Permit Support Document (36) 0i
CITY OF TIGARD PLUMBING PERMIT
r '' COMMUNITY DEVELOPMENT Permit#: PLM2019 00374
"T' ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 •l„i, ''•; - k i Date Issued: 09/19/2019
Parcel: 1 S 135BA03300
9 /IImoi ', Jurisdiction: Tigard
Site address: 10585 SW GREENBURG RD
Project: Safeguard Mini Storage Subdivision: None Lot: None
Project Description: Interior plumbing: Replacing(1)dishwasher and(2)sinks. 9/19/19:REPRINTED permit to include(1)replaced
shower stall.
Contractor: WESTERN PLUMBING Owner: UNIVERSUS
9460 SW TIGARD AVE SUITE 101 BY STEVE ECOFF
TIGARD, OR 97223 1357 MADRONE LN
SAN LUIS OBISPO, CA 93401
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/19/2019 $25.02
Specifics: 2 ea Sink 09/19/2019 $50.04
1 12%State Surcharge- 09/19/2019 $9.01
Type of Use: COM Plumbing
Class of Work: ALT 1 ea Tub/Shower/Shower Pan 09/19/2019 $12.51
Type of Const: 0 12%State Surcharge- 09/19/2019 $1.50
Plumbing
Occupancy Grp:
Stories:
Total $98.08
Required Items and Reports(Conditions)
z
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 stain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: `~ tee Signature: vf/ �' /.
.i - =fes
/�"
Call 503.639.4175 by 7:00 a.m.for the next available inspe, on date.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD PLUMBING PERMIT
114
8 ' COMMUNITY DEVELOPMENT Permit#: PLM2019-00374
Date Issued: 09/19/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135BA03300
Jurisdiction: Tigard
Site address: 10585 SW GREENBURG RD
Project: Safeguard Mini Storage Subdivision: None Lot: None
Project Description: Interior plumbing: Replacing(1)dishwasher and(2)sinks.
Contractor: WESTERN PLUMBING Owner: UNIVERSUS
9460 SW TIGARD AVE SUITE 101 BY STEVE ECOFF
TIGARD, OR 97223 1357 MADRONE LN
SAN LUIS OBISPO, CA 93401
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/19/2019 $25.02
Specifics: 2 ea Sink 09/19/2019 $50.04
1 1 12%State Surcharge- 09/19/2019 $9.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $84.07
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: * Permittee Signature: < _ /
Call 503.639.4175 by 7:00 a.m.for the next available inspe •n date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
e
t. ` Plumbing Permit Application,.
Building Fixtures r, _,
IN "", i'' Received �M
Ci OIFTigard V/4 /'l Penn"N°.: "!,h /4 a,3?sf
>�r Re eine. E
1h1ne S5 Hall .243.,l'iFax: OR 97223 Plan Review /j J ,,'�J
I Phone: 503J18.2439 Fax: 503.59$.1460: �te;gv. Other Permit No.: t " (j1
Inspection Line: 503.639.4175
TR,A It I) Date Ready/By: ,Juris ® See Page 2 for
u
Internet: www.tigard-or.gov Nonfied/Mediod. . �." ,Supplemental Information
TYPE OP'VVQit :..:._ . .. l '"' ti ..• 'c
0 Demolition For special information use checklist
1=I New constructionDescription I Qty. I Ea. I Total
®Addition/alteration/replacement 0 Other: Newt-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF cONSTRt,1Cr1OPl,, SFR(I)bath 312.70
_ ,. SFR(2)bath 437.78
0 I-and 2-family dwelling 0Commercial/industrial
SFR(3)bath 500.32
0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02
❑ Master builder 0 Other: Fire sprinkler( sq.tl.) Page 2
JOB SITE INFORMATION-AND tO I'IO - Site utilities:
Catch basin or arca drain
18.76
Job site address: 10585 SW Greenburg Road
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223 Footing drain(no.linear ft.:�) Page 2
Suite/bldg./apt.no.: I Project name:Safeguard Mini Storage 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 I.ot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: 412.51
' Backwater valve
l iOrif O WORK
Clothes washer 25.02
Interior Remodel Dishwasher I 25.02 25.02
Drinking fountain 25.02
/(g/ty �:�i4..1( (l) Si.E.-rer ,�...m. 25.02
�-.� Ejectors/sump
Lxpansion tank 12.51
Fixture/sewer cap 25.02
Name:Joel Gisler
Floor drain/floor sink/hub 25.02
Address:10585 SW Greenburg Road Garbage disposal 25.02
City/State/ZIP:Tigard,OR 97223 llose bib 25.02
Phone:(541)815-0966 Fax:( ) Ice maker 12.51
CONTAC Interceptor/grease trap 25.02
-... . Atli . . E "€ - '
Medical gas(value:$ ) Page 2
Business name:Western Plumbing,Inc. l2 51
Primer
Contact name:Dana Jensen Roof drain(commercial) 12.51
Address:9460 SW Tigard Street,Suite 101 Sink/basin/lavatory 2 25.02 50.04
City/State/ZIP:Tigard, I OR 97223 Solar units(potable water) 62.54
Fax: ( ) Tub/shower/shower pan �y/jri/tci j 12.51 ! /..a
. r
Urinal -
E-mail:danarawester Water closet 25.02
.i
AOR , Water heater 37.52
Business name:Western Plumbing,Inc. Water piping/DWV 56.29
Address:9460 SW Tigard Street,Suite 101 Other: 25.02
Subtotal 75.06
City/State/ZIP:Tigard,OR 97223
Minimum permit fee: $72.50
Phone:(503)639-.5296 Fax:( )
Plan review (25%of permit fee)
CCB 1.ic.:2439 Plumbing Lic,no.:3429PB State surcharge(12%of permit fee) _ 9.01
Authorized signature:, r t , \ i) TOTAL PERMIT FEF. 84.07
• .4`! This permit application expires ifs permit is not obtained within ISO days
Print name:Dana Jensen Date:9/13/19 after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i lnuildintePermits\PLMII-PermitAPP.doc 10/01%09 440-46 16T(l0/02/COM/WEa) /.#.� Pb .44-�J
(1) ,Stv.,.,rr-v = .414.0I
Plumbing Permit Application - City of Tigard
}
* Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities . (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' 37.52Valuation* 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 fit,, ` Fee(e ) To 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:
RECEIVED
Commercial Fixture Work: SEP 19 2019
Are you capping,adding or replacing fixtures? If"yes", CITY OF TIGARD
please indicate work performed by fixture. Failure to BUILDING DIVISION
accurately report fixtures could result in increased sewer fees*.
Fixtur Quantity by Fixture Type Plan Review for Plumbing Installations
3 Capped Added Relocate
Plan review is required for any of the following.
Work Performed; Please check all that apply.
Baptistry/Font
Bath Tub/Shower 11 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 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic 1 ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ 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"
4„ 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.
F er -Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.
Vehicle Dump Station ! /Lj /Y 6, a
.�. i
Shower Stall-Gang s ,?re-tri +/vy�n..� ,, /-_ k ,yY (.4 J,-4✓�.
Sink/Lav -Non-food related 2
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *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:
C:\Users\Admin\Downloads\PLMF_PermitApp.doc 2
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-l n 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 Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
h 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: RECEIVED
Are you capping,adding or replacing fixtures? If"yes",
SEP 1. 9 2019 � �r
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*. CITY OF TIGARD
Quantity by Fixture Type B(_f IR#or Plumbing Installations
Fixture Type for Replace/ Plan review is required for anyof the following.
Work Performed: Capped Added Relocate q
Baptistry/Font Please check all that apply.
0 Any new commercial building with water service 2"and
Bath -Tub/Shower
greater,except systems designed and stamped by
licensed
-Jacuzzi/Whirlpool
Car Wash -Each Stall engineer.
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities.
-Domestic 1 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"
-4" Isometric or Riser Diagram
Car Wash Drain
0 Isometricriserdiagrambuildings
Garbage -Domestic-non-food or is required for new
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 1
Sink/Lav -Non-food related 2
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *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:
C:\Users\Admin\Downloads\PLMF_PermitApp(1).doc 2