Permit ppli CITY OF TIGARD PLUMBING PERMIT
.....` COMMUNITY DEVELOPMENT Permit U: PLM2011 -00245
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/28/2011
. Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10120 SW NIMBUS AVE C5A
Project: Aero Hair Studio Subdivision: SCHOLLS BUSINESS CENTER Lot:
Project Description: Replace existing: (4) non -food related sinks and (1) water closet.
Contractor: BEAVERTON PLUMBING INC Owner: HANSON, RONALD D
13980 SW TV HWY ROBINSON, CONSTANCE A
BEAVERTON, OR 97005 ROBINSON, CHESTER TRUST ET AL
KENNEWICK, WA 99331
PHONE: 503 - 643 -7619 PHONE:
FAX: 503 - 643 -7620
FEES
Quantity Description Date Amount
4 ea Sink 07/28/2011 $100.08
Specifics: 1 ea Water Closet 07/28/2011 $25.02
1 12% State Surcharge - 07/28/2011 $15.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $140.11
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ( 7 , Per Sign a ture: 0/ y
( C /, c/ / -/ e, j /d`✓
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application '�;'E
Building Fixtures
City of Tigard JUL 2 7
201 ' ac r 7 t / / mink Non,"1 0 - e '2 yS
+ 13125 SW Hall Blvd., Tigard, + JJ OR 97223
Phone: 503.718.2439 Fax: 5O3,598,.• .�t Plan Review ITY Date/By:
OF OtherPcmritNo.: BUP2011 -00110
J. IC; r ., Inspection Line: 503.639.4175 LDING DIVISION Date Rearlyfliy: • • 61 See Pate 2 for
Internet: www,tigard- or.gov Noti1ied/Met • Supplemental Information
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0 New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ha, I Total
0 Addition /alteration/replacement ❑ Other: New 1- 2-family dwellings (includes 100 ft, fnr cach utili connection)
i :40 aa: iiiii,,i C, 7 .,. T r X OF a . . . „: : l1 O ' SFR (1)bath 312,70
1:1 1- and 2- family dwelling ® Commcrciallindustrial �SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/lcitchen 25.02
❑ Master builder ❑ Other: n
er�
Fire sprinkler pn ms s. Page 2
r, +IO$''SITE (18$1 0,) ^ 1111E II .: ∎ ' , �I .!:.1 : d' '''P':'- Site utllides:
Job site address: 10120 SW NIMBUS Catch basin or area drain 18.76
Drywall, leach line, or trench drain 18.76
City/State/ZIP: PORTLAND, OREGON 97223
V Fooling drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. n .: C5A_) Project dome: AERO HAIR STUDIO Manufactured home 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 A°: _ ) Page 2
Subdivision: Lot no.: Fixture or item: ,--.--
Tax map/parcel no.: • Backflow preventer • 31,2
it ll 1. . "'�iiFw��'I�N;gy'L,., �•4 H star valve 12.51
EPLA('F akl?ti H�, , . ` Gl u t a,' : tgl�l l zi1i
Clothes washer 25.02
EXIST HAMPOO SINKS, BREAK ROOM SINK, Dishwasher 25.02
TANK TYPE TOILET, PEDESTAL LAVATORY Drinking fountain 25,02
Ejectors/sump 25.02
;I I?ROP O* 4 , ,'" "iV 1IIiiju r V +" ❑ TENANT Cxptutsion lank 12.51
Name: Fixture/sewer cap 25,02
Floor drain/floor sink/hub 25.02
Address:
- Garbage disposal 25,02
City/Slate/ZIP:
Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12,51
:A)itY',ail> lv t:• * a u Ift: . P:4 pp) :: '" ; ntcrccptar /g[rasc trap 25.02
Business name: BEAVERTON PLUMBING INC Medical etc (value: $ ) Page 2
Primer 12.51
Contact name: CASEY STEPHENS .
Roof drain (t nmmercial) 12.51
Address: 13980 SW TUALATIN VALLEY HWY Sink/basin/lavatory 4 25.02 100.08
City /State/ZIP: BEAVERTON, OREGON 97005 Solar units (potable water) 62,54 -.
Phone: (503) 643.7619 I Fax: : (503) 643.7620 'rub /shower /showerpan 12.51
E -mail: Sue(a)beavertonplumbing.eom Urinal 25.02
l Water closet 1 25.02 25.02
'. h A Il n _ y ..0 .....RA.0.1,
�.�� , ,�, z:,, Water heater 37,52
Business name: BEAVERTON PLUMBING, INC Water piping/DWV 56.29
Address: 13980 SW TUALATIN VALLEY HWY _ Other: 25.02
City /Statc/ZIP: BEAVERTON, OREGON 97005 Subtotal 125.10
Phone: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72.50
�, / CB Lic.: 12889 Plumbing Lie. no.: 34-4PB
Plan review (25% of permit fee)
��/ 'I/ /// State surcharge (12% of permit fee) 15.01
Authorized signature: ,.x"\ C a,[-ti TOTAL PERMIT FEE 140.11 t/
T Print name: SUSAN DEAN Date: 7/27/11 ! Mb Permit application expirrx WA permit is nut obtained within lad days
after it has been accepted ante complete.
"Fee methodology act by Tri -County Building industry Service Board.
i "J9& Idilu\l'ornlhsl'LMU-L' mitApp.due 11/01/09 440.46161(10l02/COM/Wtu)
Plumbing.Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sur r ression S stems:
,5><rc.I>7fii1it .... ,.:....:::.:.�.�:< ;...,, ,•..- : : : .$444 .. _ .. , ,„,.,.h...:,>tiin _ ..
Footing drain - l` 100' 50.03 0 to 2,000 $121 90
Footing drain - each additional 100' 37.52 ' 2,001 to 3,60(.1 _ $169.69
- 3,601 to 7,200 $233.20
Sewer 1st 100' 62.54
7,201 and eater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 .. M Gas Systems' _ • Water Service each additional 100' 37.52 '` ' } '; 1ll l AI: :':a Pet t1itrFel`:' • ; :{*
Storm & Rain Drain - 1st 100' 02.54
$1.00 to $5,0000 0.00 Minimum fee $72.50
Storm bt Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72,50 for the first $5,000.00 and $152 for
tii ..:.. ;;. :, M,..- •,;,: Qty,:; . h• a5d each additional 5100,00 or fraction thereof, to • t D> slie " —t- yp> �Q;1 :li S , ;.:. (C7 h , :1 ` and including $10000.00.
Inspection of existing plumbing or for $10,001,00 to $25,000.00 $148.50 for the first $10,000.00 and $154 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 Foes 90.00 /hr and including $50,000.00.
Additional plan review for revisions 90A0/hr ' $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Sminimum charge —1/2 hour) .,., each additional $100.00 or traction 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 �* 4 W
uant F ixture lye :•:,;; ; , ns �
: _..� i �' by P + • .,<. :�'�P �Ip::'r�,�'te�Y. ��G� ' : P�tu�d�iinig I �illatihs
Fixture '1���,,
y pe :far RcplacN
Plan review is required for any of the following.
Wut.i'Perfoirmed :. • . ''Laid ` • •Added Retuearte
Please check all that apply.
Baptistry /Font
b /Shower 0 Any new commercial building with water service 2" and
Bath -Tub/Shower /Whirlpool _� greater, except systems designed and stamped by licensed
Cur Wash -Each Stall • engineer.
- Drive 'I'hru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918- 780 - 0040.
Dishwasher - Commercial - El Medical gas and vacuum systems for health care laciiities_
• - Domestic ❑ Any multipurpose fire sprinkler system.
Drinkin • Fountain - ❑ Any complex structure as defined in OAR918- 780- 0040.
Eye Wash
Floor Drain/sink - 2" ' " Submit 2 sets of plans with any of the above.
- 3"
4 „ : . >':. iIIet *icU r:R i serDf .., am
Car Wash Drain ;.. : ,, .
(Jarbagc Domestic — non -raoa ❑ 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 /Rofrig. Drains
Oil Separator Oas Station) - , Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower - Gang
-Stall __
Sink /Lae - Non -food related 4
- Bradley
- Commercial - food related
- Service W_
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Wishe -
Washer Clothes
Water Extractor — increase of sewer FDUs, a sewer permit will he issued and
Water Closet - Toilet – 1 fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can he issued.
Other Fixtures:
http:// www. tigard- ur.gov /city_hall/dcpartments /cd /does /PLMF- PcnnitApi doc