Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2020-00107
Date Issued: 03/17/2020
T I C A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S102BA00501
Jurisdiction: Tigard
Site address: 9744 SW TIGARD ST 500
Project: French Roofing Subdivision: None Lot: None
Project Description: Interior plumbing for a new building:Adding(1)2"floor drain/sink,(1)sink,and(1)water closet;Installing (1)
primer and(1)water heater.
Contractor: PIPELINE PLUMBING Owner: BAS PROPERTIES LLC
333 S STATE ST SUITE V-108 9740 SW TIGARD ST
LAKE OSWEGO, OR 97034 TIGARD, OR 97223
PHONE:
503-730-4050
503-624-1906
FAX: 503-624-1926
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 03/11/2020 $25.02
Specifics: 1 ea Primer 03/11/2020 $12.51
1 ea Lavatories 03/11/2020 $25.02
Type of Use: 1 ea Water Closet 03/11/2020 $25.02
Class of Work: 1 ea Water Heater 03/11/2020 $37.52
Type of Const: 1 12%State Surcharge- 03/11/2020 $15.01
Occupancy Grp: Plumbing
Stories:
Total $140.10
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 503.23 /1987 or 1.800.332.2344. ,
Issued By: • Permittee Signature: C/
\/Lo r
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 _ 6/4)_ ,y#
Building Fixtures yE [EI) 1(I li oFFIC!: USE OS I 1
1! Received
City of Tigard Permit No.:
Date/By: .3�-4 Off/ ` -M:2IOV -al)(o,
It 13125 SW hall Blvd.,Tigard,O 9722�3q�(p 92�20 i
Phone: 503.718.2439 Fax: 503598.MI;t` rL Date/By: w n, nai/g ) 3
Date/By: Other Permit No.:�J Iva f _�
r 1 GAR.I) Inspection Line: 503.639.4175 ��uji ID Date Ready/By: Suns: 0 See Page 2 for
Internet www.tigard-or.gov .,�-N!i'l 7 �[t,,,�1a„-rpI Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
lg New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes 100 ft.for each utility connection) '
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
0 Multi-family Each additional bath/kitchen 25.02
El Master builder El Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:9744 SW Tigard St Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard, Ore on 97223 • Footing drain(no.linear ft.:_) Page 2
Suite bldg./apt.no.: 5ota Project name:French Roofing Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
On the SW side of SW Tigard St.between SW Katherine and SW Rain drain connector 18.76
Grant Ave. Directly behind 9740 SW Tigard St Sanitary sewer(no.linear It:__) Paget
Stonn sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.:at% i 01 3 /1 Joy S,)f Backfiow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Add one ADA bathroom in a new steel building Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name:French Roofing
Floor drain/floor sink/hub / 25.02 ii 5 D.
Address:19430 NE Hassalo St Garbage disposal 25.02
City/State/ZIP:Portland OR 97230 Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
l APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Pipeline Plumbing Medical gas(value:$_) Page2
Primer 1 12.51 l/-3
Ol Contact name:Taylor Lotten Roof drain(commercial) 0-- 12.51
Address:333 S State Street#V-108 Sink/basin/lavatory 25.02 ,Z y_a�
�� City/state/ZIP:Lake Oswego, OR 97034 Solar units(potable water) 62.54
.` Phone:(503)624-1906 Fax::(503)624-1926 Tub/shower/shower pan 12.51
F-mail:taylor@pipelineplumbing.net .'' �,,., „2
Urinal 25.02
I • -i Ai Water closet i zs.oz 2 5 0�
CONTRACTOR ,ft/v/
f.
Water heater ' 37.52 i 7-y--),
Business name:Pipeline Plumbingt
p Waterpiping/DWV 56.29
Address:333 S State Street#V-108 Other: 25.02
City/State/ZIP:Tigard, Oregon 97223 Subtotal /AXa 1
Phone:(503)624-1906 Fax:(503)824-1926 Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:15826D Plumbing Tic.no.:3-510PB State surcharge(12%of permit fee) .S a
Authorized signature:
2 /,B LLQ?'L TOTAL PERMIT FEE 10.
Print name:Taylor Lotten Date:03/09/2020 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:1B1/ilding'PermitslPLMU-PermitApp.doc I0/01/09 440-4616T(10/022OM/WEB)
r (3E-0Gn
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
Sewer3,601 to 7,200 $233.20
-1st 100' 62.54
7,201 and greater $327.54
Sewer-each additional W0' 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:
$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 90.00ihr 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-U2 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
0 Any new commercial building with water service 2"and
Baptistry/Font
Bath: -Cub/Shower greater,except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure
-Drive Thm as defined in OAR918-780-0040.
Cuspidor/Water Aspiator ElMedical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic 0 Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye Wash Submit a sets of plans with any of the above.
Floor Drain/sink: -2" l
-3" Isometric or Riser Diagram
4 0 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) 2 Other:1 Point of Use Water Heater and 1 hose bib
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
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures: L.,*
I:\Building1Petmits\PLMF_PermitApp.doc 08/04/2011 2