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Permit
:3 CITY OF TIGARD PLUMBING PERMIT 71 " COMMUNITY DEVELOPMENT Permit#: PLM2019 00305 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/30/2019 Parcel: 25111 BD00501 Jurisdiction: Tigard Site address: 14860 SW 98TH AVE Project: BENJAMIN Subdivision: DARMEL Lot: 3 Project Description: Connect existing house to sewer: 120 ft.of sanitary sewer. Septic tank to be pumped and filled. Contractor: MILROY GOLF SYSTEMS INC Owner: BENJAMIN,WARD A/KIMBERLY A 1102 N SPRINGBROOK RD STE 206 14860 SW 98TH AVE NEWBERG, OR 97132 TIGARD, OR 97224 PHONE: 503-538-3568 PHONE: FAX: FEES Quantity Description Date Amount 120 If Sanitary Sewer 07/30/2019 $100.06 Specifics: 1 12%State Surcharge- 07/30/2019 $12.01 Plumbing Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $112.07 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: / 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 the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application Building Fixtures roa of ice tsl: oNl.\ City of TigardReceived �/ 1114 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: • /ifi f ! L�Permit No.: p` 0/s� ;2_S_ e Phone: 503.718.2439 Fax: 503.598.1964` s Plan Review Date/By: Other Permit No.:SPt t„C�� Inspection Line: 503.639.4175 T I G A K D Date Ready/By: Juris: Ri See Page 2 for t Internet: www.tigard-or.gov Notified/Method: Supplemental Information . -. _ 1 1N tt) IN x - a:- :r:.r s=7 °"! ❑New construction ❑Demolition For special information use checklist Description I Qty. I Ea. Total Fddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION-' SFR(1)bath 312.70 r. � E I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 I=1 Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE'INFORMA1'ION AND LOCATION r Site utilities: Job site address: J[(Kb 0 V U ! iii Q Catch basin or area drain 18.76 City/State/ZIP: / 1 ©Q` ) >�� Drywell,leach line,or trench drain 18.76 / r Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: 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.:Jit ) Page 2 to 0.0(0 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 ; s` I= '.4' of Backwater valve 12.51 /7 - ,-, ° � x Clothes washer ^y- /� 25.02 �`� S-eLU e k- i (1 14 0 Sep T i4/ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 a IFS ' t I t xI © y'y Expansion tank 12.51 Name: W fi.(�L7 A >r, J ry Fixture/sewer cap 25.02 N ^ Floor drain/floor sink/hub Address: J C/ `MO S C.e) qj- Q1e 25.02 r �7 Garbage disposal 25.02 City/State/ZIP: T�y�v ty l >' Cp V Hose bib 25.02 Phone:( ) &a0•??,5-i, Fax:( ) Ice maker 12.51 14. m a t �vtokwriE'`; . 4. Interceptor/grease trap 25.02 Page Business name: e'� Q. /,e Medical gas(value:$ ) Pa e 2 v l�� 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 Phvlic• Fax::( ) Tub/shower/shower pan 12.51 E-mail: (.A.) . � .Tq�/1/l1J G ega, r Q 1.4C Urinal 25.02 c _ �) la T, i: Water closet 25.02 Water heater 37.52 Business name: M rc Gy/� S(, l � Water piping/DWV 56.29 Address: 0)- it/let ,brad- lQ� ,} v� Other: 25.02 City/State/ZIP: %/l JLC c),? 92/f- 2 Subtotal L W Phone:($ S 357 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: /02/E--?y. Plumbing Lic.no.: Plan review (25%of permit fee) ,Q State surcharge(12%ofpernut fee) /),0l/, Authorized signature: ,� /l TOTAL PERMIT FEE l l t„4%`7 Print name: /.44),A)DA J(C Date: Z�Q/y This permit application expires if a permit is not obtained within 180 drays after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doe 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: t2ty `tea) Tote: SquareFootage: , Permit Fee;Sit*Utilities � � � �, ..�, Footing drain-1"100' 50.03 0 to 2,000 $121.90 2,001 to 3,600 $169.69 Footing drain-each additional 100' 37.52 3,601 to 7,200 $233.20 Sewer-1st 100' / 62.54 7,201 and greater $327.54 Sewer-each additional 100' i 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service each additional 100' 37.52 ;valuation: Permit'eek 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 Feelea)- each additional$100.00 or fraction thereof,to Other inspections Or +ees , 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. Additionallan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for p 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 A 411-L : accurately report fixtures could result in increased sewer fees*. .. II atexie f . ,ttt i. tg, . w -% (musty q mayre type, Plan review is required for any of the following. Flare Type for41-Reputed , , Please check all that apply. Work Performed: ,.. cap ' Added,, tC 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 Thru 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2> .u _ N 3» ' Isam a or mer;i - in 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 Comments regarding fixture work: Ice Mach./Refrig.Drains 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 plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14860 SW 98TH AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Plumbing PLM2019-00305 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Back fill septic tank and pump receipt- approved 2. Inspection by camera- approved. Violation Summary: Inspector Contractor