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Permit (180)Elk CITY OF TIGARD PLUMBING PERMIT ,1111 COMMUNITY DEVELOPMENT Permit#: PLM2019-00098 Date Issued: 03/12/2019 TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104CD03400 Jurisdiction: Tigard Site address: 13506 SW HILLSHIRE DR Project: LE Subdivision: HILLSHIRE ESTATES Lot: 34 Project Description: 45 ft.of water service. Contractor: PLUMBING CRAFTSMAN AND DRAIN SERVICE LLC Owner: LE,ADAM L&PAULINA Q 13300 SW BUTNER RD 17318 NE CLACKAMAS ST BEAVERTON, OR 97005 PORTLAND, OR 97230 PHONE: PHONE: 503-810-3250 FAX: FEES Quantity Description Date Amount 45 If Water Service 03/12/2019 $62.54 Specifics: 1 12%State Surcharge- 03/12/2019 $8.70 Plumbing Type of Use: SF 10 ea Minimum Fee Adjustment- 03/12/2019 $9.96 Plumbing Class of Work: ALT Type of Const: Occupancy Grp: Stories: Total $81.20 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty s and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if wor s not ,$ rt-• within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires • • fol the rules =dopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 001-009►. •urfiay •stain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.86 1441 . Issued By: Permittee '•••ture: 4017,00111. 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 FOR OFFICE LSL OM1.v City of Tigard Received�(� �[f Permit No.: t . 13125 SW Hall Blvd.,Tigard,OR 9722 it�`'j$' Date/By: ►to7i���("1�.��p Phone: 503.718.2439 Fax: 503 Plan Review 1111 I Other Permit No.: Date/By: T 1 G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov 7" 3 Notified/Method: Supplemental Information TYPE OF WORD Y 3 vi " FEE* SCHEDULE 0 New construction ❑h li �4I S,® For s ecial in ormation use checklist tet(� Description ��� Qty. Ea. Total Addition/alteration/replacement [ New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONS J•R UCTION SFR(1)bath 312.70 and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78 buildingSFR(3)bath 500.32 ❑Accessory ❑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: Job site address: S w S Catch basin or area drain 18.76 S 1- 'i.-li t 0. (QV' • Drywell,leach line,or trench drain 18.76 1-City/State/ZIP: I �,,fd, V t-')•Z;Z. �) 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: 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.:if-4., / Page 2 &it,s-z1 Subdivision: -I Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 $)ESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 ULr4VC"/V 3--V1/4-, iC-C" LUSSI\ Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 0 PROPERTY OWNER I , ; 0:"TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 ���1,{� L r. Floor drain/floor sink/hub 25.02 Address: (..3 5 t,. w ..t..i F'1.. t\S I'i 4v r 'CIV ° Garbage disposal 25.02 City/State/ZIP: I t c (c; ( ("- ct 1 2,Z.- 7 Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 APPLICANT ] CONTACT PERSON Interceptor/grease trap 25.02 k y i,� Y i 1rt C- -t-5'WI air/ Medical gas(value:$ ) Page 2 Business name: v2( Primer 12.51 Contact name: TC.,w.. =L . z''7 ` Roof drain(commercial) 12.51 Address: "3.3 L-' Lk" a'-1 1- til C',_ 'V Sink/basin/lavatory 25.02 City/State/ZIP: R v v-v. tall Solar units(potable water) 62.54 Phone:(45.-, - (t..%- .? 2.-S1/4-3 Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR • i 4 gk 4c C,(L6 - yty Water heater 37.52 Business name: C ce; Waterpiping/DWV 56.29 Address: (.3'3 i'l s S t2 `)u. 6, vim' - Other: 25.02 City/State/ZIP: R y'1 y (.4.A. 4 -'j,V`v c Subtotal 4?,5-4 Phone:6--J)) (l.. ` J. 5 Fax:( ) Minimum permit fee: $72.50 7 y 917 CCB Lic.: 2L)c-i (:,, 2. Plumbing Lic.no.: I-1 q Plan review (25%of permit fee) State surcharge(12%of permit fee) F-70 Authorized signature: ��` TOTAL PERMIT FEE 3�j�� `)�U ,,`` Print name: , \ L,;V�..r L V ,t t.- Date:"i -Li ' 1 This permit application expires if a permit is not obtained within 80 days _ after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. 1\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 Qty. Fee(ea) Total Square Footage: Permit Fee: 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 Sewer3,601 to 7,200 $233.20 -1st 100' 62.54 7,201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-1st 100' 1 62.54 (p),..5-11 Medical Gas Systems: Water Service-each additional 100' 37.52 Valuation: Permit Fee: 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 Other Inspections or FeesQty. Fee(ea) Total 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 ' 0.4c71 4c71 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 Installations Quantity by Fixture Type Plan review is required for any of the following. Fixture Type Tor Replace/ 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 Stall 0 New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918-780-0040. Cuspidor/Water Aspirator ❑ 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" 3" 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 beaid before the Water Extractor p 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: 13506 SW HILLSHIRE DR, TIGARD, OR, 97223 March 14, 2019 at 10:35:52 AM Record Type: Record ID: Residential - Plumbing PLM2019-00098 Inspection Type: Inspector: 399 Plumbing final Jeremy Burrows Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor