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Permit (91) „ CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 -00031 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2011 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST 400 Project: Everest Institute Subdivision: Lot: 0 Project Description: Interior plumbing: Adding (1) sink and (1) eye wash, and installing (1) water heater. Contractor: WESTERN PLUMBING Owner: PLAZA WEST LLC 9460 SW TIGARD, AVE STE 101 BY NORRIS BEGGS & SIMPSON TIGARD, OR 97223 121 SW MORRISON ST STE 200 PORTLAND, OR 97204 PHONE: 503 - 639 -5296 PHONE: FAX: 503 - 684 -9015 FEES Quantity Description Date Amount 1 ea Sink 02/08/2011 $25.02 Specifics: 1 ea Water Heater 02/08/2011 $37.52 25 Misc Other Fee 02/08/2011 $25.02 Type of Use: COM 1 12% State Surcharge - 02/08/2011 $10.51 Class of Work: ALT Plumbing Type of Const: Occupancy Grp: Stories: Total $98.07 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct • • - . . OUNC b calling 503.232.1987 or 1.800.332.2344. Issue = � / Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 01/27/2011 09:05 5036849015 WESTERN PLUMBING INC PAGE 01/03 'lumbii Permit A pl catiola . I I j I d c) l Co Building Fixtures 1C FOR orr.Ic E. t SE t }ti L1' City of Tigard & Rena ^ v 13125' SW Mall Blvd_, Tigard, QR. 9'7223 ^, p ► 1 `� ��� DatDate/13 . J Permit No.: '1 .. \v i Dar B view • Phone: 503 - 639.4171 Fax: 503.595.1960 44/M111 Pe p (� TT(j %. p {nnspection Line: 503.639 -4175 1' - r .. Dato%Z; : Other Permit No.: i J — Uc �� Internet wwwstgar -ot g ov r Dat Hy � d t.V ( Notified/Method: S See a e 1 for XI Ri+C3 ' . ' , t s Suppleanemial Information New construction 1?1uLT* SCR ULX�' 0 D emolition 1'or . ,. " ' ®rnvatinn we checklist Addition/alteration/replacement acement © Other New 1- 2- family dwe Dowd , on KM, OMEN ltirtgs Qncludes 100 ft for each f Y OP iSTRi;VTIO "CATEGORY 1V 2 utility connection) SF11(1)bath 312.70 0 I- and 2- family dwelling F. Commercial/industrial SFR ( bath 437.7$ ❑ Accessory building _ 0 Mniti -FR S f3) bath IIIIIII 500. 2 [J Master builder Bach addiLi�al bath/kitolten ❑ Other: 25.02 „ JOli "$riL LNFbitltl[A1'>vN A11T6 1 /0 t ! " Site uti Fire sprinkler („ s4- ft.) Page 2 LOC,Ii 1081 , r Job site address r t 111.A ' lities: ,,/ e • `. Catch basin or area drain 18.76 City /State/ZIP: - '�� i, A r if t + Dryw , leach line, or trench drain SutLe/bldg.fapt.:ao.: Project name: V , , I l , Fooftng drain (no. linear ft.: ) Page 2 Cross street /directions to job site: ,' Manufactured home utilities 30_03 Manholes _ 18.76 Rain drain connector _ 18.76 Sanitary sewer (no- linear lt: —) Page 2 Storm sewer (no, linear R.: ,,,`) r Subdivision: Water service (no linear ft.: ) 5 — Lot n0.1 Fixture or item: Tax neap /parcel no.: Baeldlow preventer 31.27 s�1 �l .. /Al ' 11. A.: 25 02 4 Dishwasher - 25.02 iiiMiil Drinking fountain 111111 25.02 MN NM 25.62 ,' a t o ?ER' ' O ER q z>Mrr�iv?r ' . Ejectors/sump Name. MN 25.02 MENU Address: Floor drain/floor sink/hub 25.02 City ZIP: Garbage disposal 25.02 Mil Phone: ( ) Hose bib 25.02 Fast ( ) Ice maker 0 ' b Af ; C`blsiTAtv 0 ! . ?bi Irrterce pt or/ ®cease trap Business came. Medical gas (valve; $ ) Page 2 Contact name: Primer 12.51 NMI Address: Roof drain (commercial) City/State/ZIP: Sirfk/baa+a� Solar units /lavatory ) 25.02 " (potable water) 62.54 Phone: ( ) Fax:: ( ) nib/shower/shower pan E -mail Urinal 25.02 N)?AC )'UXT Waba closet Ella 25.02 Business name! Western FRutrrbing, Inc, Water heater Address: 9460 S Tigard Avenue Suite 1 01 Water p%ping/D W V ; UV Other: +>� � . 1.: 25.02 City/State/ZIP: Tigard, OR 97223 . �, Phone: (503) 639-5296 Fax: to M Fax (503) 6S4 -9015 Minimum permit fee: $72.50 CO3 Mil Lie.: 2439 Plumbing Lit. no.: 34 -29PI1 • Plan review (25% of permit fee) of .Authorized signature: ,!/ iy State surcharge (12% ermut fee ) �� P Print name: Tana Jensen �`�^ Date! ; . I This den. t application e TOTAL PE1tI14 ed FEE (/ 6-1 / �plr ee u accepted ccept ae co is pet obtained within within 180 da�� after It has been ccepte a'F „ . ,,, a1hn.1n1, 1f , ,. c.. VW 1 A„∎I. ;... T., Amtry co.,r:.,. ..• CO / Zoo sc -mss 01/27/2011 09:05 5036849015 WESTERN PLUMBING INC PAGE 02/03 Plum Permit A lication - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Sur t cession Systems: Footing drain -1 100' t #ale 00 , .. _ retinif Fee: • 50.03 0 to 2,000 $122.90 Footing drain - oaci3 additional 100' 37.52 �_ 2 001 to 3,600 $169.69 Sewer - 1st 100' 62.54 3,601 to 7 200 $233.20 7 01 and greater $327.54 .. Sewer - each additional 100' 37.52 Water Service -1st 100' 62.54 Water Service - each additional 100' 37.52 Medical Gas Systems: Storm Rain Drain 1st 140' 62.54 $1.00 to $5 400 -00 Minimum fee $72.50 Storm & Rain Drain - each additional 140 37.52 $5,001.00 to $10,000.00 $72,50 for the fast $5,000.00 and $1.52 for lktetF t1t tiD 15'0,1' `e.S , Q 1 S *Fee 4g) ' li'rAgl each additional $100.00 or fraction thereof, to inspection of existing plumbing or for '' tint includita: 510 000.04- $10 ,001.00 to $25,000.00 $148.50 for nt $10,000.00 and $1,54 for which no fee is specifically indicated 90.00/1a (minimum charge — 1/2 6oarr) each additional $100.00 or faction thereof, to Inspections outside of normal business — 90.00/hr and iueludin , $25 000.00, hours (minimum charge µ 2 hours) $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for each additional $1 000. Of fraction thereof, to Reinspection Fees 90.00/121 Additional plan review for revisions — and iucludin $50 004 -00. 90.00/lu $50,041.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum char'gt -1/2 hour): each additional $100.00 Or thereof. Subtotal , Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes", please indicate work performed by fis Failure to Pla>rt I tew ifbr liiaia�tt YtNSt ll tiotls :. accurately plan i s required for any of the following. r ely report fixtures could result i n i ncreased sewer fees. Hesse check all that apply. b . kv, PeK.s 1 uuBtr ❑ Any new commercial buil �, eater, except with water service 2" and ''' .' ' try/ , ..n IM systems designed and stamped by licensed �- Bath - T1tWShowa � ❑ New exterior plumbing site utilities for any complex structure Tli VPhlr1, 01 as defined in OAR918- 780 -0040- cm- Wash Each stall d Medical was and vacuum systertts for health care facilities. - Drive Thru ❑ Any multiptupoge fire sprinkler system. Cu Aspirator Dishwasher ❑ My complex structure as defined in OAR918- 7 80 -004 Dishwasher - Commercial - Domest � � Submit 2 sets of plans with any of the above b►vrkr _Fountain E e Wash l Z" isomer i`i or Rise r' Dia0a>rli 3" Isol>raetnc or riser diagram is required for new buildings 4 " that >ltt meet tid gttalifiications above. Car Wash Drain INIMMIMMIEME=11=11 Disposal Domestic Aispos commer ig. Drain ns off Sc•arator Gsastatioq Rec. Vehicle Dump Station =1 Shower - Gang - Stall Sink BSz)'Lsvatory all - Bradley —.� ,_ -Commercial - service �� *Note: If the fixture work under this permit results in an Swimming Pool Filter increase of sewer EriUs, a sewer permit will be issued and Washy - Clothes l fees assessed for the sewer increase must be paid before the Waft/ Extractor Water plumbing permit can Closet be issued stet l oser - Toilet Urinal W Other Fixtures: