Permit a CITY OF TIGARD PLUMBING PERMIT
` C COMMUNITY DEVELOPMENT Permit #: PLM2013 00011
T f G ARD, 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/08/2013
Parcel: 2S 101 CA00400
Jurisdiction: Tigard
Site address: 7940 SW HUNZIKER ST
Project: Charter Mechanical Subdivision: 2007 -064 PARTITION PLAT Lot: 1
Project Description: Enlarge restroom
Contractor: CHARTER MECHANICAL CONTRACTORS INC Owner: MERITAGE FIVE LLC
7940 SW HUNZIKER STREET 7940 SW HUNZIKER ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 691 -1700 PHONE:
FAX: 503 - 691 -1717
FEES
Quantity Description Date Amount
g ea Fixture /Sewer Cap 01/08/2013 $75.06
Specifics: 1 ea Floor Drain/Floor Sink/Hub 01/08/2013 $25.02
2 ea Hose Bib 01/08/2013 $50.04
Type of Use: COM 1 ea Primer 01/08/2013 $12.51
Class of Work: ALT 4 ea Lavatories 01/08/2013 $100.08
Type of Const: 3 ea Urinal 01/08/2013 $75.06
Occupancy Grp: 1 ea Water Closet 01/08/2013 $25.02
Stories: 1 12% State Surcharge - 01/08/2013 $43.53
Plumbing
Total $406.32
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 Not - •• • 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 di - questions to Os by c- 'ng 503.232.1987 or 1.800.332.2344.
sued 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.
Plumbin Permit A li •
Building Fixtures ����
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54 City of Tigard �Q�f 8 Received / 4 /6
Permit No.: Ld13�wf
to 13125 SW Hall Blvd., Tigard, 04 9T22n 3 v 203 Date/By: O `(
C Plan Review
Phone: 503.718.2439 Fax Q Date/By: Other Permit No.� a - -
Inspection Line: 503.639.' 1 I'G Date Ready/By: Juris: El See Page 2 for
T I C A R U B Internet: www.tigard - or. t IL oIuG DIVISION 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
❑ 1- and 2- family dwelling 14 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: • 40 5,,..) t- 1t,tnt t ,ztz.. S,F,R.t4K Catch basin or area drain 18.76
nn Drywell, leach line, or trench drain 18.76
City /State /ZIP:
`I't +CL-I,'r.r0 , o Z. q 7723. Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Us p 1 0,00..nakks Manufactured home utilities 50.03
Cross street/directions to job site: a _ ti s . wAs„._ 5 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
4-004 lnr- 0.F 3 ul..n +5 t 1 t r1n. C.cn4.64-' t 4. Dishwasher 25.02
Li *AaaLt&S 2 Wss 6 te45. d 6 I Fc.a.+- Oftlt. NI Drinking fountain 25.02
Ejectors /sump 25.02
IB PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
lrN - Fixture /sewer cap 3 25.02 16
Name:
Floor drain/floor sink/hub ' 25.02 Z5 ,ca.
Address:
19 4, St.) t1 L Zt tatr. 5 - e - Garbage disposal 25.02
City /State /ZIP: P I OR - q7 22 2 Hose bib . 25.02 So , 04
Phone: (51) (pot 1.10 Fax: (S° G9 1 V7 t Ice maker 12.51
❑ APPLICANT 12 CONTACT PERSON Interceptor /grease trap 25.02
Medical gas (value: $ ) Page 2
Business name: Cio
Primer ( 12.51 (2., S 1
Contact name: I.4 wg 1,,_ts,44 Roof drain (commercial) 12.51
Address: at 4C Si....) 14_ ir t •• m at -__..-x. Sink/basin/lavatory 4. 25.02 ,00 ,
City /State /ZIP: Pvrtat ,A.,„O 2 9 7 2Z Solar units (potable water) 62.54
Phone: ( $ 1 vc , 8 4,„„ Fax: : ( ) Tub /shower /shower pan 12.51
Urinal 3 25.02 7S, 04
E -mail:
nu. bt. Ike : Klca I Co C Ale C Ga Cow 2 02- CONTRACTOR Water closet 25.02 5�
Water heater 37.52
Business name: C kawgisic /1644,4„taz Water piping/DWV 56.29
Address: 19 40 s `( Other: 25.02
City/State /ZIP: ro n /� / p2 9'7Z �3 Subtotal 1484-7
Phone: ( 503) 6 1700
Fax: (s_ ) 6 ' Minimum permit fee: $72.50
CCB Lic.: ti (, 5 _Plumbing Lic. no.: Bp?) Plan review (25% of permit fee) 144
State surcharge (12% of permit fee)
Authorized signature:
PERMIT FEE •
Print name: Moo Date: ` 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 Boo
1:\ Building \Permits\PLMU- PermitApp.doc 10/01/09 440-46 16T(10/02/COM/WEB) /(/`+r - 7 ,,
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 - I st 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' 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
Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
l� 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
Baptistry/Font ❑ Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
Bath: - Tub /Shower
- Jacuzzi/Whirlpool engineer.
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
Garbage Domestic non - food that meet the qualifications above.
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: -LavBar non -food related
- Bradley Z-
- 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 ' 3
Other Fixtures:
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