Permit CITY OF TIGARD PLUMBING PERMIT
IL
a COMMUNITY DEVELOPMENT Permit #: PLM2010 00262
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/11/2010
Parcel: 1 S135BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Subdivision: WASHINGTON SQUARE TOO Lot: 0
Project: Thirsty Lion
Project Description: TI
Owner: FEES
PPR SQUARE TOO LLC Quantity Description Date Amount
BY THOMSON PROPERTY TAX SERVICES,
2235 FARADAY AVE STE #0 1 ea Backflow Preventer 08/11/2010 $31.27
3 ea Dishwasher 08/11/2010 $75.06
PHONE. 7 ea Floor Drain/Floor Sink/Hub 08/11/2010 $175.14
13 ea Lavatories 08/11/2010 $325.26
Contractor: 3 ea Urinal 08/11/2010 $75.06
TIMBER VALLEY PLUMBING 4 ea Water Closet 08/11/2010 $100.08
PO BOX 34 1 12% State Surcharge - 08/11/2010 $93.82
CANBY, OR 97013 Plumbing
PHONE: 503 - 266 -4300
FAX:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $875.69
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 , .. is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No ' cation Cen > . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OU C by - ling 503.246.6699 or 1.800.332.2344.
Issu=•• By: ' / � 4_4. I ._ f 4_/_/ PermitteeSignature: — . _
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.
Plumbing Permit Applicationr'% r 4 6u_00,00-60/ 7 ?j
Building Fixtures "
V gu..
City of Tigard AUG 1 1 2010 Date/By: eeiBy: 0 /t /0 Permit No.: I IRA, O ''DO�4
I II a 13125 SW Hall Blvd., Tigard, OR 97223
III , Phone: 503.639.4171 Fax: 503598/19.¢Q T ° AR`L) Date/By: ew Other Permit No.: I2 tO .-
.,.I c; A IL I, Inspection Liner 503.639.4175p, 1 LoIN( ! )1V1SION Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. I Total
El Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
. CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
❑ I- and 2- family dwelling 1 "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 IA
D LOCATION Site utilities:
Job site address: / / S. � G��S GI , n ,..5:6/ / QQ Catch basin or area drain 18.76
City /State /ZIP: // Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project named 2ff,2 L O J 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. linear ft.: ) Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map /parcel no.: j 5/ 3 s ex QIO(, Backflow preventer ! . 31.27 3/, oZ7
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher - 3 25.02 76-,0c
• Drinking fountain 25.02
Ejectors /sump 25.02
❑ :PROPERTY OWNER I '❑ TENANT Expansion tank 12.51
Name: Fixture /sewer cap 25.02
Floor drain/floor sink/hub 311 1 25.02 /75%44
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
1 ❑ 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 13 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
CONTRACTOR Water closet _ 25.02 'IJ ��
/ Water heater 37.52 /0V, oQ
Business name' 777 b e 4 0,4 1 / P � Gt m1/i • h f A 4� grater pipingfDWV 56.29
Address: /�. 1 Other: 25.02
City /State /ZIP: (,7 „ G 0 7 7o / 3 Subtotal - 7 Vi .i7
Phone: (,/03) o ( , ( o - 1,3 D O Fax: ( ) ( 1 4 , e , - y3 Minimum permit fee: $72.50 � �l ( ------
CCB Lic.: .L ,Z U J 1 / �l Plumbing Lic. no.:3 l 71 Plan review (25% of permit fee) �"-'
. v/o State surcharge (12% of permit fee) Q 3, re.
Authorized signature: /� G�( 11 111( / /( TOTAL PERMIT FEE V 7 T (oY
me: L U This permit application expires if a permit is not obtained within 180 days
Print na � 45;,-, e li Date: O ' /e. d after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I: \Building\Permits\PLMU- PermitApp.doc 10/01/09 440- 4616T(10 /02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
• Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I 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 revie. 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 stamped by licensed
Previous Capped Added Existing / f 2 _ D�T 4. engineer.
Baptistry/Font
Tub /Sowr ❑ New exterior plumbing site utilities for any complex structure'
Bath - hower
Tub /S erlpool as defined in OAR918- 780 -0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive Thru r ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher -Commercial / 3 Submit 2 sets of plans with any of the above.
- Domestic
Drinking Fountain
Eye Wash Isometric.or Riser Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
3 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) -"VJ'^r ! n
- Bradley
- Commercial *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 •
Other Fixtures:
1: \Building\Permits\PLMF- PermitApp.doc 2
q CITY OF TIGARD PLUMBING PERMIT
n + ;: COMMUNITY DEVELOPMENT Permit #: PLM2010 -00262
11 GARE) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/11/2010
Parcel: 1 S135BA00100
Jurisdiction: Tigard
Site address: 10205 SW WASHINGTON SQUARE RD
Subdivision: WASHINGTON SQUARE TOO Lot: 0
Project: Thirsty Lion
Project Description: TI. 8/25/10 added 50 ft. of sewer line.
