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Permit (64) CITY OF TIGARD PLUMBING PERMIT 1 COMMUNITY DEVELOPMENT Permit*: PLM2018-00092 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2018 Parcel: 1 S 134DC 13300 Jurisdiction: Tigard Site address: 11409 SW SUZANNE AVE Project: Mission Meadows, Lot 5 Subdivision: MISSION MEADOWS Project Description: Irrigation backflow. Lot: 5 Contractor: CONTOUR LANDSCAPING Owner: MISSION HOMES NW 12485 SW TOOZE RD PO BOX 1689 SHERWOOD, OR 97140 LAKE OSWEGO, OR 97035 PHONE: 503-682-1302 PHONE: 503-593-5324 FAX: 503-682-1302 FEES Quantity Description Date Amount 1 ea Backflow Preventer 03/08/2018 $31.27 Specifics: 1 12%State Surcharge- 03/08/2018 Plumbing $8.70 Type of Use: SF 41 ea Minimum Fee Adjustment- 03/08/2018 $41.23 Class of Work: OTR 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 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: eN/ e / 1 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 Applicatio. BECEIVEDApplication Building Fixtures MAR 8 2018 City of Tigard CITY OF -FIGAO Received 0,2 III 41 13125 SW Hall Blvd.,Tigard,OR r Ai PING 1 e� Date/By: /6,- PermitNy ��✓f �����JCr Phone: 503.718.2439 Fax: 503.'':.1'.R ¢Nth DIVISIO b Plan Review T I G A R p Inspection Line: 503.639.4175 Date/By: Other Permit „�l ��"�d 3-41 Internet www.tigard-or.gov Date Ready/By: Jur s: I H See Page for Notified/method: Supplemental Information `v' 'TYPE OF WORK FEE*,SCHEDULEew construction 0 Demolition For special information use checklist" ALJ Addition/alteration/replacementOther: Description I Qty. I Ea. I Total 0 New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY F-CONSTRUCTION SFR(1)bath 312.70 Kr and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 0 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 JIQB,,SITE"INFORM"ATION AND LOCATION Site utilities: Job site address: Catch basin or area drain - i ©`) S i ,/L4„30.'eW�� 18.76 City/State/ZIP: �� Drywell,leach line,or trench drain 18.76 Suite/bldg./apt.no.: I Project name: ' '�� .'J'L - Footing drain(no.linear ft.:_) Page 2 v( [c'K I +�'�Cz �tttManufactured 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: Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer f 31.27 . ,, ' m x0 ''' ' . y Backwater valve .' '..m' ''' C, ,<�1: ' ' '' 4 12.51 Jj`^/�(IfJ_ , C/c�6� a% 16' Clothes washer 25.02 G i✓_F.(A, y�j,/ x,(6„. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY O .M, ANT 4 t Expansion tank ,w= �,�; r12.51 Name: KY1IST!dnt) ii )_ A)VC.��1 Fixture/sewer cap 25.02 Address: &(>61�e TFloor drain/floor sink/hub 25.02 Garbage disposal 25.02 City/State/ZIP: £ ice ailt,t).. (.0,1a q10.3Y Hose bib 25.02 Phone:( ) Fax ( ) Ice maker 12.51 APP ICAk1T :', 0 .O yT CT, PEER*O1+ 1 1 Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 Contact name: Primer 12.51 Address: Roof drain(commercial) 12.51 Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) I Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 r;. O '£CTJ Water closet 25.02 s c< ; 4 .a .kms aa * as a4 Water heater Business name: / � �,�►/ 37.52 (��o o 0 � '')L) �1 Water piping/DWV 56.29 Address: 1iatl ccl.A.,1-00• P--) Other: 25.02 City/State/ZIP: t ° Subtotal Phone:(503 ,21 e-��6,e4,- 3,c,‘... Fax:( ) `S Minimum permit fee: $72.50 7?_-SO CCB Lic.: r Plumbing Lic.no.: Plan review (25%of permit fee) State surcharge(12%of permit fee) et.. '7j) Authorized signature: , crvl ,, 1..., i.�- - . TOTAL PERMIT FEE ocr; 0 Print name: (.� r/` C- 'L., (.> 1,0 I Date: 3/ 7/is, I 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 Boa0/1 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: FeeTotal,, permit4Flee. T ` Site i7til><ties„ Q 'Oa)a k, ..Square Foot : > , A 50.03 0 to 2,000 $121.90 Footing drain-le 100' 2,001 to 3,600 $169.69 Footing drain-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 each additional$100.00 or fraction thereof,to Other Inspections or Fees (qty Fee(ea) , Total 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. $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for Additional plan review for revisions 90.00/hr 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 ww accurately report fixtures could result in increased sewer fees*. , lan view for�P i n t 1l9 9 , n ,„ 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 0 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" ,,. ,,wrSQplrrtric3 or I.iser 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/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 plumbing permit can be issued. Water Closet-Toilet Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2