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Permit (35) CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2019-00306 Date Issued: 08/01/2019 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 TIGARD g Parcel: 1 S 134CA01500 Jurisdiction: Tigard Site address: 12035 SW SUMMER CREST DR Project: Bankhardt Subdivision: BURLWOOD Lot: 8 Project Description: Replace existing plumbing fixtures due to fire repair. Contractor: OWNER Owner: BANKHARDT, BENJAMIN M BENJAMIN BANKHARDT 12035 SW SUMMER CREST DR 12035 SW SUMMER CREST DR TIGARD, OR 97223 TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Clothes Washer 08/01/2019 $25.02 Specifics: 1 ea Dishwasher 08/01/2019 $25.02 1 ea Garbage Disposal 08/01/2019 $25.02 Type of Use: SF 1 ea Sink 08/01/2019 $25.02 Class of Work: ALT ea Laundry Tray 08/01/2019 $25.02 Type of Const: 2 ea Lavatories 08/01/2019 $50.04 Occupancy Grp: 1 ea Tub/Shower/Shower Pan 08/01/2019 $12.51 Stories: 1 12%State Surcharge- 08/01/2019 $22.52 Plumbing Total $210.17 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. t � 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. 0 Plumbing Permit Application RECEIVE / Building Fixtures FOR OFFICE 1 SE ("IA City of Tigard AUG 1 2019 Received Permit N 1111 . 41 13125 SW Hall Blvd.,Tigard,OR 97223 Date By: r � i9 -0Q3©(ra IT Phone: 503.718.2439 Fax: 503.598.1PIanReview 9¢ Y OF TIGARD DateBy: Other Permit No.: p Ins ectionLine: 503.639.4175 tBUILDING DIVISION DateReady/By: Juris: H SeePage2for TIGARD Internet: www.tigard-orgov Notified/Method: Supplemental Information 0 . . New construction 0 Demolition For special information use checklist. Description Qty. I Ea. Total lddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY,OF CONSTRUCTION SFR(1)bath 312.70 and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: „?)CSC + Catch basin or area drain 18.76 r I C Cil )tom b,VI I.1.1 e y" (,-.,.'!.' . "r City/State/ZIP: --(I ` �,y i.(, ` (''3� G?' -7 '1.-z--`3 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: 2\c.,,,.-k Gtr ,,t t- Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 n4 6/ Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.: ) Page 2 4 Water service(no.linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer. / 25.02 e,44 lrwFo &X t s 1-ii'1q 1 a-Y& ✓` V�S Dishwasher ! 25.02 LJ-O r.iC- (� ' -` Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: -9)7.7 kl 4 ' --,, f" .� CLi �^ . Fixture/sewer cap 25.02 , J (....-- Address: VLlZ 013 c7; xC c" 'l 4Floor drain/floor sink/hub Garbage disposal 25.02 25.02 City/State/ZIP: co...d) i o i� q 7e) 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 1 ] Primer 12.51 Contact name: --12)(,,,v,„, .Ct-vvt.t• ✓L rl`)C 4- II,41,14-0-- Roof u.f J Roof drain(commercial) 12.51 t' r. c Address: _3`) �Cti/ ` i C4.72/l Y 1 J f' Sink/basin/lavatory t LI 25.02 L9.1City/State/ZIP: <t� ( ti O C. 7 2-Z-3 Solar units(potable water)�� f 62.54 l Tub/shower/shower pan 12.51 Phone:( ) < I Fax. :( ) E-mail: Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: 0 Lt/AT E-P---- Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal I w? c2-71 Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lie.: Plumbing Lic.no.: Plan review (25%of permit fee) , '- -"a State surcharge(12%of permit fee) .----- Authorized Authorized Signa ure: Alr / - TOTAL PERMIT FEE- .iP i► This permit application expires if a permit is not obtained within 80 days Print name - = , i/ten_ Dater/ig, /�j after it has been accepted as complete. /Q . /7 I r I'{ /1111. *Fee methodology set by Tri-County Building Industry Service Board. IaBuilding\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 Q13• Fee(ea) Total Square Footage: Permit Feer Footing drain-1St 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 Systems: Water Service-each additional 100' 37.52 valuation: Permit Fee: 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 Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to h 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*. Quantity by Fixture Type flan Rolm_for_Plu bing,Installations Fixture Type for Replace/ Plan review is any re required forof the following. Work Performed: Capped Added Relocate 9 owg' 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 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 Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings Disposal -Domestic-food related that meet the qualifications above. -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: C:\Users\Sharon\Downloads\PLMF PermitApp(1).doc 2