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Permit 17 1 CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit #: PLM2011 -00162 T1GAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011 R Parcel: 2S 101 DC04601 Jurisdiction: Tigard Site address: 7409 SW TECH CENTER DR 100 Project: Solutions Yes Subdivision: TECH CENTER BUSINESS PARK Lot: 2 Project Description: Cap (1) non -food sink and relocate (1) existing non -food related sink. Contractor: JAMES ROOD PLUMBING INC Owner: NORRIS & STEVENS 880 NE 25TH AVE, STE 2, PMB #129 621 SW MORRISON HILLSBORO, OR 97124 PORTLAND, OR 97205 PHONE: 503-648-3907 PHONE: 503 - 223 -3171 FAX: 503 - 681 -2196 FEES Quantity Description Date Amount 1 ea Fixture /Sewer Cap 05/24/2011 $25.02 Specifics: 1 ea Sink 05/24/2011 $25.02 1 12% State Surcharge - 05/24/2011 $8.70 Type of Use: COM Plumbing Class of Work: ALT 22 ea Minimum Fee Adjustment - 05/24/2011 $22.46 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, 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 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: "CC. 0/V e70,6.4//,--7-70") 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. Accumulative Sewer Tally Parcel # 2S101DC04601 Tenant Name: Solutions Yes This SWR# N/A Site Address: 7409 SW Tech Center Dr., Ste. 100 This PLM# PLM2011 - 00162 Fixture Value Previous Previous Credits Capped Fixture Fixture New New # value capped off value added added total total count off #s count # value #5 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 0 0 0 - 3 inch 5 0 0 0 0 0 - 4 inch 6 0 0 0 0 0 - Car Wash Drn 6 0 0 0 0 0 Garbage Disposal i - 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 0 0 0 - Bradley 5 0 0 0 0 0 - Commercial 3 0 0 0 0 0 - Service 3 0 1 3 0 -1 -3 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 0 0 0 Urinal 6 0 0 0 0 0 Previous EDU Count 0 0 Capped EDU Credit 0 TOTALS 0 0 1 3 0 0 -1 -3 Current Fixture Value -3 divided by 16 = -0.2 Current EDU 1 EDU = $ 4,100 Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU Change -3 divided by 16 = -0.2 over (under) $ (820.00) Enter EDU Change Here -0.2 Notes: EDU CREDIT FOR 0.2 Authorized Name /Signature: Dianna Howse Date: 5/24/2011 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 FROM JAMES ROOD PLUMBING FAX NO. : 503 6483907 May. 20 2011 03:34PM P1 Plumbing Permit Application \ Building Fixtures � 0,�,� FOR 01 I. I C L • 1.1 S E ONLY . . . • City of Tigard ,<,, ® R Pem ut N G� 0 / /1db v 2 u 13125 SW Hall Blvd., Tigard, Olt 910, L y , p„te ay: ,) .2 // j>� / �P �'" i Plrin Review `��� c�\ �bnlenly: otier Kermit No.: C • Phone: 503.718.2439 Fax. 503,59h.1960 Inspection Line: 503,639.4175 �^, V T[GARp' Internet: www.tigard Or,y�OV 0% �` DatcRcady/Ay J m 8cePage2for , ' w..�;i Notified /Method: j Supplenentat Information TYPE OF WORK v \ \�\Y" , FEE* SCHEDULE For special informaa in use rkermist [f New consn uCtion ❑ Demolition Description I Qt;:. ty. La. f Total Addition /alteratiolt/replaccment lj Other: New 1- 2- family dwellings (includes 100 tt. for each utility connection) CATEGORY OF CONSTRUCTION - • SFR (1) bath 312.70 ❑ I- and 2- family dwellingCommcrciaUindtJStriai SFR (2) bath 437,78 ❑ Accessory building Multi - family SFR (3) bath 500.32 ❑ Master builder Each additional bath/kitchen 25.02 Fire sprinkler ( sq. IL) Page 2 • JOB SITE• INFORMATION AND LOCATION Site utilities: - Job site address: t t� Catch basin or area drain 18.76 i o, s Li iie 1_ ( c.- D City /StatelLLP: `�` �� Drywell, leach line, or trench drain 18.76 ! &va Footing drain (no. linear ft.: ) Page 2 dgiapt. no,: h o Project name: T I T Manufactured home utilities 50.03 Cross street/directions to job site: Sc, 1—a770 NS ES Manholes 18.76 - Rain drain connector ME Sanitary sewer (no. linear ft.: _ ) Page 2 Storm sewer (no. linear ft.: _„„) Page 2 • Water service (no. linear it.: ) Page 2 Subdivision: _ Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 • DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25 -02 re / S Q t_f' _ ,, + / , ': (i - y ,4° r Lk bk- .. Dishwasher 1 25.02 ��'� # • -•- Drinking fountain 25,02 Ejectors/sump 25.02 0 PROPERTY. OWNER 0 TENANT Expansion tank 1E111 Name: Fixture/sewer cap 25,02 Address: Fluor drain/floor sink/ hub 25.02 Mill City /State/7.TP; Garbage disposal r 25.02 Hose bib=' Phone: ( ) Fax: ( ) ice maker 12.51 © APPLIC '0 CONTACT PERSON Interceptor /grease trap 25.02 • Business name: Medical gas (Value: $ ) Page 2 Contact name: 12.51 Address: — Roof drain (commercial) 12,51 City/State/ZIP: So r/basin/tavatory ��� Solar units (potable water) 62.54 Phone: ( ) pax:: ( ) Tub /shower /shower pan 12,51 E -mail Urinal 25,02 CONTRACTOR Water closet 25,02 13usincss '• - Water heater 37.52 1 3 J p /,,rib S . Water pTP El Address: yl a Pile m�WV 56.29 Cit r _hf t S Sa-�te Pile mar: 25.02 y !I Y, i< 7 ) ��. Subtotal Phone: ( ) « 9 , Fax j q Minimum permit fee: $72.50 9 r SO COB Lie.: . 7 b J Plumbing Lie, no -: i �$ g Plan review (25% of permit - fee) Authorized signature: „dr- State surcharge (12% of permit fee) 7,7 TOTAL PERMIT FEE '' , a° Print name: � wr 4 1+..N) } 0 p Dale: -2° & permit a11pllcad0u CxpiYe3 if n permit u nOt u btnin g l "within 180 dxy5 An after it has been accepted ag complete- sr„p mnhnelnin,n, oat h„ Tn1'nnnty Rnd rlinn TnA,mn,. Cann ,, llna,.l FROM : JRMES ROOD PLUMBING FAX NO. : 503 6483987 May. 20 2011 03:34PM P2 Numbing Permit Application - City of Tigard Paee 2 - Supplemental iinformation Fee Schedule: _ Residential Fire Su I I ression Systems: Site Utilities Qty. Fee (ea) Total ry Square Foota . e: Permit Fee: Footing drain - 1' 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37 2,001 to 3,600 $169.69 - Sewer - 1st 100' 62.54 3,601 to 7,200 $233.211 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62,54 Water Service - each additional ! 00' 37.52 Medical Gas Systems: Storm & Rain Drain • 1st 100' 62,54 Valuation: Permit Yee: Storm & Rain pram • each additional 100' 37.52 $1.00 to $5,000.00 Minimum fee $72.50 _ $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 Inspection of existing plumbing or for and including $10,000.00. which no fr c is specifically indicated 90.00/hr T $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for (mini s nt charge -1 /2 hour) each additional $100.00 or fraction thereof, to inspections outside of normal business yU 0dn _ and including $25,000.00. hour hours (minimum charge -. 2 }Tars) $- 5,001.00 to $50,000.00 $379.50 For the first $25,000.(10 and $1.45 for s (minimum Fees 40 UU/l1r each additional $100.00 or fraction thereof, to and including $50,000.00. Additional plan review for revisions 90.00/hr $50,00I,00 and up $742.00 for the first $50,000,00 and $1.20 for (minimum charge - 112 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work nerformed by fixture. Failure to accurately report fixtures could result in increased sewer fees*. Quantity by Fixture Type Plan Review for Plumbin Installations • Fixture Type for . " Ro lace/ Work Performed: Capped' Added Relocate Plan review is required for.any of.thc following. Ba tisby /Font — Please check all that apply. lath iub /Shower ❑ Any new commercial building. with waxer service 2" and - Jacuzzi/Whjrlpool al • en ,greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. Drive Thnr ❑ New exterior plumbing site utilities for any complex structure Cus • idor/Water As, irator � rIMII. as defined in OAR9l8 - 780 - 0040, Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. -Domestic ' 0 Any multipurpose fire sprinkler system. Drinking Fountain MEM Q Any complex structure as defined in OAR918- 780 -0040. 1 loot Drain/sink 2" Submit 2 sets of plans with any of the above. - 3" . -4" Czar Wash Drain � • _ Is ometrie 01' Miser 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 1111=1 - Oil Separator (Gas Station) � Comments regarding fixture work: �� Vehicle p Station _ =fir Flo Ca-re Sink/L.av -Non-fbod related - Bradley �� - e rvce cial -food related - Service Swimming Pool Filter Washer - Clothes * Note: If the fixture work under this permit results in an Water i:,;xtractor increase of sewer EDUs, a sewer permit will be issued and Water Closet - Toiler: -- fees assessed for the sewer increase must be paid before the urinal Other Fixtures: - plumbing permit can be issued.