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Permit CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2020-00093 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2020 TIGARD g Parcel: 2S104BA04100 Jurisdiction: Tigard Site address: 12490 SW 141ST PL Project: MEAD Subdivision: CASTLE HILL NO.2 Lot: 74 Project Description: Replacing existing bathtub with a shower pan and tile walls. Contractor: OWNER Owner: MEAD, STEPHEN C&JENNIFER M 12490 SW 141ST PL TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Tub/Shower/Shower Pan 03/02/2020 $12.51 Specifics: 1 12%State Surcharge- 03/02/2020 $8.70 Plumbing Type of Use: SF 60 ea Minimum Fee Adjustment- 03/02/2020 $59.99 Plumbing Class of Work: ALT 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 by calling 503.232.1987 or 1.800.332.2344. 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 Application Building Fixtures FOR OFFICE USE ONLY Received Cityof Tigard R / Permit No 11 '+ 13125SW Hall thvd.,Tigard,OR 97223 •ECEIVE Paen/By:, i� - � /9d _�Lb43 _, Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.: q qq Date/By: TIGARD Inspection Line: 503.639.4175 MAR 2 2ULU Date Ready/By: .mns ® See Page 2 for Internet: www.tigard-or.gov Notified/Method Supplemental Information CITY OF TIGARD • TYPE OF WORK FEE* SCHEDULE BUILDING DIVISION ❑New construction 0 Demolition For special information use checklist. Description I Qty. Ea. Total ©Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 9 I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑ Accessory building 0 Multi-family 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: 12490 SW 141st PL Catch basin or area drain 18.76 Drywell,leach line,or trench drain 18.76 City/State/ZIP: Tigard,OR 97223 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: Master Bath tub to shower Manufactured home utilities 50.03 Cross street/directions to job site: End of private drive(141st PL)on left 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: Castle Hill#3 Lot no.: 074 Fixture or item: Tax map/parcel no.: 2S104BA04100 Backtlow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Replace existing bathtub with shower pan. Replace existing plumbing to Dishwasher 25.02 match new shower-only install.Tile walls. Install shower door. Drinking fountain 25.02 Ejectors/sump 25.02 I PROPERTY OWNER 0 TENANT Expansion tank 12.51 Name: Stephen Mead Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: 12490 SW 141st PL Garbage disposal 25.02 City/State/ZIP: Tigard,OR 97223 Hose bib 25.02 Phone:( 412)327-5723 Fax:( ) Ice maker 12.51 © APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$_) Page 2 Business name: Primer 12.51 Contact name: Applicant is Owner 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 1 12.51 0,b--j Urinal 25.02 E-mail: Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: Water piping/DWV 56,29 Address: Work to be done by Owner Other: 25.02 City/State/ZIP: Subtotal a-5-1 Phone:( ) Fax:( ) Minimum permit fee: $72.50 )J -0.5 Plan review (25%of permit fee) ._ CCB Lie.: Plumbing Lie.no.: u � State surcharge(12%of permit fee) r. 70 Authorized signature: 7, // )� \ TOTAL PERMIT FEE/Ti, �j Print name: Stephen C Mead Date: 2/28/2020 This permit application expires if a permit is not obtained w hin 180 days P after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permils\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-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$100.00 or fraction thereof,to and including$I0,000.00. 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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 ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath. -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thm 0 Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-004 . -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" 3., Isometric or Riser Diagram 4" ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -LavBar 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 Urinal Other Fixtures: I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2