Permit (145) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2018-00555
T[GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/10/2018
Parcel: 2S102BC03700
Jurisdiction: Tigard
Site address: 12860 SW WATKINS AVE
Project: JD Hill Construction Subdivision: NORTH TIGARDVILLE ADDITION Lot: 31
Project Description: Reconfiguring plumbing for basement remodel:(1)sink, (1)tub/shower,(1)water closet,and(1)water piping/DVVV.
Contractor: CLASSIC PLUMBING LLC Owner: BIGEJ, KIMBERLY R
521 S BALINE ST 12860 SW WATKINS AVE
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503-554-1605 PHONE:
FAX: 503-538-8570
FEES
Quantity Description Date Amount
1 ea Sink 12/10/2018 $25.02
Specifics: 1 ea Tub/Shower/Shower Pan 12/10/2018 $12.51
1 ea Water Piping/DWV 12/10/2018 $56.29
Type of Use: SF 1 ea Water Closet 12/10/2018 $25.02
Class of Work: ALT 1 12%State Surcharge- 12/10/2018 $14.26
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $133.10
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 1.800.33
Issued By: ,. - ermittee Signature: 7kS C
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 r
Building Fixtures
RECEIVED FOR OFFICE (SE O\I.\
City of Tigard n Received
!PI 111 g 1l Permit No.:
13125 SW Hall Blvd.,Tigard,OR 9722'IEC �U18 Date/By: /t�//(J�j,{' /� i2�leJL��'-( `
e Plan Review
Phone: 503.718.2439 Fax: 503.598.k960 ,. Other Permit No.:
Inspection Line: 503.639.4175 ryV il„� ' T IGAR� Date/By: � )(� ��� /
T1 G A B D 9 f � DIVISION Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov 1 DI Notified/Method: lemental Information
/ d Supplemental
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist
Description Qty. Ea. Total
ien/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
•CATECTORY OF,d .CONSTRUCTION SFR(1)bath 312.70
E(.1---and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
SOB Sl E *Q ATIONrAND LOCATION Site utilities:
Job site address: Catch basin or area drain 18.76
\-D__(:; .....) tet'^ l �\Y- ,,� Footing
Drywe1,leach line,or trench drain 18.76
City/State/ZIP: V �f �-a Footindrain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I 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.:_) 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 � JON r.**6- -O , Backwater valve 12.51
Clothes washer 25.02
Nie-'
�C Qr� �aC� vJ4 \--,--Q3, \ Dishwasher 25.02
v -. C \ �h0 f \O or \�� ( Drinking fountain 25.02
�T Ejectors/sump 25.02
PROPERTY OWNER I r- 1.:',,,,, Expansion tank 12.51
Name:
V......_,....Vs,-c\
Fixture/sewer cap 25.02V......_,.... Floor drain/floor sink/hub 25.02
Address: \D-Z<p' C- •,J . -\..�,�N
r Garbage disposal 25.02
City/State/ZIP: T \ ��l UP...-__. Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Interceptor/grease 25.02
APPLIC� �,"a tt r s('� CONTACT PEA:S�z `"`' trap
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory i 25.02 ,-.'-'57c1..
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan ) 12.51 AZ,5-)
E-mail: Urinal 25.02
Water closet 25.02 ;c')-
CONTRACTOR-
\ Water heater 37.52
Business name: . . -,% 1J d���.^A. Water piping/DWV L 56.29 5 M
Address: S D_\ , \�,�� k - Other: 25.02
City/State/ZIP: 1--)Q C.)\'2......._ C\---t‘ Subtotal //O3 'y
Phone:( 21%) 5 '4\,pQ\ Fax:( ) Minimum permit fee: $72.50
CCB Lic.: \ \ . to Plumbing Lic.no.:` \'C j\( Plan review (25%of permit fee)
State surcharge(12%of permit fee) /if )L
Authorized signature:- \ \,' 2; ` ( TOTAL PERMIT FEELt/13 f e j
Print name: ` Z ' ��t Date:\Z \,O\\% This permit application expires if a permit is not obtained within 180 days
1 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Bui1dingTermits\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 Qty. #'t`ee(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 al u[ation: .is Pee:
$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 Inspectits or Feed ' 3lotpl each additional$100.00 or fraction thereof,to
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 eyes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. fi plan Revs a .Plumbing stallatlon*
Quantity by Fixture Type Plan review is required for any of the following.
Fixture Type for RePlacetA Please check all that apply.
Work Performed: CaPPed Added Relocate,
0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
-Jacuzzi/Whirlpool engineer.
Car Wash: -Each il 0 New exterior plumbing site utilities for any complex structure
as defined in OAR918-780-0040.
-Drive Thru
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ 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"
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:
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