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Permit (2) CITY OF TIGARD PLUMBING PERMIT III'l Permit#: PLM2020-00491 COMMUNITY DEVELOPMENT 1, ,1 Date Issued: 12/22/2020 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 BB01400 / Jurisdiction: Tigard Site address: 12114 SW GARDEN PL Project: Spec Space Subdivision: CROW PARK 217 Lot: 2 Project Description: Interior plumbing:Adding(3)sinks and (2)water closets; Installing(3)water heaters. 1/28/21:REPRINTED permit to show the following changes-Adding(1)sink; Installing(2)new hub drains and(2)ice makers;Removing(1) water heater and(1)water piping/DWV. Contractor: PMSI LLC Owner: BKM PARK BC 252 LLC 8295 NW EVERGREEN PKWY#204 1701 QUAIL ST STE 100 HILLSBORO, OR 97124 NEWPORT BEACH, CA 92660 PHONE: 503-466-2222 PHONE: FAX: 503-466-2211 FEES Quantity Description Date Amount 2 ea Floor Drain/Floor Sink/Hub 12/22/2020 $50.04 Specifics: 2 ea Ice Maker 12/22/2020 $25.02 2 ea Sink 12/22/2020 $50.04 Type of Use: COM 2 ea Lavatories 12/22/2020 $50.04 Class of Work: ALT 2 ea Water Closet 12/22/2020 $50.04 Type of Const: 2 ea Water Heater 12/22/2020 $75.04 Occupancy Grp: 1 12%State Surcharge- 01/29/2021 $36.03 Stories: Plumbing Total $336.25 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 or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: _ Permittee Signature: 6l 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. t Plumbing Permit Application Site Utilities D //�y 1 F-oR oFFicl: USE ONLY City of Tigard 3 E E IV E I1 o By: /I�(I/Q( e71 Permit No.: p�/YL �- oi(at 3 _ ,ate/ /�j W INI13125 SW Hall Blvd.,Tigard,OR 9722 plan Review n/ ether Permit a Phone: 503.718.2439 Fax: 503.598.1960 66 p� q 99 Date/By: /" Inspection Line: 503.639.4175 r9lin 2 ( 2f12 1 Date Ready/By: i 1 / Kris: El See Page 2 for Ti Internet:Internet: www.tigard-or.gov Norified/Metod: j 1/ Supplemental information TYPE OF WORK CITY OF TIUN't� C :G'-/YK-'i"" i'-i!"'E^'n' FEET SCHEDULE ,' ❑Dd U ItiL1I NG DIVISION For special information use checklist ❑New construction Description I Qty. I Ea. I Total Addition/alteratiotJreplacement ❑Other: New 1-2-family dwellings(includes 100 ii.for each utility connection) CATEGORY OF CONSTRUCTIO s - # SFR(1)b� 312.70 (2) 437.78 0 1-and 2-family dwelling ' f4.ommer w SFRbath 500:32 j fQ SFR(3)bath ❑Accessory building 0 Multi-f. Each additional bath/kitchen 25.02 0 Master builder ❑Other: Fire sprinkler(_sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Catch basin or area drain 18.76 Job site address: tili\tt S1� G'.,1�u-c pa ,_, (J Drywell,leach line,or trench drain 18,76 City/State/ZIP:I- Footing Page 2 tgefl-<-�S„ ��t.. �� �i. dram Suit&bldgJapt.no.: �S (Project name:�l? Sr__ 'ti e., Sit'-`nt Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.:,_ ) Page 2 Storm sewer(no,linear ft.: Page 2 Water service(no.linear ft.: ) Page 2 Subdivision: Lot no.: Fixture or item: Backflow preventer 31.27 Tax map/parcel no.: 12 51 Backwater valve DESCRIPTION OF WORK Clothes washer 25.02 s''i-U.e\a )C)e-) GC 2\Urs -S\v'Y6 P1'CAtX() Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ' PROPERTY OWNER TENANT.._ Expansion tank 12.51 Fixtafe/sewer cap 25.02 Name:'PsY,..1V\ Pckr-1tt.„. (", c1c 2 t L.L . Floor drain/floor sink/hub `a,y 25.02 ,OLi Address: 12\1 W 'I F_) t O..rike_" 'P`C-.C.,C. Garbage disposal 25.02 City/State/ZIP:-(", p,�,-,.-),t e;(2_ C"I 22 Hose bib 25.02 rp Phone:( ) U Fax:( ) Ice maker 2-, ..12.51 25,6 ., - APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: /� ' j-_,fir Primer 12.51 Contact name:A v..y., ,,,�.r. ..c. 12,sci C-> Roof drain(commercial) 12.51 Address: B'?�c JOE-, �r r-- 25.02 f7 .fP.`('�Y"GeIl P�W\1l CAG �t-'I Sink/basin/lavatory u 50 ,O City/State/ZIP: f t}\\ \^?e(-0, c j , (j‘2,t4 Snlarunits(potable water) 62.54 Tub/shower/shower pan 12.51 Phone:( jz�) (4(aCp� yZZ2i�i Fax::( ) Urinal 25.02 E-mail: s(G c+C i •y\cj e - �I S Y_�n n5 CO Water closet 2_, 25,02 ,btA CONTRACTOR Water heater , 37.52 15,01A Business name: c)1�'St) L-L_C., Water piping/DWV 56.29 Address: `^i^ic- '�,OLI Other. 25.02 R'2,q� AJ t-. �ve�r- -r-z-�n l�ki.'w�I I Subtotal �.22, City/State/ZIP: ,�rj�n.t Cl�� i`9 Minimum permit fee: $72.50 Phone:(503) 4(u(Q- ?22,Z,/ Fax:fa ) i..i(e(®-2:2A\ Plan review (25%of permit fee) CCB Lic.: `C'g� /g(0 I f(1/ Plumbing Lie.no.: ?;,t 44 LA B State surcharge(l2°h of permit fee) 3( .j) l l I 3 Authorized signature: ,Q, _ _ , t �,t2) 7// /r3 TOTAL PERMIT FEE /j- " ~rt'4t'�✓n°' Date. 1 This permit application expireba if a permit is not ol,tatned withio180 days Print name: A r AY. ca. R.c.,1 -- I i�� C) 1 I = after tt has been accepted as camplet. Fee methodology set by TreCotmty Building Industry Service Boat& I:\BuildhagiFefmitslPLMU-PmailApp.doe 10/01/09 440-4616T(10/02/COMIWES) * 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-1°' 100' 50.03 0 to 2,000 $121.90 Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.693,601 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: Stone&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 S 10,000.00 $72.50 for the first$5,000.00 and$152 for Qty. Fee(ea)` Total each additional$100.00 or fraction thereof,to Other Inspections or Fees and including$10,000.00. Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 far the first$10,000.00 and$1.54 for which no fee is specifically indicated 90.00/br 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/br $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 hi increased sewer fees*. Quast1y by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Work:Performed: . Capped added Relocate Please check all that apply. Baptishy/f/Font 0 Any new commercial building with water service 2"and Bath -rub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash -Each Stall -Drive Thru 0 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 ❑ Any multipurpose fire sprinkler system. Drinking Fountain 0 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. -3" Isometric or Riser Diagram Car Wash Dram ❑ 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/Lay -Non-food related 9-+ -Bradley -Commercial-food related -Service f. Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer-clothes increase of sewer EDUs,a sewer permit will be issued and Water Extractor Water Closet-Toilet `aZ fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: (Q I:\BuildingWetmits\PLMU_PcrmitApp.doc 2 CITY OF TIGARD PLUMBING PERMIT .11 COMMUNITY DEVELOPMENT Permit#: PLM2020-00491 Date Issued: 12/22/2020 T I O A R n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101 BB01400 Jurisdiction: Tigard Site address: 12114 SW GARDEN PL Project: Spec Space Subdivision: CROW PARK 217 Lot: 2 Project Description: Interior plumbing: Adding(3)sinks and(2)water closets; Installing(3)water heaters. Contractor: ALEGIS CONSTRUCTION INC Owner: BKM PARK BC 252 LLC 6900 SW ATLANTA ST SUITE 110 1701 QUAIL ST STE 100 PORTLAND, OR 97223 NEWPORT BEACH, CA 92660 PHONE: 503-427-6065 PHONE: FAX: FEES Quantity Description Date Amount 3 ea Sink 12/22/2020 $75.06 Specifics: 1 ea Water Piping/DWV 12/22/2020 $56.29 2 ea Water Closet 12/22/2020 $50.04 Type of Use: COM 3 ea Water Heater 12/22/2020 $112.56 Class of Work: ALT 1 12%State Surcharge- 12/22/2020 $35.27 Type of Const: Plumbing Occupancy Grp: Stories: Total $329.22 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 or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: \\� vOkr \M �C lc),0( Permittee Signature: Ov cc;C et_ ";C-)V� 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 =i City of Tigard 3 GENE Received /� rennurva.: Illie 13125 SW Hall Blvd„Tigard,OR 97223 )' /l�/h fsb7� A -d0�(�it i 0. Plan RCYie\S Phone: 503.718.2439 Fax 503.598.196°0 C 14 2020 °dm-Permit e,�-,z_ Inspection Line: 503.6394175 G a a DateBy. ✓I2 for . C��c TIGARD Internet: www.li nrd-or, ov _ -r.,tY A '-' Dateied/Metho s: 8 See Supplemental far B g � . Notified/Method: Supplemenlnl In(onuntim+ FEE* SCHEDULE ❑New construction ❑Demolition For special I formation use checklist. Description J Qty. I Ea I Total Add ition/aiteration/re lacenlent l ❑Other. New 1-2-family dwellings(includes 100 fl.for each utility connection) CATEGORY OF CONSTRUCTION g SFR(1)bath 312.70 ❑ I-and 2-family dwelling p,Cornmercial/i 1 /19t a SFR(2)bath 437.78 ❑Accessory building /❑Multi-family t! �1�1 1 SFR(3)a bath SO5.02 Each additional bath/kitchen 25.02 ❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: fCatch basin or area drain 18.76 Job site address: ! ' .,1(J ....(t4 orr-J Cv1 L DCity/State/ZIP: i S 14C� _,. 1 1-22 Footing drainwell, n(lint,or trench.: drain age 2 ( � Footing (no.linear ft.: ) Page 2 Suite/bldg./apt.no.: Project name: • _,,, , 4_ •�- ,,„k_ Manufactured home utilities 50.03 Cross street/directions to job site: " S S (L _ Manholes 18.76 6 Y, P, JI 'W y 1 Rain drain connector 18.76 J i Sanitary sewer(no.linear ft ft.: ) Page 2 !!! Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear ft: ) Page 2 Subdivision: ri le,..t n n I Lot no.: Fixture or Item: Tax map/parcel no.: /i,I ,r/ f ! l , Backflow prevenler 31.27 DESCRIPTION OF WORK Backwater valve 12.51 J � V r 1 ? Clothes washer 25.02 �/`1' 1l+}A. !'teet/ - 1'�' ( I OF CA!dI;S�' . Dishwasher 25.02 eipairk b\ de .Adding 2 unisex restrooms,each with a lavatory,water Drinking fountain 25.02 ciuset did htbtantdneuub Water Heater.Addiiiy a new sink in coffee bar area. Ejectors/sump 25.02 -PROPERTY OWNER I 0 TENANT Expansion tank 12.51 Name: TQ ?q ga• % ,.5.41 I 5 72t 11 c Fixture/sowercap 25.02 fJ G� i Floor draiti floor sink/hub 25.02 Address: 4 701 I a.1tw{ A'., S 1 v© ( Garbage disposal 25:02 City/State/ZIP: /i€put r+ 73c .1,.,, 1 ay 1LC. Hose bib 25.02 Phone:(7q1) 3of.... a^ 21 ifFax:( ) Ice maker 12.51 PPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02 rj De ks Jd _ �3 Medical gas(value:$T ) Page 2 �� Business name: i✓ (�f17 Contact name: ,wf„_ `j , ♦ mer 12.51 7"" 1 e1���" """ ��� Roof drain(commercial) 12.51 Address: ?8 )‹.ec a-t f',' '.3( p Sink/basin/lavatory 3 25.02 75.06 City/State/ZIP: �TV 1 C I c 14 I �4 I C/ Solar units(potable water) 62.54 Phone:(14 ' 2Fax::( ) Tub/shower/shower pan 12.51 Urinal 25.02 E-mail: to, 01 °C. )44.Cr e Fit,--A _L'l C • co tom. Water closet 2 25.02 50.04 CONTRACT It Water heater 3 37.52 112.56 Business name: R.0 Waterpiping/DWV 1 56.29 56.29 Address: Other 25.02 City/State/ZIP: Subtotal 2-41J'15 Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lie.: Plumbing Lic.no.: Plan review-(25%afpermit fee) State surcharge(12%of permit fee) 35.27 Authorized signature: ! TOTAL PERMIT FEE Print name: M�j4_ f u ;s Or x--^ Date: jJU 1 2 2,a•) "is permit application extdres i(n permlr is not obtained ellhi'n lap d 1+ /tt aner{tans Lecn accepted nscanlplete. / "Fee methodology set by Tri-County Building Industry Service Board. I:\Oultdina\P<rmibWl.MU-PermitApp.doc 10/OIN9 M O-4616T(10/O2/COMiWnn) It 1. 1 3 EQl t ipvcr'ee.sd 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: Pooling 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 Sewer-1st 100' 62.54 3,601 to 7,200 $233.20 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 Storm&Rain Drain-1st 100' 62.54 Valnatl000. Permit Fee:$72 $1.00 to$5,000.00 Minimum fee$72.50 Storm&Rain Drain-each additional I OD' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction Hereof,to 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$1,00.08 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$25,000.00 and$IAS 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—U2 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*. 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 BaptistrylFont 0 Any new commercial building with water service 2"and Bath ub/Shower greater,except systems designed and stamped by licensed -Jacuzzi/Whirlpool engineer. Car Wash: Each Stall 0 New exterior plumbing site utilities for any complex structure Drive Tltru as defined in OAR918-780-0040., CuspidorlWeterAsrirator ❑ Medical;gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. Floor Drain/sink: -2" 3" Isometric or Riser Diagram q 0 Isometric or riser diagram is required for new buildings i -Car Wash m Garbage -Domestic non-food qualifications that meet the ualifi ations above. g Disposal: -Domestic food,related -Commercial food related -Industrial food related 1cc MachiRefrig.Drains . Comments regarding fixture work: Oil Separator(Gas Station) Adding 2 unisex restrooms, each with a Rec.Vehicle Dump Station lavatory, water closet and Shower: -Sang Instantaneous Water Heater. Adding a Sink: -Lav/Barnon-food related 3 new sink in coffee bar area. -Bradley -Com/Serv/Util food related -Service *Note: If the fixture work under this permit results in an Swimming Pool piker increase of sewer EDUs a sewer permit will be issued and i Washer-Clothes fees assessed for the sewer increase must be paid before the Water Extractor WaterCloset-Toilet 2 plumbing permit can be issued. Urinal Other Fixtures:lnstantaneous Water 3 Heater l:113uildingkPermits\PLMF_PennitApp.doc 08/04/2011 2 - • Plumbing Permit Application Building Fixtures jj�� ("` , / FOR (*NCI: USE ONLY b7lE`'�E I M E D Received City of Tigard Permit No.: 1�_ or 13125 SW Hall Blvd.,Tigard,OR Date/By: ,1 Plan Review Phone: 50].718.2439 Fax: 503.598.19y,0oV 2 Other Permit No.: �6 1 Dnte/By: I'I C A It n Inspection Line: 503.639.4175 2020 Date Ready/Ry: yy;, @I See Pnge2 for Internet: www.tigad-or.gov Notified/Method: `lt Supplemental infommnon TYPE OFA all i OF TIGARD FEE* SCHEDULE 134 giiNgt DIVISION For special IgormNlorrrrsechecklst.. ❑New construction a cnro t Description I Qty. I Ea. J Total pif Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 R.for each utility connection) CATEGORY OF CONSTRUCTION SFR(I)bath 312.70 ❑ I-mid 2-family dwelling ommmercial industrial SFR(2)bath 437.78 ❑Accessory buildingSFR(3)bath 500.32 0Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Pago 2 JOB SITE INFORMATION AND LOCATION Site utilities: 2 11(1 S W /� 1 C„ PI . Catch basin or area drain 18.76 Job site address: I 1 1 C7nV�d 1 Drywall,leach line,or trench drain 18.76 City/State/ZIP: Ts e.r,A / O I` , '-22 3�y Footing drain(no.linear IL:_) Page 2 Suite/bldg apt.no.: I Project name: �TI/ . Bus pa..k� Manufactured home utilities 50.03 JJ Cross street/directions to job site: G S y C{,L- Manholes 18.76 L,t- f 6-•,_.�, 1e\ P, i HtuT lj 1 Rain drain connector 18.76 ��w v "� u I Sanitary sewer(no.linear ll: _) Paget Storm sewer(no.linear ft.:_) Page 2 Water service(no.linear f1: ) Page 2 Subdivision: „/h I Lot no.: Fixture or Item: T'nx map/parcel no.: Backflow proventcr 31.27 /�.6111 k , DESCRIPTION OF WORK Backwater valve 12.51 5 I.I r'ehAOJt I pF t AA CY 1s Clothes washer 25.02 V4 Dishwasher 25.02 ectY1N, 61 es . Drinking fountain 25.02 Ejectors/sump 25.02 PROPERTY OWNER I ❑ TENANT' Expansion lad: 12.51 Namc: ( Pa c. ft sa 112.5 724 LLU Fixlurc/sewer cap 25.02 �� s / Floor drain/floor sink/hub 25.02 Address: ( 70 1 eQJsw`1 54 .. J Si[ 100 Garbage disposal 25.02 Cily/Slate/ZIP: /Jev w.-+ VC/.I. i Cti- 1 LL L v Hose bib 25.02 _ Phone:(7N'() ' oI, 121/ Fax:( ) Ice maker 12.51 PPLICANT1� /,❑ CONTACT PERSON Interceptor/grease trap 25.02 Business name: AA d✓e S is y� 61(19•,P Medical gas(value:S_) Page1 . 2 Contact name: Printer 12.51 AA�� a "k'"f'� i r1�c�' Roof drain(commercial) 12.51 Address: 28 xCC.. cpail rr 3( 0 Sink/basin/lavalory• 25.02 City/State/ZIP: , sV 1 to. t c P - I >4 I L1 Solar units(potable water) 62.54 Phone:(t '3 2 Q 7 ,6 (m Fax::( ) 1 Tub/shower/slower pan 12.51 li-mnil: 1 p in ,c 'Tv�)t p A3 i v)c . CO ix..., Urinal 25.02 Water closet 25.02 CONTRACT& Water heater 37.52 Business name: / O Waterpiping/DWV 56.29 Address: ss�� Other: 25.02 City/Stale/ZIP: Subtotal Phone:( ) Fax:( ) Minimum permit fee: $72.50 CCB Lie.: Plumbing Lie.no.: Plan review (25%ofpenult fee) State surcharge(12%ofpermit fee) Authorized signaler TOTAL PERMIT FEE Print This permit application espires if n perndt Is act obtained alihht 180 days 1 rat name: f/1 r n a Date: 20 2. I after it ims peen accepted as complete. *Fee methodology set by Tr-County Building htdusny Service Road. Olulll,gnPermii TLMU•PumtuApp.due 10/01/09 •140•1616T(10102/CO,VWEn) I ' • -Plumbing Permit Application - City of Tiga rd Page 2-Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee: 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 Sewer•1st 100' 62.54 3,601 to 7,200 $327.20 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 y Storm&Rain Drain-1st 100' 62.54 Vfthon: Permit Fee: $1.00 too$ $s5,000.00 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 Other Inspections or Fees Qty. pee(ea) Total each additional S100.00 or fraction thereof,to Inspection ofesisting plumbing or for mid including$10,000.00. which no fee is specifically indicated 90.00/br $10,001.00 to$25,000.00 each,$148.50 for the first$10or fraction 0 and$1.54 for (minimum charge—U2 hour) each additional$100.00 or fraction thereof,to Inspeclions oulsidc of normal business 90.00/hr and including$25st$25,. hours(minimum charge-2 hams) • 525,001.OD to$50,000.00 each$37 a 0 for the first 525,00 fraction and thereof,for Reinspectian Fees 90.00/hr each additional$100.00 or to and including S50,000.00. 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—12 hour) each additional$100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Arc 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 anyof the following. Fixture Type for Replace/ Please check all that a VerIt Performed: Capped Added Relocate apply. Baptistry/Font ❑ Any new commercial building with water service 2"and Bath: TnblShover greater,except systems designed and stamped by licensed -Jac rziAVhirlpool engineer. Car Wash: -Bach Stall 0 New exterior plumbing site utilities for any complex structure Drive as defined in OAR918-780-0040. CnspidorAVater Aspirator IDMedical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. Domestic ❑ Any complex structure as defined in OAR918-780-0040. Drinking Fountain Bye Wash Submit 2/sets of plans with any of the above. Floor Drain/sink: -2" -3„ Isometric or Riser Diagram 4 0 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 IceMachiRcfrlg.Drains , . Comments regarding fixture work: Oil Separator(Oas Station) Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -l.av/Bar non-food related -Bradley -Com/Serv/Util food related 1Ce *Note: If the fixture work under tills permit results in an Swimming Pool Filter increase of sewer EDUs,a sewer permit will be Issued and Washer-Clothes Water Extractor fees assessed for the sewer increase must be paid before the Water Closet-Toilet :' plumbing permit curt be issued. Urinal Other Fixtures:Instantaneous Water 3 Heater 1:\Building\Pennits\PLMF I'errnitApp.doc 08/04/2011 2