Permit CITY OF TIGARD PLUMBING PERMIT
11111 :- COMMUNITY DEVELOPMENT Permit ft: PLM2010 -00314
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/24/2010
Parcel: 2S110AD08700
Jurisdiction: TIGARD
Site address: 10765 SW MURDOCK LN G
Subdivision: PACIFIC CREST APARTMENTS Lot: 0
Project: Pacific Crest Apartments
Project Description: Replace 180' of storm sewer
Owner: FEES
TIGARD COLONY LIMITED PARTNERSHI Quantity Description Date Amount
380 UNION ST STE 300
WEST SPRINGFIELD, MA 01089 180 If Storm and Rain Drain 09/24/2010 $100.06
PHONE: 1 12% State Surcharge - 09/24/2010 $12.01
Plumbing
Contractor:
VALLEY PACIFIC CONSTRUCTION
PO BOX 589
DONALD, OR 97020
PHONE: 503 -678 -2696
FAX: 503 -678 -5265
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $112.07
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.
Sep 23 2010 12:26PM HP LASERJET FAX p.l
•
Plumbing Permit Application
Site Utilities 1.(w. (I Fdcl: IIs' OrLV
City of Tigard R eceived y. r „ 00 ,49-# Permit No/t)L/ 4.20/0 - 003 / y
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
1 Phone: 503.639.4171 Fax: 503 598.1960 ma Other Permit No.:
1 . I c ; ,, t _ Inspection Line: 503.639.4175 Daze Ready/13y: Jura. ® See Page 2 for
Internet www.tigard.o Notified/Method: q � � .le�mental Information
i
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. , , t. la. "4+^ I. it' ... . i ._i: _a., R A llf1t77}7etiitAn7f.,L.:IC _r . • '�1r ur t
❑ New construction ❑ Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition /aheration/replacement I {p ( Other: - , '/'- New 1- 2- family dwellings (includes 100 ft for each utility connection)
r 41.14= l tgT,ry4j11 ■'I, :{l '1 i .'Ii ti - 3) nli „ :� I „I. It t' •,� Ae Wi „,,, ., tt d !. t� SFR (1) bath 312.70
I "ti'i�ltrt.. .1 f: I 19 r..a..r .,rtan,, 'r -, ,, 1.1. � .:IV Ig 1il -: t, � . . lr .:L� lk�,
0 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath Commercial/industrial
❑ Accessory building B'l 4ulti- Family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2
' 1 ) t l`" . '1 yl' j a 1; Aril, . d 'v;1 ',.-;...-,...f dd t t3'' Yt .4NI �el it r etli car.ennr .. ,i.1 Site utilities:
i r ,. . s t o -8, 1� l�4 r �' �
W2n,f1 %.It.l,.t (1
1 ..... _.
Job site address: f 65 g.!I 7J ' k Y d er fc L h Catch basin or area drain 18.76
City /State,21P: T 1 ce 0 ft q -7 a3., Li �Ya"tU, leach tip, or trench drain 18 76
I Footing drain (no. linear ft.: Page 2
Suite/bldg. /apt no.: G Project name:(. I di d Manufactured home utilities _ 50.03 •
Cross street'directions to job site: r . f'i'N. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft.: Page 2
) Storm sewer (no. linear ft.: i Page 2 Jett, 0 4
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
',`(:I t° Nxe ", :. y l
.� xu1� -Ir, Backwater valve 12.51
� � , 1 lY^.. `, JI' -1 'I0 1p fah. r ;SI d.
1 " �; . "'" i "� `. gI8?tt � ' `'�• Clothes washer 25.02
Dishwasher 25.02
• Drinking fountain 25.02
Ejectors/sump 25.02
yIW1 kk Yp ~� � 12.51
: 1 1 1 l .�r1 I r t � p:! w . 1 � 1n ., ' y' 7s 1 1 1� ` r . 1i l, i `.'R 7 `r. Expansion tank
Fixture/sewer cap 25.02
Name: Pcmc. ; /: ar el f A P13
Floor drain/floor sink/hub 25.02
Address: C O
1 n6,47_5 �`-'� ,
� a '�i 0G1C. ST Garbage disposal 25.02
City /StateiZIP:'� 1 ci. /-A ( R 9 7 P-X ) Hose bib 25.02
Phone: ( ) . , , ' - p S' Fax: ( ) 6 - - a.) Ice maker 12.51
t '1,7 r I ua "t" IT J
'' p ti id'1'i1l1,g1 �' i t i Niv " r t OY o: 6 ✓' o ..l..i Interceptor /grease trap 25.02
r � �. .� ur4 Y �ueu +Nti
Business name: p 7- Medical gas (value: $ ) Page 2
ci r...f: L r rP41 ArI s Primer 12.51
Contact name: S to Gi
e Cr 5 Roof drain (commercial) 12.51
Address: 06 G S tj Al t t.r ci"cx S r Sink/basin/lavatory 25.02
City/State/ZIP: r , A r. „,.,i 7 f 1 a a_L I Solar units (potable water) 62.54
Phone: ( 503 ) a 3 9 _( s .) 7) I Fax: ( G S L(- y 3 Tub /shower /shower pan 12.51
E -mail:
Urinal 25.02
r n � t ,•
1 , ".I Water closet 25.02
111 .tti p - ' 1. (. ,h.- 1 1 j Y. I;:�N° X 7tl' d L:f} � , I` , . <. w4'
11441TF'r6fNIL water heater 37.52
Business name: vAI..LE`I PAe.tFt.C. C0/45Tpvc-T -Qn) Water piping/DWV 56.29
Address: ?0 Box S q Other: 25.02
City/State /ZIP: QCIA1AL p, ota. q102.0 Subtotal
P one: (503) ( 0 " ' 1 8 , - ' j _ ( p q ( s Fax: (3 ) 4.1B- 5•2( o 5 Minimum permit fee: $72.50 /CO • 06
I . CCB Lic.: 015 '? - / ((0 Plumbin: ic. no.: I'ezt.t3 I Plan review (25% of permit fee)
III State surcharge (12% of permit fee) 1A.0/
Authorized signature: TOTAL PERMIT FEE p a , Q 7
T his p ermit a pplication expire; if a permit is not obtained within 180 days
Print name: Tow PC I Date: q -z.3 -1 after it has been accepted as complete.
*Foe methodology set by Tri-County Building industry Service Board.
J:1fuildirtgtPermks1PLMU •PermitApp.doe 10,01.09 440.46167(10/02JCOM/w6B)
Sep 23 2010 12:26PM HP LASERJET FAX p.2
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su + + ression S stems:
3 �Hl 4AFTC' Bgyill7gppt �S .1 �,y�,l,> ICI •' ' y ]1Yyal11
vy itI '• I �I9tHid.;. I!�I� !A y +�' 1i9111r1 iNlRINa II �� d;1`T'tizj siu'3u �.f. i.ic , "n��•.2r'aJ •" L��'Y°'r` '.,". �71!Ii[Iti�l � ,,
•,,.• .e..a.� `;>� n li - �. 1tt, , �:
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 S stems:
Water Service - each additional 100' 37,52 I 1 � � � i, d I P I � -t 'Ill y , ! ;. * pi rle "30 Storm &Rein Drain - 1st 100' 62.54 �/ eta. 5,000 .AM,U, LL ii �I �1
�2 . 5 7
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 3 , S $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
I ° °1n each additional $100.00 or fraction thereof to
nr. 4∎: . U�itlis�Is a ;, !ir P,
' 1 1N1 l and including $10,000.00.
Inspection of existing plumbing or for 510,001.00 to 525,000.00 5148.50 for the first 510,000.00 and 51.54 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 525,000.00.
Inspections outside of normal business 90.00/hr 525,001.00 to 550,000.00 5379.50 for the first 525,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof to
Reinspection Fees 90.00/hr and including 550,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $ 50,000,00 and $120 for
(minimum charge - 1/2 hour) each additional $100.00 or fraction thereof
Subtotal:
Commercial Fixture Work:
Are you capping, adding or replacing fixtures I[ `yes , ' a al,. ,; dUl � ' " ;' ,.: i m'!
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accuratel ' re tort fixtures could result in increased sewer fees *. Please check all that apply.
l�7111Cltr :
• l � ° " t1 l : t a a • ❑ Any new commercial building with water service 2" and
J 3 ! u r> a ,.ibo' fl iRe ter, except systems designed and stamped licensed
�,;..f „ %11.1 'ltd< {fig- rtairreuat Y;. „i.,A1;1044+f
engineer.
do Pt yst gn stamp by
e
Baptistry/Font ❑ New exterior plumbing site utilities for any complex structure
Bath -Tub/Shower as defined in OAR918- 780-0040,
-Jacuzzi/Whirlpool ❑ Medical gas and vacuum systems for health care facilities.
Car Wash -Each Stall
Drive Thru ❑ Any multipurpose fire sprinkler system,
Cuspidou Water Aspirator ❑ Any complex structure as defined in OAR918 ?80.0040.
Dishwasher Commercial an Submit 2 sets of plans with of the above.
- Domestic p y
Drinking Fountain
Eye Wash r , .1.ia "' 1114
+t � „& i •rz ° K" Iiklr: - �,��
Floor Drain /sink • 2" d - • .�-. •
" , < „3......w�� t.i��.!.
❑ Isometric or riser diagram is required for new buildings
- 3 that meet the qualifications above.
Car Wash Drain
Garbage - Domestic
Disposal :' Comments regarding fixture work:
Ice MachiRefrig• Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- 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 lumbin permit can be issued.
Water Extractor p g p
Water Closet - Toilet
Urinal
Other Fixtures:
C :\Documents and Settings\DarryN.ocal Settings \Temporary Internet FilecOLK251PLMU- PermitApp.doc