Permit (71) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00430
TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/11/2016
Parcel: 1 S 136AA00400
Jurisdiction: Tigard
Site address: 6909 SW OAK ST
Project: Oak Street Estates No.2 Subdivision: 2007-031 PARTITION PLAT Lot: 2
Project Description: Installation of private storm sewer,sanitary sewer&water to future subdivision lots.(2)catch basins,890'of storm
sewer,297'of sanitary sewer&161'of water service.
Contractor: LANDIS&LANDIS CONSTRUCTION LLC Owner: MCGUIRE, SUSAN 0
PO BOX 50 6909 SW OAK ST
MARYLHURST, OR 97036 TIGARD, OR 97223
PHONE: 503-320-9443 PHONE:
FAX: 503-213-5964
FEES
Quantity Description Date Amount
2 ea Catch Basin or Area Drain 08/11/2016 $37.52
Specifics: 267 If Sanitary Sewer 08/11/2016 $137.58
890 If Storm Sewer 08/11/2016 $362.70
Type of Use: SF 161 If Water Service 08/11/2016 $100.06
Class of Work: NEW 1 12%State Surcharge- 08/11/2016 $76.54
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $714.40
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty C•+es and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started wi •in 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted • the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00 You may obtain a copy"a of the rules
or direc •.- ions • 4.4 NC b ailing 503.232.1987 or 1.800.332.2344.
Iss ed By: , ' / / Permittee Signature: �Axr
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Call 503.639.4175 by 7:00 a.m.for the next available inspection dat . .41e5- '-'-
This permit card shall be kept in a conspicuous place on the job site until completion 4> e pT•fect.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit ApplicatilidLUYA. .LIP
Site Utilities (� i
City of Tigard AUG Received /,
Date/B y ti It( Permit No.: crt got 6-604
_ a 13125 SW Hall Blvd.,Tigard,Ott-It ct 1 i Plan Review1111 [[
Phone: 503.718 2439 Fax: 5 . 00.s.n a.1 k.:11:111,,,,I Date/By: Other Permit No.:` ,.,69,tc�„oino ti
TI c�A R Inspection Line 503.639A17 e l
Dj M ��T °i l i Date Ready/By Juns El See Pagel for
Internet www.tigard-or.gov () `iJ a 1 .0 31 Notified/Method Supplemental Information
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®New construction El Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement El Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
1.04015160P0 ' � 1t i t '*AgqrnolimiAgon SFR(I)bath 312.70
® 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ElAccessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder El Other �t „ �- Fire sprinkler
( sq.ft.) Page 2
:lei ' lat* l s� ti> � 0 � � '� e� Site utilities:� : . j .
Job site address:6909 SW Oak Street Catch basin or area drain 2 18.76 37.52
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name:Oak Street Estates No.2 Manufactured home utilities 50.03
Cross '/
street/directions'Ito job site:SW Locust Street and SW 69t"Avenue Manholes 18,76
L
5 3 4/4i C- `(c Rain drain connector 18.76
Sanitary sewer(no.linear ft.:267) Page 2
Storm sewer(no.linear ft.:890) Page 2
Water service(no.linear ft.: 161) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: 1S 1 36AC/Lot 400 Backflow preventer 31.27
ovs4tomoofmm*we,ra,4tTnMtmxfi,ZlfrdfgRmyxmstwom Backwater valve 12.51
,,. ,.:y.,: e v. ,,,�t e.,, . ,,,.,1.,.-; .VV .,.. .;4 0 ';, „ - Clothes washer 25.02
Installation of private storm sewer,private sanitary sewer,and private water
Dishwasher 25.02
to subdivision lots.Home construction will occur at a future date. Drinking fountain 25.02
Ejectors/sump 25.02
, ' rAo ;: tf a�, rye - > ��';
,, ty �, ��,r r Expansion tank 12.51
Name:Biggi Construction Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 11605 SW Normandy Lane
Garbage disposal 25.02
City/State/ZIP:Wilsonville,OR 97070 Hose bib 25.02
Phone:(503)682-7292 Fax:( ) Ice maker 12.51
toom ` e,r1ayDov l y >� �w4,-;,,,,,,,‘",
1 48 v i+, a Interceptor/grease trap 25.02
Business name:AKS Engineering and Forestry,LLC Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Shawn N.Markman
Roof drain(commercial) 12.51
Address: 12965 SW Herman Road STE 100 Sink/basin/lavatory 25.02
City/State/ZIP:Tualatin,OR 97062 Solar units(potable water) 62.54
Phone:(503) 563-6151 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:MarkmanS@AKS-Eng.com Urinal 25.02
Water closet25.02
.. t.,, 05;.,, i, ::v , .: , Water heater 37.52
Business name:Landis and Landis Construction Water piping/DWV 56.29
Address:4888 NW Bethany Blvd STE K5#195 Other: 25.02
City/State/ZIP:Portland,OR 97229 Subtotal 612.84
Phone:(503) 466-9043 Fax:(503)213-5964 Minimum permit fee: $72.50
p630,./ Plan review (25%of permit fee) 153.21
CCB Lie.: P umbing Lie.no.: p
N
�/ acv State surcharge(12%of permit fee) 73.54
Authorized signature: j TOTAL PERMIT FEE 839.59
Print name: /e„..0 jDate:8/10/2016 This permit application expires if a permit is not obtained within 180 days
'"'SSJJ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-PernutApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
_ R
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule:
lit Residential Fire SupPresy
< n
Systems:
s
a�$ b
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' 1 62.54 62.54 7,201 and greater $327.54
Sewer-each additional 100' 11 37.52 412.72
Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 1 37.52 37.52
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
t1Yy; z 1 ` Y rY
each additional$100.00 or fraction thereof,to
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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: 575.32
Other Fixtures:
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*.
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` "'" Plan review is required for anyof the following.
Bath -Tub/Shower Please check all that apply.
-Jacuzzi/Whirlpool 0 Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru engineer.
Cuspidor/Water Aspirator ❑ New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic 0 Medical gas and vacuum systems for health care facilities.
Drinking Fountain ❑ Any multipurpose fire sprinkler system.
Eye Wash ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
3„ Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain
Garbage -Domestic-non-food , ., �a l �,°;� .P°* ;M `a !��, , �,
Disposal -Domestic-food related Cl Isometric or riser diagram is required for new buildings >,
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes
Water Extractor *Note: If the fixture work under this permit results in an
Water Closet-Toilet increase of sewer EDUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
T:\jobs\4200-4299\4294 Oak Street Estates No.2\Engineering\Submittal 42 CoT Private Plumbing Permit\4294 20160810 Private Plumbing Permit
App UNSIGNED.doc
plumbing permit can be issued.
I:\Building\Permits\PLMF-PermitApp.doc 12/30/05
1111 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. D 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:\Building\Permits\PLMF-PermitApp.doe 12/30/05