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Permit • CITY OF TIGARD PLUMBING PERMIT , COMMUNITY DEVELOPMENT Permit #: PLM2011 -00185 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2011 Parcel: 1 S 134AA02100 Jurisdiction: Tigard Site address: 10300 SW NIMBUS AVE PC Project: Spec Space Subdivision: SCHOLLS BUSINESS CENTER Lot: Project Description: Remove and replace break room sink. Contractor: ASSOCIATED PLUMBING CO Owner: HANSON, RONALD D 200NE VICTORY AVE "C" ROBINSON, CONSTANCE A GRESHAM, OR 97230 ROBINSON, CHESTER TRUST ET AL KENNEWICK, WA 99331 PHONE: 503 - 492 -1922 PHONE: FAX: 503 - 492 -1923 FEES Quantity Description Date Amount 1 ea Sink 06/10/2011 $25:02 Specifics: 1 12% State Surcharge - 06/10/2011 $8.70 Plumbing 47 ea Minimum Fee Adjustment - 06/10/2011 $47.48 Type of Use: COM Plumbing 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 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: All 4/ Permittee Signature: , 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. Lr Plumbing Permit Application • Building Fixtures ^ FOR OFFICE USE ONLY City of Tigard ` 9 _ • Received �7 _� tern, t No. ' n D tcny I NI 'I 13125 SW Hall Blvd., Tigard, OR 972 , . �� '/ - . J 1 11 ` Phone' 503.639.4171 Fax 503 ,598,1960 `\A\ 9 Plan Rcvicw (,lnc�r Permit Nn.: Inspection Line: 503.639.4175 V\v DateeRR: TT G ARA �, ` QRtc Re tuns H Scc Pa�+r 2 rot• Internet: www.l.ignrd - or.} ov 'C�i7 ��QVG -' > . Notified/Me Supplemental Information TYPE OF -\ \ ` �' ‘ 11;x" SCHEDULE ❑ New construction ❑ Demob special Irt�prnrprion use checklist, - . I _ - -- - --- Dcscl'iption .... _.. - L Qty. I La.. 1 Total ,gLAddition/alteration /replacement ❑ Other: New I.2- rnmily dwellings (include 100 il. for each utility connection) 1TM3 CATEGORY OF CONSTRUCTION - -- SFR (I) bath _ 312.70 -- ❑ I -and 2- family dwcliing C'ommcrcial /industr --- _. - -- SFR (2) bath - X137.78 -- SFR (3) bath 500.32 ❑ Accessory building 0 Multi- family -- _..__. .... _. ... - • -• - -- Each additional bath /kitchen 25 ❑ Master builder ❑ Ot,her: _ ... __.. ,- --, ,�, Fire sprinkler i sq. 19.) Pat 2 'JOB SITE INFORMATION AND LOCATION Site utilities: Cara h;15i11 or t1IY a drain Job site address: © ° _ — 18.7ci — ^ - ( - -. _.'._ Divwc11, leach line, or trench drawn City/Statc/iil: - — ._.... - ^ -�- I�^!Q. •� �" 9 Z. , . - -- ._....._- .._._. 1=ootinR drain (no. linear 0.: � ) i'agt; 2 Suite /bldg. /apt, no.: project name: p ,,,,�� S _.S Mat rod hour. utilities — 50.03 -- Crass street /directions to job site: Manholes 18.76 - Rain drain connector 18,76 __y Sanitary sewer (110. linear It, r` ) Page 2 `` --- Storm sewer (no. linear ft.: 1 Page 2 - _....._ -� Water service (no. linear ft.: _ ) Page 2 Subdivision: Lot no,; Fixture nr item: Tax map/parcel no.: -�, flack flow preventer _ 31.27 - DESCRIPTION Of WORK 13ackwater valve . __ ..__�_._....•_._ 2.: I """""". - "' ° Clothes washer 2;.02 N Dishwasher 25.(12 • Drinking Fountain 25.02 _ Ejectors /sump 25.02 : P.ROli'PRTY OWN .R _,.,_ Li , TENANT - Expansion tank _ 12.51 Name: - Fixture /sewer cap 25,02 Address: _---` - - • —_ Floor drain /floor sink /huh 25.02 Garbage disposal 25,02 City/State/ZIP __ _ _ - __ Hose bib 25.02 Phone: ( ) Fax; ( ) _!cc maker 12.51 ❑ A'irPLIC ❑ CONTACT - ANT Interceptor /grease trap 25.02 name; m M Medic gas ) 1'n e 2 -..al as (value S ` B — Business - - ........ -• Primer Contact namc: __. .._ ) .51 Roof drain (commercial) 12.51 A Address: --- _. .... ..__ Addy .- -_...... —_.... Sink /hasi11 /lavalnry 25 1 tty /State /LIP' r Solar emits (potable water) 6254 - _._..... Phone: ( ) I Ff1x; _ _ ^ L - Tub/shower/shower pan 12.5 - -� 1. urinal 25 02 CC)'NTRACTC�R ..- W closet — 25, - �� -- ^--^• .. W ater heater 37,52 13usi name' S.t �rrC � 1e_ Water piping /DWV c 56.2 > Address: 7_,640 �C��*.' vYC `dug.Y ...+O41...fr " C'' Other: 25,02 .- City/State/ZIP: .<e.e ,s/.✓� vrC �a3o Subtotal Phone v3 ) 47,9. . pliZ Z r'ax: {5,.,3 ) 5.7Z -id1 Z __—_ - .. . _._— ._.,... Minimum permit tree: 572.50 72 . Sa CCB Lie.: 7p _ Plumbing_ Lie. no 26 --y /z # 0 . 4 _. _ - Plan review (25 ",iool'perntlt fee) Slat surcharge t 12% or perm it fee) , 7¢ Authorized signature. _� - - _ —, Tarm.. PERMIT 'F•/: PEE ,..4..==-1 „ [Pttint nano : O Z � T ,, I 1 Date: e 7.-// 7.-// This permit applicalion if n permit Is MA obtained within ISO days - allot it has been accepted as complete. 'Pee inolhodok ry sat by Tri- County BnikIin • Industry 'service !- Ficnrd. renrdldinp\Permlrp\PLMU•Perml A6p,doc ro/ormo ∎WO- u, I6T(10 r c /wEn) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suypression Systems: Site Utilities.,.. Qty. Fertea) Total S' flare Footage,: Permit Fee: rooting . drain - 1° 100' 50,03 0 to 2,000 , - PoOtinF drain - each additional 100• 37.52 2.00I to 3,600 $169.69 ..� 3,601 l0 7,21) -- .... 6233.20 Sewer - I st 100• 62.54 — ._... _.. ..... . . , 201 and ^realer $3?,7 9�1 7 .'ewer -cach additional 100 37.52 water Service -1st 1(10 62,54 Medical Gas Systems: Water Service - each additional 100' 17.52 -• Rain Drain - I s Sfonn & Valuation: Permit Fee: t 100' 02,54 — - , 000 ( 1 — - ...._... $1.00 in $5 00(1,((1 inim fee 872.50 • Storm & Rain Drain - each additional 100' 37.52 $51/(51.0o to $10,000.00 $72,50 for the first $5,000,00 and $1.52 for CD�II lit�er Y or Fees Qt Fee (en) Total each additional $ 100 00 or II thereof. to - _ and inch n d inLS 10,000.0(1. lnapecuon of existing plumbing or for $10.001 t o 525,0(111.00 $1.1$.50 for the lirst .$10,000.00 and $1,54 f which no fee is specifically indicated 90.00 /hr each additional S100.00 or fraction thereof, to thin ;mum charge •• 1/2 hour) and incluilimti625.000.01). Inspections outaidc or normal business • 90.00 /hr 525,001.00 to $50.000.00 $379.50 for the first ¶25.060,(10 and $1.45 for hours minim,.11ll Charge- 2 hours) each additional $100.00 or fraction thereof, to Rcinspcction Fees 90.00 /hr and inc)udino $50,00(1,0(1, Additional plan review for revisions 90.00 /11r $50.001.00 and up ¶742.00 for the lirst $50,000.00 and $1,20 for (minimum charc- I/2 hour)- -- each — cach additional $100.00 or fraction thereof. Subtotal; — Commercial Fixture Work: Are you capping, adding or replacing fixtures? i f "yes "•, Plan Review for Installations , please indicate work performed by fixture. Failure to , v Plan review is required for any t,l followinin g. accurately turf fixtures could result in increased sewer fees*. Please check all that apply. . Quantity, by (Fixture) Work Performed • Q Any new commere tl building with water service 2•' and Fixturc Type: Reran, greater, except systems designed and stamped by licensed Prcvlona Ca, Added Exigtint; engineer, Baptistry /Font Bath Tub /Sltowcr ❑ New exterior plumbing site utilities for any complex Structure -Jacuzzi/Whirlpool as defiled in OA.R918- 780 -004o. Car Wash Each Sall El Medical gas and vacuum systems for health care facilities. -Drive Thru ❑ Any multipurpose lire sprinkler system. Gus idor /Water As irator ❑ Any complex snt.iclu,c as defined in UA1Z918- 780 0040. Dishwasher - Commercial h)mCSIIC Suhmif 2 sets of plans with any ofthe above. Drinking lonntain " " Five Wash _ __- Isom'etri'c or Riser Jia .ram — Floor Drain /sink - 2' —+ 0 Isometric or riser diagram is required for new buildings that meet the qualifications above. Car Wash Drain - Garbage •Ddmesric _ Disposal -Commercial Industrial Comments regarding fixture work: Ice Mach. /Rcfrig, Drains Oil Separator (Gas Station) r " ' Rce. vehicle Dump Station Shower -Gang -Stall "-- Sink - Bar /Lavatory '" Commercial `___ *Note: if the fixltire work under this permit results in an - Service Swimming Pool Filter ^�— increase of %elder EDUs, a sewer permit will he issued and Washer • clot:hes fees assessed for the sewer increase must be paid before the Water Extractor - plumbing permit can be issued. Water Closet - Toilet . Urinal ' - Other Fixtures. , 1111111111 Cr \UsersAOwncr\ Desktop\Documcnis \Documents \Pcrmitsl Phnh.chip