Permit CITY OF TIGARD PLUMBING PERMIT
II
I'' COMMUNITY DEVELOPMENT Permit#: PLM2020-00335
T i GAR O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/1/2020
Parcel: 1S126DC03300
Jurisdiction: Tigard
Site address: 9900 SW GREENBURG RD 295
Project: MWH Office Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: ADD(1)dishwasher and(1)ice maker water line to refrigerator;RELOCATE(1)break room sink.
Contractor: ADVANCED TECHNOLOGY GROUP Owner: MEADOWS 196 LLC
455 SE 2ND AVE 5665 MEADOWS RD STE 140
HILLSBORO, OR 97123 LAKE OSWEGO, OR 97035
PHONE: 503-693-9202 PHONE:
FAX: 503-640-4333
FEES
Quantity Description Date Amount
1 ea Dishwasher 09/01/2020 $25.02
Specifics: 1 ea Ice Maker 09/01/2020 $12.51
1 ea Sink 09/01/2020 $25.02
Type of Use: COM 1 12%State Surcharge- 09/01/2020 $8.70
Class of Work: ALT Plumbing
Type of Const: 10 ea Minimum Fee Adjustment- 09/01/2020 $9.95
Plumbing
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 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 - - 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 50 1987 or 1.800.332.2344.
Issued By: Per.00
mittee Signature: ad L/Li
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 RECEIVED
Building Fixtures AUG 1 7 2020 FOR OFFICE I SF; OSI,Y
City of Tigard Received Permit N
13I SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Pate By;eP .2Y/ 4'� f c(17jo-od 33s
Phone: 503.718.2439 Fax: 503s98.t�011LDING DIVISPO an Review
Date/By: Other Permit 054. .►g, 20,(C/u1t%
Inspection Line: 503.639.4175 Date Rea /B luris: I ® See Page 2 for [[
I c n tt t Internet: www.ti and-or. ov y
g g Notified Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction ❑ Demolition For special information use checklist
Description I Qty. I Ea. I Total
®Addition/alteration/replacement ❑Other: 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 ElCommercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 9900 SW Greenburg Rd,Suite 295 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.: 295 Project name:M W H Office Breakroom 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: l.ot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK 8ack 12.51 watervalve
Clothes washer 25.02
Replacing existing sink in breakroom' Dishwasher 1 25.02 25.02
Installing new dishwasher&ice maker Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ® TENANT Expansion tank 12.51
Name: MWH Constructors Fixmre/sewercap 25.02
Address: 9900 SW Greenburg Rd,Suite 295 Floor drain floor sink F ub 25.02
Garbage disposal 25.02
City/State/ZIP: Tigard,OR 97223 Hose bib 25.02
Phone:( 561) 310-7065 Fax:( ) 1 Ice maker 1 12.51 12.51
El APPLICANT ® CONTACT PERSON Interceptor/grease trap 25.02
Business name: MWI-I Constructors / G r Medical gas(value:$_) Page 2
Primer 12.51
Contact name: Adam Ward {fin f FPS 7-
Roofdrain(commercial) 12.51
Address: 9900 SW Greenburg Rd.Suite 295 [la,,‘f'67)aFwttArcofv.-Sink/basin/lavatory 1 25.02 25-02
City/State/ZIP: Tigard,OR 97223 Solar units(potable water) 62.54
Phone:(561 )310-7065 Fax: :( ) Tub/shower/shower pan 12.51
E-mail:adam.ward@mwhconstructors.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Advanced Technology Group,Inc. Water piping/DWV 56.29
Address: 455 SE 2nd.Ave. Other: 25.02
City/State/ZIP: Hillsboro,OR 97123
Subtotal 62.55
Phone:(503 )693-9209 Fax:(503 ) 640-4333 Minimum permit fee: $72.50 72.50
CCB Lie.: 130364 7/fO 1844-
J _ Plumbing Lie,no.: 34-399PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) 8.70
Authorized signature: ,.L 1edeee�.r TOTAL PERMIT FEE -
Print name: Michael Hudson t Date: 8/13/2020 This permit application expires if a permit is not obtained within 110 days
after it has been accepted as complete. I s 3-0
*Fee methodology set by Tri-County Building Industry Service Board.
1:13uilding'Permils1PLMU-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-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' 37s2 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
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*. Plan 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
Baptistry/Font ❑ Any new commercial building with water service 2"and
greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
-Jacuzzi/Whirlpool
IDCar Wash Each Stall New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial lea ❑ 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" Isometric or Riser Diagram
❑ 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 .9-AjS ts}-r &/ j
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
-
Oil Separator(Gas Station) NO b/L}104 - /2_C7,t�`71f 72.
Rec.Vehicle Dump Station
Shower: -Gang
-Stall ' Onh/ t:.A Sink: -LavBar non-food related
-Bradley
-Com/Serv/Util food related I ea.
-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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