Permit (171) CITY OF TIGARD PLUMBING PERMIT
111. COMMUNITY DEVELOPMENT Permit#: PLM2018-00402
T(G R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/23/2018
Parcel: 1S134DC03001
Jurisdiction: Tigard
Site address: 11130 SW TIGARD ST
Project: Dirksen Nature Park Subdivision: CHERRY HILL ACRE TRACTS Lot: 6
Project Description: Interior plumbing for a new 1,465 sq.ft.restroom facility.
Contractor: REED PLUMBING LLC Owner: TIGARD, CITY OF
PO BOX 2603 13125 SW HALL BLVD
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-572-3785 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Drinking Fountain 08/23/2018 $50.04
Specifics: 4 ea Floor Drain/Floor Sink/Hub 08/23/2018 $100.08
1 ea Hose Bib 08/23/2018 $25.02
Type of Use: COM 4 ea Lavatories 08/23/2018 $100.08
Class of Work: ALT 1 ea Urinal 08/23/2018 $25.02
Type of Const: 4 ea Water Closet 08/23/2018 $100.08
Occupancy Grp: 1 12%State Surcharge- 08/23/2018 $48.04
Stories: Plumbing
Total $448.36
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 80093 . 344.
Issued By: Permittee Signature:
/ 11/4111k
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 ;
Buileling Fixtures - „ .._. I Olt OIII( 1 1 ',I iiNI l
t, t' R { Received -I�'
City of Tigard pates.:
y �/ � rPermit No.: � "T L'�G oC.
13125 SW Hall Blvd.,Tigard,OR 97223,,r. Pbm Review R71-1, � � 1 `
: Phone: 503.718.2439 Fax: 503.598.196011 -4 - t. Date/By: Other Permit No.: ,�J,1 •/�C/_ ..... 7
- Inspection Line: 503.639.4175 pate Ready/By: B See 1f ge z/for 0
7i,,',1 1, {'
Internet: www.tigard-or.gov i a `€ Notified/Method: r Supplemental&formation }}tt t
1', a to '',75-:.;-1.1-411!1''''''.''' : , t y , 1 11116 q�r i In tF`".'= ; -orr Ar 7,49 :;`...::,,,i,„-_,..1.;.:,,-..'.y �'i t 1I i
d 7r,.)-- • ....,-4-4 r ,. .: . : •_il isi. T_g int ...-..4,d: _'1711'414,. ,.,!xs+.. --e.:.-?::',..;:.;. 1.1,1!
. For special lnfomradon use ckeckli#,
®New construction 0 Demolition
Description I Qty. I Ea. I Total ,
0 Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
x"" f Niv s1#4,c 7 '-',,'!-N•:19'7,-77- -17x-5:
�, ,, z-
SFR(1)bath
+.,>@4�.!. „,Ti #i . ;.':..,-,..Z..:.., taFt..iF., .:rs`dv,..lti { l$i , ,:t± ' t
SFR(2)bath 437.78
El 1-and 2-family dwelling ®CommerciaUudustrial
SFR(3)bath 500.32
❑Accessory building ❑Multi-family Each additional batit/kitchevt 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
"11 fij 1 C ..r, ":. --Y!""..7-'!"' .t_:. . t at-n'"-+=-s''mak'r1t j,uz S ::{MW ":
,1 ilflI*"J site utilities:
Job site address:11130 SW TIGARD STREET Catch basin or area drain 18.76
Drywell,leach line,or trench.drain 18.76
City/State/ZIP:TIGARD,OR.97223 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:N/A I Project name:DIRKSEN RESTROOM/NAT PLAY Manufactured home utilities 50.03
Cross street/directions to job site:TIGARD ST AT SW TWIN PARK PLACE Manholes 18.76
ENTER DIRKSEN NATURE PARK AT FANNO CREEK TRAILHEAD. Rain drain connector 18.76
RESTROOM/NATURE PLAY IMPROVEMENTS STIED JUST NORTH OF Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:_„__) Page 2
SPORTS FIELD. Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.:IS t I 11000 /5/, i .e de. 1 Backflow preventer 31.27
�t� t 5 � -,•pert n1,'w
Backwater valve 12.51
,ti , �7,„�, :z,.�.,. .. . . P+s��� ,.-H.ts�.�.r��., :=•-•'-`-'1V4-'1. --4-- -- ",
Clothes washer 25.02
INSTALLATION OF PLUMBING FIXTURES IS A 3-STALL RESTROOM Dishwasher 25.02
_Drinking fountain ✓ 2 25.02 50.04
Ejectors/sump 25.02
t1*m-� r r .---, 6ir4"dy; t r -t"It~s"r" attH kegq *is,Pitlu'-: d. �«�'5. Ex anion tank 12.51
r ; iNftTMz&t 1f.,,k..i:�:.4.s.,::'..:.'.. . ..-r^ .s.. §1i;#i1 t�$.:. ..., 1 -.t ' ..i21ti.• 11.Nk ktk, • ..
Fixture/sewer cap 25.02
Name:CITY OF TIGARD ,
Floor drain/floor sink/hub ✓/ 4 25.02 100.08
Address:13125 SW HALL BLVD Garbage disposal 25.02
City/State/ZIP:TIGARD,OR.97223 Hose bib 1 25.02 25.02
Phone:(503)718-2466 Fax:( ) Ice maker 12.51
I, 1--:..„,,,,.„,
k 4 ,,1,i „, ,,,,,, 3"` ,,„ d"1 .,1.4,,1:' i ,1k r', 14 ' w Interceptor/grease trap 25.02
,JtA,. :,.t . -,4,4, S:*'1 ri.'i fi . :, ,s ,6 J .i.gwa .,. 7
Business name:CITY OF TIGARD Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:JEFF PECK _ Roof drain(commercial) 12.51
Address:13125 SW HALL BLVD Sink/basin/lavatory >/// 4 25.02 100.08
City/State/ZIP:TIGARD,OR.97223. Solar units(potable water) 62.54
Phone:(503)718-2466 Fax::( ) Tub/shower/shower pan12.51
Urinal i/1 25.02 25.02
E-mail:jeflp@ttgard-or goy
4 A2
100.08
tn ,•. �. ' . _ te:, ,_ Water closet
.1-,war,,,,,-- sr. om' � te;,, _. ��, .• „. >a. ;< ' water Crhe37.52
Business name:Reed Plumbing LLC Water piping/DWV 56.29
Address:Po Box 2603 Other: 25.02
City/State/LIP:Oregon City,OR 97045 Subtotal 400.32
Minimum permit fec: $72.50
Phone:(503)572-3785 Fax:(503-)656-1538
Plan review (25%of permit fee)
CCB Lie.:186365PIPl bing Lic.no.:PB 871 '- State surcharge(12%of permit fee)
Authorized signature: t •f 717 C ( ff t TOTAL PERMIT FEE 111,1f,3
vData:$�2 U2018 This permit application expires if a permit is rot obtained wi in ian Jays
Print name:Julie M.Reed _ atter it has been accepted as complete.
*Fee methodology set by 1 ri-County Building Industry Service Board.
I-\auilding ennits\PLMU-PermilApp.doc 10/01'09 440•.4616T(I0/02/COMM'EB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
. Fee Schedule: Residential Fire Su i r ression
.. .,Mo_ .:.l•f` . ,. Systems:
- ; I Cit : } i ! a ' 77,-74110!'5111t " y ` 1),:„,,,..:.,, .._1,4„.„,!,;.:-..:
_ _ - � .•t" 1 1,0.4-:-.4,1:-.114,70..4.„...r., Ly
3,snie' r ia2'. ° tx�• _ c ialt.flr . i,,.,»..,. . '.. 6 �3: i',4..-_. .'�` ':3. X
Footing drain-1°100' 50.03 1111111 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' _®_
Water Service-1st 100' 62.54 111111 Medical Gas S stems:
Water Service-each additional 100' 111111 37.52 111111a _ tt, '01'1.1"' r {, " ' i,
Storm&Rain Drain-1st 100' :.,., ,:. . ,.. -,? ,,.
, .:--� -. .i.�_ ,
.,. ,t
_®_ $I.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' _®_ $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
',Ii`alt�f s a t .111pk a,. .Jivi r; ;�:tri :40 each additional$100.00 or fraction thereof,to
',-...,,:,-.01....,2. ..
.,,..6... ....t giii ,.t.,l+u :+- lilll3glA 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 III 90.00Poreach additional$100.00 or fraction thereof,to
minimum char:e-1/2 hour) 1111 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 char_c-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 IS
90.00/hr 11111 $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
minimum char_ -1/2 hour each additional$100.00 or fraction thereof.
Subtotal: ___
Other Fixtures: I I I I
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*.
`th i ,gift= ~-sr. 7 titer" 1,J:i i T o
-.y�, i E , 'ti x ffp< �r � �p t tuet +,g 1t r1 { - -tr 77
-W-="11. ,,1 „t, ,,;:,;;',11-..---',7-,-, y t 1 -,'fix , .ei:: «..- _..,.':.Ol✓/..s as. .ti i:w r ,.Ku,Kza3.+, t,.,. ..3.r-.........4.. ..r �L .+,
na•t rJ ha s, ....-. .<<, , d, ,... .. , Plan review is required for any of the following.
Baptistry/Font
Bath -Tub/Shower Please check all that apply.
Jacuzzi/Whirlpool ❑ Any new commercial building with water service 2"and
Car Wash -Each Stall greater,except systems designed and stamped by licensed
-Drive Thru , engineer.
Cuspidor/Water Aspirator 0 New exterior plumbing site utilities for any complex structure
Dishwasher -Commercial as defined in OAR918-780-0040.
-Domestic ❑ Medical gas and vacuum systems for health care facilities.
Drinking Fountain a ❑ Any multipurpose fire sprinkler system.
Eye Wash 0 Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2" 4
-3" Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain I = "- � , ti.,.10- e-,1'' '-
,�1;,W,, " ,..-„.. . e,.z._.dr .-.,... ,: .._.,.._. _..- 7:14-.:�uttt'.
Garbagepo -Domestic-non-food
■ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related � q g
-Commercial--food related that meet the ,ualifications above,
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang
-Stall
Sink/Lav -Non-food related 4-
-Bradley .
-Commercial-food related
-Service
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet-Toilet 4 increase of sewer EDUs,a sewer permit will be issued and
Urinal • l fees assessed for the sewer increase must be paid before the
C:\tJscrs\juliestevenreed\AppDatatLoeal\Microsoft\Windows\JNetCache\gintcnt.Outlook\CMX3U4ZC\DNP-BUILDING PLUMB
FIX_PermitApp.doc
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11130 SW TIGARD ST, TIGARD, OR, 97223 December 14, 2018 at
9:05:36 AM
Record Type: Record ID:
Commercial - Plumbing PLM2018-00402
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor