Permit CITY OF TIGARD PLUMBING PERMIT
114 = COMMUNITY DEVELOPMENT Permit#: PLM2021-00361
T 1 G A 12.1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/2/2021
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: PACIFIC CORPORATE CENTER
Lot: 2
Project Description: Interior plumbing for TI. ADDING(1)sink and(1)eyewash.
Contractor: POWER PLUMBING CO Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 19418 ATTN: N PIVEN
PORTLAND, OR 97280 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Quantity Description Date Amount
1 ea Lavatories 08/26/2021 $25.02
Specifics: 25 Misc Other Fee 08/26/2021 $25.02
1 12%State Surcharge- 08/26/2021 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment- 08/26/2021 $22.46
Type of Const: 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 are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: Permittee Signature:/-'e4: 1St r aL /e47a /4...
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 Applic CEIVED
Building Fixtures rm.; of rie_ rsl: OM 1
City of Tigard AUG 2021 Received ) /_ /e�rgt�
13125 SW Hall Blvd.,Tigard,OR 9 Dm� �t�/�l' " 1/ t � / � /��
5W ur TIGAR, Plan Review ! 1
Phone: 503.718.2439 Fax 503. 9 0 DatelBy: //�Q�{�
I Ic.vItn Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: raris. 0 See age fo ��
Internet: www.tigard-or.gov Nett fiediMethod: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
D New construction ❑Demolition For special information use checklist.
Description I Qty. I Ea. I Total
®Addition/alteration/replacement ❑Other: New I-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
0 Accessory building 0 Multi-family 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: 15055 SW SEQUOIA PKWY Catch basin or area drain 18.76
City/State/ZIP:TIGARD, OR 9722 / Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no,:130 I Project name: Ye C cc 115 _ 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 fl.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
TENANT IMPROVEMENT SUITE 130 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
0 PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
Business name:POWER PLUMBING CO. Medical gas(value:$_) Page 2
Primer 12.51
Contact name: MIKE WARREN - Roof drain(commercial) 12.51
Address P.O. BOX 19418
Sink/basingavatory 1 25.02
Cite/State/ZIP: PORTLAND, OR 97280-9418 Solar units(potable water) 62.54
Phone:( 503-244-1900 Fax: ( 503F244-8825 Tub/shower/shower pan 12.51
E-mail:SERVICE@POWERPLUMBINGCO.COM Urinal 25 02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name:POWER PLUMBING CO. Waterpiping/DWV 56.29
Address:6611 SW MULTNOMAH BLVD Other: 1 25.02 EYEWASH
City/State/ZIP:PORTLAND, OR 97223 Subtotal
Phone:( 503-244-1900 Fax:( 503-244-8825 Minimum permit fee: $72.50
CCB Lic.:52378 Plumbing Lie.no.: 34-150PB Plan review (25%of permit fee)
Stale surcharge(I2%of permit fee)
Authorized signature: r o"`G7.e[ TOTAL PERMIT FEE
Print name:KRISTIE BRAM WELL Date:8-20-2021 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Fee methodology set by TB-County Building Industry Service Board.
IrBuildingPermirPPLMU-PermiiApp doe I0:01/09 440.4616T(10.0LCOMM'EB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Q7• Fee(07) Total Square Footage: Permit Fee:
Footing drain- I°100 50.03 0to2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 S233.20
Sewer-Ist 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(a) Total each additional$100.00 or fraction thereof,to
pand including S10,000.00.
Inspection of existing plumbing or for S10,001.00 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 S100.00 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
❑ 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
-Driver Taro 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 ❑ Any complex structure as defined in OAR918-780-0040.
Drinking Fountain
Eye wash 1 Submit 2 sets of plans with any of the above.
Floor Drain/sink: -2"
Isometric,or Riser Diagram
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)
Rec.Vehicle Dump Station PLEASE CALL MIKE WARREN WITH QUESTIONS 503-936-5929
Shower: -Gang
-Stall
Sink: -LawBarnon-food related
-Bradley
-Com/Sere/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: ..a/
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