Permit (176) CITY OF TIGARD PLUMBING PERMIT
4
COMMUNITY DEVELOPMENT Permit#: PLM2016-00022
13125 SW Date Issued: 01/21/2016 Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CDO1900
Jurisdiction: Tigard
Site address: 15613 SW SUMMERFIELD LN
Project: McGraw Subdivision: SUMMERFIELD NO.7 Lot: 346
Project Description: Move(1)lav,add(1)lav,rough-in(1)shower stall and(1)tub.
Contractor: LEONARDS PLUMBING&CONSTRUCTION Owner: MCGRAW FAMILY TRUST
19538 SW HEUKE RD BY MCGRAW, MICHAEL S& KATHIE L TRS
DAMASCUS, OR 97089 PO BOX 189
DENALI PARK,AK 99755
PHONE: 503-519-9633 PHONE:
FAX
FEES
Quantity Description Date Amount
2 ea Lavatories 01/21/2016 $50.04
Specifics: 2 ea Tub/Shower/Shower Pan 01/21/2016 $25.02
1 12%Stale Surcharge- 01/21/2016 $9.01
Type of Use: SF Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Slate 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
Utilil atlon Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop he rules
o erect questions to OUby cal g 503.232.1987 or 1.800.332.2344.
t.'dBy: I Permittee Signature:
(t.,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 A liFIS P
Building Fixtures 11LU 1 Y
City of Tigard I P s ��
DateB) Permit No.:Received �I^^q.s
s 1 . �� �i/fsy(lf��llr�aR/
• 13125 SW Hall Blvd..Tigard,OR 97�2T Plan Rev
Date iew '
Phony. 503.71 8.2439 Fax: 5(13.598.1960 Other Permit No.:
t, I(
i.! /Re,
Inspection Line: 503.639.41711 Y (A I IllAft Date Ready'By: loris: ® See Page 2 for
Internet: www.tlgard-or.gon1ITI'll Notified/Method: Supplemental Information
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❑New construction ❑ Demolition For special information use checklist
Description Qty- I Ea. Total
Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 f3.for each utility connection)
SFR(1)bath 312.70
I-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
El Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
❑ Master builder ❑Other: Fire sprinkler(_sq. 0.) Page 2
JOB asim INKOIRMA'nON AND L04CA71ON Site utilities:
Job site address: S �,.(� S LlJYl1l�C f' Q �(,jy) Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tl CLP-d 7 22, Footing(train(no.](neer B.:_) Page 2
Suite/bldg./apt.no.: Project name: C (,� Manufactured home utilities 50,03
Cross street/directions tojob site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear fl.:_) Page 2
Storm sewer(no.linear 0.: ) Page 2
Water service(no. linear h_
. I Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
r " D)CTION OF.WORK Backwater valve 12.51
31 N [ ,p�� Sf h Clothes washer 25A2
ove_ 1 Ltw ..
Dishwasher 25.02
0 V I� ) -S 1 1 +ub Drinking fountain 25.02
Ejeclors,'sump 25.02
•,._jx f=.i M4�>! '�' 0,MANY _ Expansion lank 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 2502
Phone:( ) Fax:( ) Ice maker 1251
t C - . . •' ."OIJ7'AC`�` .. Interr
cepto/grease tmp 25.02
Business name: Medical gas(value:S 1 Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address:
Sink/basin lavatory 25.112
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub showershower pan 1151
E-mail: Urinal 25.(12
Water closet 25.02
Water heater 1 37.52
Business name: Z_ S ,gC.O>74 W Water piping DWV 56.29
Address: � -t.S38 S e4.1'A2" leC4
Other: 25.02
City/State/ZIP: a-4- l v,s(',(,t A t O/ppt "1 7 0 0q 9 Subtotal
Phone:( � ) S) q _ 9 b Fax:( S�J B5S-306 6 Minimum permit fee: 572.50 75P
CCB Lie.: ) 501 -72, 2- y A7 /b Plumbing Lic.no.: t3 ah.3 Z Plan review (2596 of permit feel
Slate surcharge(12%of permit fee) •�
Authorized signature: -9� / Y�/ l7 TOTAL PERMIT FEE 9q.07
�QN kt)p Dale: -z/^ zV( This permit application expires if a permit Is not obtained within 180 days
Print name: after it has been accepted as complete.
9'cc methodology set by In-(ount)Building Induslq Semite Board_
I lo;,Idlna Por 1,M MU P,om,tAPPdnc 11111 01 440 461(,1(10 COM Wr.li)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression S stems:
Footing drain- 1" 100' 50.03 0 to 2.000 $121.90
Footing drnin-each additional 100' 37.52 2.001 [03,600 $169.69
3,601 to 7,200 1 $233.20
Sewer-I st 100' 62.54 7,201 and greater 1 $327.54
Sewer-each additional 100 37.52
Water Service- Is(100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52
Storm&Rain Drain- 1st 100' 62.54 ■t ��""2' II II �. of ,,.,`r-
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100 37.52 S5,1101.00 to SI0.000.00 $72.50 for the first$5.000.00 and S 1.52 for
rc-+x- r - each additional 5100.00 or fraction thereof,to
06er f s-or s Faeia)' "fin"
and including$I0,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first S 10,000.00 and S 1.54 for
which no fee is specifically indicated 90.0010 each additional S 100.00 or fraction thereof,to
(minimum charge-1'2 hour) and including$25.0011.00.
Inspections outside of normal business 90.00 In 525.001.00 to 550,000.00 5379.50 for the first 525.000.00 and SI 45 for
hours(minimum charge-2 hours) each additional 5100 00 or fraction thereof.to
Reinspection Fees 9090Atr and including 550,110090.
Additional plan review for revisions 911.110111 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum char e-I:2 hour) each additional$100.00 o1 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*. rjgp Review for Plumbing Installations -
anti by FixtureType I 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
Ba tis0 /Font greater,except systems designed and stamped by licensed
Bath: -Tub Shower
engineer.
-Jacuui Whirlpool
Car Wash: -Each Stall ❑ Newexteriori plumbing site utilities for any complex structure
-Drive Tlw as defined in 0,08918-78I-0040.
Cus idor/Water
-Drive
T ❑ 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.. 6 or Riser D rim
-4 ❑ Isometric or riser diagram is required for new,buildings `
-Car Wash Drain
Garbage -Domestic non-food that meet the qualifications above.
Disposal'. -Domestic trod related
-Commercial food related
-Industrial tiwd related
lee Mach.Refirig.Drain Comments regarding fixture work:
Oil Se armor(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav Bar nondbod related
-Bradley
-Con,Sery/Util tined 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
Water Extractor fees assessed for the sewer increase must be paid before the
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
1: Building'Pcrmits:PLMF_PcrmitApp.doc 08 04 2011 2