Permit (143) CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00357
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/09/2019
Parcel: 2S102AD00300
Jurisdiction: Tigard
Site address: 12555 SW HALL BLVD
Project: Harris-McMonagle Associates,Inc. Subdivision: TIGARD HIGHWAY TRACTS Lot: 19
Project Description: Interior plumbing for TI: Replacing(1)hose bib, (3)sinks,(2)water closets,(1)water heater,and adding(1)ice
maker.
Contractor: OASIS PLUMBING INC Owner: HARRIS, MCMONAGLE ASSOC INC
11177 S ALLEN CT 12555 SW HALL BLVD
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503-351-0743 PHONE:
FAX: 503-212-0165
FEES
Quantity Description Date Amount
1 ea Hose Bib 09/09/2019 $25.02
Specifics: 1 ea Ice Maker 09/09/2019 $12.51
3 ea Sink 09/09/2019 $75.06
Type of Use: COM 2 ea Water Closet 09/09/2019 $50.04
Class of Work: ALT 1 ea Water Heater 09/09/2019 $37.52
Type of Const: 1 12%State Surcharge- 09/09/2019 $24.02
Occupancy Grp: Plumbing
Stories:
Total $224.17
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 7 dopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. •u may obtai a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or L800.332.2344.
Issued By: Permittee Signature:
all 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 completio of th-project.
Approved plans are required on the job site at the time of each inspecti n.
Plumbing Permit Applicatio
e,. � .` FLOC
Building FixturesFOR OFFICE IL SE ONI,v
City of Tigard SEP 9 2019 Received
Date/By: �f y,// / --� Permit No.: /2b4,7,0261 4_i y�35-7
IN I 41 13125 SW Hall Blvd.,Tigard,OR 97223 W
Plan Review
Phone: 503.718.2439 Fax: 503.598,1460 Date/By: Other Permit No.: tt �I t q_00j 33
Inspection Line: 503.639.4175 „• „ See P 2
T 1 ,ARD w t.1 Date Ready/By: Juris: H Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
t.
,., ,_ -rot OF•WORK ,• _ . .E*
❑New construction 0 Demolition For special information use checklist.
Description Qty. Ea. Total
Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
IV and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
ElAccessory 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
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 11_,S c� ism Rck.l t •2 t.: Catch basin or area drain 18.76
�-_ Drywell,leach line,or trench drain 18.76
City/State/ZIP: I i t=-.vC(.
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.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION 11; ':WORI
Backwater valve 12.51
"` Clothes washer 25.02
2 r'I L 1/3 L tr
I - Dishwasher 25.02
27,' `-:> `4.- mS'jZ. '�V. U..1,4 ( C.1.I,:. ' t - 4i -.T' Drinking fountain 25.02
t�� (----- Lc4 j tz to S Lj Ejectors/sump 25.02
® PROPERTY owitER ❑ TENANT Expansion tank 12.51
�n^ ] Fixture/sewer cap 25.02
Name:
j./Cj✓Y�t'`1 v t l G✓2vi.. z ' .ffetL;c.�."tcc7
FAddress: /--2_,---,s.--4._!_;f- S % `11 \ t v'_ Garbage
drain/floor disposalsposink/hub 25.02
City/State/ZIP: � v-6,47 Garbage 25.02
t Lj Hose bib C 25.02 ���
Phone:( ) C� Fax:( ) Ice maker 12.51 / ,S
tx i
(3 APPLicANT 0 INTACT PERSON .' Interceptor/grease trap 25.02
Business name: Medical gas(value:$ ) Page 2
Primer 12.51
Contact name:
Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 3 25.02 774dc
City/State/ZIP: Solar units(potable water) 62.54
Tub/shower/shower pan
Phone:( ) Fax::( ) 12.51
E-mail: Urinal 25.02
CONTRACTOR Water closet -Z 25.02 S7,). QQL.1
Water heater i 37.52 3 7,S 1_
Business name: 6c, � `c "-E)to24.1 6,1, 11,1.E Water piping/DWV 56.29
Address: i i ( ---i.1 S (l e kv C'_• Other: 25.02
City/State/ZIP: c
` -,. ' L Subtotal
Phone:(50=- ; s( , 7 if: Fax:( ) Minimum permit fee: $72.50
CCB Lic.: ( 'Z''. Plumbing Lic.no.: Cr Plan review (25%of permit fee)
State surcharge(12%of permit fee) 01/4, 0).
Authorized signature: TOTAL PERMIT FEE ✓24.14,I-)
This permit application expires if a permit is not obtained within 180 days name: J (e_ae e Date: C /Ct I ,
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\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-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' 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
Other Inspections or Fees Fee,(ea) Total and incadluding
10,$100.00. or fraction thereof,to
I1 �� 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*. Flan Review for Plumbing Installations
Quantity by Fixture Type ' Plan review is required for any of the following.
Fixture Type for 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 engineer.
-Jacuzzi/Whirlpool
Car Wash: -Each Stall 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: -Commercialirator 0 Any multipurpose fire sprinkler system.
Domestic 0 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"
0 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) a/Ce_/-14 ! AeirdT hr Alk - A col:4 W
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -lav/Bar non-food related ex.3
-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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