Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00171
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/28/2010
T1CrtlRD� g Parcel: 2S104AB09800
Jurisdiction: Tigard
Site address: 13101 SW BENISH ST
Subdivision: MORNING HILL NO. 6 Lot: 127
Project: Ediger
Project Description: Residential irrigation backflow device.
Owner: FEES
EDIGER, JON Quantity Description Date Amount
13101 SW BENISH ST
TIGARD, OR 97223 1 ea Backflow Preventer 05/28/2010 $31.27
PHONE: 503-720-0440 1 12% State Surcharge - 05/28/2010 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 05/28/2010 $41.23
Contractor:
Plumbing
BEAVERTON PLUMBING INC
13980 SW TV HWY
BEAVERTON, OR 97005
PHONE: 503 - 643 -7619
FAX: 503 - 643 -7620
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
�� N
Issued By: d �� , Permittee Signature: .°A{ /7/3, � i (,� j �
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
May 27 2010 2:27PM BERVERTON PLUMBING INC. 5036437620 page 2
Cr "ma 0
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Plumbing Permit Application t.g L, •
Building Fixtures �/ p r� �� ; ∎ � . t �
1 Of Tigard 2 l 20 0 ` ': l t)k ( il l l a
PermrtNo. a r
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131 SW Hall Blvd., Tigard, OR 9 °` D Rccetved ��� �L/y�0 /o �QQ��f
CITY OF TIGARD Plan Review
® s- Phone: 503.639.4171 Fax: 503.59 2 OM DIN ION di
DIVISION Other PermiNo.:
Inspection Line: 503.639.4175 1 71J f L
Internet: www tigard -or gov Auto Ready/By r See ' Page
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`,(� �= .�,� 3 h ,41 �v'2.'' y : c f F gfj {7 f � rk ?y`i' ? t �r )eY a iT i r 4 lu; 4'n
: 3 x1{$iii:Y4 s.i e. :t :Zti ziA4...t., s .M!+:a._i s..1_.. i.:1L' Li;.k � .la;: J . ' *V.I. sf YF 1 Y..Hr;�L :; �. -1. 1i r r?1 a t� 1 � � } I l � ': �'
........._i, .w_ICS�iNI)iS -. . �w: i::r.. R�.. ..ii,_�S.[.E.vfr..a.tafi.£._,.. xs..l;...+.:_.w...G6r.A s:s ...re...Gil.ttftlll..c �
v - . 1 ' ` s.
❑ New construction ❑ Demolition mist tit1 +. S� n..
For speci irijor ntatlorr uae cbec
Description 1 Qty. 1 Ea. 1 Total
® Addition/alteration/replacement ❑ Other , 1- 2-family dwellinp,a (includes 100 fl. for each utility connection)
``,' �, SFR
(1) ,� s ?!�d t { ,3 � K� w s t � ., n 1 a. � s :: ti e y�� } * �.i
t . iiass :1 wr j <<wc^r.u:u�s_..�i4c::.^iuc ...c.t:itt. ...wLt.. ✓.-....: .S +- .i.:! L.Sav�. usL„t'vm.3:.:5.. -- i.•a�• e J ( ) I 3
1- and 2- family dwelling ❑ Commerci&/indiistrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder
yam, ��(�V. ❑ Other: Fire sprinkler (_ sq. R) j Page 2
?Y :f �.+ 3 r��'i l 1� i , i ; e s i f i '' ;1; 1 , 6r .1ua y� ;..f
�.. . vi;.._..,:. ..5.....c,F..� _ ..._.:So.2.. . uw .16�u'.af,,, o...1, nr , , .C,. E:.i� +3 •'a ? ��XE S " u �t'b cat utilities; basin •
Job site address 13101 SW BENISH ST basin or area drain 18.76
City/State/ZIP: TIGARD, OREGON 97223 Drywell, leach line, or wench drain 18.76
Footing drain (no. linear ft.: _J Page 2
Suite/bldg. /apt. no.: l Project name: JON EDIGER
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 1 Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 1 31.27 31.27
5 4 t t s a 5., t . t ilr dr.i E ;.-s "y,,:it a+ . is j..lw. +t -.• B ac k ws u r va _
$q.li s!_? z. :v1iL - � _aim., ,.t...:i.a.�_.JZ.:1['' a;ta,. .galIIrzirtE_ t3 YheL a 12.51
Clothes washer 25.02
INSTALL A NEW DOUBLE CHECK
Dishwasher 25.02
Drinking fountain 25.02
ry Ejectors/sump 25.02
�` - .: s r r .. _ . .._ , -t.i.+ . b. 1 I W t E s10n tank
3 � d1 i y t , �' d'� n . i {
4'S.'ZL....J.., :... . . r...L -, �..r, ...:::i.t � kYieit' 6 :F.,. ,r :t . ue. .. d r- ... ...na.. ze, (..'S....elL...i - 1 I 12.51
Name: JON EDIGER Fi xtur N st w er 25.02
Address: 13101 SW BENISH ST
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/ State/Z1P: 'IIGARD, OR 97223 Hose bib 25.02
Phone: (503)720.0440 Fax: ( ) Ice maker 12.51
=0.1 1. ,/
1 '
a5 i " ,'- ✓ i• .p J E ' `1 fi'; 1 '1" 't ''' a a .. r 1 s i -
swr� Ls 4- .2. ,. i .. . . .. w?.. ..,,_ ._ - : ;: �tx L „ at . __a,. ,1 Interceptor/grease trap 25.02
:ate �x,.� e. .ate.-:_
Business name: BEAVERTON PLUMBING, INC Medical gas (value: $ ) Page 2
Contact name: COLLEEN KNIGHTON
Primer 12.51
Roof drain (cormnercial) 12.51
Address: 13980 SW TUALATIN VALLEY HWY
Sink/basin/lavatory 25.02
City /State/ZIP: BEAVERTON, OREGON 97005 Solar units (potable water) 62.54
Phone: (503) 643.7619 Fax: : (503) 643.7620 Tub/shower /shower pan 12.51
E -mail: Colleen ®beavertouoplurnbing.carn Urinal 25.02
: -A t ''': r. '1 R f' , F �I`ti. 3 r i , a i er _tor closet 25. U2
2 �- yi'l ., - 14 t J,I7, l �:.. ... _..•:: -: : : r -, --,..} #t.i0.W,.�,u.Ikvh. ! ti''
Water heater 37.52
Business name: BEAVERTON PLUMBING, INC. w pipplyy 56.29
Address: 13980 SW TUALATIN VALLEY HWY Other 25.02
City/ State/ZIP: BEAVERTON, OREGON 97005 Subtotal
• . one: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72.50 72.50
CCB Lic.: 12889 1M /i L • ..... g Lic. no.: 34-4PB 1.,' Plan review (25% of permit fee)
i _ State surcharge (12% of permit fee) 8.70
Authorized signature: i� TOTAL PERMIT FEE 81.20 (/
Print name: COLLEEN KNIGH TON Date: 5/27/2010 Ibis 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; Inuif diaglPeermit,\PLMU- PamitApp. 10/01/09 440 -4616T tON2/OQM/'E3)
May 27 2010 2:27PM BEAVERTON PLUMBING INC. 5036437620 page 3
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su . ression S stems:
r .-
, t, •. •. ' id1 .e t b�4°S�'. mY ifY.l s
.S.cir�.c'�u:d.',.N 1..... ,..� , _.. Lau. 1.._..:..- r..' l�x4Sl .,a,:!iyiv- ,.,.....,r.. :. e..r�Hi?,., 4t�`��
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
Sewer - 1st 100' 62 3 601 to 7 00 $23320
_ 7,201 and _. $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas S stems:
Water Service - each additional 100' 37.52 ' ° , E 4 ?, 4i t ` i t ry , ARls.:° r _ Pr xr af , ; .
Storm & Rain [rain - 1st 100' 62.54
_ $1.00 to 55,000.00 Minimum fee 572.50
Storm it Ram Dram each additional 100' 37.52 $5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and 51.52 for
1 each additional $100.00 or fraction thereof to
t tx and including $10,000.00.
Inspection of existing plumbing or for 510,001.00 to 525,000.00 5148.50 for the first 510,000.00 and 51.54 for
which no fee is specifically indicated 90.00, hr ■ each additional $100.00 or fraction thereof, to
minimum char; —1 /2 hour and including 525,000.00.
Inspections outside of normal business - 90.001hr 525,001.00 to 550,000.00 5379.50 for the first $25,000.00 and 51.45 for
hours minimum ehar_e — 2 hours each additional 5 100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including 550,000.00.
Additional plan review for revisions - 90.00/hr - 550,001.00 and up 5742.00 for the first $50,000.00 and 51.20 for
minimum char l e —1/2 hour each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work: eri
Are you capping, adding or replacing fixtures? If "yes ", E'r
please indicate work performed by fixture. Failure to � ,���
e r n oft
Plan review is required for any of the following.
accuratei re 'ort fixtures could result in increased sewer fees * . Please check all that apply.
r £a a �S•`. }p x � +ti `Yt� 41kM;'� xi t , - euey.. cve
'n Fa ,, F-7: -Z s .a
❑ Any new commercial building with water service 2" and
ift ;�' 4 ��� a ct £ " ' greater, except systems designed and stamped by licensed
A .. _.. - a 5.. ",rsy' i ... s. �� - .�,i .i. engineer.
Baptistry/Font ❑ New exterior plumbing site utilities for any complex structure
Bath Tub/Shower as defined in OAR918 -780 -0040. y p
- Jacuzzi/Whirlpool
Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918 -7$0 -0040.
Dishwasher -Commercial
Domestic Submit ? sets of plans with any of the above.
Drinking Fountain
Eye Wash cG fj c n(+v# �,.�f ,� ca tF.rY a+ < -ti� d '`�.L`�11c4�.r }tq'•t °'i '?'�{�v'
Floor Drain/sink 3 , • Isometric or riser diagram is required for new buildings
4 „ that meet the • ualifications above.
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice Mach•/Rcfrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures:
http : / /www.tigard- or.gov /city_hal l /depamnentslcd/docs/PLMF -Perm itApedoc