Permit (136) CITY OF TIGARD PLUMBING PERMIT
1111
112 COMMUNITY DEVELOPMENT
Permit#: PLM2018 00044
Date Issued: 01/30/2018
a 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 104AA08500
Jurisdiction: Tigard
Site address: 12650 SW KATHERINE ST
Project: DODSON Subdivision: BELLWOOD NO.2 Lot: 100
Project Description: Replacing(1)dishwasher,(1)garbage disposal,(1)Ice maker,and(1)Sink for kitchen remodel.
Contractor: CENTRAL OREGON PLUMBING SERVICE LLC Owner: DODSON, ERIC J&KATIE L
PO BOX 696 12650 SW KATHERINE ST
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 541-390-4797 PHONE:
FAX:
FEES
Quantity Description Date Amount
ea Dishwasher 01/30/2018 $25.02
Specifics: 1 ea Garbage Disposal 01/30/2018 $25.02
1 ea Ice Maker 01/30/2018 $12.51
Type of Use: SF 1 ea Sink 01/30/2018 $25.02
Class of Work: ALT 1 12%State Surcharge- 01/30/2018 $10.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $98.08
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: ' // 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.
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Plumbing Permit Applicati k ,p,;., `j ,
Building Fixtures FOR OFFICE 11SF ONLY
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City of Tigard Received / ,.. c„)/r/ pi�7O/�
Date/By: Permit No.: 4 f^ <
411 13125 SW Hall Blvd.,Tigard,OR 9722 1, v t t, /
_ , t,+ 1 i. Plan Review �i
Phone: 503.718.2439 Fax: 503.5 :.,194.01; Other Permit No.: .Cb
Date/By:
Inspection Line: 503.639.4175 fi t x _ V r ��
1 1 c.A R D , y , ,_ t ? _ Date Ready/By: hos: la See Page 2 far
Internet: www.tigard-or.gov fi' t l .a K
Notified Method: Supplemental Information
" TYPE OF WORK FEF* SCHEDULE
0 New construction 0 Demolition For special information use checklist.
Description I Qty. Ea. I Total
I]Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
.v w_
CATEGORY OF CONSTRUCTIONSFR(1)bath 312.70
$1....1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
0 Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
;rn JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
L Z(e 50 s 4..„, 1 t„Q S7 Drywell,leach line,or trench drain 18.76
City/State/ZIP: I C.. ` CQ. CT-1 ,)-3
- Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name: Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
"n DESCRIPTION O WOK �1.: Backwater valve 12.51
._.,F1 , ' ,, er.F .: . €�I .. ..,r.
Clothes washer 25.02
k (Z '` P....„.....„.2,-e._
iDishwasher j 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
£ PR n 12TY OWNER' z J s ❑ ITNANT a Expansion tank 12.51
Name: . --12_.(K e,0.5..� Fixture/sewer cap 25.02
Address: Z c Floor drain/floor sink/hub 25.02
1� 5 T Garbage disposal 25.02
City/State/ZIP: ' 6,I .O o7c„ 7I 9-3
� Hose bib 25.02
Phone:( ) Fax:( ) Ice maker
I 12.51
APPLICANTCONTACTPERSON Interceptor/grease trap 25.02
Business name: L 12,,,,,,,3_, p�,5`..� �a,`, Li_C__
gas(value:$ ) Page 2
IPrimer 12.51
Contact name:, j #1-5 av, -'T L(.4--
Roof drain(commercial) 12.51
Address: p , -,- ,), ( C3 (, Sink/basin/lavatory 1 25.02
City/State/ZIP: 1".fi,t) Cl G,C._ e,7 i3 Solar units(potable water) 62.54
Phone:( y() 3 g0._ cr7 q 7 Fax::( ) Tub/shower/shower pan 12.51
Urinal
> F 25.02 C, 5.0, ,5 . G. Jr�47j,4v 47,-----
p
, , ,,` "" ,,,; Water closet 25.02,, „ CONi1 .CTOR
Water heater 37.52
Business name: 6,,,„tt_ o,(36r.'., jLv-R,_.4 S.,e7„ce4 e(L Waterp�tPinS/DWV 56.29
Address: Q", 6,7(,, Other: 25.02
City/State/ZIP: 41/ ,Se / �,,e 97(3, Subtotal
Phone:(SYr)3 5 v _ire-79 7 Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plan review (25%of permit fee)
,2(�01 S 1 Plumbing Lic.no.: r31 3'jo3
State surcharge(12%of permit fee)
Authorized signature: , _r.---€. 1-- TOTAL PERMIT FEE "?.OF
Print name: i./"4,t� t.,) `-6 ( Date: (_ ,-t 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\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(l0/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
'Oto Utilises 'F A4ia) Total Square Footage; Permit dee,,k,
Footing drain-Pt 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 a
Valuation: Permit Fee.u
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
Diner I spec ons 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 �a
accurately report fixtures could result in increased sewer fees*. Plan Review or umbing,Insti lla" ons,
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
0 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 Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Cuspidor/Water
irator 0 Any multipurpose fire sprinkler system.
-CommercialDomtic ❑ Any complex structure as defined in OAR918-780-0040.
-DDrinking Fountain
Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
3" Isometric tfr.Riser Ingram „xi
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
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:
12650 SW KATHERINE ST, TIGARD, OR, 97223 March 23, 2018 at 9:45:48 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00044
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Secure dishwasher to floor or cabinet. 407.3, manufactures installation instructions.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12650 SW KATHERINE ST, TIGARD, OR, 97223 March 23, 2018 at 9:45:48 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00044
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
FA I L
Comments:
Secure dishwasher to floor or cabinet. 407.3, manufactures installation instructions.
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12650 SW KATHERINE ST, TIGARD, OR, 97223 April 16, 2018 at 11 :44:45 AM
Record Type: Record ID:
Residential - Plumbing PLM2018-00044
Inspection Type: Inspector:
399 Plumbing final David Young
Result:
PASS - NoCofO
Comments:
Correction complete.
Violation Summary:
Inspector Contractor