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Permit IN , CITY OF TIGARD PLUMBING PERMIT f> COMMUNITY DEVELOPMENT Permit#: PLM2019-00414 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2019 Parcel: 1 S 136DD00500 Jurisdiction: Tigard Site address: 11580 SW 67TH AVE Project: LHL Homes Subdivision: WEST PORTLAND HEIGHTS Lot: 7-12 Project Description: 100 ft. of sanitary sewer to connect an existing business to sewer. Septic tank to be pumped and filled. Contractor: A AFFORDABLE SEPTIC SERVICE Owner: HARTUNG, RICHARD & PO BOX 1130 LESLIE, TIMOTHY J WILSONVILLE, OR 97070 11580 SW 67TH AVE TIGARD, OR 97223 PHONE: 503-969-9548 PHONE: FAX: 503-570-0779 FEES Quantity Description Date Amount 100 If Sanitary Sewer 11/07/2019 $62.54 Specifics: 1 12%State Surcharge- 11/07/2019 $8.70 Plumbing Type of Use: COM 10 ea Minimum Fee Adjustment- 11/07/2019 $9.96 Class of Work: ALT Plumbing 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 90. You may obtain a opy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 7 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 ApplicatiRECEl\JED % /p r) ,�f , ,,,1, Building FixturesNig � � ro orriCc;iisc SLY .� 4 Received City of Tigard 1 a Permit No.: t. e s a Date/By '�' Ii /11 r rr�� lei -Lt; r//L/ 13125 SW Hall Blvd.,Tigard,OR 97223 Q J _• :: c T1G�A�R �},Plan Review Phone: 503.718.2439 Fax: 503.598.19 i)1 Y V V`JI©! 'Date/BY: Wm-Permit No.: TIG AR•• Inspection Line: 503.639.4175 G��i 1�4��1N Date Rcadyley; Jurist 0 See Page 2 for rr rtwa . Internet: www.tigard-or.gov NotitiedMtcihod: E ., Supplemental Information TYPE OF WORK FEE*SCHEDULE For special information xse checklist New construction 0 Demolition Description j Qty. I Ea. I Total Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.far each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 0 1-and 2-family dwelling mmercial/industriai SFR(2)bath 437.78 3 0 Accessory building 0 Multi-family SFR(3)bath 500.32 0 Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.11.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: _ Job site address:11 cj UQ S W ,D1 ih A v� Catch basin or area drain 18.76 ®2 Q 22 Drywall,leach line,or trench drain 18.76 City/State/ZIP: 1 i G` Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: L N L N ome S Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 SVI }`y 10Y. ` -t- Rain drain connector 18.76 Pro?e i-ut V 5 Of\ irinC�. Lucile,t� t7E' � J ks-Irr1 ft S Sanitary sewer(no.linear .:I( ( Page 2 Storm sewer(no.linear R.:_) Page 2 5 V.``J 17x ... -\ 1 O f 53c- Water service(no.linear fl.:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: f ., Backflow preventer 31.27 iv& Y Backwater valve 12.51 DESCRIPTION OF WORK Sall1` a r Li Se1J.ie.x- ( lob i}f3 -r £' e -1 ) Clotheserher 25.02 ��,( / Dishwasher 25.02 Cv'Y7/1743.seCn E /S//h-a7 „c...�a fYL .S i/S,1r',7-1- Drinking fountain 25.02 f" i ' t s,J, r/ ./4' e`/X,/ ..S'f'Z vze,.-` ! Ejectors/sump 25.02 0 PROPERTY OWNER/ I ❑ TENANT Expansion tank 12.51 Name: L t-\ L irk or .e,S Fixture/sewer cap 25.02 5 V CS w Floor drain/floor sink/hub 25.02 l I Address: tin flv.� Garbage disposal 25.02 City/State/ZIP: 1,t getrrd i OQ ci )2-23 Hose bib 25.02 Phone:(503) 102 t-{ .'-1 t- 1 Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Business Warne: Medical gas(value:3 ) 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:( ) Fat::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: A- A `Or60,101e, ek-t1C se,4'VlC, Waterpiping/D\W 56.29 Address: P.U• C�O)/_- 3It3 Other. 25.02 City/State/ZIP: CAM LI t 0 Q., CV-1 013 Subtotal Phone:(503) (4e - I9 Z9 Fax:(503)'Z lo1O-C�2S Minimum permit fee: 572.50 �y.Sa . CCB Lie.: p g I .; Plan review(25%of permit fee) State surcharge(12%of permit fee) g,4-t� Authorized signatur • f`� TOTAL PERMIT FEE g( Zd Print name: n Date: ` This permit application expires if a permit Is not obtained within 180 days (L St~.� �'p Ga Z 1 Z61� after it has been accepted an complete. *Fec methodology set by Tri-County Building Industry Service Board. t:tauilding\Permit*WLMU.Pemm*App.doe 10/01/09 4404616T(t O/OLCOM/WEB) • Plumbing Permit Application City of Tigard Page 2 -Supplemental Information Fee Schedule:, Residential Fire Suppression Systems: Site Utilities: Qiy: 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 S233.20 Sewer-1st 100' 62.54 0(p a,51+ 7,201 and greater 5327.54 Sewer-each additional 100' — 37.52 Water Service-1st 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 - Storm&Rain Drain-1st 100' ?aluat on" Permit Fee 62.54 S 1.00 to S5,000.00 Minimum fee S72.50 Storm&Rain Drain-each additional 100' 37,52 $5,001,00 to S10,000.00 $72.50 for the first35,000.00 and S 1.52 for Qt01eIJ11S CCt1t7I1S Or Fees Q1Y Fee(ea) Total each additional S100.00 or fraction thereof,to � , and including$10,000.00. Inspection of existing plumbing or for S10,001,00 to$25,000.00 S148.50 for the first S 10,000.00 and$1.54 for which no fee is specifically indicated 90.00/hr each additional S100.00 or fraction thereof;to (minimum charge-1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr S25.001.00 to S50,000.00 $379.50 for the first S25,000.00 and S1.45 for hours(minimum charge-2 hours) each additional S100.00 or fraction thereof,to Rcinspection Fees 90.00/hr and including S50,000.00. Additional plan review for revisions 90.00/hr S50,001.00 and up S742.00 for the first 550,000.00 and S 1.20 for (minimum charge-1/2 hour) each additional S100.00 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*. __Plan ReVievy to lj ing • II1Stallatiops Quanhty'tip Fixtrire,Type Plan review is required for any of the following. Fixture Type for ; Repved ' Please check all that apply. WorkPcrformed: ., Copped Added Reloeate Baptistry/Font ❑ My new commercial building with water service 2"and Bath: -Tub/Shower greater,except systems designed andstamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall O. New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher; Commercial El Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in QAR918-780-0040, Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" ,. Isometric ar Riser Dllagram. 4 ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain Garbage Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -IavBar non-food related -Bradley -Com/Serv/tJtil 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 Water Extractor fees assessed for the server increase must be paid before the Water Closet-Toilet , plumbing permit can be issued. Urinal Other Fixtures: 1:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2 RECEIVED OCT 7 2019 • Plumbing Permit Application GILA DGARD BUILDD INNGG DIVlS10N Building Fixtures FOR OFFICE USE ONLY City of Tigard Received / r t// ! SPIN:Permit No.: t`% 41:ti'-/r 4 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I'✓ _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Pernik No.: Inspection Line: 503.639.4175 TIG/1RD Date Ready/By: runs: B1 See Page 21cr Internet: www.tigard.or.gov Notified/Method: "".. Supplemental Information TYPE OF WORK FEE°SCHEDULE ❑New construction 0 Demolition For special injarmation use checklist. Description ( Qty. I Ea. I Total Addition/alterationlreplacement 0 Other: New 1-2-family dwellings(includes 100 R for each utility connection) CATEGORY OF CONSTRUCTION� SFR(1)bath 312.70 ❑1-and 2-family dwelling t;ommercial/industrial SFR(2)bath 431.78 £B 0 Accessory building 0 Multi-family SFR(3)bath 500.32 El Master builder 0 Other: Each additional bath/kitchen 25.02 Fire sprinkler( sq.IL) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address:11550 S W 61 1h A v� Catch basin or area drain 18.76 City/State/ZIP: E t Cla d, (Q2. q-I 223 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft:-__) Page 2 Suite/bldg./apt.no.: I Project name: L B L Homes Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 SW o`t l or `s _Rain drain connector 18.76 *.P r(T61( 1-1 1S 1 13n e- (,O' c'I- p� �j \ l." 4 Sanitary sewer(no.linarlinear tt.: t[G0� 1 Page 2 4 wa,. Storm sewer(no.linear ft.:_J Page 2 I 6V.) 12)0J._ IOf 5A- g ' Water service(no.linear R.:_) Page 2 Subdivision: I Lot no.: Fixture or item: - Tax map/parcel no.. Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 5CA. ►1+A Sewer�,eui r ( Iton 1fner Dis hw i'4 Dishwash hheser 25.02 er 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: L 1-�1_ orr.e.S Fixture/sewer cap 25.02 Address: 11<j S 0 SW (0-1 t'L"t f� Floor drain/floor sink/hub 25.02 "vim Garbage disposal 25.02 City/State/Z►P: Ts C‘,.rd t 0Q C.Li 2-2 3 Hose bib 25.02 Phone:(503) 102 t4 •-II Ill Fax:( ) Ice maker 12.51 0 APPLICANT 0 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 Water closet 25.02 CONTRACTOR Business name: A- PI c.1 ordajoi tic, Water heater 37.52 � ��C�, Water piping/DWY 56.29 Address: c),0, �� 81$ Other. 25.02 City/State/ZIP: („ct.r )LI t Off. CV-10(3 Subtotal Phone:(50�} to82- 1 q Zq Fax: SO3 Minimumpermit fcc: S72.50 t )211 W-C)$25 � `I y Sys i/ r L Plan review(25%of permit fee) CCB Lic.: /<y L .11 ,, Pl ngt-ie-no.: State surcharge(12%of permit fee) 8•4-0 Authorized signatu - tc.-1-� TOTAL PERMIT FEE g1.Z Print name: Date: This permit application expires Ira permit is not obtained within 180 days 1 S h-v- To. • k 0 l z 1.2...0,LS after It has been accepted as complete. *fee methodology set by Tri.County Building Industry Service Board. 1:113uiWmgwesmislPLMU•PemdlApp.doe 10/01/09 440a616T(10/02/COM/wEa) 3 Plumbing Permit Application -City of Tigard Page 2-Supplemental Information Fee Schedule:- Residential Fire Suppression Systems: Site Utilities Qty Fee(es) Total Square Footage: Permit Fee: Footing drain-1"100' 50.03 0 to 2,000 5121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 5169.69 d 3,601 to 7,200 $233.20 Sewer-1st 100' 62.54 (pa,cjq 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 Storm&Rain Drain-1st 100' 62.54 Valuation; Permit Fee: S 1.00 to 55,000.00 Minimum fee 572.50 Storm&Rain Drain-each additional 100' 37.52 S5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and$1.52 for Oilier nispectionS or Fees Qty Fee(ea) Total each additional S100.00 or fraction thereof,to and including 510,000.00. Inspection of existing plumbing or for S 10,001.00 to S25,000.00 $14550 for the first 510,000.00 and S1.54 for which no fee is specifically indicated 90.00/hr each additional S100.00 or fraction thereof,to (minimum charge—1/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr 525,601.00 to S50,000.00 $379.50 for the first S25,000.00 and$1.45 for hours(minimum charge—2 hours) each additional SI00.00 or fraction thereof,to Rcinspcction Fees 90.00/hr and including S50,000.00. Additional plan review for revisions 90.00/hr S50,001.00 and up S742.00 for the first S50,000.00 and S1.20 for (minimum charge—1/2 hour) each additional S100.00 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*- " PI�nReview for Plumbing Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for. Replied Please check all that apply. Work Performed: Capped Added Relocate. Baptistry/Font ElAny new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. ❑ Car Wash: -Each Stall New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. Cuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" . 3., Isometric orfRiser Diagram 0 Isometric or riser diagram is required for new buildings-Car Wash Drain gT q Garbage -Domestic non-food that meet the qualifications above. Disposal: -Domestic food related -Commercial food related -Industrial food related Ice MachAtefrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Barnon-food related a„ -Bradley -Com/Serv/Util food related Service • *Note: If the fixture work under this permit results in an Swimming Pool Filter Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\BuildinglPermits\PLMF_PerrnitApp.doc 08/04/2011 2 Julie Drinkwater From: Julie Drinkwater Sent: Monday, October 07, 2019 11:30 AM To: 'A-Affordable Septic Service' Cc: #Building Permit Technicians Subject: RE: 11580 SW 67th Ave Permit Request Good morning Michelle Thank you for your submittal. I have placed it into the que for processing which could take between 2-3 business days. Thank you Julie Drinkwater Permit Technician City of Tigard Building Department 13125 SW Hall Blvd Tigard, OR 97223 503-718-2804 From:A-Affordable Septic Service [mailto:aaffordablesepticservice@gmail.com] Sent: Friday, October 04, 2019 11:21 AM To:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov> Subject: 11580 SW 67th Ave Permit Request Caution! This message was sent from outside your organization. Good Morning, Please see attached Plumbing Permit application for your review. Thank you, Michelle Gooding Administrator A- A ffordable S eptic S ervice, LLC 503-682-1929 office 503-266-0625 fax DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 1 Julie Drinkwater From: A-Affordable Septic Service <aaffordablesepticservice@gmail.com> Sent: Friday, October 04, 2019 11:21 AM To: #Building Permit Technicians Subject: 11580 SW 67th Ave Permit Request Attachments: DOC20191004111806.pdf Caution! This message was sent from outside your organization. Good Morning, Please see attached Plumbing Permit application for your review. Thank you, Michelle Gooding Administrator A- A ffordable S eptic S ervice, LLC 503-682-1929 office 503-266-0825 fax 1 Branden Taggart From: Branden Taggart Sent: Friday, October 11, 2019 5:45 PM To: A-Affordable Septic Service Cc: #Building Permit Technicians Subject: RE: 11580 SW 67th Ave Permit Request: PLM2019-00414 Hello Michelle, I was reviewing the plumbing application for LHL Homes, and the second page lists new fixtures that are being added under the Commercial Fixture Work section; however, the front of the application just describes 100 ft. of sanitary sewer. Please confirm the scope of work. If there are new fixtures that will be added, please revise the first page of the plumbing application. Thank you, Branden Taggart q; City of Tigard r " Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard,OR 97223 (503)718-2449' brandent@tigard-or.gov From: A-Affordable Septic Service <aaffordablesepticservice@gmail.com> Sent: Monday, October 7, 2019 11:56 AM To:Julie Drinkwater<JulieD@tigard-or.gov> Cc: #Building Permit Technicians <TigardBuildingPermits@tigard-or.gov> Subject: Re: 11580 SW 67th Ave Permit Request Caution! This message was sent from outside your organization. Julie- Great, thank you so much! Sincerely, Michelle Gooding Administrator A- A ffordab(e S eptic S ervice, LLC 503-682-1929 office 503-266-0825 fax On Mon, Oct 7, 2019 at 11:30 AM Julie Drinkwater<JulieD@tigard-or.gov>wrote: 1