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Permit
CITY OF TIGARD PLUMBING PERMIT 3 COMMUNITY DEVELOPMENT Permit #: PLM2012 -00111 T I GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/09/2012 Parcel: 25112CCO5000 Jurisdiction: Tigard Site address: 8020 SW BOND ST Project: Hagan Subdivision: BOND PARK NO.3 Lot: 78 Project Description: Replace tub with shower and change out toilet. Contractor: BRUNER PLUMBING Owner: HAGAN, ELIZABETH R TRUSTEE PO BOX 23985 8020 SW BOND ST TIGARD, OR 97281 TIGARD, OR 97224 PHONE: 503 -484 -5105 PHONE: • FAX: 503 - 624 -2173 FEES Quantity Description Date Amount 1 ea Tub /Shower /Shower Pan 05/09/2012 $12.51 Specifics: 1 ea Water Closet 05/09/2012 $25.02 1 12% State Surcharge - 05/09/2012 $8.70 Type of Use: SF Plumbing Class of Work: ALT 35 ea Minimum Fee Adjustment - 05/09/2012 $34.97 Type of Const: Plumbing 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 stions.to O C b = -lling 503.232.1987 or 1.800.332.2344. Issu d By: / / / , 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. • Plumbing Permit Application Site Utilities rolz or! lcl: I si: 0\L1 D ®�a 1alo /.% .e611 City of Tigard i Perm;t No.: 1111 a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review C Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: runs: H S ee Page 2 for Internet: www.ti T I G A R D and -or. ov Notified/Method: Y B g g Not;fid/M Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total t r,Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 -'mil' and 2 family dwelling ❑ Commercialindustrial SFR (2) bath 437.78 ❑ Accessory 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: Job site address: �0)( 5, w. g S7 Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City/State/ZIP: -T, .6,3.20 ©R 9(7aa y / Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt no.: I Project name: ' 1 4W 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.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Reface To win I SHGwLQ d CN,4NGC art Teller. Dishwasher 25.02 1 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 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: Medical gas (value: $ .) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State /ZIP: Solar units (potable water) 62.54 Phone: ( ) I Fax: : ( ) Tub /shower /shower pan 12.51 X E -mail: Urinal 25.02 CONTRACTOR Water closet 25.02 , X [� (� Water heater 37.52 Business name: u UN1sR ROM Ir lit a-nre, Water piping/DWV 56.29 - _ Address: Pia 1304 .39 .0 , Other: 25.02 City/State/ZIP: ' /464.16 Subtotal r1 - F ax: '7 ,9- '7 ,9-5--6 Phone: (�� ) ( , y8�s0 (Su3 ) l� a 17 3 Minimum permit fee: $72.50 Plan review (25% of permit fee) CCB Lic.: 5J f3-3 9 Plumbing Lic. no.: 02 6 - I/ 93 P State surcharge (12% of permit fee) R. 70 Authorized signature: TOTAL PERMIT FEE yr • a� Print name: / t'1 This permit application expires if a permit is not obtained within 180 days �-- eCCN I Date: 6- - f � after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: (minimum charge - 1/2 hour) Site Utilities Qty. Fee (ea) Total Subtotal: Footing drain - 1" 100' 50.03 Footing drain - each additional 100' 37.52 Residential Fire Suppression Systems: Square Footage: Permit Fee: Sewer - 1st 100' 62.54 0 to 2,000 $121.90 Sewer - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Water Service - 1st 100' 62.54 7,201 and greater $327.54 Water Service - each additional 100' 37.52 Medical Gas Systems: 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 each additional $100.00 or fraction thereof, to Other Inspections or Fees Qty. Fee (ea) Total and including $10,000.00. $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Inspection of existing plumbing or for each additional $100.00 or fraction thereof, to which no fee is specifically indicated 90.00/hr and including $25,000.00. (minimum charge -1/2 hour) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspections outside of normal business 90.00/hr each additional $100.00 or fraction thereof, to hours (minimum charge - 2 hours) and including $50,000.00. Reinspection Fees 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $ 1.20 for each additional $100.00 or fraction thereof. Additional plan review for revisions 90.00/hr Urinal Other Fixtures: 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) Work Performed Plan Review for Plumbing Installations Fixture Type: Replace Plan review is required for any of the following. Previous Capped Added Existing Please check all that apply. apP y 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 defmed 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 Drain Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal - Commercial that meet the qualifications above. - Industrial Ice Mach./Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Comments regarding fixture work: Shower -Gang -Stall Sink - Bar/Lavatory - Bradley . - Commercial - Service Swimming Pool Filter Washer - Clothes Water Extractor *Note: If the fixture work under this permit results in an Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and