Permit (57) t CITY OF TIGARD PLUMBING PERMIT
91
.'q> COMMUNITY DEVELOPMENT Permit#: PLM2019 00170
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/20/2019
Parcel: 1S134CC01700
Jurisdiction: Tigard
Site address: 12325 SW KATHERINE ST
Project: Mary Woodward Elementary School Subdivision: None Lot: None
Project Description: Interior plumbing for the reception and offices vestibule:Capping(4)sinks and(1)water closet;Adding(1)sink and
(2)water closets; Relocating(3)sinks and(4)water closets.
Contractor: APOLLO SHEET METAL INC Owner: TIGARD-TUALATIN SCHOOL
2300 SW 1ST AVE# 104 DISTRICT 23J
PORTLAND, OR 97201 6960 SW SANDBURG ST
TIGARD, OR 97223
PHONE: 503-222-6343 PHONE:
FAX: 503-222-2935
FEES
Quantity Description Date Amount
5 ea Fixture/Sewer Cap 06/17/2019 $125.10
Specifics: 4 ea Sink 06/17/2019 $100.08
6 ea Water Closet 06/17/2019 $150.12
Type of Use: COM 1 Plan Review 06/17/2019 $93.83
Class of Work: ALT 1 12%State Surcharge- 06/17/2019 $45.04
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $514.17
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.
Issued By: 7-7Permittee Signature:
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.
r Plumbing Permit Application 7.0 A / 04,A I
Building Fixtures FOR OFFICE USE ONLY
City of Tigard Received PennitNo.:
11111 'I 13125 SW Hall Blvd.,Tigard,OR 972 IP �+ ��e Date/By: y/ ll`i -" ��}° `t / �t^
p tr Plan Review
Phone: 503.718.2439 Fax: 503.598.1! y Other Permit No.:
TIGARD Inspection Line: 503.639.4175 PR 1 o 'Lu Date/By::Ready/By: ' (� �� ��"
Date Juns [3 See Page 2 for
Internet: www.tigard-or.gov A w• Notified/Method:S- I ry. Supplemental Information
0 New construction 111 De
$11
• `fr For special information use checklist
Description Qty. Ea. Total
®Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
€55 , Mini eIzSFR(1)
';� bath 312.70
ID1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
0 Master builder ®Other:K-12 School
.N> ., Fire sprinklersq.ft.) Page2
0 I,r'3P _x� ai 9� LOQ' # ... ' _ •site tillties:
Job site address:12325 S.W.Katherine St. Catch basin or area drain 18.76
City/State/ZIP:Tigard,OR 97223 Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
_ Suite/bldg./apt.no.: Project name: 4, licAzi -154,:ivejizt Manufactured home utilities 50.03
.11 Cross street/directions to job site: Manholes 18.76
gC Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
' Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
a
Tax map/parcel no.: Backflow preventer 31.27
1 ' Backwater valve 12.51
*�. Q . -°.. , e s Clothes washer 25.02
`�' ' (1) F1 Dishwasher 25.02
Install 13)new fixtures Drinking fountain 25.02
() £_{,6,,-FE ( j) 31 so Ks i 9(4\5. t ) .-- 5 Ejectors/sump 25.02
la •ii OWNER : [] I'B Ext. pansion tank 12.51
and Tualatin School
\ Fixture/sewer cap ��
Name:Tigard District ( l.�0000►°tie.. '
JJJ Floor drain/floor sink/hub NI 25.02
C Address:12325 S.W.Katherine St. Garbage disposal 25.02
, City/State/ZIP:Tigard,OR 97223 Hose bib 25.02
Phone:(503)431-4087 Fax ( ) Ice maker 12.51
`' ` '� 1: # CSE NT p 0 P.E oN `' Interceptor/grease trap 25.02
,
� Business name:
Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:Cheryl Nicholson
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory I AM 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:(503)278-0216 Fax::( ) Tub/shower/shower pan 12.51
E-mail:cheryl.nicholson@apollomech.com Urinal 25.02
Water closet _..._Illifin
musr..'.r , 0 CONOR s .. , _ >a . . , Water heater
37.52
Business name:Apollo Mechanical Contractors Water piping/DWV 56.29
Address:7555 SW Tech Center Drive Other: 25.02
City/State/ZIP:Tigard,OR 97223 Subtotal
Phone:(503)278-0216 Fax:( ) Minimum permit fee: $72.50
Plan review (25%of permit fee)
CCB Lic.:56241 Plumbing Lie.no.:37-413PB
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name:Cheryl Nicholson Date:4-18-2019 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
•:Fee i,.cf},Aalogy aet by Tri-Comely Building Industry-Surma Puotid.
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 Sup•ression Systems:
: 1 /. . c iijAcj, t s
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 '"'liffl -"
$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
1 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:
Other Fixtures:
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*.
: - •Quant b fixture T a e
.1 •.f Ca ed "wa• e
y���)tp� oru[�d s�; � pp �Added`� �Reloe�e Plan review i isrequired for anyof the following.
Baptistry/Font4
Bath Tub/Shower Please check all that apply.
Jacuzzi/Whirlpool El 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 0 Medical gas and vacuum systems for health care facilities.
Drinking Fountain ❑ Any multipurpose fire sprinkler system.
Eye Wash ❑ Any complex structure as defined in OAR918-780-0040.
