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Permit
CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2022-00043 Date Issued: 2/14/2022 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CB07400 Jurisdiction: Tigard Site address: 10470 SW PARK ST 101 Project: Middleton Trust Building Subdivision: 1998-084 PARTITION PLAT Lot: 2 Project Description: Interior plumbing for a new office building with accessory warehouse space:Adding(2)2"floor drains,(5)sinks, and(2)water closets; Installing(1)backflow preventer,(1)backwater valve,(1)expansion tank,(1)primer,and(1) water heater. Contractor: BRUNER PLUMBING Owner: MIDDLETON HOLDINGS LLC PO BOX 23985 PO BOX 23985 TIGARD, OR 97281 TIGARD, OR 97281 PHONE: 503-484-5105(CELL) PHONE: FAX: 503-624-2173 FEES Quantity Description Date Amount 1 ea Backflow Preventer 02/14/2022 $31.27 Specifics: 1 ea Backwater Valve 02/14/2022 $12.51 ea Expansion Tank 02/14/2022 $12.51 Type of Use: COM 2 ea Floor Drain/Floor Sink/Hub 02/14/2022 $50.04 Class of Work: NEW 2 ea Hose Bib 02/14/2022 $50.04 Type of Const: 1 ea Primer 02/14/2022 $12.51 Occupancy Grp: 5 ea Sink 02/14/2022 $125.10 Stories: 2 ea Water Closet 02/14/2022 $50.04 1 ea Water Heater 02/14/2022 $37.52 1 12%State Surcharge- 02/14/2022 $45.78 Plumbing Total $427.32 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: 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 �-( `-�---l'��� -Site-Utilities ei,l'iAt‘, DIVED City of Tigard R°ae vea DateBy: //LP,. Permit No.: /� �9 :Nva 13125 SW Hall Blvd.,Tigard,OR 9722 &8 9 2022 (�l-r1�dt 2 -�d I Plan Review Phone: 503.718.2439 Fax: 503.598.1 Date/By: 6///� Other Permit No.:/k((f - aj s Inspection Line: 503.639.4175 rikiA Rn t,ITY OF TIGAHrJ DateiMet Ready/By: Jura S See Pagel for Internet: www.tigard-or"gov Notified/Method: O//1 .45,- - Supplemental Information TYPE OF WW,ILDING DIVISION .:ri7wt1..e ;C 44iel FEE* SCHEDULE G New construction ElDemoliti• I . (�A l' II Forspecial information use checklist Description IDAddition/alteration/replacement El Other: 1 i A a ' 1 I Q1Y• Ea. Total �� New 1-2-family dwellings(includes]00 ft.for each utility connection) CATEGORY OF CONSTRUCTION 1111111111 SFR(1)bath 312.70 El1-and 2-£emitY dwellin SFR(2)bath 437.78 g 0Commercial/industrial IDAccessory building El Multi-family SFR(3)bath 500.32 El Master builder Each additional bath/kitchen 25.02 ❑Other: Fire sprinkler( sq.ft.) Pagfl2 JOH SITE INFORMATION AND CAC TION Site 'Iities: / Job site address: Catch b " or area drain 16.76 ��� �� �� Drywell,leas ine,or trench drain 18.76 City/State/ZIP: 1 C C�'-� n . 477 7 2 Z� � �M Footing drain(no. ' ear ft.: Page 2 Suite/bldg./apt.no.: i�� I Project name: I/1(dd(e f„„ ^ -2 US' Manufactured home uti"' 50.03 Cross street/directions to job site: I�Q.( w- ',"_ 1 Manholes 18.76 s( te7 7 6 0 e O f- Rain drain co or 18.76 'AL g in_.4 / t� 1-_ p/� _ Sanitary s (no.linear$.:Ste) Page t TC� ` �x 'tee V Sto ewer(no:linear ft.:/04 age 2 Water service(no.linear ft.:5Q) Page Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: 11 j f Backflow reventer � rS l�St'.g177�C.)t, preventer / 31.27 3/.�-�1 Backwater valve P d 12.51 DESCRIPTION OF WORK ,all G�S /J ` fj� Clothes washer 25.02 0 f' `" W/" eJ/ga 4 4-'," Dishwasher 25.02 Drinking fountain 25.02 ���� � Ejectors/sump -+"-prr 25.02 1PR4lPERTY OWNER 0 TENANT Expansion tank pr-J 12.51 05-1 Name: /77r f�iSd- Fixture/sewer cap p�5• / 25.02 n14 La f L_-i_..C- Address: (2 © (r� Z3 q g Floor drge oor sink/hub 25.02 �.J�I �- Garbage disposal 25.02 City/State/ZIP: ,'9�yr�,.� 6 at 7 Zg 1-3`)67S Hose bib 2, 25.02 52)_01 Phone:(5c ) 4- 4-- G5(0 5 Fax:(- 0'3) (rzc/ -Z( 7 3 Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: Medical gas(value:$ Fa/ Page 2 Primer Contact name: l6yAf 1 12.51 `� j Roof drain(commercial) p soy' 12.51 Address: Sink/basin/lavatory S 25.02 ,uSi fa City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax: :( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR 2._ 25.02 Business name: gro.le�,- e/ Water heater ( 56.29 3'j`j (inr i✓/` �c-- WaterpipinglDWV 56.29 Address: b. ,Q, Z3 Of es-- Other: 25.02 3 City/State/ZIP: � ��.( / C9g' �'70-8 1- 3'1 £fS Subtotalf .91 Phone:( � -V ,'o �� Fax:(5'j3) 6Z,ef- Z173 Minimum permit fee: $72.50 5 � CCB Lic.: �/d 3-7 Plumbing Lie.no.2b-(f j-�Q Plan review (25%of permit fee) Authorized signature: State surcharge(12%of permit fee) 1/ 7i � TOTAL PERMIT FE !117„jd Print name: Z.W./2, Igt''si-te a„� Date: /7j I This permit application expires if a permit is aot obtained bin 190 days -Clr=�' `T after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:1Building\Permits1PLMU-PmoitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) I.w't you . (:..--z- Plumbing Permit Application - City of Tigard tut '�G¢/ ( --re( '-T P L,‘ l Page 2 - Supplemental Information l �t gru 10( er- Fee Schedule: Residential Fire Suppression Systems: Site Utiljt es Qty. Fee(ea)" T *I Square Footage: Permit Fee: Footing drain_-- "100' (00 50.03 �v'p,4;Tj 0 to 2,000 $121.90 Footing drain-each-additional 100' 50 37.52 3-7 5 Z 2,001 to 3,600 $169.69 4 3,601 to 7,200 $233.20 Sewer-1st 100' \ f 2; 7,201 and greater $327.54 Sewer-each additional 1,t' 37.52 • Water Service-Ist 100' 62.54 tZ•941 Medical Gas Systems: Water Service-each addition: 100' 37.52 L»..• Val1 on: Permit Fee: Storm&Rain Drain-1st 100' ( O 0 62.54 EZ > $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each addition. r0' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to Other Inspections or a and including$10,000.00. Inspection of existing plumbi•: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' dicated 90.00/hr each additional$100.00 or fraction thereof,to (minimum charge-1/2 .ur) and including$25,000.00. Inspections outside o ormal 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 i• ge-2 hours) each additional$100.00 or fraction thereof,to Reinspection Fe-. 90.00/hr and including$50,000.00. Additional p .1 review for revisions ':00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for (minim arge-1/2 hour) each additional$100.00 or fraction thereof. Subtotal: MS, Commercial Fixture Work: 11P4 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*. Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review isrequired for of the following. Work Performed: Capped Added. Rda:ate any Baptistry/Font Please check all that apply. Bath Tub/Shower 0 Any new commercial building with water service 2"and Jacuzzi/Whiripool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain 0 Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" v Submit 2 sets of plans with any of the above. -3" 4" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food Disposal -Domestic-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach./Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lav -Non-food related Q' -Bradley -Commercial-food related -Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-Clothes Water Extractor increase of sewer EDUs,a sewer permit will be issued and Water Closet-Toilet 2- fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Petmits\PLMU_PermitApp.doc 2 Plumbing Permit Application I P - --. .") Building Fixtures FOR OFFICE USE ONLY ' • . is - City of Tigard Received Permit No.: Date/Fly: 4 IN 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Il• Phone 503.7182439 Fax: 503.398.1960 • Datolly. Met Remit No.t Inspeclion Line: 503.639.4175 Date Ready/13y rods 0 See Fagg 2 for Internet: www.figard-or.gov Notified/eActhad Supplemental leformalim t-,410'0114.90i-. :... :'.i:: ‘ ..-1,-:.'' : - '-'-''--.1.: ."'!1. '.--,. '-',1:EP,,4c#ITPLE New construction 0 Demolition For special information use checklist Description I Qty. I Es. I Total 0 Addhlon/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 It for each utility connection) , --• -''-`'-' -•• ' ---.oduovittar.coNsIRreniirr r .-- .--. SFR(1)bath 312.70 1 0 1-and 2-family dwelling E Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 50032 0 Accessory building 0 Multi-family Each additional bath/kitchen 25.02 0 Master builder D Other: Fire sprinkler C _sq.ft.) Page 2 bE Sr NFORUO1 AND L(kTIp Site titillate. Catch ham or area drain 18.76 lob site addres s: 76;i74/7 0 .,c,(4,/, --4.. Cc-/- Drywell,leach line,or trench drain 18.76 City/State/ZW. --h,,,,,a„..,....d a te_ Footing drain(no linear ft.:1 I Page 2 Suite/bldg./apt no.: i I FIRicst same:0/41/ity, etid"--/?///:7.. Manufactured home utilities 50.03 I Cross street/directions to'ob site: (1 Manholes 18.76 PTA - r)c e Rain drain connector 18.76 Sanitary sewer(no.linear*: Storm sewer(no.linear ft.:, I Page 2 Water service(no.linear ft:- _I Page 2 Subdivision: I Lot Co.: Fixture or item: Backfloev preventer / 31.27 Tax map/parcel no.: - - Bacirwater valve / 12.51 f • '.- „.', - ';,L' ' 'PEOgRa740P1.9.kile-PAgal'•Th'.'. '' " / Clothes washer 25.02 C-C1Ter)on ge.co_e ware_fioce4A0 Dishwasher 25.02 1 -( ,Z..- jerudz Is k-ss 77,..,.. 4" "Or ,,_. , Drinking fountain 25.02 .• Ejectors/sump 25.02 -.'-:-'--.'r''ttiltogivre„fiverin T.•...: .L-'":'..' ' tf;tmet-'.... -.'-!" Expansion tank / 12.51 /2,51 Fixture/sewer cap 25.02 Name: h/le API 7:ea_st- G_LC_ Floor drain/floor sink/hub 2- 25.02 50.el Address: /10 d,...,.. z.3/s%--' Garbage disposal 25.02 City/State(7,1P: 77...(.....7., Hose bib 2, 25.02 go c..,./ 131•Fne:( d3) (-)Z V •Vgit) Fax:(503) 614 2-17 3 Ice maker 12.51 PL1dANT .- in colsiier pERsoN . J hiterowtodig..,.traP 25.02 Medical gas(value'$_) Page 2 Business name: Primer i 12.51 I 2,3--/ itove„ Contact name: Roof drain(commercial) 12.51 Address: Sink/basin/lavatory ..50,,Aa''......25.02 (00,0.73 r . .2 City/State/ZIP: Solar units(potable water) 62.54 d-1k' Plsone:( ) • Fax::( ) TUb/shower/shOwer pan 12.51 Urinal 25.02 E.-mail: Water closet 2._ 25,02 5-0,04 Water hester f 37.52 3 7, r2- Business name: /70.4.7e4.-- 947(,-,7-7h7,1,1 /..7 L. Water piping/DWV 56.29 Address: ''.., c) 2_ - f -/ Other: 25,02 City/State/ZIP: ---77., Subtotal -7 Minimum permit fee: S72.50 Phone: ,2_,/-4,crso ' Fax(5,..g, bz," 2,( 7g V ...- Plan review(25%of permit fec) _„„.4"'rel-C CCB Lie.: 8-7,5-?7 Plumbing Lic.Co.: 2./..,,.cre ye5 e. t State surcharge(12%of permit fee) Authorized signature:4=;;;igunr-44140-.-------------- TOTAL PERMIT FEE / .. ,••?'' ‘'.. Print"Itcm: t-0-i...et-Z.1,78V- Date://4/ .2...Z4 Tilts' permit applkadoa expires if a permit is not*Malted w IRO days otter It has beta accepted as complete. .Fee methodology act by Tri-County Building Industry Service Board IN3i..nidiremnitt\PLNIII-PernfilAPPA.10/0039 940-90161110/02/00M/W138) Plumbing Permit Application-City of Tigard r sT 4 -{-,,,,.. at-A Page 2-Supplemental Information N1 q Le z,, Gru el e4.--- 19(ci vvt L i Fee Schedule:Schedule: Residential Fire Suppression Systems: . .: ... , . _, Sift'Iitilitles,.. .• ,. - • - : . 9ti'• 1.Fce("Y" -4q"'1;j -Saillife:r9.0tilkeii .-‘ -Permit Fie:- Footing drain-I.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 f Medical Gas Systems: Water Service-each additional 100' 37.52 V-301ditiliati','''''''''. '''''FOInit Fee:.''..".?"'''.:T.''''::'.' .'"•' '‘L "' Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Mmum fee$72.50 Storm&Rain Drain-each additional 100' 37.52 65,001.00 to$10,000,00 $72.50 for the first$5,000.00 and$1.52 for OtherliiipeetiOns or Feel:'.:: .--90'.-: .'FfaCe#:), ....Tall). each additional$100.00 or fraction thereof,to and including S10,000.00. 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-I/2 hour) and including$25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 brute first$25,000.00 ond$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 6742.00 for the first$50,000.00 and$120 for - (minimum charge-1/2 hour) _ each additional$100.00 or fraction thereof. Subtotal: 1 Commercial Fixture Work: ‘, -4,,,,, Are you capping,adding or replacing futures? If"yes", , please indicate work performed by fixture. Failure to accurately report fixtures could result In Increased sewer fees*. '. : glad Review for Pluinbinglisfallations • Capped Alidllil Plan review is required for any of the following. Work Performed: ' , Relocate Bapdstry/Font Please check all that apply. Bath -Tub/Shower 0 Any now commercial building with water service 2"and -Jacuzzl/Whirlpool greater,except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru D New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in 0AR918-780-0040. Dishwasher -Commercial 0 Medical gas and vacuum systems for health care facilities. -Domestic 0 Any multipurpose fire sprinkler system. Drinking Fountain E:1 My complex structure as defined in 0AR918-780-0040. Eye Wash Floor Drain/sink -2" 1_ Submit 2 Bits of 01411810th any of the above. . .... . .-Isometric or'bier Diagram Car Wash Drai El Isometric or riser diagram is required for new buildings Garbage -Domestic-non-food n Disposal -Domestio-food related that meet the qualifications above. -Commercial-food related -Industrial-food related Ice Mach/Refrig.Drains Oil Separator(Gas Station) Comments regarding fixture work: Rec.Vehicle Dump Station Shower -Gang -Stall Sink/Lay -Non-food related 4 -Bradley -Commercial-food rotated -Service 1 Swimming Pool Filter "Nate: If the fixture work under this permit results in an Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Wter Ey:tractor Waater Closet-Toilet 7 fees assessed fur the sewer Increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: 1:1Building1Permits\PLMU_PermitApp.doc 2 . .