350?.1 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
•54 7,201 and greater $327.54
Sewer-each additional 100' l a 37.52 395.A
Water Service-1st 100' j 62.54
Water Service-each additional 100' 37.52 Medical Gas Systems:
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
6'1.5¢ $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' to 37.52 /500.$o $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.
which no fee is specifically indicated 90.00/hr $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
each cludingal 5 00.00 or fraction thereof,to
(minimum charge-1/2 hour)
Inspections outside of normal business and including$25,000.00.
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%4.3'1
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 Plumbin Installations
Fixture Type for Re lace/ g
Work Performed: Capped Added Re ocate 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 ❑ 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 0 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"
Car Wash Drain Isometric 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
Washer-Clothes *Note: If the fixture work under this permit results in an
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
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 0 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 ckanouts 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\Pennits\PLMF-PermitApp.doc 12/30/05