Permit CITY OF TIGARD PLUMBING PERMIT
114 COMMUNITY DEVELOPMENT Permit#: PLM2020-00354
Date Issued: 10/14/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AB01606
Jurisdiction: Tigard
Site address: 7357 SW BEVELAND RD 100
Project: Well&Good Coffee Subdivision: HERMOSO PARK Lot: 17
Project Description: Interior plumbing for TI:Adding(2)2"floor sinks; Installing (1)2"hub drain, (1)grease trap,(1)primer(1)
Espresso machine,and(1)glass rinser;
Contractor: CARRIER PLUMBING INC Owner: MIF LLC
12948 SE STALEY AVE OR 7357 SW BEVELAND RD#200
DAMASCUS, OR 97089 TIGARD, OR 97223
PHONE: 503-702-2238 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Floor Drain/Floor Sink/Hub 09/10/2021 $75.06
Specifics: 1 ea Interceptor/Grease Trap 09/10/2021 $25.02
1 ea Primer 09/10/2021 $12.51
Type of Use: COM 50 Misc Other Fee 09/10/2021 $50.04
Class of Work: ALT 1 Plan Review 09/10/2021 $40.66
Type of Const: 1 12%State Surcharge- 09/10/2021 $19.52
Occupancy Grp: Plumbing
Stories: 103 Cash Over 09/10/2021 $102.82
Total $325.63
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: --7 Permittee Signature: ' G: ' t�, 1
_Eq..
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 _ '- G /3)20
1 -.i '1 et/tlfr ,YVl he CE1VhI.. FOR OFFICE USE ONLY
City of Tigard S E P 0 3 2020 Received a�,/d 2020 Permit N�,,o(Zo2v-1 23St1
Date ve
•III
* 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review l �qp�',�,���� /� �/e � yy
Phone 503 718.2439 Fax: 503.598 1960 't'�, Dateilly: C7 qL f cl2t z Other Permit No.:1Sl"'r ..,20)..' '
,c ARD Inspection Line: 503.639.4175 CITY I OF i IGARD Date Ready/By: lrris ®See Page 2 for
Internet www.tf aid-or goy PM ! 141 r'; 1 1 i!7,'!`: N,t ii..t'\fethod. TIGr Supplemental information
TYPE. OF WORK FEE* SCHEDUi.F
0 New construction El Demolition
special infsrmation use cheek list.
- -- Description I Qty. I Ea_ I Total
:it.e1dditiontalterationireplacement ❑Other: - New 1-2-family dwellings(includes 100II.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(I)bath 312.70
❑ t and 2-family dwelling Commercial'industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
.--- Each additional bath/kitchen 25.02
I ❑Master huilder ❑Oe,•
Fire sprinkles( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address' 2 t- ' ''- '',4 Catch basin or area drain 18.76
Dryw•ell,leach line,or trench drain 18.76
.f9
City/State ZIP. 7 - t� ,
7 Footing drain(no.linear ft: ) Page 2
Suite./bidg.lapt.no.41/00 Project name: `, 4. 1L'C Manufactured home utilities 50.03
Cross street:directions to job site: C_'e -ee, 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 It.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map%parcel no.: v'C J /0 I y¢-C C1 Ci'_ Backflow preventer 31.27
DESCRIPTION OF WORKBackwater valve 12.51
1G2(7-.10o)Pc Clothes washer 25.02
t Ac&-. -5144�� Dishwasher
Drinking fountain 25.02
Ejectorsisump 4ti 25.02
❑ PROPERTY OWNER I ❑ 9 t�N AN"i Expansion tank IA‘ 12.51
Name: Fixture/sewer cap 1(�(O� 25.02
Floor drain.%tloor sink/hub 25.02
Address:
Garbage disposal 25.02
City,,/State/ZIP: Hose bib 25.02
Phone:( 1 Fax:( ) ice maker 12.51
-❑ APPtJCANT 0 CONTACT PERSON Interceptor'grease trap I 25.02 Z-5 4 Z
Business manic: Medical gas(value:$ ) Page 2
�,., Printer I 12.51 '2.y,0 -
Contact name: �t � ��
!�.r"7 7 ��l L'r^n' �� ���.._ Roof drain.(commercial) 12.51
Address: Sink.hasin%lavatory DA,,..".2.,54 2,LAdiFegracti '�t
City/State/ZIP: l Solar units(potable water) 62.54 �V1�
/ fhL�111• ,,cc -----
Phone:( ) tr 7(a--74170 Fax: :( ) Tub/shower/shower pan 12.51 d
E-rtl.ril: es Ci'r Yr Y ✓ y4.k)t't.c \-� Urinal 25.02
(f V. "> Ls �J �In`�1 t C t Water closet 25.02
COViRICTaR -
Water heater 37.52
Business name"
_s'j 424, 06... iii4 2 bVaterpipiug,DWV 56.29
Address. °~
(2 Cl�( � ��� �hVoy l/t4-4 Deter: 25.02 !7.5 ,,�1-+�
f j ryi CityiState/ZCity/State/ZIP: .�"�y�, ,r{�, ` 7D87. Subtotal / t,
Phone:( 503) 7 G 2_.2 2?f Fax:( ) 7//it21) Minimum permit fee: S72.50
CCB Lic.: Z_Z I 4V Plumbing I..ic.na.:26 56f Pe25
Plan review (12%( ofpermit f . 3; 7 i,
I State surcharge Of permit
fee)) t2ir,(J•2
Authorized signature: -% '` TOTAL PERMIT FEE �3y. 5
Date: 7.,�.,, Tins permit application expires if a permit is not obtained within 180 days
Print name: ' � �•} } after it has been accepted as complete.
r 3•�-- "'Fee methodology set by TO-County Building industry Service Board.
I:'tiuilding PemitsPL.MU-PmmaApn.doe I0A1:09 44416IC,Tt tb 02/oxi WERT
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Plumbing Permit Anolication-City of Tigard
Page 2-Supplemental Iaformatfon
Fee Schedule: Residential Fire Su r>t ion
Faotiat drain-1"100' 50.03 0 to 2,000 S121.90
Footing drain-each additional 100' 37.52 2.001 to 3,600 S 169.64
3,601 to 7,200 S233.20 ,
Sewer-lst 100' 6Z54 7.201 sad w 5327.54
Sewer-each additional 100' 3732 •
•
Water Service-1st 100' 62.54 Medical Gas S stems: •
•
won Sw ioe-ach addirimd 100' 3752 °7-r . .yam- ,.
Siam St Raid Drain•la 100' 6234 S1.00 so S.5,000.00 ` Mrnmatm fcti S72.S0
Salon a Ran Drain-deb*Mammal 100' 37.52 SS,001.0o to$10,000.00 ' s1?.50 fix the first S5,000.00 and S 132 for
each additimai S 100.00 or friction tharcof,to
_ _ a and icctui nit S10,000,00.
loapoctwn damn phantom;or far S 10,001_00 to S25,000.00 S 148 50 for the firm S 10,000 00 and SI S4 for
which ao fee is specifically indicated 90.004ir oath add,hurial S 100.00 or fraction Maim(to
tmauuem chaos-1/2 how) aid hieludins S254000 00. _
Inspections outside of tamed!business 90.00Au $25,001.00 to S50,000.00 S379.50 for the first T25,000.00 and S 1,45 for
,nuts(minimum dear"-2 hours, each additional 5100.00 or Section thereof.to
Raropectian Fees 90.00/r and inetudmtt S50,000,00,
Additional plan review for revision 90.00/hr $50,001.00 and ap $742.00 for the that S50.000.00 and S1,20 for
(malignant ohmic-l t2 lour) +each additional S 100.00 or Damien thereof.
Salaatal:
Commercial Fixture Work:
Are you capping,addleg or repute!Rztnre s? If"yes",
I, please ladicate work performed by fixture. Failure to
accurately report fixtures could result to increased sewer fees*. "i . . .. . ..,...
i ' . ‘,f 'Plea review is required for any ofthe fellmwiog
1Mms r ' Please check.all that apply.
wlllefitlliAiiarie. ❑ Any new commen:ial building with water son ice 2"and
B greaser,except systems designed and stamped by licatuot!
Bath: -Tnb/Slrorer may .
7i ool 0 New exterior plumbing site utilities fee any enniploe sin catrs
Car Weak: -Eau*Soil as defined in OAR918-780-0040.
-Drive Thai ❑ Medial and vacuum system
Cospidot' arrr Anpratar , fin+ kles for health errs facilities.
Dialoosab - •Comma:id ❑ Any eadtipurpose fire sprinkler ayacnh.
0 Any complex sernatarc as d&Rmmd to OAR918-7840040.
-Doassine
MOW*Faaetm .
Eye wash — Subs* treat of pens Willi way of lied above.floorDeaii►amk: -r _ -? t/3 ,
4- aide ,Y .;
-ter vino►Dorn • isometric or user diagram is required for new buildinp
"Crrwge Daaeaec+ro.hoer tint facet the • fic tioos above.
