Permit (37) CITY OF TIGARD PLUMBING PERMIT
I . ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00105
T I(;A R p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2019
Parcel: 2S111 ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Site utilities for(5)relocated portable buildings.
Contractor: TRIPLETT WELLMAN INC Owner: UNION HIGH SCHOOL DISTRICT
PO BOX 160 NO. 3 JT
WOODBURN, OR 97071 00000
PHONE: 503-982-4188 PHONE:
FAX: 503-982-0390
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain 04/18/2019 $18.76
Specifics: 123 If Storm Sewer 04/18/2019 $100.06
1 Plan Review 04/18/2019 $29.71
Type of Use: COM 1 12%State Surcharge- 04/18/2019 $14.26
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $162.79
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.
....7.....7i,,,,
Issued By: 4i� .�"L�' '�� di ianature:
•
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 RECEIVED FOR ()EFT( F LSE ()NEN
City of Tigard Received
Date/By: ,) / i'l PermitNo.: ,�
IN 111 ml 13125 SW Hall Blvd.,Tigard,OR 97223 MAR 112019 ..10/,,,v7
� . ! 1 '"
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review cr_
Date/By. 4` l( tic -. Other Permit No.: '" q A:}�-
T I G A R p Inspection Line: 503.639.4175
4,i 1>`OF TIGARD DateReadyBy: Jens: ® See ei C7 G L �`
Page 2 for
Internet: www.tigard-or.gov �I jI DING DlVIS1nN Notified/Method:Ll1(0/t'1 6p---- supplemental Information
TYPL� (F W �; of"�Sh�,JAI �*
❑New construction 0 Demolition For special information use checklist
Description Qty. Ea. I Total
0,0 dition/alteration/replacement 0 Other:Manufactured New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling ommercial/industrial SFR(2)bath 437.78
❑Accessory building 0 Multi-family SFR(3)bath 500.32
0 Master builderEach additional bath/kitchen 25.02
0 Other:Manufactured Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address:14650 SW 975h Street Catch basin or area drain 1 18.76 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name:Twality Mid Sch-Portables Manufactured home utilities 50.03
Cross street/directions to job site:97th and Murdock Street Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.:123) 2 Page 2 100.06
Water service(no.linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.:2S111ACO2700 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
All underground work related to installing(5)portables and a temporary
Dishwasher 25.02
parking lot. Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 1 0 TENANT Expansion tank 12.51
Name:Tigard-Tualatin School District Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:6960 SW Sandburg Street
Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)431-4000 Fax:( ) Ice maker 12.51
Cs APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Day CPM Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Shawn Christensen
Roof drain(commercial) 12.51
Address:6960 SW Sandburg Street Sink/basin/lavatory 25.02
City/State/ZIP:Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(971)727-4168 Fax::( ) Tub/shower/shower pan 12.51
E-mail:shawn.christensen@otak.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name:Triplett Wellman Water piping/DWV 56.29
Address:1717 Mt Jefferson Ave Other: 25.02
City/State/ZIP:Woodburn,OR 97071
Subtotal /le,(:).A
Phone:(503)982-4188 Fax:( ) Minimum permit fee: $72.50
CCB Lic.:43496 Plumbing Lic.no.:
Plan review (25%of permit fee) )`1,7/
State surcharge(12%of permit fee) /L(, (-
Authorized signature: TOTAL PERMIT FEE pb , 91
Print name:Shawn Christensen Date:03/08/2019 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee metltedeieb f s,t by Tri-Co,mt.B tiMGag Lni.3ti y Servii,e Board.
L\Building\Permits\PLMU-PermitApp.doe 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 (NY. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1g 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
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 1 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 1 37.52 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty 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: 3CO CL
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 Plan Review for Plumbi ng Xnstauations
Fixture Type for Replace/ Plan review is required for anyof the following.
Performed: Capped Added Relocate q
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 Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR9I8-780-0040.
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.
-3"
Isometric or Riser Diagram
Car Wash Drain
Garbage -Domestic-non-food 0 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
g *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:
haps://otakinc-my.sharepoint.com/personal/shawn christensen_otak comffpocuments/Documents/TMS Portables/Permitting/PLMU_PermitApp.doc
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ISiteI A
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:
14650 SW 97TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Plumbing PLM2019-00105
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor