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Permit (149) n CITY OF TIGARD PLUMBING PERMIT � > COMMUNITY DEVELOPMENT Permit#: PLM2018-00131 T t ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/27/2018 Parcel: 2S 111 BA05500 Jurisdiction: Tigard Site address: 14140 SW 97TH PL Project: WARREN Subdivision: SOLARCREST Lot: 7 Project Description: Replacing 30 ft.of sanitary sewer. Contractor: NW HOME SERVICES LLC Owner: TERRI WARREN 6941 SE BIXEL WAY 14140 SW 97TH PL MILWAUKIE, OR 97267 TIGARD, OR 97224 PHONE: 503-722-9599 PHONE: FAX: 503-722-9779 FEES Quantity Description Date Amount 30 If Sanitary Sewer 03/27/2018 $62.54 Specifics: 1 12%State Surcharge- 03/27/2018 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 03/27/2018 $9.96 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 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: � i Rerrhittee 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 sitcat the time of each inspection. Plumbing Permit Application "" Building Fixtures FOR OFFICE USE ONLY City of Tigard N 2 7 r-��`t Received By: 3 027 is' 4 Permit No.:��� j g 313 I IIIU 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 Citi Li 1''` Date/By: Other Permit No.: i y 9,•1'7.. ) j> T 1 l'A K D Inspection Line: 503.639.4175 l ,Q r 3= Date Ready/By: Juris: !a See Page 2 for 4 Internet: www.tigard-or.gov `� Notified/Method: .1 -1 Supplemental/��t '• TE:OF WORK FEE* SCHEDULE' ❑New construction 0 Demolition For special information use checklist Description I Qty. 1 Ea. Total Al Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CQ 1S 'RUCTION SFR(1)bath 312.70 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB* I1 INFORMATION AND LOCATION 7, 5y ± 5 Site utilities: / Catch basin or area drain 18.76 Job site address: j y/�d 56,) 9. Ti/e Drywell,leach line,or trench drain 18.76 City/State/ZIP: 1,CI l�t� 0/ f Footing drain(no.linear ft.:_) Page 2 ` Suite/bldg./apt.no.: Project name: f, �ekF ,,�/ Manufactured home utilities 50.03 Cross street/directions to job site: �v Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: �'O) 1 Page 2 ,,,j-L` Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft.:_) Page 2 Subdivision: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION 0 -- ;- Clothes washer 25.02 ,-5,4 c.- 5-"K)11 r' /h e dil Dishwasher 25.02 ff7Tc,-1. -9� J ?Q Drinking fountain 25.02 Ejectors/sump 25.02 jp PROPERTY O :E gt:', 0 TENANT 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 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT,i, P 4 '0 CONTACT PERSON Interceptor/grease trap 25.02 Business name: 90d fi,€ ,.,e, E4 /::. Medical gas(value:$ ) Page 2 �Y t Primer 12.51 Contact name: J e J,, Jl�t 0 f4.� 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: ob.,1054"/,ce-- /ea,srr.tcf �; Water closet 25.02 CT '',„41?--, Az - �sFWater heater 37.52 Business name:Ma A© ,,,,,,e,5 Water piping/DWV 56.29 Address: / .i3-7/ CA(,lje/r/ X'S Other: 25.02 Subtotal City/State/ZIP: ateo„.7 G+may., i� k S'y Phone:6,1 )722 511,- Fax:( -0 ) 727_ 9 77, Minimum permit fee: $72.50 "7 CCB Lic.: / 2755 Plumbing Lic.no.: //%15Z/�j Plan review (25%of permit fee) r� State surcharge(12%of permit fee) D-7th Authorized signature: TOTAL PERMIT FEE y if,k) Print name: - /p co ,l. '�_ Date: 2 7:-/,5 This permit application expires if a permit is not obtained within 1A0 days �JB/7/r Jlr fY after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1:ABuilding APermits\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 Utilitie t Qtr' Sq e:Footage: Peri it e Footing drain-15Y 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 S 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 anon: Per 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 s .. each additional$100.00 or fraction thereof,to Other Inspections or Feed ; Qt3T Fee(ea) Total = P 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*. Plan Re_. r Plumbing Int> ll4 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 greater,except systems designed and stamped by licensed Bath: -Tub/Shower -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tallThras 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 ❑ 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" otetric a *,W .a , +igram 4„ ❑ 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/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 beaid before the Water Extractor p Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2