Permit fifitteliFW CITY OF TIGARD PLUMBING PERMIT
` , a , -. COMMUNITY DEVELOPMENT Permit #: PLM2010 00156
T I:GARI; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/09/2010
, , _,., ,;- ,, Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 500
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: University of Phoenix
Project Description: Adding (1) breakroom sink, (1) insta -hot and (1) ice maker (no drain).
Owner: FEES
GK TRIANGLE CORPORATE PARK III L Quantity Description Date Amount
BB# 73- 1771- GK1130, CBRE, PO BOX 2096
WARREN, MI 48090 1 ea Ice Maker 06/01/2010 $12.51
PHONE: 1 ea Sink 06/01/2010 $25.02
1 ea Water Heater 06/01/2010 $37.52
1 12% State Surcharge - 06/01/2010 $9.01
Contractor: Plumbing
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 $84.06
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 G Permittee Signature: 4/ .. w, , - ■ 1, r 4 , 11 ,, e
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.
FROM JAMES ROOD PLUMBING FAX NO. : 503 6483907 May. 11 2010 01 :03PM P1
Plumbing Permit Application a
Building Fixtures RECEIVE o..�� ooO 7
-
. I:Oit of 1 t: 1,1: ()NIA
City of Tigard MAY 1 1 2( t I Received
• 13125 SW Hall Blvd., Tigard, OR 97223 Datel r e.3— i. (i '37T Permit No : f✓ �, �0 -. ,105- f r
11,
C Phone 503.639,4171 Fax; 503.598.19 n/aPlan Review �Il
Inspection Line: 503.639,4175 ITY OF TIGAR :' I ,iey: other Permit No „u p 67/0 > �d 1 4 4,
r��,,�,t, BUILDINGDIVISI1 RCady�r: , r' " '
Ann. "
Internet www tlgard�r7 gov NouS odJMetbod. , I , Supplemental see Pa 2 for
' 3'PF UF: O )W �urv� r / ' �err L supplemental Inhumation
RR` r ..:4..;::. '�,D.: N.2,. 'k , co o ., i ` 1 7 ) ,,,
❑ New construction p Demolition o f. pedal i mutation use checklist
Addttlon /altcratton/replaccuieni Q U�� DeSen.tion Ea. Total
New 1- 2-family dw eningx (includes ! 00 ft, for each
. ` � l Y i utility connection)
ss , ` "" � .� 4..: TE ' 0k`cC IS* (1) bath
' ,+.,,: SFR ME 31170
❑ 1- and 2- family dwelling to Commercial/industrial SFR (2) bath
❑ Accessory building ❑ Multi- family SFR (3) b 500 32
❑ Master builder Other: Each additional battl/kitchen 25.02
❑ Fire sprinkler ( sq. ft) P 2
." Y '� .. ` .. ,) 1B 'sitF JNF[SR701�r1QN AN) I;QCA`I'11A1S1 ° Site °tillties:
Job site address: ir• , 6- .i .t 2 Catch basin or arca drain 18.76
City /State/ZIP: c_ •
�� Drywell, leach line or trench drain �
Footing drain (no linear ft.: _,_
Suite/bldgJapt. no.: • Project name: £,i 1/441,4s±Y 6 { 04.64 kr Manufactured home utilities
50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector NUM= Sanitary sewer (no, linear ft.: ,_)
Storm sewer (no. linear 11.; „_) Page 2
Water service (no. linear ft.: __) Page 2
Subdivision: Lot no.: Fixture or item:
'lax map /parcel no • /Q/ 7 q0 /D,- T3acldlow preverltar
1 ' AL `t dQ j g }`,�A.4 ,, } .,. '. .q,.M .h �1.Q�h Qr1 'g'l�li3C 'C err Backwater valve r ILESI
/ Clothes washer 25.02
r L. 6 iG I.! t—,G .. ._�. Dishwasher 25.02 IMMO
I w /c t 1'm ". _CO t-d'L V ' (Me DMGi>,) Drinking fountain 25.02
3r �� ' � ASSl
' t; Tt' Ejectors/sump 25.02
rA' t 1_.a. � p' � Y i :., ..... � T .. bxpafS101mtank ��
Name: Fixturc/sewer cap 25.02
Address: Floor Garbage disposal
sink/hub 25.02
City/State/ZIP:
disposal 25.02
Hose bib 25.02
Phone ( ) Fax ( )
Ice maker /A. S
i''" 4, : R" r a1iE;PiSr v1` � `CQTy`rwi +* *k , , 'w Interceptor / trap 25.02
Business name: Medical gas (value: $ •,�_
Contact name: Primer � ��
Address: R..f drain (commercial)
City /Statc/ZIP: astn/iavatory lin 25 a .D
Solar units (potable water) 62.54
Phone: ( ) Fax:: ( ) Tub /shower /shower pan
12.
E-mail
02
E-mail:
Urinal 25.02 ME
ga .:,;: , :eik i ,' f,. ";.: +i ; .: c l,511 l ./4 . r . ` a Water Water heatexeat MN
Business name •
'', Address:: 80 A Water , 5 A a, Ce ,7 ' 't'' /.24 then: iping/DWV 56.29
Other: r 25.02
City/State/ZIP: it 1,'0 • 7 iy
Phone: ( 3) �aSEg 39 0—) , Subtotal MIMI
Minimum permit fcc: $72.50 .O '.
` CCB Lic.: i 62: 0 Plumbing Lic. no, 5"ci Plan review (25 %ofpermit fcc)
Authorized signature: Cf
- Stale starch a ( 12 %of ermitf p cc ) �` -d
I
Print name; TOTAL PERMIT FEE _ • .42 '
��e 0 This permit application expires if a permit la not obtained witlmia 180 days
after it has been accepted as complete
+Fw , nMtin,inlnMr cM h., Tri-ream , p„ilairn tn.inatn, .
�v7n. Rnpr.i
I
FROM JAMES ROOD PLUMBING FAX NO. : 503 6483907 May. 11 2010 01:04PM P2
Plumbing_Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule
s ,, it t "e Residential 9 res S stems:
side tial Fire u sion ste
- y Fee (e> ` = 9 atal • i r
Footing drain - 1'100' a i1_�. , 6 lX 4h .. q; vk , t y
50.03 0 to 2 000 $121.90
Footing drain - each additional 100• 37.52 - 2.001 to 3,600 $169.69
Sewer - 1st 100' 62 3,601 to 7,200 $233.20
Scars - each additional 100'
7,201 and ater $327.54
_ 37,52
Water Service 1st 100' 62.54
Water Service -each additional 100: Medical Gas Systems:
6 �
Storm & Rain Drain • 1St 100' 62.54 `" 41 .4 "'' z, x I ,e «eN ? ., ,,.1 ''1 E W
Storm &Rain Drain -tech additional 100' 37.52 $1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and $1.52 for
.»s A,i 9 y Q j .. , e , :. " { 9I `. To�'91 . each additional $100 -00 or fraction (hereof, to
Inspection of exrstmg plumbing or for and includ $10 000.00.
which no fee is specifically indicated 90.00/hr $1( to $25,000.0 $1 48.50 for thc fir 51Q000.00 and $1 for
minimum char *c -1/2 hour) each additional 5I00.00 or fraction thereof, to
Inspections outside of normal business 90 Opd,T and includin: $25,000.00.
hours minimum ch argc- 2 hours) 525,001.00 to $50,000.00 5379.50 for the fast $25,000.00 and 51.45 for
Reinspection Fees OU/hr each additional $100,00 or fraction thereof, to
and including 550,000.00.
Additional plan review for revisions 90.00/hr 550,001.00 and up $742.00 for the first $50,000.00 and 51.20 fbr
minimum char e -112 hour) cach additional $100.00 or fraction thereof.
Subtotal: - -
-
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes", a
please indicate work performed by mature. Failure to 4 yo w� s "'
Plan review is required for any of thc following.
accurately report fixtures could result in increased sewer fees Please check all that apply.
(luanttty b ("tature) Work,Perrprdretf : 0 My new commercial building with water service 2" and
Ftiitnrc ,
°R a on r: : gutter, except systems designed and stamped by licensed
Previous C raved Added gisa.
Baptistry/Font engineer.
Bath •Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
JACUZti/Whiripoo! as defined in OAR918- 780 -0040.
0 Medical gas and vacuum systems for health care facilities.
Car Wash Each Stall
'Drive Thru ❑ Any multipurpose fire sprinkler system.
C - — ❑ Any complex structure as defined in OAR918-780 -0040-
Dishwasher - Commercial
- Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash
Floor Drain/sink - 2 " 5.omle Rr .'. r a " �4 ti
3" ❑ isometric or riser diagram is required for new buildings
4 " - — that meet the qualifications above.
Car Wash Drain .
Garbage - Domestic _ -
Disposal -Commercial
- Industrial - Comments • ?: rding fixture work:
Ice MachfRefrig- Draiug A' A A i
— Oil Separator (Gas Swtion) [xCt ..... r � (� /��— � C �
Rec. Vehicle Dump Statism l� r+ I??∎ l t X-i h��p ids r st r-, p (d
Shower - 0 % -
•
Sink - Bar/Lavatory
- Bradley
- Commercial
ri r * Note: Uthe fixture work under this permit results in an
Swimming Pool Fitter — increase of sewer EDUs, a sewer permit will be issued and
Washer - CiotheS • fees assessed for the sewer increase must be paid before the
Ware` Extractor plumbing permit can be issued.
Water Closet • Toilet -
_ Urinal - '
Other Fixtures: