Permit W .
CITY OF TIGARD PLUMBING PERMIT
'A' 74
� 11 COMMUNITY DEVELOPMENT Permit#: PLM2021-00211
Date Issued: 8/2/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DC00500
Jurisdiction: Tigard
Site address: 15895 SW 72ND AVE 220
Project: Hair Club For Men Subdivision: FANNO CREEK ACRE TRACTS Lot: 40
Project Description: Interior plumbing for TI: Capping(1)2"floor drain/sink;Adding(2)sinks; Replacing/relocating(1)2"floor
drain/sink and(10)sinks.
Contractor: ALWAYS FAITHFUL PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 757 ATTN: N PIVEN
WILSONVILLE, OR 97070 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-780-9486 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Fixture/Sewer Cap 06/11/2021 $25.02
Specifics: 1 ea Floor Drain/Floor Sink/Hub 06/11/2021 $25.02
1 ea Primer 06/11/2021 $12.51
Type of Use: COM 12 ea Sink 06/11/2021 $300.24
Class of Work: ALT 1 ea Water Heater 06/11/2021 $37.52
Type of Const: 1 12%State Surcharge- 06/11/2021 $48.04
Occupancy Grp: Plumbing
Stories:
Total $448.35
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
Issued By: ,eios....fsioa......... wa'"------ Permittee Signature: '
o
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.
h
Plumbing Permit Application • ;,�``0r,���n. E._4
Building Fixtures RECEIVED
FOR OFFICE USE ON1.1
CI of Tigard Received
�J g a n Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 t Date/By: �`��v l � -�-- No -��,}
Phone: 503.718.2439 Fax: 503.598.19:t/ 11111
2 2021 Plan Review ^ / v
Date/By: ! Other Permit No. p ...OM 7
T I c q IZ t� Inspection Line: 503.639.4175 Date Read B ® SPa�e 2 for q
Internet: www.tigard-or.gov ;,lT`(OF TIGARC� Notified/Method. Sj/ /' )--I Supplemental Information
`,� TYPE OF Wt (�.QIN DIVISION t;;* ..r'1's.%tr t FEE* SCHEDULE
R+I u ❑New construction ❑Demolition For special information use checklist
\ '-N Description Qty. Ea. Total
®Addition/alteration/replacement 0 Other: New I-2-family dwellings(includes]00 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
El Accessory building 0 Multi-family SFR(3)bath 500.32
Each additional bath/kitchen 25.02
•-4_0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
b. JOB SITE INFORMATION AND LOCATION Site utilities:
`L ' Catch basin or area drain 18.76
N., Job site address: 15895 SW 72ND
Z Drywell,leach line,or trench drain 18.76
City/State/ZIP: TIGARD OR 97224
Footing drain(no.linear ft.:_) Page 2
''i -
'� 'IN Suite/bldg./apt.no.: 220 1 Project name: HAIR CLUB f- /'►')e^/ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
v Rain drain connector 18.76
S
t%' Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
( Subdivision: CARMEN CENTER Lot no.: Fixture or item:
"-- `fax map/parcel no.: / �" ; Backflow preventer 31.27
�l ,Jt`�Z�`� Backwater valve 12.51
aK'+ DESCRIPTION OF WORK
`��` Clothes washer 25.02
Relocate 10 sinks, Install 2 new sinks, relocate
1 Dishwasher 25.02
41 )s1 hub drain, relocate water heater ,demo cap hub drain
t-r, Drinking fountain 25.02
Ejectors/sump 25.02
® PROPERTY OWNER 0 'TENANT Expansion tank 12.51
Name: Pacific Realty
Fixture/sewer cap 25.02 v�
Address: 6650 SW Redwood Ln Ste 290 Floor drain/floor sink/hub 1 25.02 gS;U),
{� Garbage disposal 1
25.02
City/State/ZIP: Portland/ OR/ 97224 Hose bib 25.02
Phone:( 503)624-6300 Fax:( ) Ice maker 12.51
(•4 ® APPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
Business name:Always Faithful Plumbing Medical gas(value:$ ) Page 2
Primer 1 12.51 �� f
ontact name:Corey Chamberlain Roof drain(commercial) 12.51
Address: PO Box 757 Sink/basin/lavatory 12 25.02
City/State/ZIP:Wilsonville OR 97070 Solar units(potable water) 62.54
i' Phone:(503)780-9486 Fax: :( ) Tub/shower/shower pan 12.51
S E-mail:alwaysfaithfulplumbing@yahoo.corn Urinal 25.02
`]Ct Water closet 25.02
r CONTRACTOR
Water heater 1 37.52 37 s.L
R. Business name: Always Faithful Plumbing Water piping/DWV 56.29
Address: PO Box 757 Other: 25.02
City/State/ZIP: Wilsonville, OR 97070 Subtotal '7,t),3)
Phone:( 503)780-9486 Fax:( ) Minimum permit fee: $72.50 -
Plan review (25%of permit fee) -
CCB Lic.: 217284 Plumbing Lic.no.:PB1940
State surcharge(12%of permit fee) it ro LI
Authorized signature: T •, TOTAL PERMIT FE Z
�� �,�I 3 -
Print name: Corey Chamberlain Date: 4/2 9/21 This permit application expires if a permit is not obtained wi hin 180 days
after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
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:
Site Utilities Qty Fee(ea) Total Square Footage: Permit Fee:
Footing drain-Is'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 S stems:
Water Service-each additional 100' 37.52 x c . �r
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 3752 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees i)ty• Fee(ea) Total each additional$100.00 or fraction thereof,to
P 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 rep ie‘s is required for any of the following.
Fixture Type for Replace/ Please check all that apply.
Work Performed: Capped Added Relocate
❑ 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 ❑ 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 ❑ Any multipurpose fire sprinkler system.
Domestic El 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" 1 1
3" Isometric or Riser Diagram
4" ❑ 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
-Industrial food related
Ice Mach./Refrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
Stall
Sink: -LavBar non-food related 2 47
-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:
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2