Permit CITY OF TIGARD PLUMBING PERMIT
Et COMMUNITY DEVELOPMENT ® Permit #: PLM2012 -00035
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 � m Date Issued: 02/22/2012
Parcel: 1 S 126CA01000
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 115
Project: Sport Clips Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Interior plumbing. 3/16/12, adding (1) breakroom sink and (4) salon bowls.
Contractor: WESTERN PLUMBING Owner: CAFARO NORTHWEST PARTNERSHIP
9460 SW TIGARD, AVE STE 101 PO BOX 422
TIGARD, OR 97223 FLORHAM PARK, NJ 07932
PHONE: 503 - 639 -5296 PHONE:
FAX: 503 - 684 -9015
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 02/22/2012 $25.02
Specifics: 1 ea Sink 02/22/2012 $25.02
1 ea Water Closet 02/22/2012 $25.02
Type of Use: 1 ea Water Heater 02/22/2012 $37.52
Class of Work: 1 12% State Surcharge - 02/22/2012 $13.51
Type of Const: Plumbing
Occupancy Grp: 5 ea Sink 03/20/2012 $125.10
Stories: • 0 12% State Surcharge - 03/20/2012 $15.01
Plumbing
•
Total $266.20
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 q u e s t . ' . ; • UNC by c. ing 503.232.1987 or 1.800.332.2344. `, r
Issued By: Permittee Signatu �l, `
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.
CITY OF TIGARD PLUMBING PERMIT
1111
2 COMMUNITY DEVELOPMENT Permit #: PLM2012 -00035
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/22/2012
Parcel: 1 S126CA01000
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 115
Project: Sport Clips Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Interior plumbing.
Contractor: WESTERN PLUMBING Owner: CAFARO NORTHWEST PARTNERSHIP
9460 SW TIGARD, AVE STE 101 PO BOX 422
TIGARD, OR 97223 FLORHAM PARK, NJ 07932
PHONE: 503 - 639 -5296 PHONE:
FAX: 503 - 684 -9015
FEES
Quantity Description Date Amount
1 ea Floor Drain/Floor Sink/Hub 02/22/2012 $25.02
Specifics: 1 ea Sink 02/22/2012 $25.02
1 ea Water Closet 02/22/2012 $25.02
Type of Use: 1 ea Water Heater 02/22/2012 $37.52
Class of Work: 1 12% State Surcharge - 02/22/2012 $13.51
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $126.09
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.
i
Issued By: /". � Permittee Signature:
Ca 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.
02/16/2012 14:32 5036849015 WESTERN PLUMBING INC PAGE 01/03
Plumbin Permit Aaulicatlo EC E I lE D
51 ,c,¢olc,00 S Rio x
Building Fixtures FEB 1 6 2012
FOR U! F'IC E 1:Si':'A 1,
City of Tigard Blvd CITY OF TIGA "D g �"VA 1 t
p 13125 SW Hall , Tigard, Cut
> 1!1 rrrmtt lro,; �,
I .,...._ e .., > : 503.639.4171 Far 503.59 . 4 DING DIVISION o.: '
t>r wit.:
Inspection 1,inet 175 , ' -
Trc.,�u1� vrww
..r.::•.,.� lnfotm
Daft
Ready/By: g1
S ec 1' Z far v Page
N
:
,��`•„ i �.,, :.i :.v.. :. 4 ?; � SU ' plealtlRnl
❑ New construction ' �_, a S 51�!C� I '' r . : : % . : r�
oa ❑ Demolition • For apeaiaiinformaaon we aher&i&
4� Addition/attetabiodreplacemeat Q Other New 1- Upton I 'Qty. Ea. I _ Total
c ry� , dwellings (includes 100 a for each utility connection)
';J;i ,; i. : : :: W 'jit,6 vIki � e o�,*s(J . '' � ,: � . " . S 1 bath `
.....,.. Ti ..., „,�:.:,.;•s� . > '_ ,:... ?� � .'
�rc� ° •.� O I 312.70
❑ 1 - and 2 -family dwelling OCommerciaVwdnstr al SFR (2) bath 437.78
❑ Accessory building CI DBuUi- lstni(y SFR [3) bads 50032
El Master builder ❑ Other: Each additional bath/kitchen. 25.02
,,., :. 'r'� yj� ■uryy� O
�� 7� {,. ..-. Hesprinkler �sq.it -) Page
. +.. .:• ``, Iil+l inifQ i7'.� I:4V *A�10 *.: • .iY. :..',',.,: .; Site r
Job site address: A 1 a Catch basin or area drain 18.76
City/Stet /ZIP: i 1rn re A I Diywe3l, teach One, or trench dram 18.76
� I Footing drabs (no. linear }!- �) Page 2
Suite/bldg 7 - ) 1 ° apt. no.: l s Project name: 7 - t yC Manufactured home nines 50.03
Cress snct/directions to job site: ` J i Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear B.: `) Page 2
Storm eewcr (no. linear R:, ) Page 2
t Water service (no. linear ft _,_) Page 2
Subdivision: l Lot no,: Fixture or Item_
—
Tax map /parcel no.: Baddluw prsvettter 31.27
',Y:; j' '< rri ' >1' � ; ;�.:, i�LC Q :'Q �� ::•' Backwater valve 2.5
,X '; , .... .Y . C2othea washer 25.02
Dlthvvasher _ 25.02
UUU Drinking fountain 25.02
Ejectors/sump 25.02
_4, :' "YxCt : n .l,f , ".;;`> , : ". `: y;. : ' . ontaak 1231
rY..ri ..
Name Fixtticdaewer cap 25.02
Ad dress: Floor dmilu/floor sink/hub + . m , ;�
City/Stare/ZIP:
/ZIP•
HOW bib disposal 1
ose bib , .
Phone: ( jj)
•''.' ��,yy ' Far ( ) Ice maker _
•?.:,; J • _P i'i ., .1.; 7.;4: '. -.e �.,�,,�. ., . ;' L 1� tra 1
,.. � �.: .. ����:�1�' ,,�. � �P�' /gam P
Business Haute Medical gas (vable: $ )
Contact came: Primer
Address: n
Roof drain Commercial)
Sink/basin/lavatory I P-02 . ` U d
City /State/ZIP
Phone: _ scams (potable water)
( ) Face : ( ) TuNehowerlahower pan
Prmali:
Urinal
i 'yt,: "•r.S'(: -: . , .y,. :,.: • .; e� WOW C1O c
water heater ` 37.52
Business name: Western Ptwnbheg, Inc. ,
water pip /Owv 56.29
-
Address: 9460 SW 1Ygard Avenue Suite 101 Other: 25.02
Carty /StateIZ1P: Tigard, OR 97223
Subtotal /' IAA a
Phone: (503) 39Sd96 Far (503)684-9015 Minimum peanut feel $72.50
CCB Lie.: 2439 Plumbing Lie, go.: 34. -29TH Plan review (25% of perntit fee)
State surcharge (12% of permit fee) ,,, * 151
Authorized signature �� . , /` I / . TOTAL PERMrr a
Print name: Dana Jensen f T.4e•0 - /(0.- l a niipermitappuciuonend.. If a permit is not olnatned • . : ■
after it has been accepted as complete.
..K. .. //��
..noehnrint.,,.r aril., Thu..
m.., a, l4:na r..4......, R-.,, • • • opIto .d-1
02/16/2012 14:32 5036849015 WESTERN PLUMBING INC PAGE 02/03
PlumbinkPermit Application - City of Tigard .
Page 2- Supplemental Information
Fee Schedule: Residential Fire Su , I ression S 'stems:
okutirieolgWIOi'iNqpi g$iiiiiii*Vii,ii e.iiiii
Footing drain - l 100' 50.03 0 to 2,000 $121.90
Footing drain - eacb additional 100' — 37.52 - 1,001 to 3,600 $169.69
3,601 to 7,200 $233.20
&vow - 1st 100' 62.54
7,201 and $_....._v_..._.754eater .
Sewer - each additional 100' 3732
Water Service - 1st 100' 62.54
Medical Gas Systems:
Water Service - each additional 100 37.52 ...,__
WaiiiidiliV;'.:: , ' -.: ' ' :-: -:. : , ::?::'
Moon & Rain Drain - 1st 100' 62.54
$1.00 to $5,000.00 Minimum fix $72.50
.
Storm & Rain Drain - each additicood 100' 37.52 $5,001.00 to £10,000.00 $72.50 for the first $5,000.00 and $1.52 for ---
nitiitiiiiiiiiitiiiiik.00:4:g-5. .: - ::,x.-64t,,; . -::,it.44 ,- . , , , , each additional $100.00 or fraction thereo4 to
and including $10,000.00.
Inspection ofesisting plumbing or for
$10,001.00 to £25,000.00 $148.50 for the fast $10,000.00 and $1.54 for
which no fee is specificalty indicated 90.004n
each additional $100.00 or fraction thereof, to
mininshour
and including $25,000.01
Inspections outside ofnormal business 90.00thr $25,001.0010 $50,000.00 $379.50 fortbe first $25,000.00 st7t $1.45 for
hours (minimum charge -2 hotels)
each additional $100.00 or fraction thereof, to
Rcinspection Fees 90.00/1a " , and including $50,000.00.
Additional plan review Ror revisions 90.00/br $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum chain? -1/2 hour) each additional $100.00 or fraction thereof
--_____________
Subtotal:
--..
".• 1.•111■1 NE I i I ■Fl,,,.,,............ ......... ,..,... ,........I
Commercial Fixture Work
Are you capping, adding or replacing fixtures? If "yes",
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees'. Please check all that apply.
- •,...,..... - ' ,, ,•:P.:N•_-::'!; : .;;' , 4', ,. .,:;;;°1•r : 7::::: ,,••••• I ; '••• -.. "..14114iiiii•WWiliklinstiiiies .);
fl Any new commercial building with water service 2'' and
except systems designed and stamped by licensed
':, ' ,•-:; s:•:•,:::,..:: •4 • • ‘, 'Ariaa'; ;:4;'-•- ,:: :) engineer.
Baptistry/Font
0 New exterior plumbing site utilities for may complex structure
Bath -Tub/Shower
as defined in OAR9IS
Jecuzzi/Whirlpool .
0 Medical gas and vacutnn systems for health care facilities.
Car 'Wadi -Each Stall
- Drive Mau 0 Any multipurpose fire sprinkler s
Cuspidor/Water ystem.
. • 0 Any complex stud= as defined in 0AR918
Aspirator . ,
Dishwasher -CoMmercial
, ---. Submit 2 sets of plans with any of the above.
-Domestic
Drink . ; Fountain
Eye Wash 1.,_,y;-7.N:8-'7:4t-i440W.0exoefo,),Iagovg:..-:::;K5':ii.::::
Floor Drain/sink - 2" I LI Isometric or riser diagram is required for new buildings
"
-
- 3"
. that meet the qualifications above_
4
Car Wash Drain .. .
Garbage -Domestic
Disposal -Commercial _ -
' -industrial Comments regarding future work:
Ice Machillefrig. Drains '
.
Oil Separator (Gas Station)
Ran. Vehicle Dump Station
Shower -Gang
Sink -Bar/Lavatory - 1 ,,. •
-Bradley
-Commercial
*Note: If the fixture work under this permit results in an
,
-scryico
.
increase of sewer EDUs, a sewer permit will be issued and
%victuals' g - Pool Filter . fees assessed for the sewer increase must be paid before the
washer - Clotheit
Water Extractor plumbing permit can be issued.
... .
water Close: - Toiler 1
Urinal
,
Other ruaanes: —
■i
•
03/15/2012 09:49 5036849015 WESTERN PLUMBING INC PAGE 01/01
I
Plu Permit Application i ..' -/ ' . ../ , 0 . /
Rai ding Fixtures
City of Tigard Received
19111 0 13 175 SW Hall Bl vd, Ti gard, OR 97 223 Y /5 I5 • PamitNo.: ,. A 0003
. Phony. 503.639.4191 Fa>c 503.598.1960 Plan Review
Other Permit No.:
I l G r. P. n
Inspection Line: 55033.639
Internet www,ti Notified/Method; i Ready/By: bass S Boa Page I fir
.:�, ; i^ {, , ;;' / 1 . , 1 Supplemental lnrormation
`:::..�.i'; t •': TY E:'.OP� Vtf� .�C1.�ti ,. r . . '
❑ Ne� Construction � , �� � , , ': • •�' 'ETLIE . , : . •...::
❑ Demolition Forrpecia� usecheckiitn
►' tionJalteratiodrtpisataeat ❑ Other: New .: Ott •u . Ea. Total
New 1- 2 -t R Y .1 i - (includes 100 ft- for each utilit connection)
.. , . , ..: A 3;'i • e: i 0, SFR 1 bath 312.70
..,� F ... ..... .. :, ? :. ....... _.. . ; .. ()
Ci 1- • , • 2- famaly dwelling T, .CnloumerciaUmdu*ial SFR (2) bath 437.78
■ ■ Multi-family SFR 300.32
Each additional batliddtoliea 25.02
0 Master builder El Other Fire sprinkler ( eq- ft4 Page 2
Site utilities:
. lP R ` : Catch basin or area drain 18.76
t . • lhywcll leant line, or bench drain 18.76
1 Footing drain OW. lines ft: _) Page 2
ait
Manufactured home utilities 50.03
• Manholes 18.76 Rain drain connector EMI
I
Sanitary sewer (no. linear ft.: ,,,) Page 2
Storm sewer (ml. linear tt: ,) Page 2
Water service (no. linear ft: ) Page 2
t Y g t �•
� kfl premier Eli 31.27 • 1 • o - • , Backwater valve 12.51 MIN
MB r1 it. ^ FA MI 25.02
.11111 aD/ 2-- 0 35" Dishwasher 25.02 Drinking fbnetain 25.02
Ejectors/sump 25.02
,. . :7C 6�.` • It M :
��" ;� • �' 1�� (�, Al Expansion 12.51
Name: i O t1/4.-V i l );".)QA F11 X'41,1/ f l A.� 25.02
Address �� Q
tl
Floor drain/floor cult/hub 25.02
• Garbage disposal t_ t ■ ' // 25.02
' IP: 1 a i
LA �.. � ®
Phone: (; ) Fax ( ) maker .
° o ceP /Br taP 25.02
Medical gab (value: S ) � Page
1 2 III
Roof •.. _�
Stakthasiallawilary =II 25.02 p
• Solar units (potable water) 62.54
Urinal 25.02
Business name: Western Plumbktg, Inc. Water pipingiDWV 56.29
Address: 9460 SW rived Avanue Suite 101 Other: 25.02
City/Statf!LIP: Tigard, OR 97223
Phone: ( 13) 639 -5296 Fax: (503) 684.9015 Minimum ,
Plan review (25% of penzut fee)
CCB Lief: 2439 Plumbing Lis no.: 34.29PR
Autholizfd signature: . / dr ) ,k . IP' . `� • state age (12% of permit fee) fi��rr--, d I
Punt n .. e: Dana Jensen 4 iip .:. r This p enok a TOTAL rERM1T FEE 1 18
0 days
•_1. _ 1 , PP4mtlon e yea ir permu t nw obtained within 18
alE it 4aa been ttaepted as c ompl ete.
•A w• lw Toirr.wmro AnilAine. t..A...s.. R.., ,.. Ana.*
1 '