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Permit (63) IL CITY OF TIGARD PLUMBING PERMIT dFiiCOMMUNITY DEVELOPMENT Permit#: PLM2017-00255 Date Issued: 06/27/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BC03400 Jurisdiction: Tigard Site address: 14660 SW 83RD AVE Project: Cole Subdivision: HAMBACH PARK Lot: 18 Project Description: Replace water heater Contractor: OWNER Owner: COLE, KRISTIN KRISTIN COLE 14660 SW 83RD AVE 14660 SW 83RD AVE TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 971-302-5424 PHONE: 971-302-5424 FAX: FEES Quantity Description Date Amount 1 ea Water Heater 06/27/2017 $37.52 Specifics: 1 12%State Surcharge- 06/27/2017 $8.70 Plumbing Type of Use: SF 35 ea Minimum Fee Adjustment- 06/27/2017 $34.98 Plumbing Class of Work: ALT 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 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 ques'•• to OUNC by calling 503.232.1987 or 1.800.332.2344. Issu-'. 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 FOR OFFICE USE ONLY City of Tigard Deceive 4® ' Permit No.: P(,n Aeil,1:50,01 5---5 Iiii • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review _ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.: Inspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK FEE* SCHEDULE 0 New construction ❑Demolition For special information use checklist. Description I Qty. Ea. Total 0 Addition/alteration/replacement ❑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 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATIONSite utilities: l L,&) _It() 13 Av C:hesl:::ae,:ench Job siteaddress: �1 � , �ll drain 18.76 City/State/ZIP: "Fi (-4. / U R 61-7.2';_p.Lt Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: I Project name: GC j i.- 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: Backflow preventer 31.27 Tax map/parcel no.: O ';,,,,,b1 Backwater valve 12.51 " `_. DESCRIPTION OF-',t,K; ,° 4 Clothes washer 25.02 Re-r/C4e- (-O TL(" il-e'-4.T'u Dishwasher 25.02 / Drinking fountain 25.02 Ejectors/sump 25.02 � Op v Expansion tank 12.51 Fixture/sewer cap 25.02 Name: r i-'Z-i N 't- Floor drain/floor sink/hub 25.02 Address: 1�f d S j,- 3 ✓ Garbage disposal 25.02 City/State/ZIP: ""a,r,1D R q 9y Hose bib 25.02 Phone:( q rn) 3t 6 Vi2 4.4 Fax:( ) Ice maker 12.51 . ." . Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: Primer 12.51 Contact name: 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 12.51 Urinal 25.02 E-mail: Water closet 25.02 2 Y CONTRACTOR /, ,,; ''M �'n '"r` Water heater 37.52 Business name: C r_) ( ) /'J t' -- Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Minimum permit fee: $72.50 701..S-C Phone:( ) Fax:( ) Plan review (25%of pttntit fee) - CCB Lic.: Plumbing Lic.no.: ° State surcharge(12%of permit fee) g, 7p Authorized signature: TOTAL PERMIT FEE / . 9-0 Date: `` 7� This permit application expires if a permit is not obtained within 180 days Print name: �- (r� / after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\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 Utilities Qty• Fee(ea) Total Square Footage Permit Fee: Footing drain-1st 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.32 2,001 to 3,600 $169.69 Sewer-1st 100' 3,601 to 7,200 $233.20 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 ' Storm&Rain Drain-1st 100' 62.54 Valuation: Permit Fee: $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(om) Total 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: 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*. 44 Plan Reirjevi'for Plumbing installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ Please check all that apply. Work Performed: Capped Added Relocate Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: Tub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive Thru 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" fatCtrie:4`wm' 4 0 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/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 Water Extractor fees assessed for the sewer increase must be paid before the 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: 14660 SW 83RD AVE, TIGARD, OR, 97224 Record Type: Record ID: Residential - Plumbing PLM2017-00255 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor