Permit (155) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2016-00587
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/30/2016
T t c;A l g Parcel: 2S104DC05800
Jurisdiction: Tigard
Site address: 13950 SW ALPINE CREST WAY
Project: Bull Mountain Park Subdivision: None Lot: None
Project Description: Installation of drinking fountain,drywell&hose bib.
Contractor: 1ST CALL PLUMBING&DRAIN CLEANING LLC Owner: CITY OF TIGARD
6615 SE 42ND AVE 13125 SW HALL BLVD
PORTLAND, OR 97206 TIGARD, OR 97223
PHONE: 503-639-4171
971-409-7463
FAX: 503-961-7108
FEES
Quantity Description Date Amount
1 ea Drywell,Leach Line or Trench 11/30/2016 $18.76
Specifics: Drain
1 ea Drinking Fountain 11/30/2016 $25.02
Type of Use: COM 1 ea Hose Bib 11/30/2016 $25.02
Class of Work: ALT 1 12%State Surcharge- 11/30/2016 $8.70
Plumbing
Type of Const: 4 ea Minimum Fee Adjustment- 11/30/2016 $3.70
Occupancy Grp: Plumbing
Stories:
Total $81.20
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 N.' . '. enter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dir• questions to c NC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: / Permittee Signature:
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.
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30B SITE INFORM [ION AND LOC:A[10N : ! Site utilities: i
lob site ddress: 13950 SW Alpine Crest Wav Ca:di base)or;iron dr: ti I ---T- '
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DESCRIPTION OF WORK
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sup'ression Systems:
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Footing drain-161 100' 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' 1 62.54 62.54 Medical Gas S stems:
Water Service-each additional 100' 1 37.52 37.52 F
Storm&Rain Drain-1st 100' 1 62.54 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
'14k,'"': a each additional$100.00 or fraction thereof,to
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:
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*.
Quantity by Fixture Typev
Fixture Type for ; Rcplacel..:
work Performed: . Cappedf, Added Retocatet _� Plan Reviei for.P nmb,><ng Insta�lahtin
Baptistry/Font Plan review is required for any of the following.
Bath Tub/Shower Please check all that apply.
Jacuzzi/Whirlpool ❑ 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 ❑ 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
I me I ...hase a -t
Garbage -Domestic-non-food -
Disposal -Domestic-food related ❑ 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/Lay -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
1:\ENG\1 -Active Projects\92052 Bull Mountain Park ADA path\Design\l rmitting\City Applications\Unrestricted Access to
Permits\PLMU_PermitApp_Bull Mtn Park.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13950 SW ALPINE CREST WAY, TIGARD, OR,
97224
Record Type: Record ID:
Commercial - Plumbing PLM2016-00587
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Plumbing final for Bull Mt. Park - approved
2. Provide a copy of test results for backflow device located at water meter.
Violation Summary:
Inspector Contractor