Permit m ;,., ; CITY OF TIGARD PLUMBING PERMIT
NI COMMUNITY DEVELOPMENT Permit*: PLM2010 -00241
Date Issued: 07/23/2010
TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2S101 BB01400
Jurisdiction: TIGARD
Site address: 12178 SW GARDEN PL, BLDG# 3
Subdivision: PARK 217 Lot 0
Project: Colossae Church
Project Description: Cap (1) sink (breakroom)
Owner: FEES
WALTON CWOR PARK BC 8 LLC Quantity Description Date Amount
BY TTA/EPROPERTYTAX DEPT 325, PO BOX 1 ea Fixture /Sewer Cap 07/23/2010 $25.02
4900 1 12% State Surcharge - 07/23/2010 $8.70
PHONE: Plumbing
47 ea Minimum Fee Adjustment - 07/23/2010 $47.48
Plumbing
Contractor:
JAMES ROOD PLUMBING INC
880 NE 25TH AVE, STE 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: Sby- Permittee Signature: 0A/ � C'�9 .
�/ ��" CaII 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 N0. : 503 6483907 Jul. 22 2010 09:31RM P2
Plumbing Permit Applica tilICEIVED
Building Fixtures (� (� 1 Ok 011 it E I : «L O\L, =
JUL 2 2 LU1U Reuned
City of Tigard vetc/H 7 Ag /(d •r PcnultNo/ o? 4
q ]3125 SW Hall Blvd.. Tigard. OR 97223
� 2 M 0/0 0
~ Phone: 503.639.417 i Fax, 503.5 OF TIGARD r i,in kevlc
Uatcy Other Permit No.:
Inspection tine: 503 <i39,4175 BUILDING DNISION
T1CrARD UatoRwdy/13y: lai ..._ NJ &c Page 2
Internet: www.ti9ard c r.guv Noti cthod: 7 / p Supplemental informat
TYPE OF WORK FEE* SCHEDULE.
For information use checklist
❑ New construction N Demolition
Description Qt . F:a. Total
❑ Addition/alteration/replacement ❑ Other: Ne - w 1- 2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
T
❑ 1- and 2- family dwelling Cornmemi 4) /industrial SFR (2) bath 437.78 -
Accessory building SFR (3) bath 500.32
❑ ory ig ❑ Multi - family
❑ Master builder Each additional bath/kitchen 25.02
❑ O ther: Fire sprinkler ( sq. ft) Page 2
JOB SITE INFORMA'T'ION AND LOCATION Sitc utilities:
Job site addrrzs: / I "b s � - e �r.L Catch basin or area drain 18.76
Drywcll, leach line, or trench drain 18,76
City /5tatdZlP: 7"1 �, r' 1,,
Footing drain (no. linear fi.; ,__) Page 2
Suite/bldg. /apt- no.; Project name: EP 10 C
- SSG C Manufactured home utilities 50.03
Cross street/diredions to job site: Manholes 18.76
Rain dram connector 18.76
Sanitary sewer (no. linear ft.: `� Pagc 2
Storm sewer (no. linear ft.: ) _ EMI
Subdivision: Water service (no. linear ft.: ., ) Page 2
F Lot no.: Fixture or item: -
Tax map /parcel no.: BaciciEow preventcr 31.27
DESCRIPTION OF WORK I3uckwatcrvalvc 12.51
ti Clothes washer 25.02
C G' O, A e, If tGl� ... G41t r Dishwasher ME 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER ❑ TENANT Exptmsion tank 12.51
Name: Fixture/sewer cap 25.02
Address: Floor drain/floor sink/hub 25.02
- Garbage disposal
City /State /Z1P:
Bose bib 25.02 a
Phone. ( ) Fat) ( ) Ice maker
❑ APPLICANT 12.51 MI
❑ (:ONTACT PERSON Interceptor /grease trap 25.02
Business name: Medical gas (value: $ �) P 2
a s
Contact name: Primer 12.5I
Address:
Roof drain (commercial) IV 12.51
Sink/basin/lavatory 25.02
City /Statel/TP; Solar units (potable water) 62.54
Phone: ( ) Fax:: ( ) Tub/shower/shower P 12.51
li -mail: Urinal 25.02
CONTRACTOR Water closet In 25.02
Business name: . water wetter heater 37.52
Y"`''�5 �;e� ��ai+� . th e t
r t � p p i p in � u'V 56.29 Mill
Address:
• • .� F _ u_ Sl~ �C a pt-t /a_ Other:
City/State %ZI!' 25.02
i • L . Subtotal
Phone: ( 5'03) 6 9, 3 A Fist: ( 0 �/�
e. 2/qt Minimum permit fcc: $72.50 2 50
i CB Lic.: )) Q ^) ) 6 / • lumping Lie. no.: et) C fir. Plan review (25% of permit fee)
Authorized signature: -r State surcharge (I2% of pcnnit fee) 4 , 7 C�
�" ��� r TOTAL PERMIT FEE �/J .'
Print name: r ,/� This permit a ��' "
y {� Dar pplicatio expires if A permit ix t1O1 obtained within I R(1 d.1yx
after it has beet) accepted us complete.
f •
Apr. mnrhnr,,lno,,. 6, Tri.rrtnntv IlnilAinn hvinarr q .., . VL,arri
FROM : JAMES ROOD PLUMBING FAX NO. : 503 6483907 Jul. 22 2010 09:32AM P3
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fce Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ca) Total Square Footage: Permit Fee:
—
1 noting drain 1 ° l U0' 50.a;1 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
Server - 1st 100' 62.54 7,201 and greater $327.54
— —
Sewer - each additional 100' 37.52 ...
Water service • 1st 100' 62.54 Medical Gas S '�stc
Water Service - each additional 100' 37.52 Valuation: Permit Fce:
Storm eft 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 $I0.000.00.
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 fcc is specifically indicated 90.00/hr
(minimum charge -1 /2 hour) each additional 00.00 fraction thereof, to
and including $25.000.00.
Inspections outside of normal business 90,00/hr $25,001.00 to $50,000.00 $370,50 for the first $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to
Kcinspcction Fees 90.00/hr and including $50,000.00.
Additional plan review for revisions ' 90.00/1t $50,001.00 and up 5742,00 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.
Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
Fixture Type: ' Replace greater, except systems designed and starnped by licensed
Preying'. Ca . •. d Added Existin_ engineer.
Baptistry/Font
Bath :Intl/Shower ❑ New exterior plumbing site utilities for any complex structure
Jacurni/W}tirl�ito( as defined in OAR918- 780 -0040.
Car wash Each Stall ❑ Medical gas and vacuum systems for hatlth care facilities.
-Drive 1 hru ❑ Any multipurpose tire sprinkler system.
Cuspidor /water Aspinncx ❑ Any complex structure as defined in OAR918- 780 -0040,
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Fyc Wash Isometric or Riser Diagram
Floor Drain/sink _ 1- ❑ 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 fixture work:
Ice Mach. /RCfiig. Drains J 170 t-rct - 4P
Oil Separator (Gas station) -
ul
Rec. Vehicle Dump Station Itr > m °� +�
Shower -Gang i 1
-Stall
Sink - Bar/i.avatory
Bradley
- Commercial - I *Note: If the fixture work under this permit results in an
- Service
Swimming Pool Fitter increase of sewer EDUs, a sewer permit will be issued and
washer - Clothes - fees assessed for the sewer increase must be paid before the
Water Extractor plumbing permit can be issued.
ware' Ctosct - Toilet � -
Urinal
Other Fixtures: