Permit Plumbing Permit Application
Site Utilities FOR omit,: t Si: ONL'
City of Tigard Received /
_ Date/By f,....4 j / r j..... , Permit No.:`.i/,j J� I r. . 4:4 41..4 111 + 13125 SW Hall Blvd.,Tigard,OR 97223 /
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By Other Permit No.:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: huts: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
,.,, ew construction ❑Demolition For special information use checklist
Description I Qty. I Ea, I Total
['Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
c601 ........ .
-and 2-family dwellingCommerbraVmdustrial ` SFR(2)bath 437.78
0 Accessory building 0 Multi-tam y SFR(3)bath 500.32
Each additional bath/kitchen 25.02
0 Master builder ❑Other: '
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address/ !a,0 SGfi L'< v.1 Catch basin or area drain 18.76
qG.r _,/ C t Drywell,leach ling or trench drain 18.76
City/State/ZIP:'1 r C/l
I Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: (--II Project eCI I'/C K r C,geP_� Manufactured home utilities 50.03
Cross street/directions to job site: "44/l.7 C)N_C Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:___J Page 2
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
DESCRIPTION'OF WORK Backwater valve 12.51
Ct -- Clotheshw washer 25.02
�� h`�{11` �U• � ��� r T Dishwasher 25.02
N ael {"J I n S + ( it/ 4,E ) Drinking fountain 25.02
/y.Al , Ejectors/sump 25.02
_[PROPERTY OWNER ( ❑ TENANT Expansion tank 12.51
Nam�44147( 011 f� - -�C• ct f [)fr ftlI(Wei I J Fixture/sewer cap 25.02
� ' 1-b ITS b Floor dram/floor sink/hub 25.02
Address: ff 1-1 Q Nam 1�� Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
(Z.APPLICANT CI CONTACT PERSON Interceptor/grease trap 25.02
Business nam¢� ,i �f --t/ L/ -i 4� L.4- G Medical gas(value:$_) Page 2
` Primer 12.51
Contact namej�,q/ . t IQ,' /L./ L l/ /' �F- Roof drain(commercial) 12.51
Address/3, 7-7 eJ�/` !`W f/// li/¢"r-a/ t� De.-,t�{.� Sink/basin/lavatory 25.02
City/State/ZIP CI C - 0 4 ?-7 d ( 5 Solar units(potable water) 62.54
Phone:¢y-.3 )y%a y y s-" Fax:5 R,)C-j8a _�j(j Tub/shower/shower pan 12.51
E-matY'iatC/^L1s'$be 2L.IZ7.l)Canrorc . Qj ., CO6? Urinal 25.02
CONTRACTOR +'' \/ Water closet 25.02
Water heater 37.52
/Businessname:L9ti O ( () L' 7- G: C JJ z7. Water r in8�WV 56.29 Address: ( l 'f Other: 25.02
City/State/ZIP:'L r t Subtotal
Phone:( )41 e I Fax:( ) " ' t Minimum permit fee: $72.50
r-� - 1
CCB Lie/5 3 3 oC Plumbing Lie.no. SS P
'' Plan review (25%of permit fee)State surcharge(12%of permit fee)
Authorized signature: ^ - TOTAL PERMIT FEE
Print name r^ s K L/ Date;1 1 ZO/I This permit applipdo0 espires if a permit is not obtained within 180 days
IA L (` O r/ J after it has bceo accepted u wmpletn
*Fee methodology set by Tri-County Building Industry Service Board
I:\Building1Penniu\PLMU•PermitApp.doc 10/0b09 440.4616T(10/O2/COM/WEB)
CITY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit#: PLM2019-00143
T I C;A R T_7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/28/2019
Parcel: 1 S 136DA02500
Jurisdiction: Tigard
Site address: 11090 SW 68TH PKWY
Project: Red Rock Creek Commons Subdivision: RED ROCK CREEK COMMONS Lot: 1
Project Description: Site utilities for a new four-story apartment building.
Contractor: LAUZON CONTRACTING LLC Owner: COMMUNITY PARTNERS FOR AFFORDABL
13577 SE WILLINGHAM CT HOUSING
CLACKAMAS, OR 97015 6380 SW CAPITOL HWY, STE 151
PORTLAND, OR 97239
PHONE: 503-482-5445 PHONE: 503-293-4038
FAX: 503-482-5446
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 10/28/2019 $18.76
Specifics: 417 If Footing Drain 10/28/2019 $200.11
2 ea Manholes 10/28/2019 $37.52
Type of Use: MF 1 ea Rain Drain Connector 10/28/2019 $18.76
Class of Work: ALT 41 If Sanitary Sewer 10/28/2019 $62.54
Type of Const: 221 If Storm Sewer 10/28/2019
$137.58
Occupancy Grp: 33 If Water Service 10/28/2019 $62.54
Stories:
25 Misc Other Fee 10/28/2019 $25.02
1 ea Backflow Preventer 10/28/2019 $31.27
1 Plan Review 10/28/2019 $148.53
1 12%State Surcharge- 10/28/2019 $71.29
Plumbing
Total $813.92
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 .800.332.2344.
Issued By: / ee ignature:ALW
1
� 7
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 Applicatica
Site Utilities APR 0 8 2019 FOR OFFICE USE ONLY
City of Tigard Received Z/ •
13125 SW Hall Blvd.,Tigard,OR 97 ITP OF TIGARD Date/By: L i �� ��7
3 Phone: 503.718.2439 Fax: 503.59 WING DIVISION Dat Review �22-8 404 4 ' ic'-W/,
Y -WO o
T I GARI} Inspection Line: 503.639.4175 Date Ready/By: Jam lg See Page 2 for
Internet: www.tigard-or.gov Notified/Method. S~ Supplemental Information
TYPE OF WORK _ ;( Ctior tc1.MyFEE* SCHEDULE
[(New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑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 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building tiMulti-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11090 SW 68th Parkway Catch basin or area drain 1 18.76 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard, OR 97223
Footing drain(no.linear ft.:_) Page 2 200.11
Suite/bldg./apt.no.: I Project name: Red Rock Creek Commons Manufactured home utilities 50.03
Cross street/directions to job site: 68th Parkway south of Pacific Highway Manholes 2 18.76 37.52
Rain drain connector 1 18.76 18.76
Sanitary sewer(no.linear ft.:_) - Page 2 62.54
Storm sewer(no.linear ft.: ) - Page 2 100.06
Water service(no.linear ft.:_) - Page 2 137.58
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.:1 S136DA2500 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
New construction, 4 story multifamily with 48 1-bedroom Dishwasher 25.02
apartments including accessory spaces and exterior site Drinking fountain 25.02
improvements Ejectors/sump 25.02
PROPERTY OWNER I 0 TENANT Expansion tank 12.51
4
Name: Community Partners for Affordable Housing
PO Box 23206 Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
.� City/State/ZIP: Tigard, OR 97281 Hose bib 25.02
t:4. Phone:( 503)293-4038 Fax:( ) Ice maker 12.51
t0 APPLICANT 14 CONTACT PERSON Interceptor/grease trap 25.02
Business name: Carleton Hart Architecture Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Anna Galloway
Roof drain(commercial) 12.51
Address: 830 SW 10th Ave#200 Sink/basin/lavatory 25.02
Ck City/State/ZIP: Portland OR 97205 Solar units(potable water) 62.54
ti) Phone:(503)206-3193 Fax: :( ) Tub/shower/shower pan 12.51
E-mail: anna.galloway@carletonhart.com
�� 1 °/°"'
e
a1 25.02
er closet 25.02
CONTRACTOR „IS\ V
'"f' ater heater 37.52
Business name: LMC Construction # Water piping DWV 56.29
Address: 19200 SW Teton Ave �' het: 25.02
City/State/ZIP: Tualatin, OR 4," I.( �, �4 Subtotal 83
Phone:( 503)646-05 Fax:( 503)646-682 U V N�' ,4 Minimum permit fee: $72.50
CCB Lic.: 161 Plumbin Lie.no.: a ' Plan review (25%of permit fee) .. 96
.5') State surcharge(12%of permit fee) _.,... lf.
Authorize t nature: o
g t� TOTAL PERMIT FEES
Print name. Date: 3/ This permit application expires if a permit is not obtained within 180 days
x 1 i`� L to i07- . �. /-N. �� after it has been accepted as complete.
�! *Fee methodology set by Tri-County Building Industry Service Board.
1:',Building Permits`,PLMU-PermitApp.doc 10:01109 440-4616T(1002;COM WEB) 0-13A
•
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' 1 50.03 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 4 37.52 150.08 2,001 to 3,600 $169.69
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' 37.52
Water Service-1st 100' 1 62.54 62.54
Medical Gas Systems:
Water Service-each additional 100' 2 37.52 75.04
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' 1 37.52 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/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 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.
-3"
-4"
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 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:
I:ABuilding\Permits\PLMU_PermitApp.doc 2
.
c
IN
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 ❑ site address ❑ suite number
❑ zoning ❑ applicant name El 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.
