Permit (64) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00371
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 07/30/2018
TIa11xL 9
Parcel: 2S 102C D02611
Jurisdiction: Tigard
Site address: 9735 SW MCDONALD ST
Project: WILMINGTON SAVINGS FUND'SOCIETY Subdivision: TWALITY HILL Lot: 11
Project Description: Sanitary sewer to connect existing residence to public sewer. Septic system must be pumped and filled,or
removed.
Contractor: ALPHA ENVIRONMENTAL SERVICES INC Owner: WILMINGTON SAVINGS FUND SOCIETY
11080 SW ALLEN BLVD, SUITE 100 BY SHELLPOINT MORTGAGE SERV
BEAVERTON, OR 97005 155 S MAIN ST STE 200
HILLSBORO, OR 97123
PHONE: 503-292-5346 PHONE:
FAX:
FEES
Quantity Description Date Amount
70 If Sanitary Sewer 07/30/2018 $62.54
Specifics: 1 12%State Surcharge- 07/30/2018 $8.70
Plumbing
Type of Use: SF 10 ea Minimum Fee Adjustment- 07/30/2018 $9.96
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:
Call 503.639.4175 by 7:00 a.m.for the next available inspection da e.
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
Site Utilities " _ R.,. FOR OFFICE USE ONL1
Cl of Tigard Received i
411 1111 13125 SW HallgBlvd.,Tigard,OR 97223 JUL L 3 Z O Date/By:7 - //- ,c'J f Permit Nqp , �f_9,95 7/
_ Plan Review,, s
Phone: 503.718.2439 Fax: 503.59 (. atL i �!" Date/By: Other Permit 0 /�-0�/90
Inspection Line: 503.639.4175
T I l;A R D i l n( _< 13 7,,}' Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORD= _ ''FEE* SCHEDULE "." y
..
El New construction El 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)
CATERY OF CONS'i RUC`# N SFR(1)bath 312.70
1-and 2-famil y dwellin SFR(2)bath 437.78
g ❑Commercial/industrial
0 Accessory building ❑Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
-, JOB SITE INFORMATION'i LOCATION- ,,' Site utilities:
Job site address: !• o-dCatch basin or area drain 18.76
�� �� C v '� Drywell,leach line,or trench drain 18.76
City/State/ZIP: 'r"1()C,r , c-1-72-1._-_-?
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.: 70) Page 2
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
f " DESCRIPTION O �=` r- Backwater valve 12.51
Clothes washer 25.02
S)L C-C,""►m 1 S I Vv-% S-9,4-1 �- to i x 0/`( Dishwasher 25.02°'
nn G- ‘t-tet'' 4 C.' I-1-‘-.) f F 1C'-c 1 Drinking fountain 25.02
1G,7"i Lar- L�C/p%,e z /0t--72,, G--/NIS- Ejectors/sump 25.02
41'7�ftt:OPE= OWNS ...4 'fiir N ., 1`, 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
'FLICAI e" ;"711*4-.' .[] CONI .`p , Interceptor/grease trap 25.02
Business name: / Medical gas(value:$ ) Page 2
A\c iti C rl v; e 1,1 iv\exs�'p 1 Primer 12.51
Contact name: ...:51`r.1,,_ C2,,- k 4, yl...,
/� j Roof drain(commercial) 12.51
Address:
l j sit' 'S� 1'"1) 1 i.-rt I) i , t: Sink/basin/lavatory 25.02
City/State/ZIP: 9 lle:y t✓f/.1-1,y,,, ) (-311.-- Gl.7 C-)D 5 Solar units(potable water) 62.54
Phone:(ea3) 3 I I)- "3 L{ (, Fax: :( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
r-MNc„r,-c.,,, 0111* )-1F,�Y1J1^u r r•vz. `f'A), ht-.
1' f 11 *. Water closet 25.02
z 4-:.' Water heater 37.52
Business name: SirL C. 1,--46-17.- --- Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: Subtotal
Phone:( ) Fax:( ) Minimum permit fee: $72.50 ),2-.5.6
CCB Lic.: /5 /a Plumbing Lic.no.: !s (L.) Plan review (25%of permit fee)
State surcharge(12%of permit fee) j:%, 7C
Authorized signature: TOTAL PERMIT FEE oF'7' ,2-4)
Print name:j 6,jr1 y) CD.("r) Date:7- 0-./( 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(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities
„fee(ea) Total Sgpar Foota e: 'mit Fiki,
Footing drain-151 100' 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
ivatio z 3 Permit F. :
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
ty. Fee(ea) Total" each additional$100.00 or fraction thereof,to
Other Inspections oir`Fee?, 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*.
Quantity by ore Type §°. P :4Il CYI ' Orr l I f ' _ ns Q? 0115
Fixture Type for 222. Replace/ Plan review is required for any of the following.
Work Performed: Capped Added ` Relote
Baptistry/Font Please check all that apply.
Bath Tub/Shower
0 Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thm 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
vt'
Car Wash Drain
0 Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMU PermitApp.doe 2
11mil
111 Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. ❑ map& tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS- Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size, type of material, slope of piping,manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
I:\Building\Permits\PLMF-PermitApp.doc 12/30/05
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9735 SW MCDONALD ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Plumbing PLM2018-00371
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor