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Permit (118) CITY OF TIGARD PLUMBING PERMIT " COMMUNITY DEVELOPMENT Permit#: PLM2018-00519 Date Issued: 11/06/2018 TIGARD D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134CA00517 Jurisdiction: Tigard Site address: 11720 SW MANZANITA ST Project: OLSON Subdivision: PANORAMA NO.2 Lot: 31 Project Description: Repairing 36 ft.of sanitary sewer. Contractor: ALPHA ENVIRONMENTAL SERVICES INC Owner: OLSON, KAREN L 11080 SW ALLEN BLVD, SUITE 100 11720 SW MANZANITA ST BEAVERTON, OR 97005 TIGARD, OR 97223 PHONE: 503-292-5346 PHONE: FAX: FEES Quantity Description Date Amount 36 If Sanitary Sewer 11/06/2018 $62.54 Specifics: 1 12%State Surcharge- 11/06/2018 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 11/06/2018 $9.96 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 096..92-0,01-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or .332.2344. Issued By: '•rmittee Signature: "Or 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 Site Utilities FOR OFFICE USE ONLY City of Tigard Received g Permit No.: a _ '� 13125 SW Hall Blvd.,Tigard,OR 97223 „� t cp Date/By: /��� � � �)%L/ ��� , w Plan Review I Phone: 503.718.2439 Fax: 503.59 w "" 4a Date/By: Other Permit No.: Inspection Line: 503.639.41759 TIGARD Date Ready/ByJuris: ® See Page 2 for Internet www.tigard-or.gov ,61i O, Notified/Method: , Supplemental Information # 'j'TYPP OF%ORKfit , v E* Dif1;E ❑New construction ❑ 6'14',_4'71,,,t,(-4,dI t 1 i I t ` For special information use checklist ot,\q t ° a Description i. ,.v '� P Qty. Ea. Total ®Addition/alteration/replacement ❑� New 1-2-family dwellings(includes 100 ft.for each utility connection) ' GORY OF ONSTRIJC'ITON SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 ElAccessory building ❑Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 0 Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 N`,O: Y,,NINFORl1 TIO SAND LOC TION,1 Site utilities: Job site address:11720 SW Manzanita St 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.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site:SW 1196 Ave Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:36) Page 2 62.54 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 '1 DESI TIOOFWO I'' ,,` Backwater valve 12.51 .� � . . - ., _. ., si ..-.] .. , . .. -v Lii4. Clothes washer 25.02 Sanitary Sewer Repair via bursting on property and in right of way Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 [7:11;,,,, ,P1. P RE T ' O ER.`"1 ❑ TE . N'Tu Z 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 y r +' PLrI_ ':: OIT CA( E 'QN Interceptor/grease trap 25.02 Business name:Alpha Environmental Services Inc Medical gas(value:$ ) Page 2 Primer 12.51 Contact name:Jocelyn Johnson Roof drain(commercial) 12.51 Address: 11080 SW Allen Blvd Ste 100 Sink/basin/lavatory 25.02 City/State/ZIP:Beaverton,OR 97005 Solar units(potable water) 62.54 Phone:(503)292-5346 Fax::( ) Tub/shower/shower pan 12.51 E-mail:jjohnson@alphaenvironmental.net Urinal 25.02 Z . �i gym' Water closet 25.02 •E.. , . .,. . 1 ,. , r. ,. .�.� .;.: Water heater 37.52 Business name:Alpha Environmental Services Inc Water piping/DWV 56.29 Address:11080 SW Allen Blvd Ste 100 Other: 25.02 City/State/ZIP:Beaverton,OR 97005 Subtotal 62.54 Phone:(503)928-7117 Fax:( ) Minimum permit fee: $72.50 ?.2 5ty CCB Lic.:152125 Plumbing Lic.no.:PB1612 Plan review (25%of permit fee) State surcharge(12%of permit fee) $"_"7c; Authorized signature: ' 1,,../01" 1 TOTAL PERMIT FEF i This permit application expires if a permit is not obtained wit in 8 d days Print name:Jocelyn Johnson Date: 10/30/2018 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: Stte Utl l tie .,. . ., Q Ice WO-. Total `. -(11'V-re Foo age ,Pe _.. Fee.. „x4 Footing Footing drain-15'100' 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' 1 62.54 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 ' aluat><oal, Pe rnitt.,Te, ' ... 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 .Fee#(ea) "Total " each additional$100.00 or fraction thereof,to L.© erInspectio,s or Fees 1, ... . 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 Fixture Type E % I II R e'V ,for Iumbin Ins Mations Fixture Type for Replacer Plan review is required for anyof the following. Work Performed: Capped Added' Relocate 9 Baptistry/Font Please check all that apply. Bath Tub/Shower 111 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 Thru ❑ 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 0 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. Car Wash Draineico Sed. agran Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings 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: C:\Users\jjohnson\Downloads\PLMU_PermitApp.doc 2 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11720 SW MANZANITA ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Plumbing PLM2018-00519 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11720 SW MANZANITA ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Plumbing PLM2018-00519 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor