Permit (29) CITY OF TIGARD PLUMBING PERMIT
s
COMMUNITY DEVELOPMENT Permit#: PLM2017 00199
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/22/2017
T
GAR, Parcel: 2S103CC13200
Jurisdiction: Tigard
Site address: 12076 SW WHISTLER'S LOOP
Project: Rockenstein Subdivision: WHISTLER'S WALK NO.2 Lot: 79
Project Description: Replace/update/relocate: (1)clothes washer,(1)garbage disposal,(1)kitchen sink,(1)bar sink,(4)lays&(1)
shower pan.
Contractor: EVOLUTION PLUMBING LLC Owner: ROCKENSTEIN, EDWARD&KIRENJEET
7715 NE 33RD DR SUITE D 1413 OWEN DR
PORTLAND, OR 97211 CHULA VISTA, CA 91911
PHONE: 503-655-3388 PHONE:
FAX: 503-305-8373
FEES
Quantity Description Date Amount
1 ea Clothes Washer 05/22/2017 $25.02
Specifics: 1 ea Garbage Disposal 05/22/2017 $25.02
2 ea Sink 05/22/2017 $50.04
Type of Use: SF 4 ea Lavatories 05/22/2017 $100.08
Class of Work: ALT 1 ea Tub/Shower/Shower Pan 05/22/2017 $12.51
Type of Const: 1 12%State Surcharge- 05/22/2017 $25.52
Occupancy Grp: Plumbing
Stories:
Total $238.19
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 Notif on - -r. 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 .uestions to OU b ling 503.232.1987 or 1.800.332.2344. /
Issue. 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.
Plumbing Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY v
Cf Tigard of Ti d Received 11'„ 7
.�/�� - �^
Date/By: / Permit No.: tel cc,/ r
IN 13125 SW Hall Blvd.,Tigard,OR 9722 Y 2 2 2017 Ml���.j/
Plan Review e
_ Phone: 503.718.2439 Fax: 503.598.1't i Date/By: Other Permit No.: 7�l7
TI G A R D Inspection Line: 503.639.4175 r `` qq pp Date Ready/By: Juris: la See Page 2 for
Internet: www.tigard-or.gov Alit-DING
C)I= T1�/1f1® Notified/Method: Supplemental Information
TYPE OF DING DIVISION FEE* SCHEDULE
0 New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. Total
®Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
211 and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
ID Accessory buildingSFR(3)bath 500.32
❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder ❑Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Z o 7G s w (di/i s f iers /L Catch basin or area drain 18.76
Job site address: T
ace
City/State/ZIP: 7-,.G Grp/ . � Ci�y�.3 DI'ywell,leach line,or trench drain 18.76
l Q Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: €4.t STe.4h Manufactured home utilities 50.03
Cross street/directions to job site: 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
Backwater valve
'' 12.51
'PES< ION OF WORK
�" Clothes washer
h e .-Is `I S A✓ wed Dishwasher
25.02
Dishwasher 25.02
Gt.) SIAS eve,/ '7 40 Drinking fountain 25.02
Ejectors/sump 25.02
. piiyiyi ' "4x 0 TENANT Expansion tank 12.51
Name: .6 of 4(„ Ki Irvin g,!X/�CN'1k�,� Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: SaL Garbage disposal / 25.02
City/State/ZIP: Hose bib 25.02
-
Phone:( ))� Fax:( ) Ice maker 12.51
1I,r A 1
PPLI ' ❑ CONTACT PERSON - Interceptor/grease trap 25.02
Business name:" A�yeti b�'eas/ //G
Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
C`i`i c Sd G✓
Roof drain(commercial) 12.51
Address: /Qf, 52 ?8 n�i,-- Sink/basin/lavatory 026 1/<<f� G 25.02
City/State/ZIP: pe,,,,//Q,b„, D , 7?-.L.-/S Solar units(potable water) t 62.54
Phone:(56 3 3 5//-94 y 7 Fax::( ) Tub/shower/shower pan / 12.51
E-mail: GAleIS Sfit44& rty7A€A,S k •Ga14,A Urinal 25.02
Water closet 25.02
:: a, x ~ s NTRACTOR
•• .y ," "" ��`-." Water heater 37.52
Business name: E.I/ptll P/00% p(44413,7 IL C Water piping/DWV 7 56.29
Address: 4 I S i(/6 3 504
'r"-j 56 k O Other: 25.02
City/State/ZIP: (>t✓ 14 KJ ?pi /I Subtotal
Phone: ') ( 5 S^3 Gi W Fax:(5-63 3(8'!,3 33 Minimum permit fee: $72.50
CCB Lic.: I k /i y Q Plumbing Lic.no.: Q g b'3 y Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE a 3 q,i'7
Print name: Ch!'; < S Date: 57)41/20/3, This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\PLMU-PermitApp.doc 10/01/09 440-4616T(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
Valuation: Permit Fee:
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
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
P 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*. PIan Review for plumbing Installations
Quantity by Fixture'Type Plan review is required for any of the following.
Fixture Type for $cplace/ Please check all that apply.
Work Performed: Capped Added Relocate
Baptistry/Font
0 Any new commercial building with water servicer and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: Each Stall
0 New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918-780-0040.
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial
0 Any multipurpose fire sprinkler system.
Domestic 0 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" Iso 0`-` ;Riser DiagraiW
4„ ❑ Isometric or riser diagram is required for new buildings
-Car Wash Drain
Garbage Domestic non-food that meet the qualifications above.
Disposal: -Domestic food related
-Commercial food related
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-Com/Serv/Util food 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 fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet-Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12076 SW WHISTLER'S LOOP, TIGARD,
OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2017-00199
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Secure extra length of dishwasher drain hose to the under side of counter top ,or
shorten hose.
2. Plumbing final approved with correction.
Violation Summary:
Inspector Contractor