Floor Drain/sink -2"
-3" Submit 2 sets of plans with any of the above.
Car Wash Drain
WIWWIC
Garbage -Domestic-non-food - 4
Disposal Domestic food related El Isometric or riser diagram is required for new buildings
-Commercial-food related that meet the qualifications above.
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station Comments regarding fixture work:
Shower -Gang �t
-Stall
Sink/Lay -Non-food related 3 ` AL
-Bradley 3- e2 r C t eAlde f(-
-Commercial-food related
Service 44k , /Ud Cri-C r
Swimming Pool Filter
Washer-Clothes *Note: If the fixture work�ef this permit results in an
Water Extractor
Water Closet-Toilet `2, increase of sewer EDUs,a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
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Plumbing Permit Application
Building Fixtures Fox oil ICF l SI. o1Ll
iiiiCity of Tigard Received
Date/By: Y t 6 /kg75---
Plan
- Permit No.:am..).4 t +��/��
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 1
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: --.,9-i R •e9 Other Permit No.:
Inspection Line: 503.639.4175
C I G A l D Date Ready/By: .rods: See Page 2 for
. Internet www.tigard-or.gov Notified/Method �j /� Supplemental
fupplemental l ormation
,"v--'-':- .".";..: T ' = i :, ,t��yr is iy 40 n _
:f
!i 11 i
❑New construction ❑Demolition ' or special information use checklist
- Description Qty. I Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGGORY OF CONSTRUCTION SFR(1)bath 312.70
❑ 1-and 2-family dwelling Commercial/indu Rt r,, ; .FR(2)bath 437.78
fig
❑Accessory building 0 Multi-family •f • ' FR(3)bath 500.32
Each additional bath/kitchen 25.02
❑Master builder 0 OtherFire sprinkler( sq.ft.) Page 2
JOB Fit INFORMATION' 1D LOCATION Site utilities:
Job site address: I).3.).5 s iv Iia+ke+r! Catch basin or area drain 18.76
t Drywell,leach line,or trench drain 18.76
City/State/ZIP:
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: I Project name: iN1ary WWI Ek Military 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
DESCRIPTION OF o c =) Backwater valve 12.51
* , Nt
Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
Cl.1PROI'ERTY OWNER 1 c 49' 0 TEI$A IT Expansion tank 12.51
Name: Fixture/sewer cap .5 25.02 f!a 5.(0
Address:
Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
Q APPLICANT ID CONTACT PERSON. Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Contact name:
Primer 12.51
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 4 25.02
City/State/ZIP: Solar units(potable water) 62.54
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
CONTRACTOR ` Water closet 25.02 /SO,Ia
Water heater 37.52
Business name:
Water piping/DWV 56.29
Address: Other:
25.02
City/State/ZIP: Subtotal 395,10
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) (43,83
State surcharge(12%of permit fee) ¢S.,G4
Authorized signature: TOTAL PERMIT FEE Sig./rj
This permit application expires if a permit is not obtained within 180 days
Print name: Date:
after it has been accepted as complete.
--_- _ --_ set byYti-t:
omnyig ttty service s6atd.
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:
• Qty. Fee(ea)
'Toixl Sgtlare;FOota e• Permit; Fe •
Site Utilities � g • r.w
Footing drain-Pt 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' 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
Qty.
Fed(ea) otal„ each additional$100.00 or fraction thereof,to
;Offer Inspections or Fees 5�: _ 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 hour)
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*. )Ian Review for P1U nb3 g i ii r Thous ,;
ptity b xFixture Plan review is required for any of the following.
TextureType for Replace/ Please check all that apply.
Work Perlprmetii ., Added` 0 Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thnt
Cuspidor/Water Aspirator 0 Medical gas and vacuum systems for health care facilities.
0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercialirator
El Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
Eye Wash
Floor Drain/sink: -2"
1 I I. g M "a Gla' am
4" U Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
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 4 1 3 G�,Y•J•JJ r ' /,
-Bradley CI
,Vv o �61r3�"
-Com/Serv/Util food related CGP " V '' N
-Service N *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 1 01 plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2
Branden Taggart
From: Branden Taggart
Sent: Monday, May 6, 2019 6:07 PM
To: cheryl.nicholson@apollomech.com
Cc: #Building Permit Technicians
Subject: Mary Woodward Elementary Plumbing Permit: PLM2019-00170 - 12325 SW Katherine
St.
Attachments: PLM2019-00170.pdf
Hi Cheryl,
The interior plumbing permit for Mary Woodward Elementary is ready to issue. The balance due is$514.17, and the
permit fees can be paid online now at https://aca.accela.com/TIGARD/Default.aspx or in person between the hours of
8:00 a.m. and 4:30 p.m., Monday through Thursday. We are closed on Fridays. If the fees are paid online, please have
someone pick up the permit and plans.
Please note that the credits from the capped fixtures offset the SDC fees for the new fixtures;therefore, a sewer permit
was not created, and there are no sewer fees due. Also, there will not be a credit for future usage, either. Please let me
know if you have questions.
Thanks,
Branden Taggart
,14___ • City of Tigard
a Senior Permit Technician
Community Development
13125 SW Halt Blvd
Tigard,OR 97223
X503}718-2449'
brandent@tigard-or.gov
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12325 SW KATHERINE ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2019-00170
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor