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Permit III CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2022-00077 TIC A Il.ID 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/8/2022 Parcel: 2S 102AC00700 Jurisdiction: Tigard Site address: 12540 SW MAIN ST 110 Project: Spec Space Subdivision: None Lot: None Project Description: Interior plumbing:Adding(1)hub drain and reinstalling(1)breakroom sink. Contractor: ALL PRO PLUMBING SERVICES LLC Owner: DOLAN&COMPANY LLC 2092 NE ALOCLEK DR#503 1919 NW 19TH AVE HILLSBORO, OR 97124 PORTLAND, OR 97209 PHONE: 503-579-5555 PHONE: FAX: 503-259-2555 FEES Quantity Description Date Amount 1 ea Floor Drain/Floor Sink/Hub 03/08/2022 $25.02 Specifics: 1 ea Sink 03/08/2022 $25.02 1 12%State Surcharge- 03/08/2022 $8.70 Type of Use: COM Plumbing Class of Work: ALT 22 ea Minimum Fee Adjustment- 03/08/2022 $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: 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. , riumnin rermit A llcatlon ` Building Fixtures ECEIVED rt,la 0,, ,k . ter. t,,i , City of Tigard Received /` 1312s sw Hall sloes.,Ti FEB 14 2022 Da,�y: 43/s//- Permit No.: ;� Tigard,OR 97223 Plan Review 7 t- Phone. 503.718.2439 Fax: 503.598. 9 �,�i OlherPer®lNo.: Inspection Line: s LAY OF TIGAI�D Date,Re: fr Ott T 1 G n E n Internet www ti 03.639.4175 ] In p�� Date Ready/By: 1 El See Page 2 for !St Bard-or.gov 7U�L.lJ�IWl7 n�v���nn� Notified/Method: ,S4-_De Supplemental Information k; TYPE OF WORK -' :14./4 ,Thy(e_,. FEE* SCHEDULE 0 0 N construction ❑Demolition For seecia/information use checkless. Addition/alteration/replacement 0 Other: Description Q,Y. Ea. Total '\ New I-2-family dwellings(includes 100 fl.for each utility connection) CATEGORY OF CONSTRU N SFR(1)bath 312.70 �,� SFR(2)bath 437.78 Ell-and 2-family dwelling t7�ommerciaJ/industrial SFR(3)bath 500.32 25.02 ❑Accessory building 0 Multi-family Each additional bath/kitchen ❑Master builder ❑Other: e2 `� P Fire sprinkler( sq.B.) erg 4 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: t�5 L i(J c 1 Iv�4 M� c i _ _ `_�- Catch basin or arca drain 16.76 O e-- 91 a31^�>= Drywell,leach line,ne trench drain 2 City/State/ZIP: pt t-G\ oV yFooting drain(no,linear ft,:,_) Page 2 Suite/bldgJapt no.: /' Project name: _ �c �homeutilities 50.03 Cross street/directions to job site: r f Manholes 18.76 Rain drain connector 18.76 -.. Sanitary sewer(no.linear ft.:_) Page 2 T Storm sewer(no.linear ft.:_J Page 2 Water service(no.linear ft:_) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: Backtlow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 jj�� / / / Clothes washer 25.02 j�Q //�5 ((/ v P It t^CL{ K teU d i^''t Dishwasher 25.02 a V/is.)is.) Ga/v 01 Aa(ci .'_? 17te; 0.igiset/ tiJ Drinking fountain 25.02 i �i ( / (,v.+r� C®6 j(r✓� LA An oN�Cr,i y.,I 1 C. Ejectors/sump 25.02 0 PROPERTY OWNER ❑ TENANT Expansion tank 12.51 1 Fixture/sewer cap 25.02 Name: __ ____._-_ _ Floor drain/floor sink/hub 25.02 25_0)._Address: Garbage disposal 25.02 1 City/State/Z1P: Bose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT 0 CONTACT PERSON interceptor/grease trap 25,02 Business name: Medical gas(value:$_) Page2 pl I` . 1,.b -,? ..iM.�n-ty� ems'_c 0 i CJ2 S �. s_ Primer Contact name: `/ _�`eO Nl/,�,.1!.. 1 12.51 'r`r Roof drain(commercial) 12.51 Address: ca('q Nj '\\p ae-vL .( Y - Sink/basin/lavatory 1 25.02 a 0)- City/State/ZII': A_'1--0,rJ2::, (4434:44 ! 1 1 2-1 Solar units(potable water) 62.54 Phone:(cb.5)�-1C:),.-5-S.-SS- Fax::( ) Tub/shower/shower pan 12.51 f Urinal 25,02 E-mail: VV'C�� G'C }" 6.i -0.Lk ?ll.a_w�h{nSt X. (Dr1'1 Water closet 25.02 CONTRACTOR 11 { �y � � f� Water heater 37,52 Business name: PcArl 19� 'i A �(AJ �tL > us Water piping/DWV /� ` P PurP�D 56.29 Address:a-D CID-j-).r P [.p[_V r 0lr. Other: 25.02 City/State/ZIP: o-t`1,t5(tom Subtotal 5 6, S-SSS- Fax:( ) Minimum permit fee: $72.50 7 2,7v Phone:(�) 7 l Plan review (25%of permit fee) CCB Lie.: ,gq DG 1g Plumbingp Lic.no.:S -77a.- State surcharge(12%of Authorized signature: ar8 permit fee)1, i.E ,�✓,-- TOTAL PERMIT FEE.), jr This permit application expires if a permit is not obtalaed witJIaY80 days I not name: r�e(� V ��( Date: after it has been accepted as complete. 'Fcc methodology sct by Tri-County Building Industry Service Board. ' _ lylumbing 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-1' 100' 0 to 2,000 $121.90 50.03 _ $169.69 Footing drain-each additional 100' 37.52 2,001 to 3,600 $233.20 Sewer-1st 100' 3,601 to 7,200 62.54 7.201 and greater $327.54 Sewer-each additional 100' 37.52 Water Service-Ist 100' 62.54 Medical Gas Systems: Water Service-each additional 100' 37.52 Permit Fee: Valuation: 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 each additional$100.00 or fraction thereof,to Other Inspections or Fees Qty. Fee(ea) Total 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 90.0(1/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 each additional$100,00 or fraction thereof. (minimum charge-112 hour) 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 cheek 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 0 New exterior plumbing site utilities for any complex structure as defined in OAR918-780-0040. -Drive Thru Cuspidor/Water Aspirator ElMedical gas and vacuum systems for health care facilities. Dishwasher: Commercial 0 Any multipurpose fire sprinkler system. Domestic El Any complex structure as defined in OAR918-780-0040. Drinking Submit 2 sets ofplans with Washany as Fountain bye of the above. E Floor Drain/sink: -2" 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./Ref ig.Drains Comments regarding fixture work: Oil Separator(Gas Station) re - 1119C ALA`n - t^©(»7�1 Re,c.Vehicle Dump Station I t- Ct t�n1;1 -(` `,( t �b 4 y-r ( r Shower: -Gang /\ , ,,, "� T a+ -Stall ESN' (. uLt-'"1 C[2QLI1'1 5 II L I-)- ( jr1( ncji Sink: -LavBar non-food related / -Bradley -Com/Serv/Util food related rr • 'a -Service _ *Note: If the fixture work under this permit results in an Swimming Pool Filter Washer-Clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet plumbing permit can be issued. Urinal t _,, Other Fixtures:2'' k a (.k b S4I11 CLad I \HuitAinn\PPrmitc\PI MF Prrmit Ann dnr BRIut /)n1 I 1