Permit (90) CITY OF TIGARD PLUMBING PERMIT
11 COMMUNITY DEVELOPMENT Permit#: PLM2018-00263
TF G A 11 F) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/04/2018
Parcel: 2S104DB03800
Jurisdiction:
Site address: 13212 SW WELLINGTON PL
Project: Eneboe Subdivision: AMESBURY HEIGHTS Lot: 38
Project Description: Re-pipe water throughout house.
Contractor: TRUE BLUE PLUMBING LLC Owner: ENEBOE,TORY&ANGELA NGUYEN
3300 NW 185TH AVE#311 13212 SW WELLINGTON PL
PORTLAND, OR 97229 TIGARD, OR 97223
PHONE: 503-747-9989 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Water Piping/DWV 06/04/2018 $56.29
Specifics: 1 12%State Surcharge- 06/04/2018 $8.70
Plumbing
Type of Use: SF 16 ea Minimum Fee Adjustment- 06/04/2018 $16.21
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 ay obtain a copy of the rules
or direct questions to OUNC b calling 503.232.187 or 1.800.332.2344.
Issued By: ,' y.4 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 Applicati '''
Building Fixtures '.:7111
City of Tigard ��111111111,61311131=111111111111Daeactee;Bveyd,
`i (fj�f_ //%(/ PermitNo.�/�,/),,�p�/v)��2�liq � 13125 SW Hall Blvd.,Tigard,OR 9723 v�r�N /J t/L/
C Phone: 503.718.2439 Fax: 503.5 960 Plan Review
Date/By: Other Permit No.:
T I G A IZ D Inspection Line: 503.639.4175 Date
Read/B
Ja
r s: See Page 2 for www.tigard-or.gov
Notified/Method:o Supplemental Information rmation
= ,nTYPE OffWORK�, FEE*
SCHEDULE
0 New construction 0 Demolition For special information use checklist.
Description Qty. I Ea. I Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
" 1, cAittGoltv OF CONSTRUCTION SFR(1)bath 312.70
[Al-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
❑Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
_' '""`JOB'.SITE INFORMATION AND LOCATION Site utilities:
Job site address: 1 3 21 2., c e l j i y/j..t 1)1- Catch basin or area drain 18.76
City/State/ZIP: OI'-4 � ? (4( 0 t� X72 Z Drywell,leach line,or trench drain 18.76
yt r Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: Project name: G(1 i�( cf)t 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
t.z ' 12 •47:
2 7: ,1�I atsv t , „� ,.. ;., Backwater valve 12.51
Clothes washer 25.02
S c,_-E-7; Pe- at( t c}� �` t‘,� �' s Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
1" i] PROPERTY O'V $ , I" '..7., pp TEN " Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Address:
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
< APPLICANT'' 41 4 : EOgol•ACT PERSON Interceptor/grease trap 25.02
Business name: -T-1 u e. t t,{'- p 1,.....tkyl.b 7 ofc Medical gas(value:$ ) Page 2
Contact name: Primer 12.51
����c7 ���� Roof drain(commercial) 12.51
Address: 3-3300 A)t,,.) t /40e, # '3 (1 Sink/basin/lavatory 25.02
City/State/ZIP: )wc' -jailcl G2/ l:2_ 97 y .9 Solar units(potable water) 62.54
Phone:(50)) 7 - 7- 79?'_9 Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
' CONTRACTOR Water closet 25.02
-. - Water heater 37.52
Business name:
Water piping/DWV 1 56.29
Address:
Other: 25.02
City/State/ZIP: Subtotal
Minimum permit fee: $72.50
Phone:( ) Fax:( )
CCB Lic.: ? Plan review (25%of permit fee)
17 �(� Plumbing Lic.no.: 1) Z
/� %'�� State surcharge(12%of permit fee)
Authorized signature: c/
� ^� TOTAL PERMIT FEE O[•�)
Print name: � 5. /' K� h� Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as111 / after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Permits\PLMU-Penn tApp.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'Utilit es Fee ea) total ,„Square Footage: ' 'Pernut{Fees
Footing drain-1'100' 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' 37.52s `�
�aluatiait� <PelrmitFee;
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
r, each additional$100.00 or fraction thereof,to
4t3'= l (ea) tat
Other;Iuspectons'or Fees ;f 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
accurately report fixtures could result in increased sewer fees*. foiAPIRI.O.j4g Installationx,_
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
❑ 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 ❑ 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"
3" ' 51it�lIl,Rilk afn
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 plumbing permit can be issued.
Water Closet-Toilet
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:
13212 SW WELLINGTON PL, TIGARD,
OR, 97223
Record Type: Record ID:
Residential - Plumbing PLM2018-00263
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor