Permit CITY OF TIGARD PLUMBING PERMIT
gi
11 s COMMUNITY DEVELOPMENT 41111*4 ' Permit#: PLM2013-00415
T t -AR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/25/2013
' Parcel: 1S 134 BC00300
Jurisdiction: Tigard
Site address: 12220 SW SCHOLLS FERRY RD
Project: Greenway Town Center Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Site utilities,(1)manhole,(6)catch basins,(1)drywell or trench drain,230'of footing drain,(1)rain drain
connector(1)grease interceptor,(1)backflow preventer,(1)back water valve,approximately 150'of sanitary sewer
service and 524'of storm service.4/2/14,adding(1)add'I catch basin and 26'of storm sewer.
Contractor: LANDIS&LANDIS CONSTRUCTION LLC Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 50 PO BOX 790830
MARYLHURST, OR 97036 SAN ANTONIO,TX 78279
PHONE: 503-320-9443 PHONE:
FAX: 503-213-5964
FEES
Quantity Description Date Amount
7 ea Catch Basin or Area Drain 04/02/2014 $131.32
Specifics: 1 ea Drywell,Leach Line or Trench 11/25/2013 $18.76
Drain
Type of Use: COM 230 If Footing Drain 11/25/2013 $125.07
Class of Work: ALT 1 ea Manholes 11/25/2013 $18.76
Type of Const: 1 ea Rain Drain Connector 11/25/2013 $18.76
Occupancy Grp: 150 If Sewer Service 11/25/2013 $100.06
Stories: 550 If Storm and Rain Drain 11/25/2013 $250.14
1 ea Backflow Preventer 11/25/2013 $31.27
1 ea Backwater Valve 11/25/2013 $12.51
1 ea Interceptor/Grease Trap 11/25/2013 $25.02
1 Plan Review 04/02/2014 $182.92
15 ea Info Process/Archiving-Lg 11/25/2013 $30.00
$2.00(over 11x17)
1 12%State Surcharge- 04/02/2014 $87.80
Plumbing
Total $1,032.39
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 'cation 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 rect questions to OUNC by • • .03.232.1987 or 1.800.332.2344.
I ued By: "V , , Permittee Signatur . •
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.
i
Plumbing Permit Application
Site Utilities FOR OFFICE USE ONLY
City of Tigard J3E1EIVED Received t/ /5/( Permit No.: /4.Jf/)/3 / ol5
III Date/By: `/
I �� 13125 SW Hall Blvd.,Tig
Plan Review
Phone: 503.718.2439 Fax: 5031,5M19602 2014 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 II''tt(( Date Read B Juris: El Page 2 for
TIGARD Ready/By: g
Internet: www.tigard-or.gov ���A� Notified/Method: Supplemental information
11 WAR)
)
TYPE O '7' �I FEE* SCHEDULE
BO ''''GD!VI
El New construction "" r ,1 emohtion For special information use checklist.
Description I Qty. I Ea. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
El 1-and 2-family dwelling El m
Comercial/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: /A 9,,,,20 LLS E ad y / J Catch basin or area drain / 18.76
City/State/ZIP: Drywell,leach line,or trench drain 18.76
� Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: 04,E wm y/ 1pW� Manufactured home utilities 50.03
Cross street/directions to job site: ( t io f 2 Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:41 Page 2
Water service(no.linear 1t.: ) Page 2
Subdivision: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
�s 2 Clothes washer 25.02
A�,� --re ex,ST 06 PE4Ht n: Pu/A0/-oo46 Dishwasher 25.02
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 siric/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:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
-
Water heater 37.52
Business name: i�t S 4 /.._bi,...) 16 oe,,T-_ Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:(5P!) p2i 3-596c/ Fax:( ) Minimum permit fee: $72.50
CCB Lic.: NI 74'1 Plumbing Lic.no.: /`J 304
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signat . TOTAL PERMIT FEE
Print name: Date: T 0 y 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:\Building\Permits\P -PermitApp.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-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
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
p 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/ Plan review is required for any of the following.Performed: Capped Added Relocate q y g'
Baptistry/Font Please check all that apply.
Bath Tub/Shower CI 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 El Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain El 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.
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food El 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
WaterCloset-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMU_PermitApp.doc 2
,I CITY OF TIGARD PLUMBING PERMIT
�r'I! COMMUNITY DEVELOPMENT Permit#: PLM2013-00415
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/25/2013
Parcel: 1 S134BC00300
Jurisdiction: Tigard
Site address: 12220 SW SCHOLLS FERRY RD
Project: Greenway Town Center Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Site utilities,(1)manhole,(6)catch basins,(1)drywell or trench drain,230'of footing drain,(1)rain drain
connector(1)grease interceptor,(1)backflow preventer,(1)back water valve,approximately 150'of sanitary sewer
service and 524'of storm service.
Contractor: LANDIS&LANDIS CONSTRUCTION LLC Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 50 PO BOX 790830
MARYLHURST, OR 97036 SAN ANTONIO,TX 78279
PHONE: 503-320-9443 PHONE:
FAX: 503-213-5964
FEES
Quantity Description Date Amount
6 ea Catch Basin or Area Drain 11/25/2013 $112.56
Specifics: 1 ea Drywell,Leach Line or Trench 11/25/2013 $18.76
Drain
Type of Use: COM 230 If Footing Drain 11/25/2013 $125.07
Class of Work: ALT 1 ea Manholes 11/25/2013 $18.76
Type of Const: 1 ea Rain Drain Connector 11/25/2013 $18.76
Occupancy Grp: 150 If Sewer Service 11/25/2013 $100.06
Stories: 524 If Storm and Rain Drain 11/25/2013 $250.14
1 ea Backflow Preventer 11/25/2013 $31.27
1 ea Backwater Valve 11/25/2013 $12.51
1 ea Interceptor/Grease Trap 11/25/2013 $25.02
1 Plan Review 11/25/2013 $178.23
15 ea Info Process/Archiving-Lg 11/25/2013 $30.00
$2.00(over 11x17)
1 12%State Surcharge- 11/25/2013 $85.55
Plumbing
Total $1,006.69
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable la will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issua..-, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U'ity Notification Center. Tho•- ules are set forth in OAR 952-001-0010 through OAR 952-001-1090. You may obtain a copy of the rules
or direct questions to OUNC •• calli 103. 2.1987 or 1.800.332.2344. ,�''=
Issued By: • //// I� /s Permittee Signature: /� ��,a)1
Call 503.639.4175 by 7:00 a.m.for the next available inspectio• ate.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures IVE FOR OFFICE USE ONLY `
City of Tigard �.��J Date/By: // /$ / aj .Cj Permit No.: •(04;94/:3'CO is
IN
a 13125 SW Hall Blvd.,Tigard,OR 97223NOV 1 8 2013 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: her Permit No.: 5.i r�jr 3_a.
T FG A R D Inspection Line: 503.639.4175 Date Ready By: 21_'� luris El See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
- TYPE OF WO FEE*DIVISIO!« FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist -
Description 1 Qty. 1 Ea. I Total
JE Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El 1-and 2-family dwelling DR1 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: f A' AA° ,Sc� c 1- '`1 • Catch basin or area drain 6 18.76
Drywell,leach line,or trench drain ' 18.76
City/State/ZIP:
Footing drain(no.linear ft.:_) _230 Page 2
Suite/bldg./apt.no.: Project name: �(`,_,QQMLo ( i >"� Manufactured home utilities 50.03
Cross-street/directions to job site: V - Manholes - - -18:76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:j5 b) Page 2
Storm sewer(no.linear ft. s-ay Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer f 31.27
•• DESCRIPTION OF WORK . . Backwater valve / I 12.51
l q, Clothes washer 25.02
-1-►� 1G1 11 Pew Co-^i e-L k� Ue^ `' -7 - 14 • p/ Dishwasher 25.02
EI L1 )1 �j✓cC,SQ, 3 v 015 JG / 1 1J f 2sJ�pi1 - r/e" Drinking fountain 25.02
1 I Ejectors/sump 25.02
..❑.PROPERTY OWNER ' ''I .0,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
' 0 APPLICANT ❑ CO,VTACT PERSON Interceptor/grease trap 1 25.02
Business name: p 1 L Medical gas(value:$ ) Page 2
,di, . ,_Gr 7s Lek) vVVi G,,,-)
Primer 12.51
Contact name: 7�l, e
Ly, )� Roof drain(commercial) 12.51
Address: I J 4,-.6 Sink/basin/lavatory 25.02
ity/State/ZIP: v I c.l o 9)03-6 Solar units(potable water) 62.54
/In GtJ 1 J J ,
Phone:(r-56" ) 32 , -01144:3 Fax: :(563) Z i 3-5C/6 Tub/shower/shower pan 12.51
E-mail: '� \ 6 y f,�;c, et( c d,^�-'N U( VIP-' Urinal 25.02
J 1,� Water closet 25.02
CONTRACTOR
-
‘ .,\.1 Water heater 37.52
Business name: Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: /' Subtotal
Phone:66-5 )cite- ({044-"3 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 1'l c57`l 811 //S Plumbing Lic.no.: P6 604 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
' Authorized signature: 7//// TOTAL PERMIT FEE
Print name: Lc, Date: This permit application expires if a permit is not obtained within 180 days
l.(,t V"/" 1/r I �I after it has been accepted as complete.
/ *Fee methodology set by Tri-County Building industry Service Board.
1:\BuildingWermits\PLMU-PermnApp.doc 10/01/09 440-4616T(10/O2/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-l 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-I st 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
p 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
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
-Drive Thru 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 MachJRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang _
-Stall
Sink: -LavBar 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:
I:\Building\Permits\PLMF-PermitApp.doc 08/04/2011 2