Permit CITY OF TIGARD PLUMBING PERMIT
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:. COMMUNITY DEVELOPMENT Permit #: PLM2010 00228
!TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2010
Parcel: 2S102CB01802
Jurisdiction: Tigard
Site address: 13407 SW PACIFIC HWY
Project: AutoZone Subdivision: Lot: 0
Project Description: Site utilities for new construction.
Contractor: PACIFIC UNDERGROUND Owner: BAR -AM, LLC
PO BOX 2258 BY GODFATHER'S PIZZA
OREGON CITY, OR 97045 1416 THIRD AVE
SEATTLE WA, 98
PHONE: 503 - 632 -3534 PHONE.
FAX:
FEES
Quantity Description Date Amount
3 ea Catch Basin or Area Drain 11/17/2010 $56.28
Specifics: 1 ea Manholes 11/17/2010 $18.76
3 ea Rain Drain Connector 11/17/2010 $56.28
Type of Use: COM 52 If Sewer Service 11/17/2010 $62.54
Class of Work: ALT 400 If Storm and Rain Drain 11/17/2010 $175.10
Type of Const: 63 If Water Service 11/17/2010 $62.54
Occupancy Grp: 1 12% State Surcharge - 11/17/2010 $51.78
Stories: Plumbing
Total $483.28
Required Items and Reports (Conditions)
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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 -0090. You may obtain a copy of the rules
or direct q ons tO -OUNC b = .fling 503.232.1987 or 1.800.332.2344.
Issued y: / 12 '`4 D1- Permittee Signal 4 / , 0
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
CITY OF T I GARD PAGE 03/ 03
11/17/2010 @Eli !sp 5131591
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Plumbing! gmnit Application ; : ;- 1,; :: -,,:, . i p 1 i; i'i c5be c960 - 06M?
Sit® Utiiities , , 11 1
ant Of Tigard . .' ' , Reael.ed
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hopeution Ler 503.639.4113
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to • Total
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Now 1. 24eaully doelingo (inc] tules 100 ft. in nob • w oatineerlon)
CATSCORP1 OF i ,• el20 • SFR (1) liods 351.70
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• Jos an! 1195‘012115ATION i• LOCAtI6P4 .' ' .. . • . ligEnommi_ I
Job slto address: 13405 SW nettle Highway 11.76 56.28
tirywell, Meth line. a leash droin 0
City/S um/ZIP: lipod101te9122.3 11.76 0
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Footing &en (no. linen ft: f) 0 hp 2 0
Steltellaldgivi. no.: hojelec tam • eut Store No. 3'756 Moen awed boon unreel 0 50,05 0
CF959 staceegditections to.iob site Wee of SW rocifle ,,, wilY. Manhole 1 KM 1176
Sone of SW Pink Street Dui ond Noe* of SW Wit . ns AVM" Roe don coonector 3 18.76 35.28
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Sauey ever (,n. leer ft. &) 1 EMI 6254
Storm dower (no linear h.; .1 1 Pags2 17510
wee eroloo In*. Nee it,: LI) 1 hie 2 6234
Subdivision: Niii Lot no,: 01812
Ten Throtparrel no.; R994507 REINIMIIMIIIMMIIIMI
. • . ' RISCRIPTION or x . ' • — . 12.51
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Distranshor 23.02
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einnhing foomons MI 25.02 IIIN
CencernetStorro core:Mon, mid rase drain system. Ind Mood to Wee nein 1 ) Illootoetnorp 23.02
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• 0 raorairv. orfsa' ' ' I,- • Citesorr • - . ' •:iligion ow& 12 31
, Fume:ewer cap 25.02
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Floor dreeloor sinklhub 25.02
Address '
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Phone: ( ) I73i ) ERMIIIIISII 1211 IN
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Business nom: Avelino Med1oni gas (vole: 5 )
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Coneel name: StIltob Droinlitt 1
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Addles; 123 Soo* From Sine
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Phone: MI) 4984714 Fax:I! ( ) ll=11111111111M 25.02 1
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JUL -19 -2010 MON 03:22 PM FAX NO. P, 07
Plumbing Permit Application City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities: Qty. .Fee (oa) ! Total Sq uar e F ootage:. • . • • Permit Fee: • .
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Footing drain • 1 100' 0 ' 50.03 0 0 to 2,000 $121.90 -
Footing drain - each additional 100' 0 37.52 p " - 2 to 3,600 $169,69
Sewer - 1st 100' I 6 2.54 6..54 3,601 to 7,209 $233.20
7,201 and greater $327.54
Sewer - each additional 100' 0 37,52 0
' water service- 1st 100' - - -- 1 62.54 62.54 Medical Gas Systems:
Water Service - each additional 100' 0 37.52 0
Storm & Rain Drain - 1st 100' 1 ' 62.54 62.54 Val�tati0ln: Pertn .
$1.00 to $5,000.00 Minimum fen $72.50
Storm & Rain Drain -Hach additional 100' 3 37.52 112.56 $5,001,00 to $10,000.00 572.50 for the first $$,000.00 and $1.52 for
Other • Inspections Or Fees. Qv.- ;; F (ea) . ' Total, each additional 5100.00 or fraction thereof, to
inspection of existing plumbing or for 514 including $10,000.00. ccifacall indicated 0 90,00/hr 0 $10,D01,00 to $25,000,00 5148.50 for the fin-t $10,000.00 and $1.54 for
which no fee is specifically y each additional $100.00 or fraction thereof, to
(minimum charge -1/2 hour) and including $25,000.00.
Inspections outsidc of normal business 0 1 90.00/hr 0 $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
Reinspeetion Fees 0 90.00/hr 0 and including $50,000.00.
Additional plan review for revisions 0 : 90.00/hr 0 $50,001.00 and up 574 100 for the first $50,000.00 and 51.20 for
(minimum charge- 1/2 hour) , each additional $100,00 or fraction thereof.
Subtotal: 0 0
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Commercial Fixture Work:
Are you capping, adding or replacing fixtu If "yes ", 'P lai n R eview for Plumbing Installations . • .
please indicate work performed by fixture .; Failure to P lan rev is required for any of the following,
accurately report fixtures could result in increased sewer fees*. Please check all that apply,
quantity by (Fixtur i) Work Performed , Any new commercial building with water service 2" and
Fixture Type: i Replace greater, except systems designed and stamped by licensed
' Previous capped I Added , ' Existing engineer.
Baptistry/Font
Bath - Tub /Shower � .. ❑ New exterior plumbing site utilities for any complex structure
b /Sh /Whirlpool as defined in. OAR918- 780 -0040,
Car Wash -Each Stall ❑ Medical gas and vacuum systems for health care facilities. •
Drive Stall ❑ Any multipurpose fire sprinkler system.
Cusp /Water Aspirator ❑ Any complex structure as defined in OA1.918 - 780 - 0040.
Dishwasher - Commercial r
Pomcstic Submit 2 sets of plans with any of the above,
Drinking Fotintairr
lye Wash Isometric or Riser Diagram.' .
Floor Drain/sink - 2" G7 Isometric or riser diagram is required for new buildings
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I that meet the qualifications above.
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Car Wash Drain I`
Garbage - Domestic I ' _
Disposal - Commercial r
- Industrial I; — ° Comments regarding fixture work:
ice MachiRefrig. Drains _
Oil Separator (Gas Station) •
Rex:. Vehicle Dump Station
Shower -Gang ' '
• -Stall
Sink - Bar /Lavatory .
- Bradley
- Commercial - I' *Note: If the fixture work under this permit results in an
- Service i - 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 1' plumbing permit can be issued.
Water Closet - Toilet
Urinal
Other Fixtures: �i
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