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Permit
CITY OF TIGARD PLUMBING PERMIT �. COMMUNITY DEVELOPMENT Permit#: PLM2019-00457 T l C3 A R ID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/14/2019 Parcel: 2S112BD11600 Jurisdiction: Tigard Site address: 7730 SW HANSEN LN Project: Elderberry Ridge,Lot 12 Subdivision: ELDERBERRY RIDGE Lot: 12 Project Description: Backflow preventer for landscape irrigation. Contractor: TRUSCAPES INC Owner: RIVERSIDE HOMES LLC 21600 NW AMBERWOOD DR. 17933 NW EVERGREEN PL STE 370 HILLSBORO, OR 97124 BEAVERTON, OR 97006 PHONE 503-969-2144 PHONE: 503-645-0986 FAX: 503-531-9216 FEES Quantity Description Date Amount 1 ea Backflow Preventer 11/14/2019 $31.27 Specifics: 1 12%State Surcharge- 11/14/2019 $8.70 Plumbing Type of Use: SF 41 ea Minimum Fee Adjustment- 11/14/2019 $41.23 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 wo is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fol.w 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 503.2 .1987 or 1 00.332.2344. .� Issued By: Permittee Signature: �—L 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 Application Buildin % . " _ g Fixtures �� '` '--°p. FOR 01-110E USE oZI,Y City of Tigard Received III • 13125 SW Hall Blvd.,Tigard,OR 97223 NOV0 V 1 2 9 PlanRe Date/By: l Y �9 / y�(/c�0l li Plan Review Phone: 503.718.2439 Fax: 503.598.1960 i.,,• �,s i , Date/By: At%.3 G .oole T 1 G A R D Inspection Line: 503.639.4175 B i L tr era,°: O /1 +i Noti Date Ready/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov Supplemental Information TYPE OF WORK FEE* SCHEDULE 2 New construction ❑Demolition For special information use checklist. Description I Qty. Ea. I Total 0 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 El1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437,78 0 Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: 7730 SW QArntrtt Ln Catch basin or area drain 18.76 �� Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard, OR 97224 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: I Project name: Elderberry Ridge Manufactured home utilities 50.03 Cross street/directions to job site: SW Bonita Rd & SW 76th Ave 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: Elderberry Ridge Lot no.: 12 Fixture or item: Tax map/parcel no.: Backflow preventer 1 31.27 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Construction of SFR Clothes washer 25.02 Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 El PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Riverside Homes, LLC Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 17933 NW Evergreen Pl., Ste 370 Garbage disposal 25.02 City/State/ZIP: Beaverton, OR 97007 Hose bib 25.02 Phone:(503)645-0986 Fax:( ) Ice maker 12.51 Q✓ APPLICANT Q✓ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Riverside Homes, LLC Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: Nikki Pruett Roof drain(commercial) 12.51 Address: 17933 NW Evergreen Pl., Ste 370 Sink/basin/lavatory 25.02 City/State/ZIP: Beaverton, OR 97007 Solar units(potable water) 62.54 Phone:(503)645-0986 Fax::( ) Tub/shower/shower pan 12.51 E-mail: npruett©riversidehome.com Urinal 25.02 CONTRACTOR Water closet 25,02 Water heater 37.52 Business name: TruScapes Water piping/DWV 56.29 Address: 21600 NW Amberwood Dr. Other: 25.02 City/State/ZIP: Hillsboro, OR 97124 Subtotal Phone:( 503 531-8216 Fax:( ) Minimum permit fee: $72.50 CCB Lic.: LCB#7962 Plumbing Lie.no.: Plan review (25%of permit fee) , State surcharge(12%of permit fee) Authorized signature: t_eic 1,6,r%z TOTAL PERMIT FEE i Print name: Nikki Pruett Date: 11/13/19 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\Pennits\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-l't 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-I st 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 p 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 any of the following. Work Performed: Capped Added Relocate Baptistry Font Please check all that apply. ❑ Any new commercial building with water service 2"and Bath -Tub/Shower 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 ❑ 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" 4" Isometric or Riser Diagram Car Wash Drain ❑ 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 -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lay -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\npruett\Downloads\PLMF_PermitApp.doc 2