Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2010 -00059
Tt GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 02/26/2010
Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72 AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Common Area
Project Description: Cap (2) breakroom sinks. Reset (10) w /c, (3) urinals, (8) lays, and (1) breakroom sink.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 2 ea Fixture /Sewer Cap 02/26/2010 $50.04
1 ea Sink 02/26/2010 $25.02
PHONE: 503-624-6300 8 ea Lavatories 02/26/2010 $200.16
3 ea Urinal 02/26/2010 $75.06
Contractor: 10 ea Water Closet 02/26/2010 $250.20
ADDISON PLUMBING 1 12% State Surcharge - 02/26/2010 $72.06
27425 S BEAVERCREEK RD Plumbing
MULINO, OR 97042
PHONE: 503 - 740 -8116
FAX: 503 - 632 -1168
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $672.54
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: ` •� - V - 1 Permittee Signature:
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.
q CFFY OF TIGARD PLUMBING PERMIT
• COMMUNITY DEVELOPMENT Permit #: PLM2010 -00059
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/26/2010
T I GA'RD' 9 Parcel: 2S113AB00101
Jurisdiction: TIGARD
Site address: 16101 SW 72 AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Common Area
Project Description: Cap (2) breakroom sinks. Reset (10) w /c, (3) urinals, (8) lays, and (1) breakroom sink.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 2 ea Fixture /Sewer Cap 02/26/2010 $50.04
PHONE: 503 624 -6300 1 ea Sink 02/26/2010 $25.02
8 ea Lavatories 02/26/2010 $200.16
3 ea Urinal 02/26/2010 $75.06
Contractor: 10 ea Water Closet 02/26/2010 $250.20
ADDISON PLUMBING 1 12% State Surcharge - 02/26/2010 $72.06
27425 S BEAVERCREEK RD Plumbing
MULINO, OR 97042
PHONE: 503 - 740 -8116
FAX: 503 - 632 -1168
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total .. $672.54
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: Permittee Signature:
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.
Plumbing Permit Application
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Building Fixtures 1 h � T' I 12 O1 I U ti l O ' !
.. ;:' " i; City of Tigard 1.. ., .. • _ � Permit No. ? l Q 1 ' '
s ` 0 13 12 5 SW Hall Blvd., Tigard, OR 97223 Plan Rev 1
„! : .. C :: :: Phone: 503.639.4171 Fax: 503.598.1960 FEB • 2 6 01 Date/13y: Permit No.: Q� pj l6,O03�
Inspection Line: 503.639.4175 O Nu r or
,;+;,,)1,,,,A K 1Y Ins p Daze Ready /By: luris: ® See page 2 for
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CITY OF Notified/Method: Supplemental Information
1 - f IGARD
TYPE OF WORK fl fl DING DIVISION FEE* SC EDULE
❑ New construction ® Demolition v 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)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
El 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
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: 16101 SW 72 Ave Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
City /State /ZIP: Tigard, OR
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: A I Project name: Common Area Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Ram 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: I Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Remove and reset 10 water closet, 3 urinal, 8 Iays, and 1 break room sink Dishwasher 25.02
Remove and cap off 2 break room sinks Drinking fountain 25.02
Ejectors /sump 25.02
® PROPERTY OWNER I - ❑ TENANT Expansion tank 12.51
Name: Pactrust
Fixture/sewer cap t 25.02
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, suite 300
Garbage disposal 25.02
City /State/ZIP: Tigard, OR Hose bib 25.02
Phone: (503)624 -6300 Fax: (503)624 -7755 Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name:
Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 9 25.02
City/State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 3 25.02
Water closet 10 25.02
CONTRACTOR
Water heater 37.52
Business name: Addison Plumbing LLC Water piping/DWV 56.29
Address: 27425 S Beavercreek road Other: 25.02
City/State /ZIP: Mulino, OR 97042 Subtotal
Phone: (503) 632 -1657 Fax: (503) 632 -1168 Minimum permit fee: $72.50
CCB Lic.: 151754 Plumbing Lic. no.: 3-449P6 Plan review (25% of permit fee)
State surcharge (12 %ofpermit fee)
Authorized signature: vy cst2. TOTAL PERMIT FEE (6
Print name: Jay Moore Date: 02 - 26 - 10 This permit application expires if a permit is not obtained within 18
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
IABuilding 'Permits\PLMU- PermitApp.doc 10/01 /09 440- 4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information2C)k6
Fee Schedule: Residential Fire Suppression Systems:
- Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1' 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer - 1st 100' 62.54 7,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' 37.52
Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum 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
Other Inspections or Fees Qty. Fee (ea) Total 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 each additional $100.00 or fraction thereof, to
(minimum charge - 1/2 hour) and including $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
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Reinspection Fees 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 first $50,000.00 and $1.20 for
(minimum charge 1/2 hour) each additional $100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", Plan Review for Plumbing. Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
Quantityby (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
Fixture Type: Replace greater, except systems designed and stamped by licensed
Previous Capped Added Existing engineer.
Baptistry/Font
Bath - Tub /Shower ❑ New exterior plumbing site utilities for any complex structure
as defined in OAR918- 780 -0040.
- Jacuzzi/Whirlpool
Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities.
-Drive e Tani ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ 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 Isometric or Riser Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-4"
Car Wash Drain
Garbage - Domestic
Disposal - Commercial
- Industrial Comments regarding fixture work:
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory f
- Bradley
- Commercial t 2 *Note: If the fixture work under this permit results in an
- Service increase of sewer EDUs, a sewer permit will be issued and
Swimming Pool Filter fees assessed for the sewer increase must be paid before the
Washer - Clothes
Water Extractor plumbing permit can be issued.
Water Closet Toilet /
Urinal 3
Other Fixtures:
http: / /www.tigard- or.gov /city_hal l /departments /cd/docs/PLM F -Perm itApldoc
CITY ®FTIGA►RD
E_ 5 �1_ 4 DIVISION ■ PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ri ddyp o � /
Inspection Requests (24 Hrs.): (503) 639 -4175 �_' %
INSPECTION WORKSHEET FOR DATE: - 3/2„...fr c. TIME: PAGE:
SITE ADDRESS: /‘%. / d / — 2 412 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #: 7 ye --of
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: e'pC f y - / Pour Time: ,�.
Code # Inspection Description �. rr # Contact # Message ._ / — A i
395 1444'3 / 0 4/Y , . ._ A',-(-b- 1) ,--e—L—I'VC.-
Corrections /Comments /Instructions: raj &,,,,),
PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I l FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V61 Date:' / 0 1 U Phone #: (503) 718 - -2.-(2_,L1(