Permit (63) CITY OF TIGARD PLUMBING PERMIT
IN -. COMMUNITY DEVELOPMENT Permit#: PLM2017-00028
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 02/14/2017
Ti(;rIif) 9
Parcel: 1S135CB00600
Jurisdiction: Tigard
Site address: 11570 SW TIEDEMAN AVE
Project: LN Curtis Subdivision: None Lot: None
Project Description: Interior plumbing:Adding(1)domestic dishwasher,(1)2"floor drain,(3)sinks,and(2)water closets;Capping(2)
sinks and(1)water closet.
Contractor: JAMES ROOD PLUMBING INC Owner: MCCALL PROPERTIES LLC
125 S 1ST AVE#542 BY NED MCCALL
HILLSBORO, OR 97123 5480 NW FRONT AVE
PORTLAND, OR 97210
PHONE: 503-547-0491 PHONE:
FAX: 503-547-0492
FEES
Quantity Description Date Amount
1 ea Dishwasher 01/31/2017 $25.02
Specifics: 3 ea Fixture/Sewer Cap 01/31/2017 $75.06
1 ea Floor Drain/Floor Sink/Hub 01/31/2017 $25.02
Type of Use: COM 1 ea Primer 01/31/2017 $12.51
Class of Work: ALT 3 ea Sink 01/31/2017 $75.06
Type of Const: 2 ea Water Closet 01/31/2017 $50.04
Occupancy Grp: 1 ea Water Heater 01/31/2017 $37.52
Stories:
1 12%State Surcharge- 01/31/2017 $36.03
Plumbing
Total $336.26
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 qu- •_to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued :y: Permittee Signature
-
Call 503.639.4175 by 7:00 a.m.for the next available inspe on 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.ppliC [3 i.3 C a L. - ABuilding Fixtures " FOR OFFICE USE ONLY
: City Tigard JAN 2017 Received / 1a Permit No.: p o. r
11 q 13125 SW
W Hall Blvd.,Tigard,OR 97223 Aata/)By;
Plan Review
Phone; 503.7182439 Fax: 5 '96h 1 GARD Da y; Other Permit Nc, -, y ,y
Inspection Line: 503.639.417 t* a°a /-s�(1�
T I G A R l) p �� t NIG 1 �� � a � Date Ready/By: )oris: f3 See page Z for
Internet: www.tigard-or.goV Notified/Method: I 31 7 ,.Ji 7e. Sup,ementai Information
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°'an ' r 1 2. s . 1 IF 1 tw.,K a t 1
❑New construction ❑Demolition For s,ecia[r ruination useckecklist.
Description Qty. I Ea. I Total
IAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
.vr ' Ilii"4E�.1,, 1 ,3 �,.. `t ,.. ybjrgn�a 1¢ �" r v! a: eft nt'Rt f
uoyig ig jai? S A 0 r/r ,�r�r; 26,,,14-i4.r i ~ r td dl 3�' l,t"tea'°. SFR(I)bath 312.70
ii.CSI
CI1-and 2-family dwelling ( .Commercial/industrial SFR(2)bath 437.78
5FR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
[l Master builder ❑Other:
' ; l .?,..!511',7', , Fire sprinkler( sq.ft.) Page 2
f,Y TJ ' �g VPP 1jVr iel Site utilities:iaTra,, ;;';.sii9i LJ15i a ;l,,\-o},Y; tr 4 i ?si1a• Yr , ,; ,Ac ' # , , irc , . ,..-
Job Site address:1/ e-t-l61/tr Catch basin or area drain 18.76
ee r Drywell,leach line,or trench drain 18.76
City/State/ZIP: `-i'-4� +ry(._ (DI _ Footing drain(no,linear ft.:_) Page 2 ,w
Suite/bldg./apt.no.: Project name:L#1 C_.i a-- iS +4140.5 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Ram drain connector 18,76
Sanitary sewer(no.linear ft.: Page 1i
Storm sewer(no. linear ft.;_ ,.,,_,J Page 2
'�- - (/ �'+/ !_- Water service(no.linear ft.•_) Page 2
Subdivision: Lot no.: w Fixture or item:
Tax rnap/parcel no.: d Backflow preventer 31,27
'r 'lir, 4 R,./'"M dN it IP[it ii F.,I(r+ , . , i',Iim.i J iptJl(ia1 ik4;1 lit, 5 ify,y,S �1�{}t,� Backwater valve - , 12.51
..,' , f. •s ii � :}„ 1'.6w': }si+A. >x' :ti!i�AUS ., S:? ,i,,alt,,,,,too. '�T 1,•il�.Pl f' r.r,l., . A!r
t . LL►n��S z e $ b� o Diothes washer 5.02
I'' ,.,1 , . �,��✓ Dishwasher _ 1 / zs.o2 as`r��.
Iia F 4 )e"+4 ^E (. / f Aa A ,ne Drinking fountain 25,02
Ejectors/sump 25.02
1����'f l'rl lriva' .. . '.t P i o 1 P l ww„ ff,-) Pea �$ 41-7,,,,44,1,1,,,,, ,I,1,:'MI x ''1 Expansion tank 12,51
?�i,i,.;'_:.-( .-.3„6"'.,,.»3^" �.-' r"`kt2.ru aq .d•. .,4 -Ri'13 lL ., 'Aiti A ,
Fixture/sewer cap 3 25.02 "T-.04
Name: __
- - lour drai :oor sink/hub N' En 25.02
glsa
Address: _ 'S ,age disposal 25.02
City/State/ZIP; Hose bib 25.02
M
Phone:( ) Fax:( ) Ice maker 12.51
1511,•ai ' ,,J.a . rr l* ,l( utr kge.;;
' ;t interceptor/grease trap 25.02
Business name: Medical gas(value;$ ) Page 2 / '
Primer ( 12.51 fv} 5 /
Contact name:
Roof drain(commercial) ..„,.-12.51
Address: w Sink/basin/lavatory 25.02 751,rti
City/State/ZIP: Solar units(potable water) 62,54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-
mail: Urinal 25.02
y k t " Water closet /25,02
,,1 4i i pplj�{' t t �a 1G)' tifit�a. , fi 'ilk..!#'`''r 9�}r "�i r , stn �O-P
.,1).arjz. .L--#.`10,t,,..Tiff,14 t i 7M a: Tr+a6:h .,:, ,M•,LiN-.i51 =-"5.- ii:E ' ...i-:tr::.
water heater 1 37.52
Business name: , lits ,*- ;rN f y,, ,- Water piping/DWV 56.29
Address: ,;; S7 /51- a Sites Other: 25.02
City/State/ZIP: a/4 v 1� �' / l� Subtotal ' ), :'
Phone:(Sti/) 5-1,0„ 0 i,/Q) k•� Fax:(Cp ) �'ti?-0 /leg?" wMinimum permit fee: $72.50
r Plan review (25ee of permit fee)
CCB Lic.: l F I^r 0! Plumbing Lic.no.: ej S- 7 State surcharge(12%of permit fee) ��
Authorized signature: J e
4... mow, TOTAL PERMIT FEE/ 3
Print name: \'M.a I -7 Date: / f This permit application expires if a permit is not obtained wit in ISO days
after it hes been accepted as complete.
I/ 'Fee methodology set by Tri-County Building Jndugtry Service Board.
I:13uilding\Pgmiti\PL6,M1J-PennitAcp'doc 10/01/09 440-4616T(IO/02/COM/wes)
Piumbini Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Su► r gression Systems
,''' t�b M 'ft.
F/t1S �q t Tlex1 hS n,
, i.Y? Wu4fit`:c A7t,�r t r , ,,,1',0 At, f-17� . gfti( 41
a , SQS , 0, .t . "I;Y;yim �4 XV', t14.Atf,r °C, ' 1i4,hu, M'4 i.� ,l�naf-1 ��itx � 1.} �� : filiie1'11,50Footing drain-I�
,:.
100 50.03 0 to 2,000 _$121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer 1st 100' _ 62.54 3,601 to 7,200 $233.20
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 ,'fi 4; ":''.470,-=-.-',;;"'i!*
y i' '.-4;0.s^ai "l ,'r[4I ` jx.!' , �. .i tfr-f„a,;'.- , a ',,It don ' { ;Storm Rain Drain 1St 100' 62,54 .:44.;,;-,,„,,?
$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
,;tr4 „f i' 7¢ ' G i 2 1 B tj 5, S *�Y,,71 ri m p, each additional$100.00 or fraction thereof,to
e'..a .. t;..i.4,/.1 �'a3xld-o »..r r,•�ti �irot. I=,ti 4 °.,,l::;i,Fi$t x%•.,-Zi.'' 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
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof,to
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 00.00/hr and including$50,000.00.
Additional plan review fpr revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
, (minimum charge-112 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 re i ort fixtures could result in increased sewer fees*.
,inill Vii*s�€, • , g� 01 ;y i ,l,l w.; m . ,• " •, , ;� ; s "`:=�, .1 `{W 47-Y 1! .,,,;R t7 :T 7 R t 7 ,,,,
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v• V. fi.ri t) ru�ir K f r Tyr t !14-� I 1, ,41 riG�.{.i:,ik,Ap til»�i,g;4:2 ,,t 14,91 i 1!,U1 Z, , i Ni,,
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yy �'
,1 k. Y $3 A '1�1�i� .t°a ! F^fuii+y ' y y.r r.0�` r i}t Plan review is required for anyof the following.
7��1 '�S.�ti t. .��!l��,f),d�S18d8 � „�1.!?`.L�ki�Z:S�� �ffih �'!�W�:�•;!yl?� �l
Baptistry/Font ""` 9 please check all that apply.
Bath -Tub/Shower ❑ Any new comm ercial 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 Aspiratoras defined in OAR918-780-0040.
Dishwasher -Commercial - . % - 0 Medical gas and vacuum systems for health care facilities,
-Domestic l i;/ ❑ Any multipurpose fire sprinkler system.
Drinking Fountaini 0 Any complex structure as defined in OAR918-780-0040,
Eye Wash
Floor Drain/sink C25 l i-" Submit 2 sets of plans with any of the above.
-4' t. r.'e . lith iy i r ITA: i p i„r n` .T4+'
,�py h rl 7M t} w . 4 B 8 taltA. w�
Car Wash Drain - - -�_ '.'r IlifJr iK {i.t V..n� nl1,1, ,: k ulaf »:S-0.n 3 A ,.4"i y ,4 1,7 ;if
Garbage -Domestic-non-food II Isometric or riser diagram is required for new buildings
Disposal -Domestic-fbod 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 S. 14-5 e.-- ,
Shower -Gang ,
_ -Stall ! - "- -r1 . �,: C',r . i Iv . tL-
SinkJLav -Nan-food related- - .! / ,V4 5
-Bradley
"Commercial-food related -
-Service
Swimming Pool Filter �- "�"
Washer-Clothes . - 'Note: If the fixture work under this permit results in an
Water Extractor """ increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet j 7" .7' fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\jim\Downloads\PLIMIF_permitApp(11 j.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11570 SW TIEDEMAN AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2017-00028
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor