Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2009 -00311
.T I GARO 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/28/2009
Parcel: 2S113AD01900
Jurisdiction: Tigard
Site address: 16600 SW 72ND AVE B10
Subdivision: OREGON BUSINESS PARK I Lot: 9
Project: Spec Space
Project Description: Install (2) roof drains at low point on roof.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 2 ea Roof Drain (Commercial) 10/28/2009 $25.02
1 12% State Surcharge - 10/28/2009 $8.70
PHONE: 503 - 624 -6300 Plumbing
47 ea Minimum Fee Adjustment - 10/28/2009 $47.48
Contractor: Plumbing
HARDER MECHANICAL
2148 NE MLK BLVD.
PORTLAND, OR 97208
PHONE: 503 -281 -1112
FAX: 503- 287 -5284
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
issu ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ity 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
r direct questions to OUNC,by 503.246.6699 or 1.800.332.2344.
Issued By: L Permittee Signal
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.
OCT -27 -2009 05:23PM FROM- T -467 P.002 /004 F -900
Plumbing? Permit Application
Building Fixtures RECEIVED FOR OFFICE USE ONLY
Received City of Tigard nn rr 2 8 2009 D /o �or 1) PermitNo.: jr, , :i -.
7 13125 SW Hall Blvd., Tigard, OR 9Y20 P Review
: F : ' Phone: 503.639.4171 Fax 503.598.1960 Date/BY: Other Peanut No.:
Inspection Line: 503.639.4175 CITN OF TIG ARD N Date /B , e1 See rage z for
� Internet wa+w.tigard- or.gov TING DI VIS10 No : Supptemeutnt laarenadon
►_ ' , "., i . • , `. ' -- �TXP $w O1ZJ4 is 1 ` : m:• Fo p f �> ,._,
c:7 �::a_n.. �+� iit C �:F�.i�r ni,fu�1,_ I ���•u'.`� Ef "" � • �1 �3 E:
:..f... 4 �m:1��� 1� �`� - s..3� :r::. ,. _ - i
❑ Demolition _ r special' in ormn8on use checklist
❑ New construction Description 1 Qty. Ea. j Total
a Addition/alteration/replacement ❑ Other New 1- 2- family dwellings (includes 100 R for each.utiliry connection)
� « .- .ter »,•2x- s, „r,•.r.:i,r:.,.i-w, 24
S: qq � T ' dig65 'CWOI51'RUC 1, 1 k *1 ; 17 ••. LrZkLA: SF (1) bath 9
rr �... � �A.�`�� n. .....R..mnr�ra:r,-- ...a�... .: i- ��-, 3i.,�;ts.i>•?�?uf�.,_;`- _�,:... 20 350.00
❑ 1- and 2-family dwelling EiComunerciallmdustrial SFR (2) bath
SFR (3) bath 399.00
1:1 Accessory building ❑ Multi-family
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinlder (, sq. R) ' Pagc 2
7 h .� ,, „y „- ;fir. r- r •.t.. WA,r u �.; Y :•§ ' . , ,,,
4 ,z•,•. , :W++�.2 ''' >E. :•a - . � O...VF'filt -......4z...4.•••••••••.;., l, TP � ,7il ' : . f- ,4 9. , : i :: S ntill i - '
-JH .. M.
Job site address: / ( / p 00 5 t,.t.) 7 Z n d 4. v 6 Catch basin or area drain 16.60
City /State/ZIP: po,x .q• „G pp 97 2_ 2- e1 Drywell, leach line, or tench drain 16.60
Footing drain (no. linear ft.: _) Page 2
Suit l d apt. no.: *VD Project name: DvQ ?b° /D Manulncdaed home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Ram drain connector 16.60
Sanitary sewer (no. linear ft: _ Page 2
Storm sewer (no. linear ft.: _) Page 2
- Lot no.: Water service (no. linear 8.: ) Page 2
Subdivision
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
ear = - r te r,x ;A =c �,, „w ..:... y ,, 7 ._ [ ,_ i :_q IF : `• p..- -
i t g -- ;;� , CR* OFT YOKE; r = a -:'> "; ,;, '
� s;- 'F= Page 2
#i :�t:;'.:. = s.n,:�« sr,- _,e...•,_. r ,: ,.;e. _':. -..... BackSowpreventer
Pec gzo,r ID itZ"rZ s p, i L. w Po r nr A-r PeoF Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
_ _ .�. T :: _ Drinking fountain 16.60 r
s.� `` :,PROP R�TYtO : °, ry .. . .. ,tl, s.: •�•. ~.:..'Q ; :;:TE T ` = .,, •h E-cctors/s�P 16.60
Name.-. C- ,•G a- g7eJ L.-P Expansion tank 16.60
Address: /•5 3...2.. 5 cc) 6 1.t.0 (A 0,-.4. Fixture/sewer cap 16.60
City /State/ZIP: 'P0.�� 4 , oz_ Gf 7 2-2- y _ - Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Glisbilge disposal 16.60
:.: , :- _ , ;, ; ,u. d: a tc _;N;i= Huse bib 16.60
:.; ,.�.- : :_., • • �:: • Ice maker
. 3Ji r i: r - .,.dL9' .,..,•=••,,. ..:_„-- „-- ., .- z••�lCi�:� .. _ .. 1
Business name: H »')M A`A te.4 L _ = Interceptor/grease trap 16.60
Contact name: j r (,.%:-4- Medical gas (value: $ ) Page 2 _ 04
Address: Lig, N, G fL. ALA/41 Primer i 16.60
City /State/ZIP: Q,- q Roof drain (commercial) 2 16.60 ' •
�D/�1 /• rl Sink/basin/lavatory 16.60
Phone: (503) Z$ / ^ ) 1 l7 Fax: ($93) 2R, - 5.03 Tub /shower /shower pan 16.60
E -mail J.{ tyi Fr t • C�c•1 _ Urinal 16.60
� - -1 7 : ' gi n ; a r01 : 2 1 . ; •.,rA.'? ' t :_- ? �. - .u .F.. :4 r .:. '.. 16.60
1•tinT, reP_:n'y!! !•' �,7. L I.. f� . - 1.:Il i,•
� ` .CON TRA C T Oxi Wage[ Closet
1 ^'•,.,• r . , e�� � ..r.1�ir�_ _ _ 11.4. v1-s - :�h11.. _r..�2kik: i::.G.i i'- � _. __:.
:: is urT.l��l �iL.7.fi'� .:.0
Business name: . A � , ry1 Wa ter heater 16.60
Other:
Address:
Subtotal IA `
City/State/ZIT: Minimum permit fee: 572.50
Phone: ( ) Fax ( ) Residential backflow minimum permit fee: 53625
P Lic. no.: ? d a 6, -35- Plan review (2590 of permit fee) 7
ccs Lie.; 07 _
Stat surcharge (12% of permit fee) $
Authorized signature: 4 TOTAL PERMIT FEE $) -.°-
` Prinz name: < te it g + � l Date: / - a7 -lam( This permit application expires if a permit is not obtained within
/ 180 days after it has bccn accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
L1BuildineermiL -1.4 LMFBeemltApp.doc 1227/06 440.4616T(1o107/COMIW B)
0't- 27-2009 05:23PM FROM- T -467 P.0031004 F -900
Y Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
`}4'W- -�'-v ) GF ryi4 �.r..,ry �a.1 .; Q � i l• .fi:$TEA Fr �`! �q ^. �te •'S , EN' 7 . i {t Y 5 h
�te.��i�leS -���t ��L,��:�; �r�.,���� � -3' t -7 uare - -. e����-c`'.�-' -e•��• -fit. �#. : � ,
��. �•L� -: ter.,: a q.�_._ ...
Footing drain - 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3 601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service -1st 100' 55.00 _ Medical Gas Systems:
Service 46.40 f •.I �w.,n+wrr �T.I'1:'¢C,f��! s
Water CR -each additional Aa .. x -J a a "i' 7 �"
Storm & Rain Drain -1St 100' 55.00 x:� - _ _ _ . r +, I, eX . ... : - ; _ >x..: `1' :so 0 ,. _:
- $1.00 to 5 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000 -00 $72.50 for the first 55,000.00 and $1.52 for each
cfri1 r.0! tCm f,' rr c ,_ y`- .,r0ty .s: 1 "i () 1,•• °fst": additional $100.00 or fraction thereat to and
q. G .._� .._.�tdi irenn2$`x.7c,� +�''- _:_. .w&7 ,:w :tip" a: including $10.000.00.
Commercial Bade Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional 5100.00 or fraction thereof, to
(minimum permit fcc 53625) 27.55 and including $25.000.00,
Rain Drain, single family dwelling 65.25 $25,001.00 to 550,000.00 $379.50 for the Sin $25,000.00 and 51.45 for
each additional 5100.00 or fraction therco£ to
Inspection of existing plumbing or and inciuditi 550.000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: cacti additional $100.00 or faction thereof
Commercial Fixture Work: 22 `any _,s,;a � TuMrl gh . :
flan Revitew� foiCiPlumbug� QSta�l]aions;;Y:; ;
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees * . ❑ 4y new commercial building with water service 2" and
• 4, ; 'm'r - -: = � ` -- WorKPerfoiii ed :�; greater, except Systems designed and stamped by licensed
i 1n rt p X4;1 i:. Q 6y (Fix . ''R r=e -:. engineer.
, . W - F rR p bin
' 'M i p h ' ;; 1 :t -ai ` ' itn Cnv 1 , ` . Add ea_=r. :i:. t Ea u li l t a 0 New exterior plumbing site utilities for any complex structure
Baptistry /Font as defined in OAR918- 780-0040.
Bath - Tub/Shower ❑ Medical gas and vacuum systems for health care facilities.
-Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall _ 1=1 Any complex structure as defined in OAR918- 780 -0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
-Domestic -- .1 TI ._' .a s i u- w F ns,ra.. T SC.- '?1
; .1 - -Is or. s L a : ': .r : rp4: "::
-
Drinking Fountain - �. '+5 l
jye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" _ that meet the qualifications above.
- 3" .-
-4"
Car Wash Drain
Garbage Domestic Comments regarding fixture work:
Disposal - Commercial
-Industrial -
Ice Mack/Refrig. Drains -
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink -Bar/Lavatory aley *Note: If the future work under this permit results in an
- C omtuci al increase of sewer TDt's, a sewer permit will be issued and
- Service _ fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor - -
Water Closet - Toilet
Urinal
Other Fixtures:
intladmgWanmtaMLM- PermitApvAooc 17/27/06