Owner: FEES
PPR SQUARE TOO LLC Quantity Description Date Amount
BY THOMSON PROPERTY TAX SERVICES,
2235 FARADAY AVE STE #0 1 ea Backflow Preventer 08/11/2010 $31.27
PHONE: 3 ea Dishwasher 08/11/2010 $75.06
7 ea Floor Drain/Floor Sink/Hub 08/11/2010 $175.14
13 ea Lavatories 08/11/2010 $325.26
Contractor: 3 ea Urinal 08/11/2010 $75.06
TIMBER VALLEY PLUMBING 4 ea Water Closet 08/11/2010 $100.08
PO BOX 34 1 12% State Surcharge - 08/11/2010 $93.82
CANBY, OR 97013 Plumbing
PHONE: 503-266-4300 63 da Plumbing Permit 08/25/2010 $62.54
8 da 12% State Surcharge 08/25/2010 $7 50
FAX:
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $945.73
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. J
Issued By: • • Permittee Signa 1 -.
��
di" 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 Applicat or � , � \I 6u ®, /0 60 / 7 3
Building Fixtures 1:()R c,rl IU;I 1,.1: tiNI.i
A UG 1 1 2010
o o�ls
City of Tigard Received Q I t� it,
Permit No 1 1,4 1 1319/19 •
.� / ' ' 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: U '
rt P Plan Review
Phone: 503.639.4171 Fax: 503 8�19�Q i ;r I) Date/By: Other Permit No.: Q2. t
1 ' i` i s Inspection Line:. 503.639.4175 � 1LD I `j
NG !�IISION Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
• TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information ase checklist
Description 1 Qty. 1 Ea. 1 Tot*
'Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connect
. CATEGORY OF CONSTRUCTION . SFR (1) bath 312.70
❑ 1- and 2- family dwelling I 'CommercialJindustrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
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: /DAD s, t: )elsh • , 7 /r' 55' ' pp e Catch basin or area drain 18.76
City /State/ZIP: / (UJ Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ^) Page 2
Suite/bldg. /apt. no.: I Project name]% /,5y L.f G 40 Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: . j t)) j P 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.: / 5/ 3 -46- 0(9/00 Backilow preventer 31.27 5/. .
DESCRIPTION OF WORK Backwater valve 12.51
• Clothes washer 25.02
Dishwasher ' 3 25.02 7 S.
Drinking fountain 25.02
Ejectors/sump 25.02
❑ ,PROPERTY -OWNER ❑ TENANT . Expansion tank 12.51
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub 311 1 25.02 / 7
Address: Garbage disposal 25.02
City /State /Z1P: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
1 ❑ 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 1 3 25.02 3 a
City /State/ZIP: Solar units (potable water) I 62.54
Phone: ( ) 1 Fax: : ( ) Tub /shower /shower pan I 12.51
E -mail: Urinal . _ 3 25.02
• CONTRACTOR Water closet _ 25.02 7 • n Water heater 37.52 /00. •
Business name' /71 hr 6 4 OA f / �_ 7 p/44 me, / 7 7 CJ 4t , Water piping/DW V 56.29
Address: 2 p, 3 V UJ Other: 25.02
City /State/ZIP: e412 G 04PL 970 19 Subtotal 7 W
Minimum permit fee: $72.50
Phone: (303) G!o .� O O Fax: ( ) 4- 4/544_ Minimum
review (25% fee) .-
CCB Lic.: 'A f
3 f5/ Plumbing Lic. no.:3 / 64 R � ,
1 11 // `' State surcharge (12% of permit fee)
Authorized signature: d��GB� 1 // fit TOTAL PERMIT FEE $ 7G
This permit application expires if a permit is not obtained within ISO da
me G y
Print na , s Q Date: 9 U A , - D after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
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 GI ,51 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 Dram - 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 Ins ections or Fees Qt Fee (ea) Total each additional $100.00 or fraction thereof, to
P and including $10,000.00.
Inspection of existing plumbing or for 510,001.00 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 525,001.00 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:P,lumbiing 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 ill that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
.Fixture Type: - / Replace greater, except systems designed and stamped by licensed
Prev Capped Added Existing ' rt. engineer.
Baptistry/Font
-Tub/Shower ❑ New exterior plumbing site utilities for any complex structure'
Bath - e
Tub/Show as defined in OAR918- 780 -0040.
Car Wash zi /W e r it rlp ool ❑ Medical gas and vacuum systems for health care facilities.
Drive Thru ❑ Any multipurpose fire sprinkler system.
• Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial / 3 Submit 2 sets of plans with any of the above.
- Domestic
Drinking Fountain
Eye Wash Iso Riser Diagram.
Floor Drain sink 2" ❑ Isometric or riser diagram is required for new buildings
- 3" a , that meet the qualifications above.
-4 „
Car Wash Dram
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) . "67, •. n
- Bradley
- Commercial *Note: lithe 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 ..? .R
Other Fixtures: •
r
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