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Permit (33) CITY OF TIGARD PLUMBING PERMIT (' COMMUNITY DEVELOPMENT Permit#: PLM2018-00292 Date Issued: 06/13/2018 T I C;A 1=.I) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 3AA00101 Jurisdiction: Tigard Site address: 10865 SW WALNUT ST Project: Fowler Middle School Subdivision: None Lot: None Project Description: Replacing water heater. Contractor: OWNER Owner: TIGARD-TUALATIN SCHOOL DISTRICT FOWLER MIDDLE SCHOOL BY MAPLETHORPE, BONITA 10865 SW WALNUT 6960 SW SANDBURG ST TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503-367-0421 PHONE: 503-367-0421 FAX: FEES Quantity Description Date Amount 1 ea Water Heater 06/13/2018 $37.52 Specifics: 1 12%State Surcharge- 06/13/2018 $8.70 Plumbing Type of Use: COM 35 ea Minimum Fee Adjustment- 06/13/2018 $34.98 Plumbing Class of Work: ALT 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 OU by calling 503 232.1987 or 1.800 332.2344 / erm • ignature: Issued By: AC:" 411 K j i7 -‘/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 Application Building Fixtures N ` x : ' Cityof Tigard Received l � g �LJ r�J Date/By: (LI �1.,,,X\ Permit Nori.� v/S��c�+� 14 U 13125 SW Hall Blvd.,Tigard,OR 97223 2013 L �� �J I Plan Review Phone: 503.718.2439 Fax: 503.598.1960r Date/By: Other Permit No.: Inspection Line: 503.639.4175 T I G ARD Date Ready/By: Juris ® See Page 2 for Internet: www.tigard-or.gov -- `J Notified/Method: Supplemental Information TYPE OF WORK FEE*SCHEDULE 0 New construction 0 Demolition For special information use checklist Description Qty. Ea. 1,gt-Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 ❑ 1-and 2-family dwelling commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 :JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address:i 0 8 6 5 5 , { ,l l*3 0+ City/State/ZIP: ( y7 }Z Drywell,leach line,or trench drain 18.76 T, 4/' Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.: Project name: �©w I Gt/t_ Manufactured home utilities 50.03 Cross street/directions to job site: Lo& ' mo 1- 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 ;" D DTIV OF WORBackwater valve 12.51 I ,� " Clothes washer 25.02 l/"& 1 e hr i s Yz__ ti cicev,t-t-Lyik_ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 PERTY OWNER ' 1 0 TENANT Expansion tank 12.51 Fixture/sewer cap 25.02 Name: 0---/ 1 4i it Ciet- 1:)1� - tc Floor drain/floor sink/hub 25.02 Address:6° ( c� 4 J S.aog-t by en, . --i- � - A Garbage disposal 25.02 City/State/ZIP: I treL....0_ f` (151,2.._(151,2.._ ''..Z..'7...- X Hose bib 25.02 Phone:(5 l�) -3j'7J Fax:( ) Ice maker 12.51 APPPLIC AN`_'' I N TCT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ ) Page 2 A S ^ Primer 12.51 �J Contact name: f -t r , ,e1....t.S Lt.1-1-'1/4. Roof drain(commercial) 12.51 c7 Address: c( /4, LotrL. t. Sink/basin/lavatory 25.02 City/State/ZIP: Solar units(potable water) 62.54 Phone:(5 .5(7.-C 'Z I Fax::( ) Tub/shower/shower pan 12.51 E-mail:, tL�t,u,r v�.S .t 4 -�1 .-r'' E s c l j i4. Co e..us Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater t 37.52 Business name: Water piping/DWV 56.29 Address: Other: 25.02 City/State/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lic.: Plumbing Lic.no.: q 0 uci Plan review (25%of pernut fee) State surcharge(12%of permit fee) Authorized signature: TOTAL PERMIT FEE Fl,2) Cts I . 1 This permit application expires if a permit is not obtained within 180 days Print name: t� ,,^ - Date: I 1s' 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: Site Utilities Qty; Fee(ea) . Total Square Footage: Permit Fee: 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' 37.52 Storm&Rain Drain-1st 100' 62.54 Viluat on•; ; 'ermit'Fee: $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 u pections or Fees ' Fee( ) TOS 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 Review for Plumbing Installation 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 Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as 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 0 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" 3" Isometric or., iser Diagram 4" 0 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 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: 10865 SW WALNUT ST, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Plumbing PLM2018-00292 Inspection Type: Inspector: 399 Plumbing final Don Sylvester Result: PASS - NoCofO Comments: 1 . Replace existing water heater- Approved Violation Summary: Inspector Contractor