Permit CITY OF TIGARD PLUMBING PERMIT
"! 2 ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00495
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2019
Parcel: 2S 114B B 14500
Jurisdiction: Tigard
Site address: 10498 SW KENT ST
Project: LANNON Subdivision: SWANSON'S GLEN NO.2 Lot: 86
Project Description: (1)dishwasher,(1)garbage disposal, (1) ice maker,and (1)sink for kitchen remodel.
Contractor: RUPP FAMILY BUILDERS INCORPORATED Owner: LANNON, BRADFORD
29030 SW TOWN CENTER LOOP E 10498 SW KENT ST
SUITE 202 BOX 429 TIGARD, OR 97224
WILSONVILLE, OR 97070
PHONE: 971-264-9392 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Dishwasher 12/16/2019 $25.02
Specifics: 1 ea Garbage Disposal 12/16/2019 $25.02
1 ea Ice Maker 12/16/2019 $12.51
Type of Use: SF 1 ea Sink 12/16/2019 $25.02
Class of Work: ALT 1 12%State Surcharge- 12/16/2019 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total S98.08
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: X.....„.„,...e...... 14'42 Permittee Signature: c":. ��
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
Building Fixtures FOR OFFICE USE ONLY'
City of Tigard \r Received �}�- Permit No.: /�L 11 l
• 13125 SW Hall Blvd.,Tigard OR RECEIVED �teBy. i����I(�l 7�, J w 1 (-(��
;IN S g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:�Ilc. 4 w 1
4.... rt..
1 1(i A It I) Inspection Line: 503.639.4175 ^r r 1 g {R.019 Date Ready/By: l�eris-:`t'� 61 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: - ^ Supplemental Information
TYPE OF WORK 1 Y Ur 1 IblAtiLjki FEE* SCHEDULE
. -,,.tr rt\/141C)1.
-4 New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. 1 Total
Addition/alteration/replacene t . 0 Other: New 1-2-family dwellings(includes 100 tt.for each utility connection)
. -" CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
®'1-and 2-family dwelling ElCommercial/industrial SFR(2)bath 437 78 -
❑Accessory building y SFR(3)bath 500.32
❑Multi-famil 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: I0t.{ c. 1 ,5�, /,,ek
Catch basin or area drain 18.76
(l Drywell,leach line,or trench drain 18.76
City/State/ZIP: 11 c.k- & 0 g q 7 2 2 4 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:J I Project name: % __t�lV Manufactured home utilities 50.03
Cross street/directions to job site: !�'� 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
iii,�j j. �f (r1' Clothes washer 25.02
"�'I J c 14 1-, Rear C IX -L Dishwasher ( 25.02 ;SO),
Drinking fountain 25.02
Ejectors/sump 25.02
YY % PROPERTY OWNER 0 TENANT Expansion tank 12.51
Fixture/sewer cap _ 25.02
Name:(5 4 �GL�rnrr:l.
-
W �� Floor drain/floor sink'` 25.02
Address:'in Li lL' ? 5 1<cm., / _ 25.02 ;S 4,1?
City/State/ZIP: ; .54 v-a oi& 17 Z 2-�( 25.02
Phone:( ) 6 Fax:( ) Y 12.51 /3.-�
❑ APPLICANT El CONTACT PEI
/ 25.02
Business name: yy�l Page 2
12.51
Contact name:
12.51
Address: _25.02 4)57,0.7
City/State/ZIP: 1 A.ei' 62.54
Phone:( ) Fax::( ) 12.51
E-mail: 25.02
15.02
CONTRACTOR
• 7.52
Business name:R wp n r�.pl I 6 Cl,i i oi'e✓✓. F-�e/!t ( �� t+�
1 f ���fff r✓ � 5.29
Address:1A 03 0 ,SU1 ToW eeltd2✓ Lp E. sr mac-66 ;.02
City/State/ZIP{J1 (5pvt V► U,e 0 4707b C J (,.64" �,"-I' auototal t7 -7
Phone:( ) Fax:( )
U y S ~� Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:20 7 Plumbing Lic.no.: �/t �� I State surcharge(12%of permit fee) N.5-I
Authorized signature: Po
TOTAL PERMIT FEI( 0 OJ
e Print nam �ett ik. w.e-ws'f`� Date: 17 -(G--ZO t et. This permit application expires if a permit is not obtained hin 1 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Buldiag'Petmits\PLMU-PermitApp.doc 10/01/09 440-46i6T(I0/02/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-I"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
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 fast$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*. Plan Review for Plumbing Installations
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font El Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
ElCar Wash: Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
ElCuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Corato l ❑ Any multipurpose fire sprinkler system.
Domestic El 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 or Riser Diagram
-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: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util 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 fees assessed for the sewer increase must be paid before the
Water Extractor
plumbing permit can be issued.
Water Closet-Toilet P g P
Urinal
Other Fixtures:
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