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Permit CITY OF TIGARD PLUMBING PERMIT _ s C OMMUNITY DEVELOPMENT Pe rmit #: PLM2011 -00124 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/19/2011 TIGARD Parcel: 25101 CA00200 Jurisdiction: Tigard Site address: 7902 SW HUNZIKER RD Project: BPMI Subdivision: Lot: 0 Project Description: Interior Plumbing: (2) 2" floor drains, (5) sinks, (1) urinal, (4) water closets, and (1) water heater. Contractor: PRO DRAIN & ROOTER SERVICE, INC Owner: NIC VIAL 3300 NW 185TH AVE #213 7900 SW HUNZIKER ST PORTLAND, OR 97229 TIGARD, OR 97223 PHONE: 503 - 740 -7340 HONE: 503 - 533 -0430 FAX: 503 - 533 -9376 FEES Quantity Description Date Amount 2 ea Floor Drain /Floor Sink/Hub 04/19/2011 $50.04 Specifics: 5 ea Sink 04/19/2011 $125.10 1 ea Urinal 04/19/2011 $25.02 Type of Use: COM 4 ea Water Closet 04/19/2011 $100.08 Class of Work: ALT 1 ea Water Heater 04/19/2011 $37.52 Type of Const: 1 12% State Surcharge - 04/19/2011 $40.53 Occupancy Grp: Plumbing Stories: Total $378.29 • 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 -: or 1.: • II 44. • Issued By: .- Permittee Signature: Call 50 . • •.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. Apr 19 11 09:08a Pro Drain & Rooter Srvc. 503 533 -9376 p.1 Plumbing Permit Application �� 0 C/4 C1 v ` (AID X) (J - _ Site Utilities �t FOR OFFICE USE ONLY YY Received 14 City of Tigard �Q�\ Permit No.: ,_ 13125 SW Hall Blvd., Tigard, OR 47223 Plan Review Adi Phone: 503.639.4171 Fax: 503.598.1960 �� te Other Permit No.: 1.� ll - pn1 -a P c ,0s. /1 y TIGARD Inspection Line: 503.639.3175 OV `t vl$1 DateReadylBy: Juns. l See age for Internet: www.tigard- or.gov CO �l Notified/Method: / Supplemental tn mental Ioforation TYPE OF WORK ,. lti l FEE* SCHEDULE ❑ N w c onstruction El Demolition For special ieforntalion rue checklist Descri �tion Q . Ea. Total Addition /alteration/replacement ❑Other; New 1- 2- family dwellings (includes 100 fl. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2- family dwelling [Co 'mtnereiaUindustrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bathlkitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities lob site address: 7C )o 5L:� th viii i Catch basin or area drain 16.60 City/State /ZIP(FO.1 \ c+ 0, q1 ga Drywell, leach line, or trench drain ■ 16.60 Footing drain (no. linear ft.:. ) Page 2 Suite/bldg. /apt. no.: Project name: bp Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) ! Page 2 �, n Witei• servile (6o'.'Ftnear tt.: ' 1 Pag' 2 r1RhttTlvi.e /Pi I. Lot no.: i let no.: Absorption valve 1 2 DESCRIPTION OF WORK Bacfcftow preventer Page 2 I UYYIVDI r`t " }- Q CJ fl VPd o,.l' t Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ©PROPERTY OWNER 0 TENANT Ejectors/sump 16.60 Name: Expansion tank 16.60 Address: Fixture/sewer cap 16.60 City /State/ZIP: Floor drain/floor sink/hub r Phone: ( ) Fax: ( ) Garbage disposal 16.60 ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 , Contact name: Medical gas (value: 5 ) Page 2 Address: Primer 1 16.60 City /State/ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory ! L 6 6 t,S. W Phone:( ) I Fax::( ) Tub /shower /shower pan 16.60 E -mail: Urinal I ! ,QL CONTRACTOR - Water closet ,., J 1U) 0 Business name: h 1 0 'V 4 ie bo i` {' Q Water heater .5 1�� Address: vs- r. ' ) ������ Subtotal Gr`L' City /State/Zl10 c ep 9 Minimum permit fee: $72.50 Phone: (43,x) 1 1462 -- 9 le ,--- ,� Fax: ( 5) i - pi-4 I Residential backflow minimum permit fee: $36.25 7. 7 CCB Lie.: 1 U ` Plumbing Lie. no.: , � / 7'�, P4 Plan review (25% of permit fee) "�f�Y i • R ! ` � � State surcharge (12 %of permit fee) , iji J (\ Authorized signatur : I i c � � , TOTAL PERMIT FEE / w1 Print name: 17•- C.' 4,.� i `��I / Date: �I ..-1 ' - / i This permit application expires if a permit is not obta et! within 11 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. L P37 71 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 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 ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace( Plan review is required for any of the following. Work Performed: Capped Added Relocate Y g Baptistry/Font Please check all that apply. Bath - Tub /Shower ❑ Any new commercial building with water service 2" and Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918 -780 -0040. Eye Wash Floor Drain/sink - 2" L- Submit 2 sets of plans with any of the above. -4" Car Wash Drain Isometric or Riser Diagram Garbage - Domestic- non -food ❑ Isometric or riser diagram is required for new buildings Disposal - Domestic -food related that meet the qualifications above. - Commercial -food related - Industrial-food related Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lav - Non -food related - Bradle - Commercial-food related - Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer - Clothes P Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet - Toilet �-i fees assessed for the sewer increase must be paid before the Urinal _ / plumbing permit can be issued. Other Fixtures: I: \Building\Permits\PLMF- PermitApp.doc 02/24/2011 2 Accumulative Sewer Tally Parcel # 2S101 CA002001 Tenant Name: BPMI This SWR# SWR2011 -00057 Site Address: 7902 SW HUNZIKER This PLM# PLM2011 -00124 Fixture Value Previous Previous Credits Capped Fixture Fixture New New r value capped off value added added total total count tf +-`> count # value #s values Baptisery/Font 4 0 0 0 0 0 Bath - Tub /Shower 4 0 0 0 0 0 - Jacuzzi /Whirlpool 4 0 0 0 0 0 Car Wash - Each Stall 6 0 0 0 0 0 - Drive through 16 0 0 0 0 0 Cuspidor /Water Aspirator 1 0 0 0 0 0 Dishwasher - Commercial 4 0 0 0 0 0 - Domestic 2 0 0 0 0 0 Drinking Fountain 1 0 0 0 0 0 Eye Wash 1 0 0 0 0 0 Floor Drain /Sink - 2 inch 2 0 0 2 4 2 4 - 3 inch 5 0 0 0 0 0 - 4inch 6 0 0 0 0 0 - Car Wash Drn 6 0 0 0 0 0 Garbage Disposal - Domestic (to 3/4 HP) 16 0 0 0 0 0 - Commercial (to 5 HP) 32 0 0 0 0 0 - Industrial (over 5 HP) 42 0 0 0 0 0 Ice Machine /Refrigerator Drain 1 0 0 0 0 0 Oil Sep (Gas Station) 6 0 0 0 0 0 Rec. Vehicle Dump station 16 0 0 0 0 0 Shower - Gang (per head) 1 0 0 0 0 0 - Stall 2 0 0 0 0 0 Sink - Bar /Lavatory 2 0 0 5 10 5 10 - Bradley 5 0 0 0 0 0 - Commercial 3 0 0 0 0 0 - Service 3 0 0 0 0 0 Swimming Pool Filter 1 0 0 0 0 0 Washer - Clothes 6 0 0 0 0 0 Water Extractor 6 0 0 0 0 0 Water Closet - Toilet 6 0 0 4 24 4 24 Urinal 6 0 0 1 6 1 6 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 _ 0 0 12 44 12 _ 44 Current Fixture Value 44 divided by 16 = 2.8 Current El )U 1 EDU = 5 4,100 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change 44 divided by 16 = 2.8 over (under) $ 11,480.00 Enter EDU Change Here 2.8 Notes: Authorized Name /Signature: BRANDEN TAGGART X2449 Date: 4 /19/2011 Building Division Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be submitted to the City of Tigard Building Division to redeem credits towards future system development charges. I: \Building \Sewer Tally \SewerTallySheet- 4100.xls 07/01/10