Permit CITY OF TIGARD PLUMBING PERMIT
It: COMMUNITY DEVELOPMENT Permit #: PLM2011 -00311
Date Issued: 10/20/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439
Parcel: 2S111CAl2300
Jurisdiction: Tigard
Site address: 9708 SW OAKS LN
Project: JASSO Subdivision: SATTLER PARK Lot: 8
Project Description: Backflow for irrigation.
Contractor: DOWN TO EARTH IRRIGATION Owner: JASSO, JOEL S
402 BEAVERCREEK RD STE 106 9708 SW OAKS LN
OREGON CI TY, OR 97045 TIGARD, OR 97224
PHONE. 503 - 723 -6212
PHONE: 503- 685 -1591
FAX: 503 - 723 -6244
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 10/20/2011 $31 27
Specifics: 1 12% State Surcharge - 10/20/2011 $8 70
Plumbing
Type of Use SF 41 ea Minimum Fee Adjustment - 10/20/2011 $41.23
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 . - •4.
_ f
Issued By: / Permittee Signature:
Call 503.639. • 5 by 7:00 a.m. for the next available inspecti ' e.
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
4G60 FOR OFFICE USE ONLY
City of Tigard g � � Date/By /O '] Permit No . QLin � J / () )) ( J
114
'I 13125 SW Hall Blvd., Tigard, l
1 7 Plan Review
Ph 503.718.2439 Fax: 3 8. 960 2Q11 Date/By Other Permit No
Inspection Line: 503 639 4175 ®
TIGARD D ate Read /B ions See Page 2 for
t. ' Ready /By g
Internet www.tigard- or.gov ^ C� %�® ,E , itotrfied/Method —e Supplemental Information
TYPE OF WORK �1 —0.:. �"ei'�� FEE* SCHEDULE
N New construction ~ oli.t i d nt.' .,' For special information use checklist.
��':' " Description Qty. Ea. Total
❑ Addition/alteration/replacement . ❑10th r: New 1 dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
Vf 1- and 2- family dwelling 111 Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500 32
❑ Accessory building ❑ 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: q in 5-,A1 em-'4g Z so Catch basin or area drain 18.76
City/State/ZIP: Drywell, leach line, or trench drain 18.76
G Agb , `� ' ' Footing drain (no linear ft ) Page 2
Suite/bldg. /apt. no.: Proj name: 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.: Backliow preventer / 31 27 J7/r 24
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
. :.."- - _ -. 7 - -,-, - e _: .�r"� .t./ r . 1 s .a Dishwasher 25 02
k A" Zr--7 61*1 ' ,J '(j5' Drinking fountain 25.02
Ejectors /sump 25 02
yl PROPERTY OWNER ❑ TENANT Expansion tank 12 51
Name: Fixture /sewer cap 25 02
- --� V i� Floor drain /floor sink/hub 25 02
Address: 17 o g' 5-1,i f�S t . .J Garbage disposal 25.02
City /State /ZIP: I t ,K,A,A,J 012_,-- ‘?"2.-- n Hose bib 25.02
Phone 4633 ) t gs---- 1) f Fax: ( ) Ice maker 12 51
•% APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: DINA) _ Medical gas (value $ ) Page 2 A i 775
Primer 12.51
Contact name: OJT
ArJf 4 -- Se/fXreASY Roof drain (commercial) 12 51
Address: pe 4 06y' 27.51 Sink/basin/lavatory 25 02
City /State /ZIP: 4 g, kI je 1 ` , 'a? L.0 ' Solar units (potable water) 62 54
Phone: ( 2 -2.3 (, 2_ / Fax. : ( ) Tub /shower /shower pan 12 51
E -mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37 52
Business name:. S . Water piping/DWV 56 29
Address: • - 0) 0 ?7 Other 25 02
City /State /ZIP: _ / - 1 d4 g— Subtotal
Phone: (�r 71 Fax: ( ) Minimum permit fee: $72.50 �� 57) CCB Lie.: �7 Plan review (25% of permit fee)
1 )- Plumbing Lic. no.: ,
lb State surcharge (12% of permit fee) F 70
Authorized signature: j� � TOTAL PERMIT FEE r- )'0
Print name `�� , Date: �� This permit application expires if a permit is not obtained within 180 days
. . _ r after it has been accepted as complete.
*Fee methodology set by Tit-County Building Industry Service Board
I \ Building \Permits\PLMU- PermitApp doe 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
Storm &Ram 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
Q ty. Fee (ea) Total each additional $100 00 or fraction thereof, to
Other Inspections or Fees 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
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub /Shower ❑ Any new commercial building with water service 2" and
Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
Eye Wash
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
- 3"
4 " Isometric or Riser Diagram
Car Wash Dram ❑ Isometric diagram for new buildings
Garbage - Domestic —non -food c or riser g ram is required g
Disposal - Domestic —food related that meet the qualifications above.
- Commercial —food related
- Industrial -food related
Ice Mach /Refrig Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay - Non -food related
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer - Clothes
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures
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