Permit (130) CITY OF TIGARD PLUMBING PERMIT
IIIIa COMMUNITY DEVELOPMENT , Permit#: PLM2018 00019
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1 /'� Date Issued: 01/11/2018
Tt AP`L� g �; �I I /Mil Parcel: 1S126CA00200
�J Jurisdiction: Tigard
Site address: 9285 SW GREENBURG RD
Project: JEMMA CO Subdivision: None Lot: None
Project Description: 130 ft.of water service and replacing interior water lines. 1/22/18:REPRINT to add(1)hose bib.
Contractor: LOVETT INC Owner: JEMMA CO LLC
PO BOX 86280 BY STORABLES
PORTLAND, OR 97286 3250 NW YEON AVE STE W12
PORTLAND, OR 97210
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
130 If Water Service 01/11/2018 $100.06
Specifics: 1 ea Water Piping/DWV 01/11/2018 $56.29
1 12%State Surcharge- 01/11/2018 $18.76
Type of Use: COM Plumbing
Class of Work: ALT 1 ea Hose Bib 01/23/2018 $25.02
Type of Const: 0 12%State Surcharge- 01/23/2018 $3.00
Plumbing
Occupancy Grp:
Stories:
Total $203.13
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: J -N..; Permittee Signature:
,, ,.A____.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
A
li
Plumbin Permit A Hear '" E
Building Fixtures FoR OFFICE USE ONLY
City of Tigard JAN r`; 2
1 01� Received
Permit No.: #
III 'i 13125 SW Hall Blvd„Tigard,OR 972 ( ?� 0 Date/By: / LZ (F � �a! U�Q
■ q Plan Review p
Phone: 503.718.2439 Fax: 503.598.14,i° .+ l�lvli it :i`� DateB Other Permit No.:
Inspection Line: 503.639.4175 B���_Divi a y'
T IGARD DateReady/By kids 0 See Page for
Internet www tigard or gov Notified/Method Supplemental r ormation
d.z n x
r.�,. ' L � 'FJ Qr WOJ `x F. 11 a 1 1r i D",<<, rx z. `,j rt s ` 1 tSOHL�`ZIITLE i 11 ,
❑New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
nvprog;g ` CAI'1;GOR'11'QF C9 Jc i$ `. '?x` .., aas:k_ SFR(1)bath 312.70
❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 1:
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen 25.02
❑Other Fire sprinkler( sq.ft.) Page 2
' ` ?0$ SITE NT+OR1l11.T1ON.r NI' LQC`AA 9s site utilities: 1,
Job site address:9285 SW Gr•eenburg Rd Catch basin or arca drain 18.76
Drywell,leach line,or trench drain 18.76 li
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear ft.:_) Page 2 {
Suite/bldg./apt.no.: 1 Project name:Jemma Co Manufactured home utilities 50.03
K
Cross street/directions to job site:SW Hall Blvd Manholes 18.76 r
Rain drain connector 18:76
Sanitary sewer(no.linear ft.:_) Page 2 x
Storm sewer(no.linear ft.:, ) Page 2
Water service(no.Linear ft.:_) Page 2 1
Subdivision: 1 Lot no.: Fixture or item:
I'
Tax map/parcel no.: Backflow preventer 31.27
1
_. . Backwater valve 12.51DESCRIPTION Ol WQs
;. ,. ,'''''.
Clothes washer 25.02
Need to add add yard hydrant/bose bibb to permit#PLMV12018-00019 Dishwasher 25.02
Drinking fountain 25.02 I
Ejectors/sump 25.02 1
❑, #0.#4 RT ' OWNER -,...,I. .. Q.l'El`I N"..r.', Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sinklhub 25.02
Address: l
Garbage disposal 25.02
City/State/ZIP: Bose bib 1 25.02 25.02 I
Phone:( ) Fax:( ) Ice maker 12.51 1
;❑ APPLICANT ,0 CONT'ACT'1' RSON Interceptor/grease trap 25.02 i
Business name:Lovett Inc Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Mike McVey
Roof drain(commercial) 12.51
Address:6240 NE 42nd Ave Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 079238 Solar units(potable water) 62.54 E
Phone:(503)737-8423 Fax::( ) Tub/shower/shower pan 12.51
E-mail:linda.p@lovettservices.com lovettsetvices.com Urinal 25.02
CON)T;AGTQR Water closet 25.02
Water heater 37.52
Business name:Lovett Inc Water pipinglDWV 56.29 1
Address:Same as above Other 25.02
City/State/ZIP: Subtotal
Phone:(503)737-8423 I Fax:( ) Minimum permit fee: $72.50
CCB Lie.:1255017 + mbing Lic.no.:26-773PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) 3,Ud
Authorized signature:4,14d. " TOTAL PERMIT FEE 2g ZThis permit application expires if a permit isnot obtained within I80 daysPrint name:Linda M Date:1/17/2018
after it has been accepted as complete.
{Fee methodology set by Tri-County Building Industry Service Board.
I:WuildinalPermitslPLMU-Penni1App.d°c 10/01/09 440-4616T(10/02/COM/1vah)
CITY OF TIGARD PLUMBING PERMIT
III ' COMMUNITY DEVELOPMENT
Permit#: PLM2018-00019
T f c ;\IT D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/11/2018
Parcel: 1S126CA00200
Jurisdiction: Tigard
Site address: 9285 SW GREENBURG RD
Project: JEMMA CO Subdivision: None Lot: None
Project Description: 130 ft.of water service and replacing interior water lines.
Contractor: LOVETT INC Owner: JEMMA CO LLC
PO BOX 86280 BY STORABLES
PORTLAND, OR 97286 3250 NW YEON AVE STE W12
PORTLAND, OR 97210
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
130 If Water Service 01/11/2018 $100.06
Specifics: 1 ea Water Piping/DWV 01/11/2018 $56.29
1 12%State Surcharge- 01/11/2018 $18.76
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $175.11
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: A' Permittee Signature: S-Z .a(1/�%6x=71 f..-,
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.
Jan. 9. 2018 ~IV' Lovett Excavating No. 5838 P. 2
Plumbing Permit Application
Site Utilities ,
City of Tigard deceivjL
f
pxte/ri (ii! ,( fr .� Permit No.: Y ';l ..,r,��,711 r 13125 SW Mall Blvd.,Tigard,OR 97223 2 1Q �m+ " / �`�� �7�t+j Y �`�
o Phone: 503.7182439 Fax: 503.598.1960 Dan Other Parrot No.;
Date/By:
1 is A l;l 1 Inspection Line: 503.629.4175 ...i•�y i" !l i io t'
Internet: wlvw.tigerd-or.gov t +', dfieeady/By: kris: Sco ieot 2 IIor
d 1 p /�5 a nfied/Methnd: I13 Supplemental Information
i. M t ,, . 1'1 yJ a .117 r . ,
,1 ,6.,'.; e l,.a'r;�',,, � 4�,.. , : »,, 0••,.,1•• J• ax,�,,c•1•i •-•,=.1.1-1-',.'� + , rEiJ • ,,� n,
❑New construction 0 Demolition For special information use checklist:
Description j Qty, I Ea, I Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
I ,.i n, ,:4, r .vJ-ki,i j :/1,3,--,;',(,..,.v,0 it1i11.i>Jtc1 1, SFR(I)bath 312.70
❑1-and 2-family dwelling ®Commercial/industrial SFR(2)bath437.78
❑Accessory building ElMulti-family
w SFR(3)bath r r
❑Master builder Each additional bath/kitchen r
❑Other: Fire sprinkler( sq.ft.) Page 2
F a ",X.V 7s)iC) .j;I�''t�,�,"�7,-� -7-, 'lo ,i1f1 I2lt;l" -7-7'''7771.1, Siteutlities:
Job site address: C,?,,-,12 -S f� AA C, Catch basin or area drain 18.76
Ciry/St ri` l Q l 1 �� Drywell,leach line,or trench drain 18.76
r•/ I 1 . ?f` Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: 441 Project name: \ 1 Y>, (,J. Manufactured home utilities 50.03
T�
r .
Cross street/directions to job site: ,Nit._,) l C t i.,41. ' 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.:0_ Page 2 )qo•1).-
Subdivision: Lot no.: Fixture or item; .
Backflow preventer 1 � DTax map/parcel no.: 31.27
'.7"'` 1 �9 i!1''�?�^w .E, C'c• '<;-, ' ''''''''.7717':
c, c +,t<,': 13a0kwater valve 12.51
„.._.. ___L2,.-y.4.1.2 •...,e-,,,,..1.'"..:`.„' dt il(s1: 07 ,Id�l.'tl'._.-_._,._.'f',._ ,.. .:. ��.
t / Clothes washer 25.02
``sA.e_tc4/`1i �/c.1)� ..C.Y��J� �1 Dishwasher 25.02
.'"� t,. fig ` Drinking fountain 25.02
Ejectors/sump 25.02
ti -,.1 ',4j,,.q 14f4„kAM:01'"401.i y ,4 �"F° •;t "tE,3')eq)ni Wn13F ,amu'. Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: Hose bib ."0 25,02 " 0,6r
Phone:( ) y Fax:( ) Ice maker 12,51
n.i.--:,;;::',41`,4,‘":e','SL4 iti,: ++7fr"Zrwtt*!;', ";'illi,; , t.11 p- 01`i,'(,yi l t 1 i I 1 til l�r a ',y, Interceptor/grease trap 25,02
Business name: Medical gas(value:$�) Page 2
Contactnamc:� � '' � Primer 12.51
G�k e.S1 v,,,, })tf Roof drain(commercial) 12.51
Address: _ t
Lip �^' L. Lip.Z! U., _ Sink/basin/lavatory 25.02 54)o0
City/Statc/ZIP: d (.6a. f. ,.6 4=?, t p Solar units(potable water) 62.54 ,
i. o
Phon 65. ..-77.r,,qq A Pax::( ) Tub/shower/shower pan 12.51 _
E-mail; i �v�Xr
, Urinal 25.02
fy.Wf,a '• > 'p ���gfc� fw9 �R C0i ?t 4 �� ' � Kacloset 25.02
.O
.t }
Water heater 37.52
Business name: bt t - Water m m WV
r �F P'P' P,ro 1 56.29 5-t•di..4
Address:
1Z• 6 U- other: 25.02
City/State/ZIP: Subtotal
Phone:,g)3 ) rI 7,2 L.)`? Fax;( ) Minimum permit fee: $72.50
CCB Lic.: t ---0Z Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) 58:63-( ,
AO ,.
Authorized signature:/ fes- .A� TOTAL PERMIT FEE� _ p
Print name: ft ' r"?r Date:t ( Q This perrnil application expires if A permit is not obtained wit 1180, . --
/te /:� 1 Q After it hes been accepted as complete, p e
*Fee methodology set by Tri-County Building Industry Servicer L I(
rAlleflding1Permrrs1PLMU-PermilApp.d°c 10/01/05 4404616T(10/02/COMJWE9) '-------
Jan. 9. 2018 4:45PM Lovett Excavating No. 5838 P. 3
Plumbing Permit Application - City of Tigard
, Page 2-Supplemental Information
Fee Schedule: Residential Fire Su i t ression S stems:
'ni.,A�° i.:,�,y ,,, �...,", , !7' 0 1 u 7t S p 1 4�t-� o..,� 1 T.f.Citi �t i 1171�,j t r µ n rw p �l w
,� I�d ,1 .,��1 pil)t�t� J ��n ,•n..'p�..R �. .'" ,' ' �, F, �e.:'1.7 (o.@Ilii t 1:,LY)SII r�'�.f .':i•1:'I f If lid9��-�. ' : •,u.:�CJ
Footing drain-191100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 no 2 001 to 3,600 $169.69
3.601 to 7 200 $23320
Sewer-1st 100' 62.54 MI 7,201 and greater $327.54
Sewer-each additional 100' 37,52
Water Service-1st 100' = 62.54 MIE
Medical Gas S stems:
Water Service-each additional 100' in' 37.52Mg
a ,
rl,11 tl�) 9d _ .. iP'( Arc ii10 1 7 rc s :�m,t
Storm&Rain Thain-1st 100' 62.58 `'
$1.00 to$5 000.00 Minimum fcc$72.50
Storm&Rein Drain-each additional 100' 37.52 $5,001.00 to$10,000,00 $72.50 for the fust$5,000.00 and$1,52 for
Jit-j-;.5111 .77;71'5(7 a a r a dpi h Irt.,477 '(" 1F1 y'y�Fm; each additional$100.00 or fraction thereof to
. ( l :,� • ,�,:s..._+., .,w `' and includin•110 000.00.
Inspection of existing plumbing or for 110,001,00 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 inclodin:$25 000.00.
Inspections outside of normal business - 90.00/17r - $25,001.00 to$50,000.00 $379.50 for the fust$25,000,00 and$1.45 for
hours minimum char:c-2 hours each additional$100.00 or fraction thereof,to
Reinspection Fees _ 90.00/lir end includin_$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: _ME
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by future, Failure to
accurately report fixtures could result in increased sewer fees*.
'0.iq"<9 7 t � Y:r,,• � .t.. pro,: ^^^^ �m ^;r�m� ra��ars�^c�r��
�`.°i i • I r t i t ttnarltlt?lly Fixture Type F n 14 111 i i 7f�lpt��1 tni��1�1 f 1�e�t F t 1 TT�1. t`s1• l.•tva`TRWTEM. 1 t It,�.._
�IgCe!L'YPpioz~ - ..,. ... ,......,,_ ..
Orli keifoisuieil --.1 Gappcd:c� n+Added . :��Rislocato.+ il
Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower El Any new commercial 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 Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system
Drinkin Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
4» "ow; �,-_ 2! :1:,1ii�(7yt.-. .1B t .fci" 1,41'.,.., .,i,II" <:t ! (•, �.
Car Wash Drain `' " ' _ �'
Garbage Domestic-non food Y - - " 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the •ualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) ,_ _ - Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under thisermit results in an
Washer-Clothes P
Water Extractor increase of sewer IEDUs,a sewer permit will be issued and
_Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures;
C;1User•s\linda.p\Downloads\PLMU Pen'nitApp(10).doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9285 SW GREENBURG RD, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2018-00019
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor