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Permit (110) ,, CITY OF TIGARD PLUMBING PERMIT 1 ` � COMMUNITY DEVELOPMENT Permit#: PLM2018-00502 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/08/2018 TIGARD Parcel: 1S136DD05300 Jurisdiction: Tigard Site address: 11850 SW 67TH AVE, STE# 105 Project: Spec Space Subdivision: WEST PORTLAND HEIGHTS Lot: 9 Project Description: Add(1)break room sink for tenant improvement. Contractor: COLUMBIA MECHANICAL INC Owner: PNWP LLC#2 PO BOX 2164 PNWP LLC WOODLAND,WA 98674 6600 SW 105TH AVE#175 BEAVERTON, OR 97008 PHONE: 360-225-1600 PHONE: FAX: 360-225-8755 FEES Quantity Description Date Amount 1 ea Sink 10/29/2018 $25.02 Specifics: 1 12%State Surcharge- 10/29/2018 $8.70 Plumbing Type of Use: COM 47 ea Minimum Fee Adjustment- 10/29/2018 $47.48 Plumbing Class of Work: ALT Type of Const: 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 ado. -d by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-00 0090. Y> may o. F c.1.y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800. .' Issued By: Permittee Signature: �i, 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 ''‘E a 34 Building Fixturesmbi `m FOR OFFICE I SE O\1.1 Cl of Tigard OCT 2018 Date/By:atei0/ / �/ �. 13125 SW Hall Blvd.,Tigard,OR 97223 _ /(,' �� �r Permit N M 1n���'fsy� IN I • h.u Plan Review /�, '-`" L Phone: 503.718.2439 Fax: 503.598.196U;( 0 GAR S t'Date By: Other Permiti��� �,i�p©02 < Inspection Line: 503.639.4175 i3 !1..„D!N G D l V i F, O y y. T I C. A l l.D i e Read/B Juris: H See Page 2 for Internet: www.tigard-or.gov Notified/Method. Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑New construction 0 Demolition For special information use checklist Description I Qty. Ea. Total ❑Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) CATEGORY OF CONSTRUCTION SFR(1)bath 312.70 µ dwelling 0 Commercial/industrial ❑ 1-and 2-familySFR(2)bath 437.78 ❑Accessory building 0 Multi-family SFR(3)bath 500.32 Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: //y 5 Ci S e,_, 6 2 /Iv t_ Catch basin or area drain 18.76 City/State/ZIP: -re(,:4 2D Drywell,leach line,or trench drain 18.76 C.). Footing drain(no.linear ft.:_) Page 2 Suite/bldg./apt.no.:/QS' 1 Project name: -7-) ; Manufactured home utilities 50.03 Cross street/directions to job site: V 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: 1 Lot no.: Fixture or item: Tax map/parcel no.: Backflow preventer 31.27 DESCRIPTION O*':WORK Backwater valve 12.51 Clothes washer 25.02 4 4.1a r✓a) $// 1 �4?-- 5. c'in. - T ..5P/G e-S Dishwasher 25.02 t Drinking fountain 25.02 Ejectors/sump 25.02 1g-PRQPERTY OWNER. 1 ❑.TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 ��i p /L S, ,,a4--.772-. 77 gL,/y Floor drain/floor sink/hub 25.02 Address: E(, : /q.� �p/V itil li /n.cie Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 0 APPLICANT. ] CONTACT PERSON Interceptor/grease trap 25.02 Medical gas(value:$ ) Page 2 Business name: .SFS-T9g- Contact name: I Primer 12.51 Address: Roof drain(commercial) 12.51 Sink/basin/lavatory2�z3/G/1_GCr1 / 25.02 City/State/ZIP: I Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/shower/shower pan 12.51 E-mail: Urinal 25.02 Water closet 25.02 CONTRACTOR Water heater 37.52 Business name: C)(,C.t,�l/( N OAcokikN-w\L71,14: Water piping/DWV 56.29 Address: (..d, il 0 x 21 t Other: 25.02 City/State/ZIP: 1.4rj094-r�1-) \ cj�S c?6 7 Y Subtotal Phone:(36c) ) Sl'_ &I . ?? Fax:( ) 7.bi 714; Minimum permit fee: $72.50 CCB Lic.: l S'(I 2-1. Plumbing Lic.no.: 3 )-4-15-(/-"BPlan review (25%of permit fee) / State surcharge(12%of permit fee) Authorized signature:7k- 2 i,/� TOTAL PERMIT FEE //,)) Print name:Kofi 6 t.2 0.4.4.kc Date:JO-2'1- 4 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. em/l %�czi/, Go -71' t=., tJ+/�t/ t <I:�BuildingTermits\PLMU-Perm oc 10/01/09 Th 440 1T�1 2/( COOM-/WFC /3C+ V Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. tree(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 $169.69 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 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$10,000.00 $72.50 for the first$5,000.00 and$1.52 for Other Inspections or Fees Fee(ea) Total each additional$100.00 or fraction thereof,to pee 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*. Pian Review for Plumbing Installations Quant1y by Fixture Type Plan review is required for any of the following. Fixture Type for Reply/ Please check all that apply. Work Performed: Capped Added Relocate 0 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 0 Medical gas and vacuum systems for health care facilities. 0 Any multipurpose fire sprinkler system. Dishwasher: -Commercial Domestic 0 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„ L _' 1 I '. 4" ❑ 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 Ice Mach./Refrig.Drains Comments regarding fixture work: Oil Separator(Gas Station) e Rec.Vehicle Dump Station Shower: -Gang -Stall Sink: -Lav/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 Water Closet-Toilet plumbing permit can be issued. Urinal Other Fixtures: I:\Building\Permits\PLMF PermitApp.doc 08/04/2011 2