Permit CITY OF TIGARD PLUMBING PERMIT
,, Permit #: PLM2011 -00328
w - COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 11/02/2011
Parcel: 25111 BC01300
Jurisdiction: Tigard
Site address: 10150 SW VIEW TER
Project: Urn Subdivision: GREENBRIER Lot: 5
Project Description: Connect existing house to sewer service, approximately 35'
Contractor: LOVETT EXCAVATING INC Owner: UM, EUNKYU C & KWANG Y
PO BOX 86280 10150 SW VIEW TER
PORTLAND, OR 97286 TIGARD, OR 97224
PHONE 503 - 504 -2847
PHONE* 503 - 620 -8287
FAX: 503 - 288 -1630
FEES
Quantity Description Date Amount
35 If Sewer Service 11/02/2011 $62.54
Specifics: 1 12% State Surcharge - 11/02/2011 $8 70
Plumbing
10 ea Minimum Fee Adjustment - 11/02/2011 $9.96
Type of Use SF 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, • ' irk is suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Iotification Ce -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules
or • rect questions to OU b a g II 232 1987 or 1 800 332 2344.
Is . ued By: I / / 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.
Nov, 2. 2011 12:14PM50a�Lovett Excavating
CITY OF TIGARD No. 6029 P. lm 01/01
Building Fixtures
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Phone: 503.718.243 Tigard OR 97 23 � Aoeetted (`f.
i i ., : t n t. >. tnvpection TAG: S03,639,4175 SD3.398 1. , g 60 .. - -.'..':.:::D Dm e/0 ; ` P
In fermi. ( P Review 'WIN N
wt+w.ugard -0r goy �„ - - . a nI n.: � � i
New �onaJerj0 TYPE of woRK I ~ 1.. ' NOlirr hod: Other permit N / —
o.:
e alb rA ' r /��
AddlQntl/aht1retiott/ro ❑ Demolition
Sri Iemantai reformation
Addition/alt eration/replac ement
FEZ* BC k
CATEGORY De�ct'r,on Iron !n!i rforn„ertonu se eNCCR/1nG
kCaR�f AF
0 1.. a 2. rt11Iy dwelling CON �RUCITON New 1 . 2.fam fly eit
Y werlin' (includes 100 Total
ilccessory banding ❑ Commercial /industrial 3!2.70 f0t c coh utility connection) MN
j(
❑ Master builder CI MUi Gy,i1v _ aill
yob 0 Other: l lcir additional 500 12 Nan
Job a' 91T 1 N 1 Ft7lt • T1ON �d+�krtchen 2
tto ad l r� _ �� LOCq TION tiro sprinkler 2 5.02
City/Slate/Z1P; lip „,. . Q.) �
� Catch basin or area drain
Sulte/bldg, /fit no,: p ro j ect Drywall, W
project name: ss♦ h 1L,c, Or rtes- drain street/directions to job site: 17i Noting d
g rein (no linear R__
Manufactured pnrnc zhldres
R1in drain ctil=i
lelli 1.111111121
emEtri Subdivision:
o page 2 MN
Storm sewer {n °• linear ar R.:
Ttur map /parcel no.:
l,ot no.; Page z
FlatUre or I cat•- Page 2 MEI
AncktloW prevcnter
r D OS' WORI( Min
h
Backwater l s Wa varvo
t7 CI per Clothes washer
/ Dishwasher ME 754
Drinking fountain MO 25
2s.0z MEI
YRQp� OWNER TENANT 25 -02
N >• F ix t ur e / S e tank � 2
egro: ,
k Fixture/Se
cup
Addr i7/0 Floor drain/floor s(ttk/tlub 25.02 MEM
Sb .y% ' &r 25.02
City/Stoic/ZIP: r Ar4 0 ,, �, Garbage disport M5 .
Phone: (5 ) 6 t �' !
Intercepter /greas trap
Fax; ( ) Hoso bib MN 25.02
Q APYIGTCANT/ Teo maker 12.51
CONTACT PERsON
Business name: 25,02
Contact name; MEI
Sink Prlmc[ � Page 2
t 2,51
Roof drain (commercial) 12.51
Addrt~ca:
SOI /basin/(av ttory _ 2 5
City/Stec/7Th City/Stec/7Th nt un(c (yatablc Water)
_
12.51
_
Phone: ( ) Fria: ; ( ) Tub /shower /shower pan 12 51
E
E•111811: Urinal 2.02
CONTRACTOR Water clasot 25.02
GG / Water heater 37.52
NM
�U$1n5 ttattt C.. J �! r �+ Water pi .ing/Dw�V _
Addres_ lb 6 ..1.1.-'-- - - a Other: 25.02
City /Scala? ∎ D I ' l�(� JJ A-4,1_, a �'$� SnhinUtl
� ' � :per: ( � � j Minimum pa mitt fee: S7z,50 .
Phone: �� �— Phut curlew (2S% oPpermit fee)
CCD Lie -5.1/' t P)umBl 1 • iC. no.: ''�� °
state surcharge (II%ofpermit fee) �•��
i
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Plumbin Permit A licatign Er , r ,p, I
Building Fixtures = 1 k FOR. OFFICE USE ONLY
City of Tigard NOV 0 2 2011 Received
Date%By l� � I Permit No L��` / -03�.
II
- 'I 13125 SW Hall Blvd , Tigard, OR 97223 l
Plan Review
Phone 503 718.2439 Fax 503 598 co Other Permit No _
tf Date /B
Inspection Line: 503.639.4175 �� l 't I � Date/By ° �l
T I G A Rp re F ' C°' Date Ready/13y Juns ® See Page 2 for
Internet: www.tigard- or gov "V�L��� Notified/Method Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition /alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312 70
ID 1- and 2- family dwelling ❑ 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: (o p svi V e le 1' Catch basin or area drain 18 76
City /State /ZIP: ( Drywell, leach line, or trench drain 18 76
"� / ( ( y y Footing drain (no linear ft _ ) Page 2
Suite/bldg. /apt. no. Project name: an() Manufactured home utilities 50 03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18 76
Sanitary sewer (no linear ftg5 ) 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.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
�� Clothes washer 25.02
� � n
"`'I ' ' ^ -IV G l � p " " v'L.- Dishwasher 25 02
Drinking fountain 25.02
Ejectors/sump 25 02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12 51
/ Fixture /sewer cap 25.02
Name' Vt_( f/,�'/J`/! Y
_ Floor drain /floor sink /hub 25.02
S _
Address: tO' O SP.) V l e r f 1 v Garbage disposal 25 02
1 City /State /ZIP: f t: `LY'/( O 4 ,'?Hose bib 25 02
Phone: (5 ) 611 —Y 47 Fax: ( ) 11 Ice maker 12.51
1 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
1 Business name: Medical gas (value $ ) Page 2
Primer 12 51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
1 City/State/ZIP: Solar units
�� Y (potable water) 62 54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12 51
E -mail: Urinal 25.02
CONTRACTOR Water closet 25.02
���,� Water heater 37 52
Business name: �i� J ��r� EX e4)I I p l l i4 r 13 i ' Water pipmg/DWV 56 29
Address: Pb �� X S &; SD Other 25.02
City /State /ZIP: P0 aTL OT Q,2 g 2.0? Subtotal
Phone: lj j5) 6 gc( -f') Fax: (6)5) gg -• /6750 Minimum permit fee $72.50 z.?, 50
CCB Lie.: j 2550 Plumbing Lic. no.: Ay' 775 P�, Plan review (25 % of permit fee)
State surcharge (12% of permit fee)
y e---A 0 •70
uthorized signature TOTAL PERMIT FEE gl This permit application expires if a permit is not obtained within 180 days
Print name: Date:
///54/ after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board
I \Building\Permits\PLMU- PermiApp 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 - 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 $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
❑ 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
Car Wash Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918- 780 -0040
Cuspidor /Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ 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
❑ 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 -Lav /Bar 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
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