Permit (5) CITY OF TIGARD PLUMBING PERMIT
1111 ,
I COMMUNITY DEVELOPMENT Permit#: PLM2019-00392
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/01/2019
Parcel: 2S102CB03402
Jurisdiction: Tigard
Site address: 10025 SW GARRETT ST
Project: CONDON Subdivision: None Lot: None
Project Description: Replacing 48 ft of sanitary sewer line.
Contractor: JACK HOWK PLUMBING/RESCUE ROOTER Owner: CONDON, JEFFREY L&OLGA B
PO BOX 2830 10025 SW GARRETT ST
CLACKAMAS, OR 97015 PORTLAND, OR 97223
PHONE: 503-598-7353
HONE: 503-850-3100
FAX: 503-491-2932
FEES
Quantity Description Date Amount
48 If Sanitary Sewer 10/01/2019 $62.54
Specifics: 1 12%State Surcharge- 10/01/2019 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 10/01/2019 $9.96
Plumbing
Class of Work: OTR
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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 b -fling 503.232.1987 .r 1.800.332• .
Issued By: //i /� Permittee Signature: , ,-___/-7,_
i
7 Call 503.639.4175 by 7:00 a.m.for the next available inspecttio dat.,
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures FOR OFFICE USE ONLY
City of Tigard _ Received )�•�/
. _ 5 ^,1"� Date/By: Nj' •,c j .,) J -7
13125 SW Hall Blvd.,Tigard,OR 97223 M !f� Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK # FEE* SCHEDULE
El New construction ❑ Demolition For special information use checklist.
Description Qty. Ea. Total
Add ition/alteration/replacement El Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
and 2-family dwellingSFR(2)bath 437.78
Commercial/industrial
111Accessory building ❑Multi-family SFR(3)bath 500.32
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: ' V1Drywe��7��/t/ L}! Catch basin or area drain 18.76
(ink, % -�tA� tiro.r Footing
1,leach line,or trench drain Page 2
City/State/ZIP: ��� 3 Footing drain(no.linear ft.:_) 2
Suite/bldg./apt.no.:t Project name: a/006i
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Itc I 109)1 opus o Sanitary sewer(no.linear ft.. Page 2 + 5
Storm sewer(no.linear ft.:_) Page 2
11ft -AV/ ��VJJ Water service(no.linear ft.:_) Page 2
Subdivision: J Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
- (Rl ( a 1 (16(000s ,
$- Dishwasher 25.02
cA- (4 (l 14-1/1 pivogys De -i-rtvoitI Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: n j`ry.i Fixture/sewer cap 25.02
tit
V, 1 Floor drain floor sink hub 25.02
Address: `/
i Atm✓`l Garb 5p 25.02
City/State/ZIP: /� 3 Hose ib 25.02
Phone:
OS '� Flax:2/APPLICANT
�' ,' ' � ( ) Ice maker (
E APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
AIea*t,tt1 VW i t1 cyn .qn�9/a av-ty � } ;1 r j { Medical gas(value:$ ) Page 2
�JU, : K' 12.51
l
Contact name: ' c pi°1Pri
Roofmer drain(commercial) 12.51
..51
'V!f� Sink/basin/lavatory 25.02
t y-1 '4+4_.11.1 it/ 1 Solar units(potable water) 62.54
Phone: ) • V (O D Fax: 60 Air I.' ••3, Tub/shower/shower pan 12.51
E-mail S i @, ' Urinal 25.02
' a Water closet 25.02
CONTRACTOR
���(� �/�j�/ �D�� p `' �, J Water heater 37.52
'-'��/ �I"i'► 1 ���� �1'C.Y/ tl --' _. Waterpiping/DWV 56.29
Address: •tt )[' � t'� Other: 25.02
t}jaPiti-�� ��\(� /1 i 9'1�O I �/ Subtotal
Phhoontlly � �t�0 ! Fa(600)
4C1l- q Minimum permit fee: $72.50
CCB Lic.: !�/� Plumbing ic.no.: -
Plan review (25%of permit fee)
fQl � ' n . �✓ho
State surcharge(12%of permit fee)
Authorized signature: e.-----11) 'tot TOTAL PERMIT FEE
(�V� This permit application expires if a permit is not obtained within 180 days
nleqki) f m after it has been accepted as complete.
`�'� "Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PermitApp.doc 10/0109 440-46161(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page s2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total -Square Footage: Permit Fee:
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' 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
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 Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.
Work Performed: Capped Added Relocate q
Baptistry/Font Please check all that apply.
Bath Tub/Shower 1:1 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.
-3"
-4„
Car Wash Drain Isometric or Riser Diagram
Garbage Domestic-non-food CI 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:
https://www.tigard-or.gov/document_center/Building/PLMF_PennitApp.c c