Permit CITY OF TIGARD PLUMBING PERMIT
s ' COMMUNITY DEVELOPMENT Permit #: PLM2012 -00054
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/17/2012
Parcel: 2S114AA00100
Jurisdiction: Tigard
Site address: 9000 SW DURHAM RD
Project: Tigard High School Subdivision: 1993 - 078 PARTITION PLAT Lot: 2
Project Description: Less than 200' of storm service for newly paved parking lot.
Contractor: PORTLAND ROAD & DRIVEWAY CO INC Owner: TIGARD - TUALATIN SCHOOL DISTRICT
10500 SE JENNIFER ST 6960 SW SANDBURG ST
CLACKAMAS, OR 97015 -9511 TIGARD, OR 97223
PHONE: 503 - 650 -5006 PHONE: 503 - 431 -4000
FAX: 503 - 650 -8022
FEES
Quantity Description Date Amount
200 If Storm and Rain Drain 04/13 /2012 $100.06
Specifics: 1 12% State Surcharge - 04/13/2012 $12.01
Plumbing
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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 qu ons to • - C by calling 503.232.1987 or 1.800.332.2344.
Issued B • , / 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.
M Flumbin Permit A licati CEIVED
Site Utilities FOR OFFICE USE ONLY
City of Tigard MAR 9 2U�L Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 DateBy: ��e / . d �o��C1^�o
Phone: 503.718.2439 Fax: 503.5 D an Review Other Permit No _ �
Inspection Line: 5036394175
j
.. �I OF Date/By: �/T /i "t17
TIGARD Internet: www.ti and -or. ov BUILDING DIVISION Date ReadyBy: e od: ,/� �� luris: upp
0 See Page 2 fnr
g g Notifitl/Meth �S S lementall n f otvta t ion
_........ ................. ........................_._ T. 1` BE.. OF... W04tK .........._....._,,...._..._.., .. _.. :;; ..� .: -:: ';;:CIiEDt)1E0- l:
❑ 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)
• • c.' : :. _,= -:-= i::CAT.EGOR'? OF-:'CONSTR[ICI1ON :_-i;;:=a: €si_;':::; = :.::i:' =€ ::= SFR (1) bath 312.70
❑ I- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 437.78
- building SFR (3) bath 500.32
❑ Accessory g ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder ® Other: Educational sq. ) g
Fire sprinkler L- s . ft. Page 2
::::` ;:: ' i i JOB SITE:: INFORMATION AND :LOCATION ` :: . _; Site utilities: •
lob site address: 9000 SW Durham Road Catch basin or area drain 1 8.76
City/State/ZIP: Tigard, Oregon 97224 Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
•
Suite/bldgiapt. no.: Project name: Tigard High School Track _ Manufactured home utilities 50.03
Cross street/directions to job site: SE corner of Durham Road and SW 92nd Ave Manholes 18.76
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Rain drain connector 18.76
Sanitary sewer (no. linear ft.:_. Page 2
Storm sewer (no. linear ftd ) I Page 2 /Oat*
Water service (no. linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
J ____
Tax snap/parcel-no.: 2SIWI4AA 00100. Backflow preventer 31.27
•
::i4:i:`:':':ii€ _;_:' = ??._. s s= ._bESCRIILTION::OF.::,...URK `.= ;= i' ::-: ;_r.::.:;: .
Clothes washer 25.02
Paving of an existing gravel parking area, resurfacing of existing track and
Dishwasher 25.02
construction of impervious surfaces for sports purposes adjacent to the track. Drinking fountain I 25.02
Ejectors /sump 25.02
= - - Expansion tank 12.51
.....:...::..._- . ��'ROPEkTIr iOWfiIET2�.;: =�'-` °;:�;= �:; ~i=_ _ =_ ❑:TFN?�iVT' : �- :`::: P
Name: Tigard- Tualatin School District Attn:Phil Wentz Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 6960 SW Sandburg Road --
Garbage disposal 25.02 I
City /State/ZIP: Tualatin, Oregon 97223 Hose bib 25.02
Phone: (503)431.4000 Fax: (503)431.4020 Ice maker 12.51
- :.....
:.. ATP ' Interce tor/ re trap
:: ':.: :'.: ,::::�:" ...._LLCATIT: ;- :..::�:? =ri:':'.: `- �_i €�`:'''. ®�;CQNTA.(I :PER$,QN:' ° :'l:.`;' P B ase ua 25.02
Business name: Tigard- Tualatin School District Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Phil Wentz .
Roof dram (commercial) 12.51
Address: 6960 SW Sandburg Road • Sink/basin/lavatory 25.02
City / Statc/ZIP: Tualatin, Oregon 97223 Solar units (potable water) 62.54
Phone: (503) 431.4000 Fax: : (503) 431.4020 Tuh /shower /shower pan 12.51
E -mail: pwentz®ttsd.k12.or.us Urinal _ 25.02
::::• : .:: ..........., _.: .:..:: - Water closet 25.02
_..
_ _ . -: _ : Water heater 37.52
Business name: Npt t-D..ee.•minrd poQ. Le . .yr as, Water piping/DWV 56.29
Address: (,OHO j er.. , . .i.pu)„fu2_ 42-1- Other: 25.02
City / State/ZIP: C_„ /q- Q (2_ 770/4 \ Subtotal /Do .
Phone: m3) (0.57,_ 5 " ' -"� p Fax: ( ) Minimum permit fee: $72.50
Plan review (25 % of permit fee)
CCB Lic.: lumbing Lie. no.:
/ State surcharge (1 fee) / -.
Authorized sigtature:_ 1 TOTAL- PERMIT FEE // a.07
Print name: go b ,5 &X to,' Date: 3 L ,L 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.\BuildinpWermits\PLMU- PermitApp.doc 10/01/09 440-4616 f( IW02 /CO61/W
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Plumbing Permit Application - City of Tigard
• Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site ''Feg (ea) Square Footage • _. .. • ..
. . . . . ......... ...„
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 & Rain Drain - 1st 100 1 62.54 62.54 •
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' I 37.52 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other rnspections or Fees ..• • .• .
each additional $100.00 or fraction thereof to Y Fee (ca) Total
•- 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:
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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 Fixture Type. Plan Review forPlu -3-: • •
Fixture Type.for' • . . . •: Replace/ -
Work PerforMed Cappe4 Added fieloCate., Plan review is required for any of the following
Baptis ont .
Please check all that apply.
try/F
Bath - Tub/Shower 0 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 Ei New exterior plumbing site utilities for any complex structure •
•
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher - Commercial 0 Medical gas and vacuum systems for health care facilities.
- Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
'E or Riser-Diagram
Car Wash Drain
0 Isometric or riser diagram is required for new buildings
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/Lav -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:
W : \ 21 I 96690\Communication\Applications\PLUMBING-PermitApp.doc 2
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7 1 ... y Site Utilities — Plumbing .Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. ® map & tax lot # Ei project name ' site address ® suite number
i zoning El applicant name ® phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS - Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans: •
•
. A. Storm drainage plan showing:
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1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping. .
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper. terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location, pipe size, type of material, slope of piping manholes
and cleanouts provided as required for storm.
. 2) Size and location of domestic water piping and drainage. •
3) Proposed location of connection to a public water or sanitary sewer. line.
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I: \ Building \PermitsTLMF- PennitApp.doc 12/30/05 .