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Permit (3) r Plumbing Permit Application Site Utilities FOR OFFICE USE ONLY Received City of Tigard Date/By: -71�i��}a - Permit No.: �J wn ��„j t IIII • 13125 SW Hall Blvd.,Tigard,OR Q7 $ Plan Review G r[/e f (/� ® Phone: 503.718.2439 Fax: 503.598.1960 ' Date/By: L?/tr.fr,9Ti A Other Permit No.: // ,t,P)?)-elm 3 I I C 4 R l) Inspection Line: 503.639 4175 Date Ready/By: Juris: FA See lPage 2 for Internet:. ,4 w w w tr and or o•vNotified/Method: No hP f ed/Met hoLd �Ij �- . ,. . is y Supple mentalInform Information v € " hls ` a€ jit - I IE 517q: r I:fl: ,k : _ ! i El New construction ❑Demdiitibn . .. For special information use checklist. Description I Qty. I Ea. I Total leAddition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) o:' >iMrs; 00ta -a`t `I. , Ssa glggligig t€ I a;I€ ; SFR(1)bath 312.70 ❑ 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory buildingVlulti-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 liiiNillEWWMIIMiI r Il i s s Cs aA r ";E o Site utilities: Job site address: 7520 SW Bonita Road Catch basin or area drain 31 18.76 iy 4)a City/State/ZIP: Portland OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft. 6 Page 2 6 r©. 33-- Suite/bldg./apt.no.: I Project name: Bonita Villa Apartments Manufactured home utilities 50.03 Cross street/directions to job site: SE corner of SW Bonita Manholes 1 18.76 i 1s'i 7G Road and SW 76th Ave. Rain drain connector 18.76 Sanitary sewer(no.linear ft.:_ Page 2 Storm sewer(no.linear ft.: ) Page 2 Water service(no.linear ft.: 225) Page 2 i 3 7..S R Subdivision: I Lot no.: Fixture or item: Tax map/parcel no.: 2S 112 B DOO 1 OO Backflow preventer 31.27 1%41 n- us n ,. a i ,. z€o ,`I Backwater valve 12.51 o\ ,3 [_ o es wa er Cl th sh 25 02 1 ..� Y' v _4�a a _ L !YG� . . Dishwasher 25.02 i c;�nn , Drinldng fountain 25.02 r'�' /�' Ejectors/sump 25.02 Iif : I N 9 �tk4 I T tr. # a ,� a a , 1�"�?u � °� „ * Expansion tank 12.51 Fixture/sewer cap 25.02 Name: HAWC AHP4 LIMITED PARNTERSHIP Floor drain/floor sink/hub 25.02 . • Address: 111 NE LINCOLN ST. SUITE 200-L y; Hose bib City/State/ZIP: HILLSBORO, OR 97124 H ebib sposal 25.02 25.02 (: "" Phone:( ) 503-846-4794 Fax:( ) Ice maker 12.51 :' t z ,Y h 'ay , _m s t' k t 7Z s:: Interceptor/grease trap 25.02 Business name: PINNACLE ARCHITECTURE Medical gas(value:$ ) Page 2 Primer 12.51 Contact name: RYAN CAI N Roof drain(commercial) 12.51 Address: 960 SW DISK DR. SUITE 101 Sink/basin/lavatory 25.02 City/State/ZIP: BEND, OR 97702 Solar units(potable water) 62.54 Phone:( ) 541-388-9897 Fax::( ) Tub/shower/shower pan 12.51 E-mail: RYAN@PARCH.BIZ Urinal 25.02 ' ,.-.-2(S.* 131'•z y e a e[i �-'E =t.• ?y P I"€9 s�` s+ i d sm 3,�€�," Water closet 25.02 .at i k Pe'i, .,m o€i3€i,., i, ..,g d E s.=.b 1 ,,,,.,a.,., . ,<A is i.;:" .,a,,mr_; ., .. Water heater 37.52 Business name: LMC CONSTRUCTION Waterpiping/DWV 56.29 Address: 19200 SW TETON AVE. Other: 25.02 City/State/ZIP: TUALATIN, OR 97062 Subtotal 13,'1 -'; y' Phone:( ) 503-646-0521 Fax:( ) Minimum permit fee: $72.50 CCB Lie.: 161282 Plumbing Lic.no.: Plan review (25%of permit fee) 3� 7, 6 E �C.l�� State surcharge(12%of permit fee) I , 5.c? Authorized signature: TOTAL PERMIT FEE /Cie-.).j, C j` Print name: l �La �u. Date: )/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. I:\Building\Permits\PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB) FLM 2622760 Plumbin! Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: s* :..$e•$=•t t I promo `C 2 to t t wirasW-qmPl•WPRIIMPiliirAT 9I k.. :,.. tea. - ,- ., •. w,- _,i.h r��y •,: .. :r.'. ...6..m Footing drain-1'100' , 50.03 c j 0 to 2,000 $121.90 Footing drain-each additional 100' 1 37.52 60c ,3 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' 1 62.54 b ,S'i Medical Gas Systems: Water Service-each additional 100' a 37.52 7;- 0,4 t E = i Storm&Rain Drain-1st 100' 62.54 •, 1 �` $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 It:1 each additional$100.00 or fraction thereof,to € s .��°.!:'� ,•: ,.:_ . tt tt8q� � (` 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 90.00/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*. 0401 T. „ tpt _Homizame Plan review is required for any of the following. Work'Performcd. @ Added Baptistry/Font Please check all that apply. Bath Tub/Shower ❑ Any new commercial building with water service 2"and -Jacuzzi/Whirlpool 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 ❑ Medical gas and vacuum systems for health care facilities. -Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040. Eye Wash Floor Drain/sink -2" Submit 2 sets of plans with any of the above. _ � x8 1�4 NYa ®fit ' ®t Oat tfi Car Wash Drain �na. Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings 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 -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 fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: I:\Building\Permits\PLMU_PermitApp.doc 2