Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2023-00263
T!CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/26/2023
Parcel: 2S112DD01000
Jurisdiction: Tigard
Site address: 15700 SW UPPER BOONES FERRY RD
Project: Holiday Inn Express Subdivision: None Lot: None
Project Description: Tub to shower conversion for(92)hotel rooms.
Contractor: PIPE IT PLUMBING LLC Owner: BHGAH TIGARD LLC
PO BOX 1389 5895 JEAN RD STE 100
BORING, OR 97009 LAKE OSWEGO, OR 97035
PHONE: 503-544-0477 PHONE:
FAX: 503-912-0045
FEES
Quantity Description Date Amount
92 ea Tub/Shower/Shower Pan 06/26/2023 61,150.92
Specifics: 1 12%State Surcharge- 06/26/2023 $138.11
Plumbing
Type of Use: ME
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $1,289.03
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
ti
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
Building Fixtures FOR OFFICE USE ONLY
City of Tigard RECEIVED Received-
Da[e/By: q Permit No.: ,,,,
v I3125 SW Hall Blvd.,Tigard,OR 97223 L//O p. A 1 3-�/L�pz6,
Phone: 503.718.2439 Fax: 503.598.19 Plan Review
fP1 N 2 6 2023 Date/By: Other Permit No.:
T 1 G A R p Inspection Line: 503.639.4175 Date Ready/By: orris: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
I FIU
TYPE OF WO ALfTY nIOFPlC DIVISIGAnN FEE* SCHEDULE
❑New construction ❑Demolition For special information use checklist
Description I Qty. I Ea. I Total
tit Addition/alteration/replacement ❑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 .ommercial/industrial SFR(2)bath 437.78
❑Accessory building El Multi-familySFR(3)bath 500.32
El Master builderEach additional bath/kitchen 25.02
0 Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: (.c-Tat, 5 W b ft[ ,•AAA y S 1i � Catch basin or area drain 18.76
City/State/ZIP: T6,Ai Y _�fJVt"C. 1 Drywell,leach line,or trench drain 18.76
(C It Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:
Manufactured home utilities8.76
Cross street/directions to job site: ; //vli ,,, NJ - Manholes 18.76
/ .I rr"-'� 1
I�I 1� fr. - - «f ` _ Rain drain connector 18.76
s� Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision:
E Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
\y geP y e! u AS Ull i h. S/-f o k, 6ri- ti74. -0 Dishwasher 25.02
S r (/i +4 C-lta---v Q VA-L�/� Drinking fountain 25.02
/f//� Ejectors/sump 25.02
3 JD PROPERTY OWNER ❑ TENANT Expansion tank 12.51
Name: tcu p� j _ isob-N
Fixture/sewer cap 25.02
ka Address: 7 Ir/�� f ` InnzTT �i7 Floor drain/floor sink/hub 25.02` City/State/ZIP: ) nXW�6>V Y Y/� � !!���S �Ge L{�t/,r� Garbage disposal 25.02
�' G [/ lS Hose bib 25.02
,S Phone:�3 ) s S Fax:( ) Ice maker 12.51
pAPPLICANT 0 CONTACT PERSON Interceptor/grease trap 25.02
C Business name: A P 1�4, /S' / L� Medical gas(value:$_) Page 2
Contact name: C Primer 12.51
A 3 r 73 N r"](� Q C� - Roof drain(commercial) 12.51
Address: i 1.l/�/j�? �f�"u Jp pi �� Sink/basin/lavatory 25.02
City/State/ZIP: ( r
1. - c (� S . 5-w 35 Solar units(potable water) 62.54_
Phone:(7 ) ' `-,,5 ( Fax::( ) Tub/shower/shower pan q��12.51 /; L ,1�A.
E-mail: 4 (i)hL•.� et t'��1 C�1 CS1-�?, ..`y� -� Urinal try 25.02 -(
J ��-SC/ONTRACrTOR /y ll�� Water closet 25.02
/� �1 i r` T P`wh v,Ter heater 37.52
Business name: 12' 1„ /r'I2 � j
{'�Jf-e ^-'I ((.��5//LL�I!`MM'�-.� �VVaterpiping/DWV 56.29
Address: 227Lj A/G aft, 1'()nF g,p Other: 25.02
City/State/ZIP: I r,7�V IM""'✓ /1 Q�l
C/ESN/Cl ' r 1 /(___ tr:),,7-Q,-;G Subtotalkl/I /9).4
Phone:(5-21) ) cLI i ^nil ry� Fax:( ) Minimum permit fee: $72.50 l
CCB Lie.:'�� 2 t_.... 17- tl 3 4 Plumbing Lic.nopo 1 Plan review (25%of permit fee)
f�f'/ l State surcharge(12%of permit fee)Y 13 e, I f
Authorized signature:
/ L TOTAL PERMIT FEE/ ^2`UQ
Print name: / � Date: o 5/ f 9� This permit application expires if a permit is not obtained wiIa80 days
•O�
/ !F+ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:lnuilding\Permits\PLMU-PermilApp.doc I0/01/09 440-4616T(10/02/COM/WEB)
Plumbing 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-l'100' 50.03 0 to 2,000 $121.90
2,001 to 3,600 $169.69
Footing drain-each additional 100' 37.52 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 Valuation: Permit Fee:
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 $5,001.00 to$I0,000.00 $72.50 for the first$5,000.00 and$1.52 for
Total each additional$100.00 or fraction thereof,to
Other Inspections or Fees Qty. Fee(ea) 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
each additional$100.00 or fraction thereof.
(minimum charge-1/2 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 check 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 CO engineer.
-Jacuzzi/Whirlpool 0 New exterior plumbing site utilities for any complex structure
Car Wash: -Each Stall as defined in OAR918-780-0040.
-Drive Thru ❑ Medical gas and vacuum systems for health care facilities.
Cuspidor/Water Aspirator 0 Any multipurpose fire sprinkler system.
Dishwasher: -Commercial 0 Any complex structure as defined in OAR918-780-0040.
-Domestic
Drinking Fountain Submit 2 sets of plans with any of the above.
ye Wash
Floor Drain/sink: -2"
3., Isometric or Riser Diagram
0 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 Comments regarding fixture work:
Ice Mach./Refrig.Drains
Oil Separator(Gas Station)
Rec.Vehicle Dump Station
Shower: -Gang
-Stall
Sink: -Iav/Bar non-food related
-Bradley
-Com/Serv/Util food related
-Service *Note: 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 plumbing permit can be issued.
Water Closet-Toilet
Urinal
Other Fixtures:
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