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Permit
y CITY OF TIGARD PLUMBING PERMIT `! COMMUNITY DEVELOPMENT Permit #: PLM2011 -00098 T f f a A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2011 Parcel: 1 S126DCO3300 Jurisdiction: Tigard Site address: 9900 SW GREENBURG RD 110 Project: Wells Fargo Subdivision: Lot: 0 Project Description: Remove and replace (1) sink, add (1) water heater. Contractor: CASCADE PLUMBING CO Owner: ATHERTON REALTY PARTNERSHIP 2630 N HAYDEN ISLAND DR #3 2100 S WOLF PORTLAND, OR 97217 DES PLAINES, IL 60018 PHONE: 503 - 289 -7095 PHONE: FAX: 503 - 283 -9514 FEES Quantity Description Date Amount 1 ea Sink 03/30/2011 $25.02 Specifics: 1 ea Water Heater 03/30/2011 $37.52 1 12% State Surcharge - 03/30/2011 $8.70 Type of Use: COM Plumbing Class of Work: ALT 10 ea Minimum Fee Adjustment - 03/30/2011 $9.96 Type of Const: Plumbing Occupancy Grp: Stories: Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, . " • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N ification Cen :. Tho - rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direc' questions to OUN . coffin,' : - .232.1987 or 1.800.332.2344. Issued Permittee Signa # r " Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Building Fixtures FOR OFFICE USE ONLY City of Tigard Dateived I Permit No o� Ih . : !C t�l _q�Q ,t 13125 SW Hall Blvd„ Tigard. OR 973 3 V n 2011 P lan Review ` ---r Phone; 503.639.4171 Fax: 503.598 Other Permit No,; TI G ARD Inspection Line: 503.639,4175 Ready /$y; 1uris: Bl See Page 2 for Internet: www.tigard- or.gov Notified /Method! SupptemontalInformation TYPE OF WORK FEE* SCHEDULE ❑ Now construction ❑ Demolition • For special information use checklist, Dcscri.tion Q . Ea. Total :Itfir ddition /alteration /replacement ❑ Other: New I.2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath _ 312.70 ❑ 1- and 2- family dwelling mmercial /industrial SFR (2) bath 437.78 • SFR (3) bath 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder © Other: — sprinkler (` sq. R.) Page 2 JOE SITE INFORMATION AND LOCATION Sit utilities: Job site address: 9c:: VD !1 - . A r I ' Catch basin or area drain 18.76 Drywell, leach lint, or trench drain 18,76 City /State/ZIP: I i -,l y di' Footing drain (no, linear ft.: _) Page 2 Suite /bldg. /apt. no.: j 1 Project name: . ' I D Manufactured borne 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 f3,: �) Page 2_ Subdivision: Lot no.: Fixture Or item: 'lax map /parcel no,: Backflow preventer 31.27 Backwater valve 12.51 DESCRIPTION OF WORK ,� ` ` Clothes washer 25.02 ?Oi- I i .. - I'l 4C.r • A _ ` ti t1 1 G1 -Li Dishwasher 25.02 I, Drinking fountain 25.02 Ejectors/sump 25,02 El PROPERTY OWNER ❑ TENANT Expansion tank 12.51 Fixture /sewer cap 25.02 Name: Floor drain /floor sink /hub 25,02 Address: Garbage disposal 25.02 City /State/ZiP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12,51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25,02 Business name: CASCADE PLUMBING COMPANY Medical gas (value; $ ) Page 2 - Primer 12.51 Contact name; CRYSTAL JONES Roof drain (commercial) 12.51 Address: 2630 N. IIAYDEN ISLAND DRIVE #3 Sink/basin /lavatory / 25,02 , O City /State/21 P: PORTLAND, OR 97217 Solar units (potable water) 62,54 Phone: (503) 289 -7095 .._-i Fax:: (503) 283 -9514 Tub /shower /shower pan 12.51 E - mail: CASCADLPLUM @YAHOO.COM Urinal 25,02 • Water closet 25.02 r� CONTRACTOR Water heater / 37,32 3 ..50, Business name: CASCADE PLUMBING COMPANY Water piping/DWV 56.29 Address: 2630 N. HAYDEN ISLAND DRIVE #13 Other: 25.02 City /State /ZIP: PORTLAND, OR 97217 Subtotal Phone: (503) 289 -7095 Fax: (503) 283 -9514 Minimwn permit lee: $72.50 - ja. 5 Plan review (25% of permit fee) CCB Lie,: 120893 Plumbing e. no.: 34 -412PB E; Stare surcharge (12% of permit fcc) SI. -70 Authorized signature: j . / • t TOTAL PERMIT FEE .'(, a.Q This permit ap expires if a permit is not obtained within 180 days Print name: CRYSTAL JONE Date: A fter it has been accepted as complete. -- P l.ss_ . / • r V . ,,,� + I "FcC,nethodology act by - Fri-County Building industry Service Board. IAH❑ilding \Perna \PLMU- PcrmitADD.doc 10 /01 /09 `� --,h 4 -4616T(l0 /02 /COM/WEB) EB/IB 3EEtd 3QVDsVD bTS6E8zE09 6z:lt ITOZ /9E /E9 ■ Plumbing Permit A _pplication - 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 5169.69 3,601 to 7.200 $23320 • Sewer - 1st 100' 62.54 7,201 and greater 5327.54 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 • let 100' 62.54 - 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 Qt Fee (ea) Total each additional $100.00 or fraction thereof, to Other Inspections or Fees 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 char_c- 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 each additional $100.00 or fraction thereof. (minimum char_e- 1/2 hour) _ 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 stamped by licensed Previou Cupped Addeu E xistine engineer. 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 ❑ Any multipurpose fire sprinkler system. -Drive Thru , ❑ Any complex structure as defined in OAR918 -780 -0040. Cuspidor /Water Aspirator Dishwasher - Commercial Submit 2 sets of plans with any of the above. - Domestic . Drinking Fountain Eye Wash Isometric or Riser Diagram Floor Drain/sink - 2" 7 – Isometric or riser diagram is required for new buildings • 3 " - that meet the qualifications above. - 4" — Car Wash Drain Garbage - Domestic Disposal - Commercial _ Comments regarding fixture work: - Industrial Ice Mach. /Refrig, Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station — Shower -Gang — -Stall Sink - Bar /Lavatory t — - 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 _ — plumbing permit can be issued. Water Extractor Water Closet - Toilet Urinal Other Fixtures: C:\Documents and Settings\Cascade Plumbing \Desktop\PLMF- PermitAp12doc E0 /Z0 39tiel 3GdOSdD tIS6E8ZE09 6Z :TT TTOZ /0E /E0