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Permit
PLUMBING PERMIT CITY OF TIGARD �I al i ii ` 1 " s: COMMUNITY DEVELOPMENT Permit #: PLM2010 -00152 d Date Issued: 05/11/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112AA00600 Jurisdiction: Tigard Site address: 6777 SW BONITA RD 120 Subdivision: NELSON BUSINESS CENTER Lot: 0 Project: Stone & Wood Outlet Project Description: Cap (1) break room sink. Owner: FEES WALTON CWOR NELSON 13 LLC Quantity Description Date Amount BY TTA/EPROPERTYTAX DEPT 735, PO BOX 1 ea Fixture /Sewer Cap 05/11/2010 $25.02 4900 1 12% State Surcharge - 05/11/2010 $8.70 PHONE: Plumbing 47 ea Minimum Fee Adjustment - 05/11/2010 $47.48 Plumbing Contractor: JAMES ROOD PLUMBING INC 880 NE 25TH AVE SUITE 2, PMB 129 HILLSBORO, OR 97124 PHONE: 503 -648 -3907 FAX: 503 -681 -2196 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: AI' � ; / Permittee Signature: D `9-// /J "J / / P L �r � �o �V 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. 2' FROM : JAMES ROOD PLUMBING FAX NO. : 503 6483907 May. 06 2010 02:41PM P1 Plumbing Permit Applic - g g COPIVFO Suildin Fixtures � , rui; ()I us( l ;l: () \l,1 111111 City of Tigard M1 � / ��( _ 6 2010 ��d 4., PermitNo��y� ais . G • 1 3125 SW 13011 Blvd„ Tigard, OR 923 /� .pp A o ® Plan Acvic Uu /� / tJ Phone: 503,639.4171 Fax: 503.598.1960 a Date/13y. Ohba' Permit No.' 0 !� Inspection Line: 503.639.4175 CITY OF r .ARD t IGAi.f7 Date Rea /B l ScC Pale 2for Internet: www ttgard - or goo I I t Ready /0y: BU ' C DIVISION �S�ON Notrfied/Method: " Supplemental Information Intc ❑ New eonstructivn [J Demolition For special in ornurlionaaechecklit Dcseri.non i Qty. L Ea 1 Total Addition/alteration /replacement © Other. New 1- 2- family dwellings (includes 100 0. for each utility connection) i y. r €ONS� RTT 11V .70 SFR (1) bath 312 • - � ':tit � 'Y .1M ... ❑ 1- and 2- family dwelling lkj Commercial/industrial SFR (2) bath 437 38 Accessory building ❑ Multi-family SFR (3) bath 500.32 [] Master builder Other: Each additional bath/kitchen 25.02 _ Fire sprinkler ( sq. 0) Page 2 a JO u S *Q 2M,A..` `> 1 ; NP ;J ::e„ ,L ON :..,. ,, , Site utilities: Job site address: 7 � (313K; t�. ed Catch basin or area drain 18.76 Drywell. leach line. or trench drain 18 -76 City /State/ZIP: 7-i 60, 0 l., S Footing drain (20. linear R.: Page 2 Suite/bldgJapt. no.: i Project name: S1 rdz,„ & pt„„t(t 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. l ft.: ` J Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: Lot no.: Fixture or item: Tax map /parcel no.: e_ 2 S • � / A i 4 i i 6 Back flow prcvcnter 31.27 Backwater valve a. ,. z +, I' + • . -iON U Pl-.. -..e 12.51. . ,. clothes washer 25.012 OUS'o / 644k5-i n,r ( Dishwasher III 25:02 Drinking fountain 25.02 , •ill(/t /�'.,, ( I c�W� -/Z�Nr -% 4 C p P& ��( r Ejectors/sump 25 .02 '; Jae r t c 0 .,., 1 , ;R +... ` ,,. ' ' Q : 4Lt'A'1) . Exptmsiontank IIIM 12.51 Mill Name: Fixture/sewer cap 25.02 Address: Floor dram/floor sink/ 25.02 City /State/ZIP: ---- Garbage disposal 25.02 Hose bib 25.02 Phone: ( ) Fax ( ) lee maker EMI � r - ta s �i0• iTC ; ' , ' ti `D; CONU . 3410,* 1 ` Interceptor /grease trap En Business name: Medical gas (value: $ ) I Page 2 Contact name. Primer 12.51 Address: Roof drain (commercial) 12,51 Sink/basin/lavatory 25.02 City /Statc/ZII': Solar units (potable water) 62.54 Phone: ( ) I Fax:: ( ) Tub /shower /showcr pan � E-mail Urinal 25.02 Mil W c S lll. T lLblas T OR 25.02 Business name: 0.,,,t) , 04 Water heater 37,52 Address: a.,-4, el: Water piping/DWV 56.29 IMO s -- - _ p1 /.1�1 ()titer. 25.02 City /5tatc/GJ1': Subtotal Phone: ( 0 1) I . — 0 Fax: (j ) a : — : 4'6 Minimum permit fee: $72.50 MN d I Plumbing Lic- no.: •s,: S ' Plan review (25% of permit fee) Authorized signature: ��/ Stan surcharge (12% of permit foe) TOTAL PERMIT FEE f • 1./.-- Print name: „ Date: 5II d This permit Application txpires if a ' , ermit is not obtained within 180 dap atter it has berm accepted se_ complete_ •GK .nr.fhrvinInnv cep l,, Tr:l`nn. tv Fin:Minn rnrlrrcn.r Csrvi•• RncrA FROM : JAMES ROOD PLUMBING FAX NO. : 503 6483907 May. 06 2010 02:42PM P2 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Su t e rtlsion S stems: s ^' S : Qt9 Fee' {ea) .;Tot*l . _ K'�T 1. ♦ ti d �.� ,� 1t .• ., � � � ,.;,�. : , 'Z ,_ Footing drain -1' 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 3.52 ' 2001 to 3,600 $169.69 - -_ Sewer - 1st 100' 62.54 3,601 to 7,200 $233.20 Sewer -tech additional 100' 7 201 and greater $327.54 - $ 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 f r g rya g f s Biotin & Rain Drain - t st 1 UU' 62.54 1«000.00 a` .. / 5 eS�' o1. �h�.; 0Pra .4i,•; S,it;1 $1,00 to $5,000.00 M 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 $1.52 for . 41ei . + VAI ` , p p4` {e, '. z ^Totai$J., each additional $100.00 or fraction thereof, 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 ( minimum charge -1/2 hour) each additional $100.00 or fraction thereof, to and includ' I • $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 lours (minimum 2 charge - hours) each additional $100.00 or fraction thereof to Reinspection Fccs 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 fins $50,000.00 and $1.20 for (minimum charge -1/2 hour) , each additional $100.00 or fraction thereof Subtotal: - . • ..rte .= Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", ` " `'v j i • r s : yo please indicate work performed by fixture. Failure to e. ' y �"I ° � '' Ilan review is n0quited for any of the following accurately report fixtures could result in increased sewer fees Please check all that apply_ ,iQutintity bfFixtare) WorlL Perfoirtie ;: ❑ Any new commercial building with water service 2" and k9 r u rC Fyp .` ' ' ::40 greater, except systems designed and stamped by licensed : t'rcvtaits Gauped , Added "' £us ;' engineer. Bapttlstry_/Font - Bath IlublShowcr ❑ New exterior plumbing site utilities for any complex structure ,Iacuai/Whidp001 as defined in OA1t91S- 780-0040. Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities. •Drive Thu ❑ Any multipurpose fire sprinkler system. Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR91 8-780 -0040, Dishwasher -Commercial - Domestic - Submit 2 sets of plans with any of the above. Drinking Fountain = Eye Wash Floor Drain/sink - �_2 "`a a µ • 2 �.x„- Y . .fib 3�a',c 1> 3 IN Isometric or riser diagram is required for new buildings -4 that meet the qualifications above. Car Wash Drain Garbage - Domestic - Disposal -Commercial -Industrial _ Comments regarding fix a work: Ice Mach.lRefrig. Drains c • ➢ _ • l,2 1 , of S7k /C 011 S�arator (Gas Station) � Roc. Vehicle Dump Station .- Shower -Gang .Stall -• --- Sink •Bar/L,a `- - Bradley ---- -- commercial _ 'Note: if the fixture work under this permit results in an - Service - Swimming pool Filter increase of sewer EDUs, a sewer permit will be issued and Wisher - Clothes --.-- fees assessed for the sewer increase must be paid before the Water Extractor plumbing permit can be issued. Water Closet • Toilet Urinal ' Other Fixtures! Accumulative Sewer T ally Parcel # 1 2S112AA00600 1 Tenant Name: Stone & Wood Outlet This SWR# j N/A 1 • Site Address: 6777 SW Bonita Rd. This PLM# ; PLM2010 - 00152 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #s values Baptistry/Font 4 0 0 0 0 0 Bath - Tub /Shower 4 0 0 0 0 0 - Jacuzzi /Whirlpool 4 0 0 0 0 0 Car Wash - Each Stall 6 0 0 0 0 0 - Drive through 16 0 0 0 0 0 Cuspidor /Water Aspirator 1 0 0 0 0 0 Dishwasher - Commercial 4 0 0 0 0 0 - Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 0 0 0 0 - 3 inch 5 0 0 0 0 0 - 4inch 6 0 0 0 0 0 - Car Wash Drn 6 0 0 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 0 0 0 0 0 - Commercial (to 5 I -IP) 32 0 0 0 0 0 - industrial (over 5 1 -1P) 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 0 0 0 0 0 Oil Sep (Gas Station) 6 0 0 0 0 0 Rec. Vehicle Dump station 16 0 0 0 0 0 Shower - Gang (per head) 1 0 0 0 0 0 - Stall 2 0 0 0 0 0 Sink - Bar /Lavatory 2 0 1 2 0 -1 -2 - Bradley 5 0 0 0 0 0 - Commercial 3 0 0 0 0 0 - Service 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet - Toilet 6 0 0 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 6.8 108.8 108.8 Capped EDU Credit 0 TOTALS 0 108.8 1 2 0 0 -1 106.8 Current Fixture Value 106.8 divided by 16 = 6.7 Current EDU 1 EDU = S 3,600 Previous Fixture Value 108.8 divided by 16 = 6.8 Previous EDU Change -2 divided by 16 = -0.1 over (under) S (360.00) Enter EDU Change Here; -0.1 Notes: Authorized Name /Signature:1 Dianna Howse I Date:1 05/11/2010 Building Division Note: The property owner shall retain the ORIGINAL., sewer tally record. If credits exist, this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I:\ Building \ Sewer Tally \Sewer 1'allyShcet- 3600.xls 06 /25/08