Permit CITY OF TIGARD PLUMBING PERMIT
1114
' ' � COMMUNITY DEVELOPMENT Permit#: PLM2020-00108
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/10/2020
Parcel: 2S113AB00300
Jurisdiction: Tigard
Site address: 16037 SW UPPER BOONES FERRY RD 300
Project: Oregon State Bar Subdivision: FANNO CREEK ACRE TRACTS Lot: 38
Project Description: Interior plumbing for TI:Capping(1)drinking fountain;Adding(1)sink and(1)water closet.
Contractor: A ABSOLUTE COMFORT HEATING &COOLING INC Owner: OREGON STATE BAR, THE
15886 PARK PLACE CT 16037 SW UPPER BOONES FERRY RD
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503-513-4795 PHONE:
FAX: 503-513-0797
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 03/10/2020 $25.02
Specifics: 1 ea Sink 03/10/2020 $25.02
1 ea Water Closet 03/10/2020 $25.02
Type of Use: COM 1 12%State Surcharge- 03/10/2020 $9.01
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
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 9 . Yo in a copy of the rul s
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Sign to
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 /4 7 to--'"L u P�a� ' 000v 9
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Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received ,Q g ����� /a�� -�I/ Permit No.. �LQl
111 13125 Plan Review
Phone: 503.718.2439 Fax: 503.5 8. 60 q Date/By Other Permit No.6/4,QvesU 7
Inspection Line: 503.639.4175 MAR 1 Q 2OLa Page TIGARD Date Ready/By. funs: El See Page 2 for
Internet: www.tigard or.gov Notified/Method.
1 GARD C, Supplemental Information
TYPE OF WORCITY OF �I�ISIa FEE* SCHEDULE
❑ New construction F_4Yemotitlon For special information use checklist
-- --- --- Description Qty. Ea. Total
dition/alteration/replaccmcnI ❑ Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUICTION SFR(1)bath 312.70
❑ I-and 2-family dwelling .commercial/industrial SFR(2)bath 437.78
ElAccessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities: _
/ � /J_ _ e, Catch basin or area drain 18.76
Job site address: /`p3�Y7+ 4. ICJonW'�
City/State/ZIP: �'JjQ inr. 4V / Diywell,leach line,or trench drain Page 2
J/�`"' ! Footing drain(no.linear ft.: ) 6
2
Suite/bldg./apt.no.:300/ Project name:0 t/ E r 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: I Lot no.: Fixture or item:
Tax map/parcel no.: e245//J ,Z /3ee j 3 do Backflow preventer 31.27
Backwater valve 12.51
DESCRIPTION OF WORK
ik f // e r / Clothes washer 25.02
! (J�6 7.
Dishwasher 25.02
sr
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: - Fixture/sewer cap ] 25.02 .Q7.
Floor drain/floor sink/hub 1 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:
s Medical gas(value:$ ) Page 2
-��(� �/, / y �� _. �� .
Primer 12.51
Contact name ito/S, oelie/7 Roof drain(commercial) 12.51
Address: i1-S e 4 ' IX iaice -r Sink/basin/lavatory 1 25.02 ' ,p2,
City/State/Z1P: D ofyt.. -'. dj 1)4ILj/J"" Solar unitswater)
// (potable 62.54
Phone:(Sea) s 3 , Lool Fax: :(03)613-Oil Tub/shower/shower pan 12.51
E-mail' A- 4 r�"p Urinal 25.02
pfi4�fee, �Psr�.a/-E Lsur�
CONTRACTOR Water closet \ 25.02 .32
- Water heater 37.52
Business name: ��-A,. // i - Waterpiping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal -757,cp
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lie.: i s P mhing Lie.no.: Al �t`7k,7 Plan review (25%of permit fee)
�„� State surcharge(12%of permit fee) '�, 0
Authori ed sign. i_
TOTAL PERMIT FEE crlf 07
Thisa application expires if apermit is not obtained within ISO days
Print nam . y�i ��' Dater �� permitPP P Y
�r�� aMk' after it has been accepted as complete.
*Fee methodology set by 7n-County Building Industry Service Board.
I:\Building\Permits4PLMO-Porm0App.doe 10/01/09 4404616T(10/02JCOM/WEB) 4,A [pi r. `.
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 5121.90
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 S100.00 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*. 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 pp y'
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thu
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher. Commercial El 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 that meet the qualifications above.
Garbage -Domestic non-food
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: -Lay/Bar non-food related I
-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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet l plumbing permit can be issued.
Urinal
Other Fixtures:
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