Disposal -Domenic food milord
•Conrmac+at food rehod ,
-b aea&fed mired y
!oe Mac h.ditat ..Omniis Apart work:
Oil Sgeramarieles Sambas) C72117b40 4,42erK4 7 V.e 4,1, .
Ice Vehicle Ebb,Saw 7_:r �r..r:3 i-- ska'Azbt �� 2`f f�tree-7�
Slower [i.re ,"I'r7T' S•-vim X "'
•yea
Sink -Las/B.,arOOsd Wood ' ✓70-N,c, - :
•CossiSc oVed food wined
$jf1MdC -NNE If die ewer*worn eerier obis permit reemlis be se
Sr.mrar4Pool filar *atom re(sewer EOM,a saver per will be ivied set
Ladds-Cloaca
Waver Exmoor hes aeeeand far fibs sewer bees see 0ri be paid brier*the
Water Claw-Tama pig perish can be hoe&
tlimd . L
{)rhea Emma Ll„0-att� .f---
Plumbing Permit Application
' } wilding Fixtures FOR OFFICE USE ONL\
g Received ft�1o20-.0035g
Cl of Tigard Permit No.: V V
111 13125 SW Hall Blvd.,Tigard,OR 97223 Date/By:
e g Plan Review z1 Other Permit No.:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: �-.Z�"�� ad
I I G A l D Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑New construction 0 Demolition For special information use checklist.
Description Qty. Ea. 1 Total
rAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
El1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
I. ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
1 JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: r 3s 9 sso. 132u,I I va .St
City/State/ZIP: Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.:0/oe, 1 Project name:LiitU ii-&and (e t�n t t 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: Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
;�11
p { �� Clothes washer 25.02
R.ct.mCiLL.& L.t", ter-- -�`^-CJJ1 Dishwasher ,
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I 0 TENANT Expansion tank 12.51
Fixture/sewer cap 25.02
Name: •�
Floor drain/floor sink/hub 3 25.02 11 siO4,
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 gas ,co,
Business name: Medical gas(value:$ ) Page 2
Contact name: (f ,rCt Primer 1 12.51 ,S
664 iY4i� t1 jac..A Roof drain(commercial) 12.51
Address: �y�,j fritdo�tsini3rator�-- n 2S•"" ` rUY
City/State/ZIP: LI` 41„jJI t Solar units(potable water) 62.54
Phone:( ) Fax::( ) Vf Tub/shower/shower pan 12.51
E-mail: }.itI Urinal 25.02
fp6• Water closet 25.02
CONTRACTOR ;, ii r
`�t�' Water heater 37.52
Business name: 13;i' Water piping/DWV 56.29
Address: Other:ES p rexsa otlt:lt; ( 25.02 5-0t d 7
City/State/ZIP: ,( 1,1 nser,/ Subtotal .9.39;O. �'
Phone:( ) Fax:( ) Minimum permit fee: $72.50 ( +1
CCB Lic.: Plumbing Lic.no.: Plan review (25%of permit fee) fr, V
State surcharge(12%of permit fee) fat' 'tv:d
Authorized signature: TOTAL PERMIT FEE I3j" '
l
This permit application expires if a permit is not obtained within 180 dayt�,
Print name: Date: after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard # , l
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 Systems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54
Storm&Rain Drain-each additional 100' 37.52
Other Inspections or Fees Qty. Fee(ea) Total
Inspection of existing plumbing or for Lk-3 j'
which no fee is specifically indicated 90.00/hr
(minimum charge—1/2 hour)
Inspections outside of normal business 90.00/hr
hours(minimum charge—2 hours) f
Reinspection Fees 90.00/hr ` ,\ `
Additional plan review for revisions 90.00/hr
(minimum charge—1/2 hour)
Subtotal: tr. . r `
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes", i S \V-41
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 D Any new commercial building with water service 2"and
Baptistry/Font greater,except systems designed and stamped by licensed
Bath: -Tub/Shower
Jacn77i/whirlpool engineer.
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive as defined in OAR918-780-0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: -Commercial ."„riG jr ❑ 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
4 ❑ 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) �7+ihf 77'y711.rt �1f •t kab.4 if- 111-4 t%j,/d-i 4,�,p,-rw
Rec.Vehicle Dump Station 4,77
Shower: -Gang
-Stall
Sink: -Lav/Bar non-food related
-Bradley
-ComiServ/Util food related ANf t �
-Service Or t Illie /'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: it,,h i1/✓ {
I:\Building\Permits\PLMF_PermitApp.doc 08/04/2011 2