Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00348
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2019
f �'� Parcel: 2S101 DD00500
Jurisdiction: Tigard
Site address: 6755 SW SANDBURG ST
Project: Reece Security Subdivision: SALEM FREEWAY SUBDIVISION Lot: 2
Project Description: Site utilities for a new storm water system.
Contractor: CIVILWORKS NW INC Owner: REECE HOLDINGS LLC
PO BOX 5698 25977 SW CANYON CREEK RD, STE E
VANCOUVER,WA 98668 WILSONVILLE, OR 97070
PHONE: 360-694-8849
PHONE: 503-803-7673
FAX:
FEES
Quantity Description Date Amount
5 ea Catch Basin or Area Drain 09/11/2019 $93.80
Specifics: 2
ea Manholes 09/11/2019 $37.52
4 ea Rain Drain Connector 09/11/2019 $75.04
Type of Use: COM 820 If Storm Sewer 09/11/2019 $362.70
Class of Work: ALT 80 If Water Service 09/11/2019 $62.54
Type of Const: 1 ea Backflow Preventer 09/11/2019 $31.27
Occupancy Grp: 2 ea Ejectors/Sump 09/11/2019 $50.04
Stories: 25 Misc Other Fee 09/11/2019 $25.02
1 Plan Review 09/11/2019 $184.48
1 12%State Surcharge- 09/11/2019 $88.55
Plumbing
Total $1,010.96
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
bins Permit Application
f Site Utilities
,, 14 . City of Tigard E C E IV E, Received Permit No.: •
Date/B :
13125 SW Hall Blvd.,Tigard,OR 7 23 y � � 1`+r VO i` -ti))17
Pi
Plan Revt w f
_ Phone: 503.718.2439 Fax: 503.598.1 j.M G 2 2 2019 Date/By. ��/ �t� Other Permit No.: /� p 1 ,
Inspection Line: 503.639.4175 / ( - y 1'=
T I G A R D Date Ready/By: ® See Page 2 for , 1`
Internet: www.tigard-or.gov TY(�F p Notified/Method: q 1/ %t ;ar Supplemental Information
Fy'"n41 .-ti+'P• 'S.... ,x.
M•M'1•M�PL'N�l.f i`•Y"frVa'::'�l Wx}l.XO EHYY A, M.W@MA: T"r$i�"tlrYur53'#` _
0 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)
'i CATEORY.OF' CONSTRUCTION SFR(1)bath 312.70
i 0 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
• ❑`Accessorybuilding ❑Multi-family
3 Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
' mJQ t IN QQwMATION AND LOCATCQ1 Site utilities:
LOUr
Job site address:6755 SW S g St. Catch basin or area drain 2 18.76 37.52
3 Drywell,leach line,or trench drain 18.76
I CniSt*ate/ZIP:Tigard,OR.97224 Footing drain(no.linear ft.: ) Page 2
g
Sift/bldg./apt.no.: I Project name:Reece Security Manufactured home utilities 50.03
V Cross street/directions to job site:SW 72nd Ave.&SW Sandburg St. Manholes 2 18.76 37.52
Job site is at the end of the Cul-de-sac. Rain drain connector 4 18.76 75.04
Sanitary sewer(no.linear ft.: ) Page 2
41-4..... 878
Storm sewer(no.linear ft.: ) 7 Page 2 287.66
•r••• Water service(no.linear ft.:80) 1 Page 2 62.54
subdivision: I Lot no.: Fixture or item:
ax map/parcel no.: Backflow preventer 1 31.27 3l.27
1ESCRIPTION OF WORK' Backwater valve 12.51
Clothes washer 25.02
We will be installing a new storm system for Reece Security Solutions. Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
t PROPERTY OWNER I TENANT = Expansion tank 12.51
Name:Reece Holdings LLC Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
' Address:25977 SW Canyon Creek Rd,Suite E
Garbage disposal 25.02
City/State/ZIP:Willsonville,Oregon.97070 Hose bib 25.02
tj
Phone:( ) Fax:( ) Ice maker 12.51
V!
►® APl L1CA/a` la(OsTAcr`PI RSON Interceptor/grease trap 25.02
Business name:CivilworksNW Inc. Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:John-Michael
Roof drain(commercial) 12.51
Address:PO Box 5698 Sink/basin/lavatory 25.02
ii City/State/ZIP:Vancouver,Wa.98668 Solar units(potable water) 62.54
Pho 71234-9740 Fax::( ) Tub/shower/shower fan 12. 1.4
E-mail:Jpilot@civilworksnw.com Urinal 25.02
Water closet 25.02
J ONTRACTOR
... Water heater 37.52
Business name:CivilWorksNW Inc. ip t m WV 56.29
P
Address:PO Box 5698 Water Other: 25.02
City/State/ZIP:Vanvouver,Washington.98668 Subtotal 531.55
Phone:(360)694-8849 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee) 132.88
• , CCB Lie.:154103 Plumbing Lic.no.:PB-88
State surcharge(12%of permit fee) 63.78
Authorized signature: 9,7?ia, TOTAL PERMIT FEE 728.21
Print name:John-Michael Pilot Date:8/21/19 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
4
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COMIwEB)
r
4161.7 1umbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site [Jtil ties Qty. Fee(ear NIOttiF Square Footage; Permit Fees.
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' 1 62.54 62.54 Medical Gas Systems
Water Service-each additional 100' 37.52 ,
Valaatlton: Permit dee:
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' 6 37.52 225.12 $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
. ' Qty.' Fee(a) o .. and including$10,000.00.
=,Qth�r`Insp�ct>lo�g or Fees ,
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$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
� l$•" � yp2.ri[ ._' �*.,ar. ,= n -Quantity.. . rb..� Fixture
T� e� ri, < .. ey _ • ..o a top
s
,. .,.
Wo k 11'erlbt intd: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower El 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 0 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.
Car Wash Drain
0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
botediriel 41.AeA 9
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:
S:\Shared Folders\1904-Reece Security\6)Job Files\6.9)Permits\Reece Security-Plumbing Permit.doc
s
+rr..
114 I 44
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# 0 project name ❑ site address 0 suite number
0 zoning 0 applicant name 0 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 cleanouts provided as required for storm.
- •a . 1 • at •. •_ - 1I I• _ /1 I • I..- "._ _..... .J
3) Proposed location of connection to a public water or sanitary sewer line.
I:\Building\Permits\PLMF-PermitApp.doc 12/30/05
Plumbing Permit Application
Site Utilities
City of Tigard Received � R.y pr ,- PermitNo.:PLfv Arilig /�348
111 a 13125 SW Hall Blvd.,Tigard,OR 97223 DateBy: / Vv
S Plan Review �} Other Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 1-�" 1 life Other
Inspection Line: 503.639.4175 Date Ready/By: 7uris: H See Page 2 for
I t G A R D Internet: www.ti and-or. ov y Y� g
g g Notified/Method: rlA ri a 71 Supplemental Informafion
TYPE OF WORK FEE* SCHEDULE
- -
❑New construction ❑Demolition For special information use checklist
Description Qty. Ea. Total
-14 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 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 955 .S .). Sa t. r1 s&.
Catch basin or area drain 5 18.76 ��J,
City/State/ZIP: y� �y AA Drywell,leach line,or trench drain 18.76
y Tad- 0(k ct�call Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name: R,eec,� Se co._e fy Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 2 18.76 3 7 5a
Rain drain connector 4 18.76 /75,d 4
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:ti(;) c7 Page 2 .3 a 76
Water service(no.linear ft.:f'C\) r Page 2 a S
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer / 31.27 31,:,19
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
S i'l---42... �4-i Hie t`e s Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 1 25.02 5c, 0 e
0 PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sirllc/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
0 APPLICANT ❑ CONTACT PERSON Interceptor/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 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other:y' ,r tAjo.: ¢,cr % 25.02 .CAS: 4
City/State/ZIP: DaelK lt.ir1=I Subtotal 137,y'3
Phone:( ) Fax:( ) _ Minimum permit fee: $72.50
CCB Lic.: Plumbing Lie.no.: Plan review (25%of permit fee) /f 41 4t'
State surcharge(12%of permit fee) eF. 55
Authorized signature: TOTAL PERMIT FEE 1 IC,d
Print name: Date: This permit application expires if a permit is not obtained within 180 days
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- 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' l 62.54 6`„Z,'54 Medical Gas Systems:
Water Service-each additional 100' 37.52
s
Storm&Rain Drain-1st 100' / 62.54 b a, Valuation: Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 8 37.52 goo 16 $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
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: 05.4
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 Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate 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 ❑ 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.
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 *Note: If the fixture work under thisermit results in an
Washer-Clothes p
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
TEGARD
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 ❑ site address ❑ suite number
❑ zoning 0 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 cleanouts providedas require 1 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\Permits\PLMF-PermitApp.doc 12/30/05