Loading...
Permit I ' CITY OF TIGARD PLUMBING PERMIT �t DEVELOPMENT SERVICES PERMIT #: PLM2003 -00509 +L t 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/18/03 SITE ADDRESS: .J AVE - /D350 Su) L! /l 6I- Sr PARCEL: 1 S135AB -00100 SUBDIVISION: TOWN OF METZGER ZONING: R -4.5 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: 2 MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: 1 \- BACKFLOW PREVNTRS: 2 • OCCUPANCY GRP: El FLOOR DRAINS; 25 TRAPS: 1 STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 60 URINALS: 8 GREASE TRAPS: LAVATORIES: 20 OTHER FIXTURES: 54 • TUB /SHOWERS: SEWER LINE: ft ' WATER CLOSETS: 30 WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Building fixtures, 1650' of footing drain, other fixtures are: (3) drinking fountains, (1) sump pump, (2) expansion tanks, (26) hose bibs & (22) roof drains. FEES Owner: Description Date Amount WASHINGTON CLACKAMAS CO SCHOOL DIST 23J [PLUMB] Permit Fee 11/18/03 $4,230.20 6960 SW SANDBURG STREET [PLMPLN] Plan Review 11/18/03 $1,057.55 TIGARD, OR 97223 [TAX] 8% State Surcharp 11/18/03 $338.42 Phone : Total $5,626.17 Contractor: POWER PLUMBING CO P 0 BOX 19418 PORTLAND, OR 97280 REQUIRED INSPECTIONS Phone : 503 Rough -in Insp Top -out Insp Reg #: LIC 52378 Rain Drain Insp PLM 34 - 150PB Drinking Fountain RP /Backflow Preventer Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issue ` _ . ' , " L , Perm ittee Signature: _ _ i Call (5s3) 639 -4175 by 7:00 P.M. for an inspection needed the next business day Building Fixtures a-00.5-00371 Plumbing Permit Application FOR OFFICE USE ONLY Received / ,,,, Plumbin 1n Date/By: 495 / O Permit No • /4 I 19-0 0 3 -00 5. 7 /+ CI of Ti and �����® Planning Approval Sewer i2a� - O03� �J g Date/By: Permit No.: C41 7 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 SEP 25 Date/By: 9 1d 3 Permit No.: Phone: 503- 639 -4171 Fax: 503 - 598 -l96U Post Review Land Use / / �a o '4' (' �� - Date/By: Case No.: Internet: www.ci.tigard.or. sc T , RO ` . I f I Contact JJuu .s . El See Page 2 for 24 -hour Inspection Re q uest 1 ISI�N Name/Method: / /6 Supplemental Information. - ; ,, , TYPE QF``WORK : .-• •••,...;',', ',, ' • . , `.F "SCHEp J .;E:(for speciahinfgrinatigriiise checklist) . • New construction El scri Demolition Description I Qty. Fee(ea.) I Total \ El Addition/alteration/replacement ❑ Other: . >> - A , .# New..1 -f &2- family `d ,ellingf. . CATEGORY=OF C _ O) STRUCTiON - : r_ • f• �''' : , inclydes,�00 ft. foreac6�u i ty conn '�_ -i h ` SFR (1) bath 249.20 ❑ 1 & 2- Family dwelling IV Commercial/Industrial SFR (2) bath • 350.00 ['Accessory Building ❑ Multi - Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00 ` - ' JOBISU;I:t. INFORMATI,ONand7L CA- ON ' . - .: Fire sprinkler - sq. ft.: Page 2 Job site address: 1615 .S C IO ^ . En ., ,..- d Site Utilities ' <a., {, , Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60 Pro' ect Name: r" �{,t2. cik,s5k Drywell/leach line/trench drain 16.60 Footing drain (no. linear ft.) ✓ 16s0 Page 2 79,, `/0 ross treet/Directions to fob site: Manufactured home utilities 110.00 // - � l�C,�S�' L v�W� Manholes 16.60 ✓1 Rain drain connector 16.60 - k Sanitary sewer (no. linear ft.) Page 2 Subdivision: I Lot #: Storm sewer (no. linear ft.) Page 2 Tax map /parcel #: Water service (no. linear ft.) Page 2 .. - DESCRIPTION OF WORK » . ;� ixtur or Item.. - - ' . l Absorption valve 16.60 7 Ift Wt. 4 S uk,∎ Pk w4�.,tp n.%Ai a Backflow preventer / 1 Page 2 4 t LA5 J Backwater valve 16.60 Clothes washer , / % 16.60 /to .490 Dishwasher / / 1 16.60 /6 Drinking fountain / / 3 16.60 P y . so ROP RTY OWNER ,' ' • • k ❑'T�EZ�A1�T •�.= . J '''''•' Ejectors/sump / 1 16.60 /6.649 Name: S l Vevi R Expansion tank / • 16.60 33 , Address: 640 Ky .. ) N It Fixture /sewer cap 16.60 City /State /Zip: �� S'' OQ q � Floor drain/floor sink/hub !i 16.60 Ig/ /, j do 3 Garbage disposal / ,2. 16.60 3 ?, . gb Phone: cnk- goo Fax: co\ - 4037 Hose bib f 7.(, 16.60 i/;5 /, /00 *El :APPLICANT - . ` , -, =CONTACT,PERSON` ' "' • Ice maker 16.60 • Name: C . s � U p ( t•ta...- P.1)„)4 N Interceptor /grease trap / \ 16.60 /(o. Address: isktz> SW t ply ) ,Sk Z Medical gas - value: $ Page 2 City /State /Zip: F o q�z3 Primer 16.60 � I Roof drain (commercial) / 16.60 346: ark Phone: /act- Fax: 2 Sink/basin/lavatory , J) 16.60 / 3a e . C E -mail: t , c , n ly t „p v-A. _cit Tub /shower /shower.pan 16.60 ,- `; ;CONTRACTOR � '.' ` . - Urinal / I B 16.60 / 3A. Business Name: pc /04 L Water closet ,i SD 16.60 y98 . on Address: Water heater i 2 16.60 3 3 .� Other: City /State /Zip: Other: Phone: Fax: ' . ;, 'Plumbpng Perinit' Fees. „ . ` ' • - CCB Lic. #: Plumb. Lic. #: Subtotal $ Minimum Permit Fee $72.50 $ 22 Authorized Residential Backflow Minimum Fee $36.25 � ,[Q, 0-0 Si ' Signature: - Date: 4 1113:143 r / Plan Review (25% of Permit Fee) $ /O 5 7. 5S - , , State Surcharge (8% of Permit Fee) $ 3 $ . ` ., (Please print name) TOTAL PERMIT FEE $ 5/p,;t6 , /7 Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri -County Building Industry Service Board. i:\Dsts\Permit Forms \PlmPermitApp.doc 01/03 3 \ Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information • Fee Schedule: Residential Fire Suppression Systems: : ..Site Utilities • Qty. Fief* 1 offal Square Foofa t Permit Fee: • Footing drain - 1" 100' / 55.00 . 5 DD 0 to 2,000 $115.00 Footing drain each additional 100' (p 46.40 NoV7G 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation• ' Permit Fee•, Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each r - Fiztuire or Item Qty Fee (ea) additional $100.00 or fraction thereof, to and • including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $37950 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof', to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. Quantity by (Fixture) Work Performed Comments regarding fixture work: Fixtur_eType: , ' Replace< Nevi; . Moved Existing ' apped Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool • Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial I - Domestic Drinking Fountain 3 2 Eye Wash Floor Drain/sink - 2" -3" • 4 .. Car Wash Drain *Note: If the fixture work under this permit results in an Garbage - Domestic Disposal - Commercial Z 2 increase of sewer EDUs, a sewer permit will be issued and - Industrial fees assessed for the sewer increase must be paid before the Ice Mach./Refrig. Drains _ plumbing permit can be issued. Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar/Lavatory •ZO l Y • - Bradley - Commercial - Service 60 4B Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet SO 23 Urinal e) Other Fixtures: c L . - kolas $ -2 Ao ae t; - 26 RoaC ea t i:\Dsts\Permit Forms\PlmPermitAppPg2.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST ;3! 34 ( 0 Col u BUP l ir Received Date Requested � ePM BUP Location I © 5ED S. / . Yl Go ) VI cl Suite MEC Contact Person /A )G Ph ( 5 Si PLM (9 577? Contractor Ph ( ) SWR ' BUILDING Tenant/Owner LA 2 Zn A ) ZX-io ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear / / / �/ Framing i /i - = Insulation Drywall Nailing Firewall J Fire Sprinkler y Fire Alarm a*umurAir �` . r Susp'd Ceiling / Roof Other: AV,���rAV / // ./ Final . PAS 'ART FAIL r " • & Beam Under Slab Rough -In I ,a / i Water Service lilt ��� - � �� ! �� - _ � _ - — vow Sanitary Sewer Rain Drains / Catch Basin / Manhole Storm Drain Shower Pan AillIF Other: / ��7�r�i� Arr5P- �J t R FAIL ECHA AL — Post & Beam , 11. / 4 Ro • h -In �� ' / mo e Dampers if � f�i Final AV OP'■ Car PART FAIL ELECTRICAL ' Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date _ Inspector Ext Other: Final DO OT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST // BUP Received Date Requested 7 - AM PM BUP Location / Suite MEC Contact Person Ph ( ) ° )9 g5S7 PLM 0203--0 O Contractor , Ph ( ) SWR BUILDING Tenant/Owner / ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall -. / /�� j / Fire Sprinkler ! ; � � 1� Fire Alarm i Susp'd Ceiling _ Roof !j Other: — — Final PASS PART FAIL PLUMBING Post & Beam Under Slab > Rough-In Se W / Water Service �� Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain o Shower Ran / L Other: n / � - // J -F . PART FA HANICAL /�Li `��/ Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA 1/( Approach/Sidewalk Date / D Inspector #2�� Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL