Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2011 -00350
Date Issued: 11/22/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10110 SW NIMBUS AVE B1
Project: People Growers Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: Add (1) non -food related sink.
Contractor: BEAVERTON PLUMBING INC Owner: HANSON, RONALD D
13980 SW TV HWY ROBINSON, CONSTANCE A
BEAVERTON, OR 97005 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE:
PHONE: 503 - 643 -7619
FAX: 503 - 643 -7620
FEES
Quantity Description Date Amount
1 ea Lavatories 11/22/2011 $25.02
Specifics: 1 12% State Surcharge - 11/22/2011 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment - 11/22/2011 $47.48
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: ,� / Permittee Signature: 11/1/ y %oL/C
"yy , 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.
Plumbino Permit ApDlicatn •
Building Fixtures CEIVED
FoR oFF1(.... I SE 0 \ 1.1
City of Tigard Received
Date/13 : // 0 (7 46c/ Permit N°- Aria20// -60 -
13125 SW Hall 131vd., figard, OR g Y 2 2 2011
Plan 'Review -
-.
Phone: 503.718.2439 Fax: 5 env* TIGARD
spection Line: 503634175
.9, Dateilly: Other Permit
In No 4)0 12 .2411/-190/37
fIGANI) Dale Reody/Sy: miC.. gi See Page 2 far
Internet: www.tigard-or.gov BUILDING DWISIONI • N O 60 'me"°d .
. .. • 77_---Supplemelliai Information
1:YrE (AIRK. • '!'.•:.•:.. .' ........ •. • •4f .,.:!.:...• .:.,.. vl . ..::•:.:.:•.FE „...SCVMULE.,., . . , . , . .
CI New construction 0 Demolition Fur special information use checklist
-
Description I Qty. l ha, Total --
E] Addition/alteration/replacement 0 Other; New I- 2-family dweiiings (includes 100 ft. for each utility connection)
::,,;.:. ., . • ....;: :": ' :•.,9N,, :..„, :.:•.. ... . :.. ;... • ( ) t. A 12 , 70
0 I - and 2-family dwelling 18:1 Commercial/industrial SFR (2) high 437.78
SFR (3) bath 50032
0 Accessory building 111 Multi-family
Each additional bath/kitchen 25.02
El Master builder ID Other:
Fire sprinkler ( sq. ft.) Page 2
• . ' • :•'' ''''. " :'.. ''. JOB SITE INFORMATI N .AND ''::1 OVATION • • ::;.,,.. . ' - : -.• • • ' '' ,i P Site utilities.
Catch basin m area drain 18.76
Job site address; 10110 SW NIMBUS
Dryuiell, leach line, or trench drain 18,76
Ciry/State/ZIP: PORTLAND, OREGON 97223
Footing drain (no. linear It; ) Page 2
Suite/bIdg./apt,71.. 13-1 Project name: 5(211011.S BUS. STE. II-1
Munirfacnired home utilities 50,03
..
Cross streelldircctions to job site: /),#O E - 6/2.0--t.,/ e7Z.•_s Manholes 18.76
Rain drain connector 18,76
Sanitary sewer (no. linear ft.; __) Page 2
- " - Storm sewer (no. linear It.: ) Page 2
" - Water service (no. linear ft.: ) Page 2
Subdivision: Tot no.: Fixture or hem: - _,
'fax map/parcel no.: Hackllow preventer 31.27
- -
.:• :: :: . ':';: : :'... :7 :•:.: . ..'.1.b:7.. :..kgiov..**, '..,.: : • "N§.. Backwater valve 12.51
Clothes washer 25.02
RE-LOCATE AND INSTALL A NEW BREAK ROOM SINK
. Dishwasher 25.02
Drinking fountain 25.02
..
.. . „., ...
1-3iectors/sump 25,02
..:.: "..'• ,' : .Q,..OttoPERTYOWNEli. ..:.:..• ,',,..::.. ,...: ...:;.. • ,... ..a oNAST :1.,... .. Expansion lank 12.51
.._
Fixture/sewer cap 25,02
Name:
Floor drain/floor sink/huh 25.02
Address:.
•
. Garbage disposal 25.02
City/State/ZIP;
_ Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
..''''.:,:,,i,,:. ' • : a.APPLII( ANT...:.. ' . :'.,: :1 f : J:: . : .. ' tr ,: i r A1)NE:A.C1'..14iiiSdoN' '.," interceptor/grease trap 25.02
Medical gas (value: $ ) Page 2
Business name: BEAVERTON PLUMBING, IN(:
Primer 12.51
amtact name: CASEY
Roof dram (commercial) 12,51
Address; 13980 SW TUALATIN VALLEY HWY
Sink/basin/lavatory I 25.02 25.02
City/State/ZIP: BEAVERTON, OREGON 97005 Solar units (potable water) 62.54
Phone: (503) 643.7619 LI:i : (503) 643.7620 . . Tub/shower/shower pan 12.51
........_
E-mail: Sue@hcavertonplumhing.com Urinal 25.02
25.02
:..:::.•.:•''.;:...•• • •: ' ' • :'"%:: •::..:1'... ' : :::: •: • ••,:::. .;:, • ' :•• • ' • .,.. Water heater " -
37.52
Business name; BEAVERTON 'TVA/MING, INC
Water piping/DWV 56.29
-, -
Address: 13980 SW TUALATIN VALLEY HWY Other; 25,02
___„ ------
City/State/Z1P: BEAVERTON, OREGON 97005 -. . Subtotal.
- .
Phone: (503) 6437619 Fay. (503) 643.7620 . Minimum permit fee: $72.50 72.50
- ,-
Plan review (25% of permit fee)
CCB Lie.; 12889 Plumbing Liu. no.: 34-4PH
- State surcharge (12% of permit fee) 8.70
„ -
Authorized signatu
'IA', PERMIT FEE 81.20
Print name: SUSAN DEAN Date: 11/22/11 This permit a pplication espi M
rm ii permit is noi obtained within 180 dayx
after it has been accepted as empty*,
*Fee methodology set by Tri-CouniyiloOding Industry Serva4 !loud.
Enuitding■peonasomil.Permitaso do 10(010) 440-46161.(10/02/CONIAWA)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee tt�e'TTtzi... * � Fire Suppression Systems:
Schedule: Residential Fir
.. ��lr(z Ott, @ , ];.•-
Footing drain - 1'p' 50.03 0 to 2,000 $121,90
Footing drain each additional 100' 37,52 2,001 to 3,600 $169.69
Sewer - 1st 100' 62.54 3 601 to 7,200 $2332(1
7,201 and greater $327,54 `
Sewer - each additional 100' 37.52 _
Water Service - 1st 100' 62,54
- Water Service - each additional 100' 37.52 7If1U11.... titelll
Medical Gas S
:..:.....
ee
Storm
& Rain Drain - 1st L00' 62.54 " 'alu Persil '�
51.00 to $5,000.00 Minimum fee $72,50. .
Storm & Rain Drain • each additional 100' 37.52
$5 0i
, 11,00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for
!Other?ijii ,Ong 'or, ;l. eeg ";i,,M; `f ty...: 14ee:rea7' ii, • 1'atal each additional $100,00 or fraction thereof, to
Inspection of existing plumbing or for — and including $10,000.00.
which no tee is specifically indicated 90.00 /hr $10.001.00 to $25,000.00 5148.50 for the first $10,000.00 and $1,54 for
(minimum charge 1/2 hour)
each additional $100.00 or fraction thereof, io
Inspections outside of normal business 90.00 /hr and includin $25,000.00,
hours ( arEe - 2 minimum ch 525,001.00 to 550,000.00 $379.50 for the first $25,000.00 and 51.45 for
hours
Reins (mem Fees 90.00/hr each additional $100.00 or fraction thereof, to
and includin_ $50,000,00-
Additional plan review for revisions 90,00/hr $50.001.00 and up . $742.00 for the first $50,000.0(1 and $1.20 fix
(minimcharge -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 * .
.- •Quaulity by Fixture' , '1: ..
Fixture Type for Replace,/
-
;;Finial kr„ew:fo>gwPlUlt>plbil�t>< • 1181011at1,ODS ; ' .
Work Performed; Cappeu Added Reloca Plan review is required for any ot'the following.
11aptistry/Font — Please check all that ripply.
Bath -Tub/Shower 12 Any new commercial building with water service 2" and
Jacucci /Whirlpool - greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer,
-Drive Thru 0 New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR9I l -780 -0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care &citifies.
—D Domestic — _ D Any multipurpose fire sprinkler system.
Drink' Fountain LI Any complex structure as defined in OAR918- 780 -0041).
Eye Wash
door Drain /sink 2" Submit 2 sets of plans with any of the above.
-3 >, —
Car Wash Drain {. .: Ctii! Isometric ior'R iser.
Garbage i �omcstic - non - food 0 isometric or riser diagram is required tier new buildings
Disposal - Domestic-food related - that meet the qualifications above_
- Commercial -food related
- industrial - food related
Ice Mach./Refrig, Drains
Oil Separator (Gas Manion) _ Comments regarding fixture work:
Rec, Vehicle Dump Station _.
Shower -Gang
-Stall
Sink/Lav - Non -food related 1
- Bradley
Commercial -food related
- Service . i —
Swimming Pool Filter —
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDIIs, a sewer permit will be issued and
Water Closet - Toilet fees assessed far the sewer increase must be paid before the
urinal
— plumbing permit can be issued.
Other Fixtures:
http: / /www.tigard- or_gav /city hall / departments /cd /does/1 PemiitAp s roc