Permit CITY OF TIGARD PLUMBING PERMIT
III = e COMMUNITY DEVELOPMENT Permit#: PLM2021-00395
Date Issued: 9/23/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101A603400
Jurisdiction: Tigard
Site address: 7090 SW BEVELAND RD
Project: Univox Media LLC Subdivision: 2014-011 PARTITION PLAT Lot: 2
Project Description: ADD(3)2"floor drains,(1)sink and(1)water closet; RELOCATE(2)sinks and(1)water closet;replace water
heater.
Contractor: K& C PLUMBING INC Owner: BEVELAND STREET LLC
PO BOX 2124 7080 SW BEVELAND RD
OREGON CITY, OR 97045 PORTLAND, OR 97223
PHONE: 503-518-0234 PHONE:
FAX: 503-518-1100
FEES
Quantity Description Date Amount
3 ea Floor Drain/Floor Sink/Hub 09/17/2021 $75.06
Specifics: 3 ea Sink 09/17/2021 $75.06
2 ea Water Closet 09/17/2021 $50.04
Type of Use: COM 1 ea Water Heater 09/17/2021 $37.52
Class of Work: ALT 1 12%State Surcharge- 09/17/2021 $28.52
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $266.20
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: 4 Permittee Signature:
dr qpp1;C,A4ity-N
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 ApplicatiE''EIVED -4
Building Fixtures
City of Tigard SEP 5 ZOZ Received
1111 ■ 13125 SW Ffall Blvd.,Tigard,Olt 97223 ICY= //J 4/Z , 420 ��ltiP 2624-nO SI s
a !'bona: 503.718.2439 Fax: 503.598.1 OF TIGARLJ rw olntl Per> wJ 22)21-A9LS3
11(,�1:I, Inspection line: 503.639.4175 3UILDING DIVISION' Dater kaay/By- 0 Sec l*ase2fr
Internet: www.tigard-or.gov Nutineermaihoe//ik/Z/ !hl`G' 1.1277 Anppkmrnta l Information
TYPE OF WORK 4-/(_ ft4 s'-S FEE' SCHEDULE
❑New Construction 0 Demolition For special infurnau'ion use diedliat
� Descripticn 1 . I EL Total
a Additian/altoration roplaeement 0 Other New 1-2-tan4Iy dr Map(in lute 106 S.f.,e‘age1,utility connection/
CATEGORY OF W. srKm-rION SFR(1)bath 312.70
❑ 1-and 2-family dwelling algitConunercialinduatrial SFR(2)bath 437.7K
❑Acccsaory building 0 Multi-family SFR(3)bath 506.32
Each additional badrlitchaa 25.02
❑Master builder 0 Other, Fire sprinkler sq.IL) Page 2
JOB SITE INFORMATION AND IAECATION Sttc tllkks:
Job site address: 70 9 p _ ,4° / / ,y /�b am Catch basin or arta drain 18.76
(rJ /L �t �C T !� `
Ikyvm11,leach line,a trench drain 13.76
CityiStatoZIP: TIA4,� a
/ Footing drain(no linear R. _) Page 2
Suitdbldglapt.no.: •
1 rrojcct name: !i/JfL//)k /y(-Di' Le-C_,{anutietured hcmtc utilities 30.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
. l' Sonilwy sower(no.linear R.: ) Page 2
r -' / '' - Stain sewer(no.linear It.:_) Page 2
Water service(no.linear ft.: Page 2
Subdivision: I Lot no.: nature or item:
Tax map+parcel no,: Rae.flowpreventer 31.27
DESCRIPTION OF WORK Badcwaler valve 12.51
Clothes wisher 25.02
iA s csT___ :(1.4 / 3, sII/A e 3 llishwrdrer 25.02
T tnni• GYtet p-ki '14 4-toi I- 4r-Ae . J&.e f-eve Drinking fnmta n 25.02
Ejectors•srunp 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 1231
Name: Fixturo'sewar cap 25.02
Flan drai&luor sink/huh 3 25.02 ` 75:s t.
Address:
Garbage disposal 25.02
City/StatoZIP: (lose bib 25.02
Phone:( ) Fax:( ) Ice snakes 12.51
0 APPLICANT 0 CONTACT rumor{ Intercepturfgrease bap 25.02
Business name:
Medical gas(who::S_) Page 2
Printer 12.51
Contact name:
Roof drain(ammo-Mal) 12.51
Adder: Sinkibasin+kvaray 3 25.02 7 f 0 4
Cityy/Stata/LIR Solar units(potable twtea) 62.54 ,
Phone:( ) Fat: :( ) Tub.dtowar/shower pm 12.31
E-mail- IDj) h j/J 0 1 , Cti Urinal 25.02
leo�._47_%alR.►CPDR Water closet L. 25,02 5o4 oy
) Water heats j 37.52 3e 7..rZ
Business name: K 4)C F',L� b Water P tP G•in"DW 3629
Address:I(o, .�6 ,0 ,e Other: 25.02
City+Star 'Z1P(1i+ , �, �. f, c)cid 9 ?o yr Sub404 tl 237.6 b'
Phone:Lye S 17€ _7 �' 7 .� F.: ( ) /C/fA
Minimum i.cnni*far: $72.50
Plan review (25. of permit fee)
CCB Lie..I(p�pGzi, '7 Plumbing Lie.na.: 5 State surcharge(12%of permit fcti) 7 9'i /'
Aarhnrired sign TOT.IL PER.\IIT F r. 2 t t.. 7.8 V
' Ikt1c / '� I Thl. rrmltapplication rapers ita permit k not obtained elthnat dn.
Pintnaat , .{�j <c,
after it M.tern aacptn)as complete
'l•cc rnthoda logy net by Tr:i{'nunty Building Indmtry Suvxc Board
I.'tldalilFttrueria.Mii•renniAlp.aa l0•DtN'> aa.aairatialet%Xi4•WtBi
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Taal Square Footage: Permit Fee:
Footing drain-1`100' 50.03 0 to 2.000 S 121.90
tinting drain-each additional 100' 37.52 2.001 to 3,600 S169.69
3.601 to 7,200 S233.20
Sewer-1st 100' 62.54 7.201 and grotto' 532754
Server-each additional 100' 37.52
Ward Scn'icc•1st 100' 62.Y1 Medical Gas Systems:
Water Sovice-each additional 100' 3752 Valuation: Permit Fee:
Storm 2t Rain Dram-1st 1tt4' 62.54 S1.00 to S5,o00.00 Minimum lee S72.50
Storm&Rain barn-each additional 100' 37.32 55.001.00 to S10,000.00 S72.50 litr the first S5.000.00 and S1.52 for
Other inspections or Fees > <°a1 Total �additional ding1 fraction�,naaear,toa�
0.
intpcction of existing plumbing or tar S10,001,00 to 525,000.00 5148.50 for the fast S10.000.00 end$1.54 lie
which no fee is specifically indicated 90.O0,hr each additional$100.00 or fraction thereof.to
(minimum charge- 112 hour) and including S25.000.00.
inspections outside of normal business 90.001tr S25,001.00 to S50,000.00 S379.50 for the fast S25.000.00 and 51.45 for
hours(minimum shuec-2 bolas) each additional 5100.00 or fraction thereof,to
Rein pcction Fees 90.001r and including 550.000.00.
Additional plan review for revisions 90.00'u S50.001.00 and up S742.00 for the first S50,000.00 and 51.20 for
(minimum charge 1/2 hour) each additional S100.00 or faction thoroof
Subtotal:
Commercial Fixture Work:
Are you capping.adding or replacing Maurer? if"yes",
please indicate pork 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 oldie following.
Fixture Type for Repined Please:clack all that apply.
Work Performed: Capped .,ddk-d Helot-Mt
Baptistry`Foal ❑ Any new commercial building with water service 2"and
greats-,except systems designed and stamped by licensed
Bath: •Tuth'Showsr etlgiaeei.
a■curzi.Whirlpool ❑ New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR9 i 8-780-0040.
-Drive Airu
Cuspidan'Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial 0 Any multipurpose fire sprinkler system.
Domestic ❑ Any complex structure as defined in OAR918-780-0040.
EveWash Drinking Fountain
Eve Submit 2,sets of plans wills any of the above.
Wash
Floor Drain!sink: -2-
-3' Isometric or Riser Diagram
4„ 0 Isometric or riser diagram is required for new buildings
-Car Wash Drain that meet the qualifications above.
Garbage -Domestic non-food
I1lspnsal. -Domestic taod related
-Commacial loud related
-Industrial feral related
Ice\lachiRefrig.Drains Comments regarding fixture work:
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Lav:Barnen•1Lodrebind f 2.
- ley
-CautiSa-uUtii food rolatod
-Smice "Note: If the fixture work under this permit results in an
Swimming Pool flier increase of sewer EDUs,a sewer permit will be issued and
U'asher-Clothes fees assessed for the sewer increase must be paid hcforc the
Watts Extractor
Water Closet-Toilet 1 1 plumbing permit can be issued.
t. heal
Other Fitmtraa'
riBuilding\Pmttits\PLMF_PermitApp.doc 08/04/2011 