Permit CITY OF TIGARD PLUMBING PERMIT
'' COMMUNITY DEVELOPMENT Permit#: PLM2016-00318
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/21/2016
Parcel: 1S134DC00900
Jurisdiction: Tigard
Site address: 11631 SW 114TH PL
Project: VAIL Subdivision: 114TH PLACE Lot: 1
Project Description: Replacing galvanized piping from fixtures to crawl space only,and replacing(1)water closet,(2)sinks,and(1)
water heater.
Contractor: OWNER Owner: VAIL,VALERIA ALEJANDRA&JESSE
JESSE VAIL 18047 SW LOWER BOONES FERRY RD
11631 SW 114TH PL #125
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503-523-8222 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Sink 06/21/2016 $50.04
Specifics: 1 ea Water Piping/DWV 06/21/2016 $56.29
1 ea Water Closet 06/21/2016 $25.02
Type of Use: SF 1 ea Water Heater 06/21/2016 $37.52
Class of Work: ALT 1 12%State Surcharge- 06/21/2016 $20.26
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $189.13
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ermittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available ins.ection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures FOR4‘.8 orrlcl, USE otil.1
City of Tigard Receivede o?, 9�- Permit No.: Q
13125 SW Hall Blvd.,Tigard,O' t. ,3t- /L �"r/ p0 /�-d 3 1$
Plan Review
5 Phone: 503.718.2439 Fax: 50 't 1 '�rp Date/By: Other Permit No.:
Inspection Line: 503.639.4175 1 �O
T I G A R D U�l y �� Date Ready/By: lir s ® See Page 2 for
Internet: www.tigard-or.gov , Notified�'Method: �- j Supplemental Information
TYPE OF WORK,, ,, � �1 FEE* SCHEDULE
❑New construction 0 Iaij igtt;�,- _c., For special information use checklist
�� Description Qty. Ea. Total
®Addition/alteration/replacement 0 0, New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTR I CTION SFR(1)bath 312.70
® 1-and 2-family dwelling El Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11631 SW 114th Place Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 1 Project name:Vail Residence Addition Manufactured home utilities 50.03
Cross street/directions to job site:SW 114th Place&Tigard St. 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: 1 Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION DF-WORK ,
Backwater valve 12.51
Clothes washer 25.02
Replace galvanized pipe in walls and replace with Rex.
�it/ l✓p��� Dishwasher 25.02
Add water to refridgerator Drinking fountain 25.02
Remove&replace 1/EA toilet,2/EA sinks and 1/EA water heater Ejectors/sump 25.02
® PROPERTY OWNER 'i (] 'I'ENAINT i Expansion tank 12.51
Name:Jesse Vail Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 11631 SW 114th Place
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)523.8222 Fax:( ) Ice maker 12.51
APPLICANT ', 0;CONTACT':PERSON Interceptor/grease trap 25.02
Business name:Same as Above Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 2 25.02 _ori
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
Water closet f 25.02 dt�',CJ�2S
O1V�RACTQIt � Water heater 37.52 37_
/
Business name:Same as Above ( vtiJ/,,,r_ Water piping/DWV I 56.29 5-6,....i,
r
Address: Other: 25.02
City/State/ZIP: Subtotal 16 Sr .--'7Minimum permit fee: $72.50
Phone:( ) Fax:( ) D
Plan review (25%of permit fee)
CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee)
j
Authorized signature: TOTAL PERMIT FE i. (3
Print name:Jesse Va. Date:5/26/2016 This permit application expires if a permit is not obtained wi hfp 780 days•
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:A Building\Permits\PLMU-PermitApp.doc 10/01/09 440-46161(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
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
Qty Fee(ea) Total each additional$100.00 or fraction thereof,to
Otller�Il peCtions or.Fees 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.
Work Performed: Capped Added Relocate
Baptistry/Font Please check all that apply.
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 Thar 0 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.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food
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:
C:\Users\Jesse.Vail\Documents'esseVESSE\Duplex\Tigard Plumbing PeanitApp Remodel only.doc
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
11631 SW 114TH PL, TIGARD, OR, 97223
Residential - Plumbing
399 Plumbing final
PASS - No C of O
PLM2016-00318
Don Sylvester
Violation Summary:
Inspector Contractor