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
V
V
'Plumbing Permit Application
Site Utilities �CE'�E® FOR OIFI('l: 1 Sly, ()NIL)
City of Tigard T Received Permit C - )
ill 13125 SW Hall Blvd.,Tigard,OR 9722 �+ 2019 Date/By: 40/74v/� ►4- L-/- c! l C /v
Plan Review
Phone: 503.718.2439 Fax: 503.598 1960Other Permit No.:
Inspection Line: 503.639.4175 CITY OF TIGARU Date/By:
T I G A R D I-,I, t 111\,l �ON Date Ready/By: Juris: ES See Page 2 for
Internet: www.tigard-or.gov nt Ili �G Notified/Method: Supplemental Information
TYPE OF WORK,. ' FEE' SCHEDULE
ew construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF'CONSTRUCTIUN '; SFR(1)bath 312.70
" SFR(2)bath 437.78
NIS„-and 2-family dwelling ommtr`oJtna ` ""`"'
,,,a SFR(3)bath 500.32
❑Accessory building ❑Multi-f illy
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 16 Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:"-r , c,
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project nami(dc lc Manufactured home utilities 50.03
Cross street/directions to job site: 1 Al Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
DESCRIPTION OF;WORK Backwater valve 12.51
Clothes washer 25.02
i. ! - Oil - t Dishwasher 25.02
eatl, V.2 I Drinking fountain 25.02
I Ejectors/sump 25.02
PROPERTY OWNER., 9,TENANT ` Expansion tank 12.51
Fixture/sewer cap 25.02
Name `t476461 I i d. -� 4 (it'
Floor drain/floor sink/hub 2 5.02
Address: 0 r'1.,. (42,5 Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
APPEICANT; CONTACT PERSON Interceptor/grease trap 25.02
Business name 4 Medical gas(value:$ ) Page 2
' } "e) --: /4Primer 12.51
Contact name), ,,.
741 5, ,
,. '
7 Roof drain(commercial) 12.51
Address/ 766-GO,/f i Sink/basin/lavatory 25.02
City/State/Z .. o g ( Solar units(potable water) 62.54
Phone. )14 C I Fax:: )L/ Tub/shower/shower pan 12.51
E-majVCrU , L q rif CieiF a°'+P_ COUrinal 25.02
^-
Water closet 25.02
. CONTRACTOR
Water heater 37.52
Business name: V r1 $ Water piping/DWV 56.29
Address: ( I. '/ Other: 25.02
City/State/ZIP:�'t- t l Subtotal
dhone:( )`1 * I Fax:( ) t'" ° t Minimum permit fee: $72.50
) CCB Lie3/5-3 Plumbing Lic.no.: _, Plan review (25%of permit fee)
. " State surcharge(I2%of permit fee)
Authorized signature: aM TOTAL PERMIT FEE
Print name' r P Date:i This permit applicationexpires if a permit is not obtained within 180 days
F k„ ! j after iext has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application SY'9-/ i far - ,--may
4
Site Utilities FOR OFFICE USE ONLY
City of Tigard Date/By:Received
q 7 fir J;�,/��7Permit No.:a.m.`aOt�_�143
e 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review n
• Phone: 503.718.2439 Fax: 503.598.1960 Date/By: I -22-I1 41,41
Other Permit No.:
T I C,A R D Inspection Line: 503.639.4175 Date Ready/By: _ +� Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: � �j/`t 73-17-- Supplemental Information
TYPE OF WORK FEE* SCHEDULE
XX.New construction 0 Demolition For special information use checklist.
. Description I Qty. I Ea. I Total
❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accgssory building jki Multi-family Each additional bath kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11 V q0 StO, 6 2"JA Ptcy It wail-0 Catch basin or area drain 1 18.76 18. .74
Drywell,leach line,or trench drain 18.76
City/State/ZIP: "1�'tr �,,rQ 0R. C a _3 Footing drain(no.linear ft.:VI) 5 Page 2 dad. I
Suite/bldg./apt.no.: - Project name: RFa ICdCK c;f ,, lL cowlmc t; Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76 3 9,sal
Rain drain connector / 18.76 /8,96
Sanitary sewer(no.linear ft.:4 i ) ( Page 2 6a, 54 ✓
Storm sewer(no.linear ft.:221) 3 Page 2 /39 S$
Water service(no.linear ft.: 33) f Page 2 6a,54 ./--
Subdivision:
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 1 31.27 N,a1
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer 25.02
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
0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
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/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51
Urinal 25.02
E-mail:
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: b e f ty,-1 i 0 vN Sy Stalin / 25.02 ,: 5,0a
City/State/ZIP: Subtotal 5?¢, /0
Phone:( ) Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee) /48,53
CCB Lic.: Plumbing no.:Lic. State surcharge(12%of permit fee) f/.0 Q
Authorized signature: TOTAL PERMIT FEE 811, cl ,
Print name: Date: This permit application fer it has been accept d as co pleteed within 180 days
*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-10 100' 50.03 50,03 0 to 2,000 $121.90
Footing drain-each additional 100' y 37.52 1$0.0$ 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 62,54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 G 2,54 Medical Gas Systems:
Water Service-each additional 100' 37.52 Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 6.1,5g $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 7544 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or FeesQty 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: 4/ 1 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 Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.
Work Performed: Capped Added Relocate 4
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 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.
-3"
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.
-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 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:
I:\Building\Permits\PLMU_PermitApp.doc 2
Site Utilities — Plumbing Permit Application
0 mg
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 ❑ 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 cleanouts 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\Permits\PLMF-PermitApp.doc 12/30/05