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Permit (36) iptii ,, CITY OF TIGARD PLUMBING PERMIT 2 COMMUNITY DEVELOPMENT Permit#: PLM2017-00246 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/21/2017 Parcel: 1 S 134CD07400 Jurisdiction: Tigard Site address: 11680 SW TIGARD DR Project: Brenneman Subdivision: BURLWOOD NO.3 Lot: PTS 33, Project Description: Remove and replace(1)shower and(1)tub. Contractor: OWNER Owner: BRENNEMAN, HEIDI E& KEVIN T KEVIN BRENNEMAN 11680 SW TIGARD DR 11680 SW TIGARD DR TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 971-266-7056 PHONE: FAX: FEES Quantity Description Date Amount 2 ea Tub/Shower/Shower Pan 06/21/2017 $25.02 Specifics: 2 12%State Surcharge- 06/21/2017 $8.70 Plumbing Type of Use: SF 47 ea Minimum Fee Adjustment- 06/21/2017 $47.48 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: 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 Notific ion 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 dire uestions to•UNC b .fling 503.232.1987 or 1.800.332.2344. Iss ed By: n d / / L n 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 Appli r �: -1� rt Building Fixtures -. '-1 If FOR OFFICE LSE ONLY City of Tigard Received // 7 ' 7 Date/By: �0V / / Permit No.: �1 7�a T4 111 m 13125 SW Hall Blvd.,Tigard,0114422 1 2 01 j X� _ Phone: 503.718.2439 Fax 503.598 1960 Plan Review Date/By: Other Permit No.: TIC ARD Inspection Line: 503.639.410r '` %`a 4 t,1 ";,`t Date Ready/By: f���17-� � Internet: www.tigard-or. v Juris: S See Page 2 for *�, +- ,J_ r, si Notified/Method: Supplemental Information TYP d C►1 G 0 lSJ �: . FEE* SCHEDULE For special information use checklist 0 New construction ❑Demolition 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 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 ❑Master builderEach additional bath/kitchen 25.02 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: �/j'62�5'� 77,617,-/ 7 � ' Catch basin or area drain 18.76 City/State/ZIP: � li '1 Drywell,leach line,or trench drain 18.76 � r/ " ' 9 7.. 2-- 3 Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project nameA j i2 E / /�1�.� 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: I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 D '. ' Backwater valve t)1I�:aDF �VO�RI�fi e = ,- _ fix, .4, as: `' ' . " 12.51 � Clothes washer 25.02 i«�'c/ / ",1 //-fZ 5, e 72-5" Dishwasher 25.02 / 7Cie Drinking fountain 25.02 Ejectors/sump 25.02 PPO R Expansion tank 12.51 Name: /� JyzJ / - !7 Fixture/sewer cap 25.02 Address: ! e- A/l5 �/©�v�/� Floor drain floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: (/ G/ Hose bib / /- 25.02 Phone:(97 •� V/ ) -7O 4P Fax:( ) Ice maker 12.51 ' ' * 4 i*A P RSON �C � � � ].tie , Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 2 12.51 956 2- E-mail: Urinal 25.02 4 , �'`, ,� �s .� � ' '�� t� � - Water closet 25.02 £q C O , aw. . 4_: . Water heater 37.52 Business name: 060 ii g `li. Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 7a:5-r) Plan review (25%of permit fee) .----- CCB Lic.: Plumbing Lic.no.: State surcharge(12%of permit fee) , 76 Authorized signature// L^ TOTAL PERMIT FEE '/,A a Print name� �/�/t,/��� 1 4,, / Date: This permit application expires if a permit is not obtained within 180 days /7„/ after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:\Building\Permits\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 Utilitiesa Qty, Fee(ea) Total Square Footage: Permit Fee: to2,000 $121.90 Footing drain-1 100' 50.03 0 2,001 to 3,600 $169.69 Footing dram-each additional 100' 37.52 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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections 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 each additional$100.00 or fraction thereof. (minimum charge-1/2 hour) 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*. r Pian Review or, lamb ng II>tst llatiotls Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Capped Added- Relocate Work Performed:._: ❑ Any new commercial building with water service 2"and Baptistry/Font greater,except systems designed and stamped by licensed Bath: -Tub/Shower engineer. -Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure Car Wash: -Each Stall as defined in OAR918-780-0040. -Drive Thm ❑ Medical gas and vacuum systems for health care facilities. Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040. -Domestic Drinking Fountain Submit 2 sets of plans with any of the above. Eye Wash Floor Drain/sink: -2" 3>, ,: ., 49111g C Or 1set Diagram , 4" 0 Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage -Domestic non-food Disposal: -Domestic food related -Commercial food related -Industrial food related Comments regarding fixture work: Ice Mach./Refrig.Drains Oil Separator(Gas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/Bar non-food related -Bradley -Com/Sery/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 plumbing permit can be issued. Water Closet-Toilet 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: 11680 SW TIGARD DR, TIGARD, OR, 97223 Record Type: Record ID: Residential - Plumbing PLM2017-00246 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Tub and showers , fixture's only replaced like for like per owner. Violation Summary: Inspector Contractor