Permit ` a CITY OF TIGARD
PLUMBING PERMIT
v COMMUNITY DEVELOPMENT Permit #: PLM2010 -00074
T tGiCRla 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/17/2010
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7228 SW DURHAM RD, STE# 100
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Style Shock
Project Description: Plumbing TI, all new, additional fixtures.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 2 ea Drinking Fountain 03/17/2010 $50.04
2 ea Floor Drain /Floor Sink/Hub 03/17/2010 $50.04
PHONE: 503-624-6300 1 ea Primer 03/17/2010 $12.51
1 ea Sink 03/17/2010 $25.02
Contractor: 2 ea Lavatories 03/17/2010 $50.04
POWER PLUMBING CO 1 ea Urinal 03/17/2010 $25.02
PO BOX 19418 3 ea Water Closet 03/17/2010 $75.06
PORTLAND, OR 97280 1 ea Water Heater 03/17/2010 $37.52
PHONE: 503-244-1900 1 12% State Surcharge - 03/17/2010 $39.03
FAX: 503 - 244 -8825 Plumbing
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $364.28
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: ^ 11 n j Permittee Signature:
`—'4\
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.
MAP /10 /2010 /PEON 12 :41 ?M POWER PLUMBING FAX No. 003 244 8822 P. 002
... -_ n .... .
P1uinbing Permit Application 201 �`'�O���r d�0 �/
MAR `Y 5 U a rt "AGSF wL?�a "
Building Fixtures •� ," 4_ i�ot or le.E 11Sr iiEyr K ;
. '''%'..:4Z4 - 10 City of Tigard CITY 0i 1 ' `Received * 5 to
71 Permit No.: 1, A0/O-6610 7
a - s ]3125 SW Hall Blvd., Tigard OR 97223 { _ Uli��� r p anR vie •
Phot tc: 503.639.4171 Fax: 503.598,1960 Oth Permit No.: Q, �/O..a4" 34
a. i :. Datc
e? =y Inspection Line: 503.639.41 Date Ready/By: furs: 1 0 Sec Page 2 for
te T ,n l � ° sA D Internet www.tigard Notified/Method: • l pp o
{y{ Supplemental Information
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f {tr f' yf ' (;y���yy b ail I - v t t 17 rf '' � Xi •. w Lm+ es 1 1 �'
Y��r . 4 al :N t.' >2 6N/ ! � A l AU ? ,'� �t RF �, } 1�.�.� • � .��i� � 't 1 1!�
12 New construction 1=1 Demolition For special information use checklist
Description 1 Qty. 1 Ea, 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
r,'7°6gt ; , `Ir'�vs v r ttp' d"• .fn F; (iA' I ,.. '# l„ . .,. td,'r SFR (1) bath 312.70
11 1 -and 2- family dwelling
Commercial/industrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ' ❑ Multi - family
Each additional bath /kitchen 25.02
-- 3vlaster budder - D0iher -- 'ire-spt inkier -(=4 t- )--- ,�____p_agr� _
6472621i,', .7� k 5 Vy 3d�-(! L . .'_ .'.'Y�}r,. t., r e Sui ut ilities: -
i�.�:' 1 Q �±'s„ i a. lOb3hS ,:.4).,:., . .. : .1 +..i.y E. J +�, � �.;:m:,
+ n Catch basin or area drain 18.76
Job site address: ' l '. 8 c D._, Y,c,�v>^ 1�r�-
Drywell, leach line, or trench drain 18.76
City/State/ZIP: •‘ c,A, K� 09, , C I `7 4 ii Footing drain (no. linear ft.: ) Page 2
ui ldg. /apt. no.: p Project name: Sk ^ C • • (Manufactured home utilities 50.03
Cross street/directions to job Site: i i:)t.x„ \\ e•Z\r 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: r� ,. /� Lot no.: Fixture or item:
Tax map /parcel no.: r J / 7 C CO Backflvw preventer 31.27
� s r h. y,, y w" ••' 1 r r Backwater valve 12.51
d'�t��,� �` tiy��'° !or�(Jt�;Ca l�tid¢! { q,�� � {� �,-r � d Iv1KRr rymttd
i "i' p agw?,'�. ;r' g ,72 T 'nE i,, r w ,.., >, ^ . ' c d, �a . ..3 fl.wAtt ,. �t . ,0ii• Clothes washer 25.02
K) -- • , La a 16 , a - _ _ Dishwasher 25,02
- • .. • -' e. 6 . w Drinking fountain tri 25.02 _6o • o9 • Ejectors /sump 25.02
�„p r [� , ,,•,. ., , ii ` ,,,V A. {•lt�r^� 1" - "s 7t," 1 } ; Expansion tank 12.51
�, "� "t s -' 6+ �.Sn 4xNGx b um I, . 4 ,- ,u " t +. ,„ ., t: . , - A r �, ,�'' , . �G r'd' p .. •
Fixture /sewer cap 25.02
Name- f �s u', p5� „,,-G `.s
P Y Floorflrain /floorsink/hub V 25.02 60 ,0
Address: Garbage disposal 25.02 •
City /State /Z1P: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
cease trap C" rt It " t> 8 .if M 0 S' a ' `" �+ -3w nterce tor/ 25.02
; "i „, t ?P r ?; :, ,r k l{i � 6Z , I t i • .4 ... l it l ,, &. 1 k;,li�' p g (value: 5 Page Medical gas (
Business name: ) c 2
B
�Cr_�d; �Llt m b' tn �' Primer 1 12.51 i a2�:51 '•.
Contact name: L1 ac.s CCt� Roof drain (commercial) 12.51
Address: S _ t.6-• a • u 4. -A • u r! • Sink/basin /lavatory 3 25.02 IS, , 04„,
Solar units (potable water) 62.54
Phone: (,<-0;) ., lj _ 'a •* Fax:: (563) ,[,I c/ - I 5 Tub /shower /shower pan 12.51
Urinal j 25.02 .5,p..
E-mail: , , • " A ' • A_ CO Water closet 3 25.02 `7 F✓, 04. .��,}y!..45:441' 4' . .115; f t 6 7-;: ry x o i l, c) f $ ° l 'l S 2 c q ° G "''''.417'."r'54 k r, ° �. x y
t�.4`ll .r +�,ti o1>d, .a _ - . aw' : rr. ... X r' ,+4.. t'' '' .a! 4 d'Wilri r ', ' • Water heater I 37.52 3 1 r 6 .
Business name: • - - • - . ,al • a Waterpiping/DWV 56.29
/ Address: E ( b g _ . a . Other. 25.02
Subtotal Jj e
. City /state /ZiP: �� T � a � : minimum permit fee: 572.50
Phone: 303) ot Q9 , c Fax: (503) avq�/- 85 5
341 r 6c) Plan review (25% of permit fee)
CCB Lic.; 5, 378 . Plumbing Lic, no.: P IS State surcharge (12 % of permit fee) 39, p'5
Autbotized ` ' TOTAL PERMIT FEE ,36 F,1 r
7 -, C- Da b This permit application expires if a permit is not obtained within 180 days
Print name: , �� r Date: J J after It bas been accepted as complete_
'Fee methodology set by Tri- County Building Industry Service Board.
LlBuildin ;Wermi;:WLMU- PnmitApp.doc 10/OV139 440. - 161er ( i O /OLCOM/WF.e)
MAR /15/2010/MON 12 :41 PM POER PLUMBING FAX No. 503 244 8825 P. 003
0,3
Pliimbinlg Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: 1�� p .4.:7413.i,:, Residential Fire Su • ression s � �Hl steins: rv
2 ;,,,r?, l 111 a q6 : p o ... •i,Tc = . t, ,I li 1 1 5f . } ° **k a!'.1. +U, ",� �... =tt• " iA
Footing drain - I" 100 50.03 0 to 2,000 $121.90
Footing drain each additional 100' 37.52 2,001 to 3,600 3,601 to 7.200 _ 5169.69
5233.20
Sewer - 1st 100' 62.54 7,201 and greater 5327.54
Sewer - each additional 100' - 37.52 •
r WaterService - 1st 100' 62.54 Medical Gas S stems
Water Service - each additional 100' 37.52 '� ✓ + °'I Ae 'C"' 7,'",� '� 'Y r . 4 .,4 ( f . t , u
.,�_ gill" : t 1 ' 1 A�� ° ' ! J t r : dz'N if 4 -, . 6-A:4- -
Storm & Rain Drain - 1st 100' 62.54 51.00 w $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.5 $5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and 51.52 for
, ' : , ay y # 4It . , owl* each additional $100.00 or fraction thereof, to
TO 4 1 1 ;Z! .!.! . ='t 1. _ i .: r-�yttvia includin: $10,000.00.
^~ Inspection of existing plumbing or for - - 7$111;001700 25;000:00 $148-50 - for the - first$Id -000-00 d'514- for -- ---.
which no fee is specifically indicated 90.00/hr each additional 5100.00 or fraction thereof, to
(minimum char - hour and including 525,000.00.
Inspections outside of normal business 90.00/hr 525,001.00 to 550,000.00 5379.50 for the first 525,000.00 and 51.45 for
hours (minimum char :e - 2 hours each additional 5100.00 or fraction thereof, to
Reinspection Fees 90.00/hr and including 550,000.00.
Additional plan review for revisions 90.00/hr 550,001.00 and up 5742.00 for the first 550,000.00 and $1.20 for
each additional 5100.00_ or fraction thereof.
(minimum chlkge- 1/2 hour)
Subtotal:
Commercial Fixture Work:
fi, "' a r ru •�, Wtr3 � � s H ' a'�
Are you capping, adding or replacing fixtures? if "yes", 5 W , ° s cross " ��o r ? M 1 ; (ij' t _ 1 1 y .. ? ?
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately resort fixtures could result in increased sewer fees * . Please check all that apply. •
: ; �< ° °° t el• `�� t 1 :3, t rJ •tl tiaittr `F1 twt W RIe et urmUc': ❑ Any new commercial building with water service 2" and
ginx i. -c Tii; P 3 t ' r ry , ft . 1 , ycr �;. -! - , gb11 greater, except systems designed and stamped by licensed
3r 4, <
's.. ,(l" � ;:i 9uur{} i -4. , . , Ec O; k A ' 'a ii4; !"41,5s'6o €a' engineer.
BaptisufFont - _ ❑ New exterior plumbing site utilities for any complex structure
Bath - Tub /Shower _, as defined in OAR918- 780 -0040.
- Jacuzzi/Whirlpool ❑ Medical gas and vacuum systems for health care facilities.
Car Wash •Each Stall _ ❑ Any multipurpose fire sprinkler system.
- Drive Thru ❑ Any complex structure as defined in 0AR918- 780 0040.
Cuspidor /Water Aspirator
Dishwasher - Commercial Submit 2 Sets of plans with any of the above.
- Domestic I
F o u n t a i n Drinking n fq 5 53)6 r ,, r m In ' �.i r tw' 7b.6rMC rla crr�rr . 23 ,
E c Wash X;� ci S; bi14W 3.11 yx, O s,'e aa T1 � nnS k ,
F1oo oral . /sink !e► • Isometric or riser diagram is required for new buildings
- 3" that meet theaualifications above.
Car Wash Drain
Garbage - Domestic -
Disposal - Commercial Comments regarding fixture work:
_ - industrial ,
Ice Mach./RefriLDrains _ -
Oil Separator (Gas Station) 1 -
Rec. Vehicle Dump Station
Shower - Gang
-Stall _
Sink B • '1 avafo - _
- Bradley
- Commercial *Note: If the fixture work under this permit results in an
-S rv=c - J , increase of sewer EDUs; a sewer permit vvi(1 be issued and
Swimming Pool filter fees assessed for the sewer increase must be paid before the
Washer - Clothes _ plumbing permit can be issued.
Water Extractor -
Water Closet - Toilet s . 1c _ 6 - uc `\\ per, 0A s - c-c
p
- Other Fixtures: _ 0C. S GA S Sc � S l ` ANA C OuX: ..
http : / /www.tigard- or.gov /city_hall/ departments /cd /docs/PLMF- PermitApp2doc L IP 4_,. OJLe_ f CC-P.,-