Permit CITY OF TIGARD PLUMBING PERMIT
•. COMMUNITY DEVELOPMENT Permit#: PLM2014-00117
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/16/2014
Parcel: 2S 113AB00700
Jurisdiction: Tigard
Site address: 16255 SW UPPER BOONES FERRY RD
Project: The Circuit Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: Site utilities for TI:(1)catch basin,88 ft.of sanitary sewer,7 ft.of storm sewer,and 97 ft.of water service.
Contractor: FIVE STAR BUILDERS INC Owner: COLEMAN BOULDERING LLC
PO BOX 555 ATTN:ANDY COLEMAN
BANKS, OR 97106 16255 SW UPPER BOONES FERRY RD
TIGARD,OR 97224
PHONE: 503-324-5220 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 04/16/2014 $18.76
Specifics: 88 If Sewer Service 04/16/2014 $62.54
97 If Water Service 04/16/2014 $62.54
Type of Use: COM 1 12%State Surcharge- 04/16/2014 $24.77
Class of Work: ALT Plumbing
Type of Const:
7 If Storm and Rain Drain 04/16/2014 $62.54
Occupancy Grp:
Stories:
Total $231.15
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 t rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. obtain a cop of the rules
or direct questions to OUNC by calling 503.232.1987 or 1400.332.2344.
Issued By: Permittee Signature: Ale
P
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 Applicati j C'Ej IVEJ
Site Utilities t HI:l: t)l l l t I i ,,l ()NI
City of Tigard APR 16 2014 DateB : �i Permit No.: / _,
1,11
• 13125 SW Hall Blvd.,Tigard,OR 97223 plan Review
Phone: 503.718.2439 Fax: 503 Q� C T !� r'r1 DateBy: Other Permit No.: 84P020 r 1-Q 1
Inspection Line: 503.639.4175 i �r ! V/�Ail I
7 1 G n R I) p Date Ready/By: ns: See Page 2 for
Internet: www.tigard-or.gov BUILD[NG 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
eiAddition/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 O_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: /ip255 uF rM-WA--Vi Fe. [i Catch basin or area drain 1 18.76 1Y--.7c,4,147-v, Drywell,leach line,or trench drain 18.76
City/State/ZIP: 'r( 0� °1 7 223
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project nam I The 4',faM ufactured home utilities 50.03
Cross street/directions to job site:e74 91 6j t 141 � Manholes 18.76
�, ��` Yy 11 Rain drain connector 18.76
Sanitary sewer(no.linear ft.:eS ) l Page 2 Cam(,9I
Storm sewer(no.linear ft.: 7 ) 1 Page 2 0Sj+-A
Water service(no,linear ft.:q1 ) ) Page 2 6) S'1(
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: 2.511 3 Aga9 7 a3 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNER f ❑ TENANT Expansion tank 12.51
Name: Y1N1' ! 001,01 Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 6450 4t G (.4-i MA Ar2/1,M }\V Garbage disposal 25.02
City/State/ZIP: fO(1L / 9 72.39 Hose bib 25.02
Phone:(50,3) g(,--GOLD Fax:( ) Ice maker 12.51
APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name: S pNEN C E8m Arch) Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: '57 34 JN C--1E
� 1 Roof drain(commercial) 12.51
Address: 9510 S W H(o$Ep6 j1)u. F
�C4 Sink/basin/lavatory 25.02
City/State/ZIP: 7 c, M1 NNVIU-L , /7 126 Solar units(potable water) 62.54
Phone:6a3) -7731 /� Fax::( ) Tub/shower/shower pan 12.51
E-mail: h e rlc r 01 r r'ar� ,COY] Urinal 25.02
Water closet 25.02
ONTRACTOR
Water heater 37.52
Business name: I r i
-LtlP 1 I1_�1ac 1_11.4� Water piping/DW V 56.29
Address: P p, � �565-
Other: 25.02
City/State/ZIP:$ e17/D� 9 7 lb( Subtotal de4, . k r-
Phone:( i)3) 3 24`5•ZZ.D Fax:(5)3) 32`-- D 803 Minimum permit fee: $72.50
CCB Lic.: 9 32,98 / lumbing Lic.no.: ,j(,/_k6,gP� Plan review (25%of permit fee)
[[ State surcharge(12%of permit fee
Authorized signature: We /i4 A TOTAL PERMIT F
X31 15
Print name: ' -r pf) , ��,l�1-i3E Date:L�//4/7.2/Q- This permit application expires if a permit is not obtained in rau aay&
��'1t��-'r''"-�r'''� /` 1 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
t:\Building'Permits1PLMU-PennitApp.doe 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
62.54 // 11 3,601 to 7,200 $233.20
Sewer-1st 100'
G/' 7,201 and greater $327.54
Sewer-each additional 100' 47 52
Water Service-1st 100' _ 62.54 • •24 Medical Gas Systems:
Water Service-each additional 100' 37.52 i►_�
Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee:
4 S-`7 $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 9 y g'
Baptistry/Font Please check all that apply.
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 defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
4" - Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food ❑ 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:
1:\Building\Permits\PLMU_PermitApp.doc 2
II •
I 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# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ 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:
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.
I:1Building\Permits\PLMF-PermitApp.doc 12/30/05
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16255 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2014-00117
George Heimos
NOTE: documentation regarding men's and women's bathroom sinks received and
accepted. (Faucet's and sink sealing)
NOTE
1. All inspections for site plumbing were done on permit PLM2014-00068.
2. Catch basin pump and cleaning receipt provided by: Scott Warner Construction,
dated, 07/14/14, and passed
Violation Summary:
Inspector Contractor