Permit CITY OF TIGARD PLUMBING PERMIT
1 ' ''. • COMMUNITY DEVELOPMENT Permit #: PLM2009 -00323
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/04/2009
TIGARD, Parcel: 2S101AB02703
Jurisdiction: Tigard
Site address: 7450 SW BEVELAND RD 100
Subdivision: MCA OFFICE BUILDING Lot: 27
Project: MCA Building
Project Description: Install new rain drain.
Owner: FEES
MCCAFFERY, HUGH R & NANCY J TRS Quantity Description Date Amount
7450 SW BEVELAND ST STE 100
TIGARD, OR 97223 100 If Storm and Rain Drain 11/04/2009 $62.54
1 12% State Surcharge - 11/04/2009 $8.70
PHONE: Plumbing
10 ea Minimum Fee Adjustment - 11/04/2009 $9.96
Plumbing
Contractor:
CASCADE PLUMBING CO
2630 N HAYDEN ISLAND DR #3
PORTLAND, OR 97217
PHONE: 503 - 289 -7095
FAX: 503 - 283 -9514
Type of Use: COM
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 adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions / to '� OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /J / Permittee Signature: FA/ .170/0‘../ C.�Q /
'fr2)47 /�( Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
ED
Permit Application � FOR OFFICE USE. ONL\'
Plumbing Permit R 9
City of Tigard N0 � '; 200 Permit No,rOZ /-1.20 O 3
1
a 13125 SW Hall Blvd., Tigard, OR 97223 A % • lan Review
• Phone: 503.639.4171 Fax: 503.598.1960 � T\G`' �S By: Other Permit N IJ ZOO /- DO / ?,�
TI CiAR1J Inspection Line. 503.639.4175 C �� p D,V Rea /By: El See Page 2 for
Internet: www.tignrd- or.gov BOO Notified/Method: it< Supplemental Information • ' T]T E WO F EE * . SCBEDYJf E . .
❑ New construction ❑ Demolition 1 For special information use checklist
Description 1 Qty. f Ea. 1 Total
1!:/. ddition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft, for each utility connection)
. CAr C0* 010 SFR (1) bath I 249.20
111 1- and 2- family dwelling P.,,210. ommercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family
SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Mastcr builder 0 Other Fire sprinkler ( sq. ft.) 1 Page 2
JOB';SITE' t\ ?OR11 11.TTON AN LOCA'TIO\". Site utilities
Job site address: i " 5D 4eA/t{il/ , Catch basin or arcs drain 16.60
City /State/ZIP: 7 l 44f( pR Drywcll, leach line, or trench drain 16.60
Suite/bldg./apt. no.: 1 Project name. ` / S ) Footing drain (no. linear ft.: _ , Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60 7
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: 1 Page 2 -
Storm sewer pro. Iincar ft.: 1 I Page 2
Subdivision: Lot no.: Water service (no. linear ft: ) l Page 2
Fixture or item
Tax map /parccl no ion valve 1 16.60
r 4 x .{ Absorpt
` DESC M.. II1 Fr Q`P WORK .... Backflow prcventer Page 2
/ ' Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
? _ . . Drinking fountain 16.60
❑)('A¢FER TY OWNER ❑ T ENA.N T ., ; :. ; .
Ejectors /sump 16.60 _
Name: Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16.60
( )
Fax: ( ) Garbage disposal 16.60
Phone:
,-
. Hose bib 16.60
r� AP>P)L7iCA`1T Q EONTACT "PElLS4N 16.60
Business name: # ` � �� ice maker
1 UAL?' i
C Interceptor /grease trap I 16.60
Contact name: l ' • Len Medical gas (value: $ ) Page 2
Address: , - 30 ` • x... _ 4 L t • >1 '3 Primer 16.60
r 1 w f Roof drain (commercial) 1 16.60 11 to p
City/State /Z1P:
p`'��r�' ��l Sink/basin/lavatory 16.60
Phone: (cD3) l '7(7 I Fax:: (5 - 7 l
Tub /shower /shower pan 16.60
E -mail: Urinal 16.60
. >. ; CO r NTRACT OI(t , . , - _Water claret _ 16.60
/,, Iv/� AI _ Water heater 16.60
Address: &;, 30 ���p7 L_ .1)42_ 2_ ' Other:
(A.f c� �� �/ 1
Subtotal
�j� - Minimum permit fee: $72,50
Phone: ( ) ��J.'7c2 Fax: (5) 9 i 7 j f y R esidential backflow minimum permit fee: $36.25 7x
City /Statc/ZIP:
CCB Lic.: if, ii' tV/ Plumbing Lic. no.: 7j q "-it .2l� Plan review (25% of permit fee
State surcharge (12% of permit fee) - 6 g . 10
Authorized signature: ' . TOTAL PERMIT FEE . IN • f
Print name: t( ' Q nQ� ,, c ,I 1/'�,/ D a atte: `•� 1 This permit application expires if a permit is not obtained within
`YL(�I C^^c�' 180 days after it has been accepted as complete.
O e ,e *Fee methodology set by Tri-County Building Industry Service Board.
1:■aulldinaPermits\PLM•Per ItApp.do 06/ 06 4404616T(10 /02/COMlWEa)
CO /TO 39t7d alVOSVD iIS6E8ZEO Lb:80 6002/E0/TT
Plumbing Permit Application '- City of Tigard
01 2 ��'- 6Y) ,3
Page 2 - Supplemental Information
Fee Schedule Residential Fire Su • r ression S steins;
, ` `f , i,f 1 i! • 1,. iM1 o . p ' ,:r '"r+� l ,. r . .' .� ` t , r L e o , , ,_ ( p6gry fl f �:,d . a .�! k 2 y .;;t
: ..� l r { / �f;'1ii &, .. , .1.., 1.; . x l „ Y :::., t. r� i 6? -
o � tin !` .. n . 1 ¢ 1 w n!
Footing drain • 1 0 to 2 000 S115.00
100' 55.00 2.001 to 3 600 $160.00
Footing drain - each additional 100' 46.40 3 601 to 7.200 $220.00
Sewer - 1st 100' 55.00 7 201 and • realer $309.00
Sewer - each additional 100' 46.40
Water Service- 1st 100' - 55.00 Medical Gas S stems:
Water Service - each additional 100' 46.40 ,ti 1•�t ry ` ' 1 `
' r
, 7; �C , t., ; ,,,s' .
'1F' , t
•sr 7�yb T„ ,_ ;...,..:,;..i).4,:::.....:0. . .
Storm &Rain Drain - 1st 100' f SS.00 `-
L �j5 • $ 1 . 00 to $5 , 0 00.00 Minimum fee $72.50
Storm & Rain Dram each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
7 �, y+ w„ 1 fokT1 • �, Wirt q additional $100.00 or fraction thereof, to and
r AY r ; ! 6 vh 'tat '
/ , `i ,] !J ;r ?,' 0,?; .. ,.rr'tl' ^ y '.% , r includin,$10000.00.
1 rx.,J� . ...., ci M :. ^ � 1' h. �
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
minimum crmit fee $36.25 27.55 _ and 'including, $25,000.00.
Ram Drain, single family dwelling 65.25 T 525,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
_ each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first 550,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
- : ;' ,, , 6 - 1 1"Vi ?TT'���ti./14•U" k Q4 .34
Fixture Work: ',%..WiL �' ,t-'4' A 3 t 4 i l i'oili ,�.. L . y � ,! +; t'
Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
* ❑ Any new commercial building with water service 2" and
accurate) re ! ort fixtures could resul i n increased sewer fees greater, except systems designed and stamped by licensed
!, "? ::,, c• ,� t �j;,,' y „ RX.. M `� _ „ t: .. ; }nn` { ' �; t engineer.
' iiiitPtilrf °� ' F o. r , y ii . h' , rJ _ ' }y I X42 . a
1p , x ,� . ° r � ' y., 0, li 1 , y ` a . ❑ Any new exterior plumbing site utilities.
B - . tis /Font ❑ Medical gas and vacuum systems for health care facilities.
Bath - Tub /Shower _ ❑ Any multipurpose fire sprinkler system.
,lecuai/Whirlpool ❑ Any complex structure as defined in OAR918 -780 -0040.
Car Wash -Each Stall -
- DriveThru Submit 2 sets of plans with any of the above.
Cuspidor/Water Aspirator �• s _ .y , }Fvr a
tshwasher - Commercial x „ o-n } r , s' j� , L e f , g fl "t K.; . .
Domestic ❑ Isometric or riser diagram is required for new buildings
- Drinking Fountain
Eye Wash that meet the qualifications above.
-
Floor Drain/sink - 2"
-3" Comments regarding fixture work:
Car Wash Drain
Garbage -Domestic
-
Disposal - Commercial , _ ---
-Industrial
Ice Mach./Refrig. Drains -
011 Separator (Gas Station) .
Rec. Vehicle Dump Station
Shower - Gang _ _ *Note: If the fixture work under this permit results in an
-Stall increase of sewer EAUs, a sewer permit will be Issued and
Sink - Bar/Lavatory _ fees assessed for the sewer increase must be paid before the
- Bradley plumbing permit can be issued.
- Commercial
- service
Swimmin • Pool Filter
Washer - Clothes -
Waur Extractor x _
Water Closet - Toilet
Urinal
Other Fixtures:
l w ,.;ua3naTennitllPLM- PamilApp.dce 09122/06
E0 /Z0 39dd 3QdDSt7S bIS6E8ZE05 Lb :80 6002/E0/TT