Permit •
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2009 -00203
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/27/2009
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L6
Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project: NW Computer Support •
Project Description: TI
Owner: FEES •
ROBINSON, CONSTANCE A & Quantity Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT
MGMT, 10240 SW NIMBUS AVE #L3 1 ea Ejectors /Sump 07/27/2009 $16.60
1 ea Sink 07/27/2009 $16.60
PHONE: 1 12% State Surcharge - 07/27/2009 $8.70
Plumbing
Contractor: 39 ea Minimum Fee Adjustment - 07/27/2009 $39.30
Plumbing
BEAVERTON PLUMBING INC
13980 SW TV HWY
BEAVERTON, OR 97005
PHONE: 503 - 643 -7619
FAX: 503- 643 -7620
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Type of Use: COM
Class of Work: ALT ' Type of Const:
Occupancy Grp:
Stories:
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Total $81.20
Required Items and Reports (Conditions)
1 Pln Gen INSTALL 12 ADDTNL PKNG SPACES
2 PIn Gen PLNG DIV. FINAL INSPECTION
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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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued By: „ n X p 11 9 ,� ^ Permittee Signature: ^ ,� ;J . t : M
1 l C.. � C } al ll l 503.639.4175 by 7:00 a.m. for an inspection that business day.
1F') (1JLJ1 l
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.
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a .
PlumbingPermit App
!... ..,.evED
Building Fixtures FoR ()H. t V. ON I
JUL
City of Tigard 2 7 2009 Received
, I Permit No.:.11
DatelBy: • e if .
II II I ,-- • 13125 SW Hall Blvd., Tigtell ■••
II • Phone: 501639.4171 1,4531 RD Piaa Review
Date/By: . Other Permit No.3,0e700q .00a72
D
TIGARD inspection Line! 503.63RIFa ING DIVISION
r x i m Ready/Ay! J i ; El See Pate 2 for
Internet: www.tigard Notified/Method: II • Su • • mental information
4tiiiii n i-.00*
................_::_.........
0 New construction 0 Demolition For special Wonnotion use checklist.
• Description I Qty. I Es. t Total
ts1 Addition/alteration/mplacement 0 Other: , New 1 - 2-family dwellings (includes 100 R. for each utility connc.ction)
• • .....•. ,,
'21 :4;••f,:Acl'I r •ii*:00igik 1 70:04 4 •#*,000' i i'N:54: . 4 j! SFR ( bath 24920
0 1-and 2-family dwelling 181 Commercial/industrial SFR (2) bath 350.00
0 Accessory building CI Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
CI Master builder CI Othe.r:
Fire sprinkler ( sq. ft.) Page 2
- 1 01 ;i,
;11.4.040,0:40:007044...00.t site utilities
Job site address: 10240 SW NIMBUS AVE UNIT-1716-81.4217 L( ci- L 7 Catch basin or area drain 16.60
City/State/ZIP: TIGARD Drywall. leach line, or trench drain 16.60
Suite/bldg./apt. no.: I Project name: 1 iJ (0 Q orivi 3 Fooling drain (no. linear ft.: _J Page 2
Manufhetured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
, Rain drain connector 16.60
Sanitary sewer (no. linear ft.; _1 Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision; _......._ ,... Lot no.: Water service (no. linear ft.: )
I Page 2
- Fixture or item
Tax map/parcel no.: ?) 4-42\ a I ('1) --1 ,.._.......,,...„...... Absorption valve 16.60
!,::,•;:::rj„;,,f0•:-:;gi.A.::.-,.R,ii.,,e;,,p.Tifigo'fikixiiiiji*ititioNiq:NfAt.,..).!:,:y,,..,.„A:.:.,;;;::, Page 2
INSTALL BREAKROOM SINK NEED SAMLL EJECTOR TO PUMP WASTE Backwater valve 16.60
, -
RESTROOM FINISHED OFFICE SLAB ON GRADE Clothes washer 16.60
Dishwasher 16.60
. . _
:' iii 4iidiiiiiifirel "Wiiike.0..'41','...!::Ori:i*i.iiiiii.,.N :...., Drinking fountain 1 16.60
1 16.60 16.60
Name: Expansion tank 16.60
Address: r Fixture/sewer cap 16.60
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City/State/ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax ( ) Garbage disposal 16.60
- ....;:?.Y3.. 1:O:t4iVfg2.,.?"4:,V.:...,,, ...,',.. Hose bib j 16.60
Ice maker
I 6.60
Business name:
- Interceptor/grease trap 16.60
Contact name: Medical gas (value; $ ) Page 2
Address: Primer 16.60
City/State/Z1P: Roof drain (commercial) 16.60
Sink/basin/lavatory _ 1 16.60 16.60
Phone: ( ) Fax: : ( ) -
Tub/shower/shower pan 16.60
E-mail: . '
Urinal 16.60
;Ift:;1.,- Oti.#.47:f .. ..9.*Rff..M:S.: , .. 2..'.;.':i %rata dont 16.60
Business name; BEAVERTON PLUMBING, INC Wider heater 16.60
Address: 13980 SW TUALATIN VALLEY HWY , Other:
City/State/ZIP: BEAVERTON OREGON 97005
Minimum permit Subtotal 13.20
Mn t fee: $72.50
Phone: (503) 643-7619 Fax: (503) 643-7620 Residential backflow minimum permit fee; $36.25 72.50
CCB Lie.: 012889 f) , , Plumbing Lic. no.: 34-4PB Plan review (25% of permit fee)
.. State surcharge (12% of pennit fee) 8.70
Authorized sign . ' A g - ,
TOTAL PERMIT FEE 81.20
Print name: TINA QUELLA Date: July 27, 2 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Foe methodology set by Tri-County Building Industry Service Board.
muiisiainPerreitowv-Parnil.App.dee 12/77/06 4404616T(100021COMNIEB)
.07/27/2009 09:55am #499 Page 03/03
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
ts► s . :
• . :: : ..... .. . ,Qy c ..) : t oa ' 'PerifTe
SYI l �•` ,;.... i . r�, r. .:�a °�: s., .,.i r.. �.<.1�: , ,:'+:h,� , 1 . 1 ... t �. f :
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Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 -,-
Footing drain - each additional 100' 46.40 2.001 to 3,600 $160,00
3,601 m 7,200 $220,00
Sewer - I st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.4
WaterService - 1st 100' 55.00 Medical Gas Systems:
Winer Service - each additional 100' 46.40 fir i '1 i i k •; 4:,:::.::;
Storm et 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
: ure "u `" T l . t . , ;;P r Td additional $100.00 or fraction thereof, to and
.. -_tom... t. t.e ?41411`tiT:yi•:`�ar xu ii.;:1 'a •C. c'- ': .'..... - including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to 525,000.00 $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 $3625) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379,50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing each additional $100.00 or fraction thereof, to
g P 8 or and including $50,000.00.
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specially requested inspectionser hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
a
Commercial Fixture �• ;.. , ..:. 1
Ca i7cture Work: ,� , � 'PlauR��ie�;foerr.[um�lil��`s'ta
'llati'io ' � • • .
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ My new commercial building with water service 2" and
..,_: • , , .
:, ,.;,,., _,,, N .. ' ,; , greater, except systems designed and stamped by licensed
, � ,i. i,rn .t `:i% 4:i. e $ ' e. ititya$1(`.1Y`tute .r, . _ °oiEd.
yAv,S .i 'alu.; -.; 1,:k., .;,alrc'}i .i..1` ): `., ; ; ;y;:;; .: :. i 1 ' 0 : :: . engineer.
' ?? ° 1..;..::w 0: :, !1! :? 5': ¢ : .., ■+; ; i :.7 rit , ,:itddi f ` :'thin: ❑ New exterior plumbing site utilities fur any Complex structure
e ,..tis /Font as defined in OAR918 780 - 0040.
Bath - Tub/Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool _ ❑ My multipurpose fire sprinkler system.
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Car Wash -Each Stall ❑ My complex structure as defined in OAR918 780 - 0040.
-Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
-Domestic ;• :1 fi!;P : : : • . . . : ometnc .. s : ` D
Drinking Fountain . '`I9r. . 8 111 '' '�� 's .....
Eye Wash 0 Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" _ that meet the qualifications above.
-3"
- 4^
Car Wash Drain _
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- industrial
Ice Mach /Kvfrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Rer/Lavatory _
-Bradley *Note: If the fixture work under this permit results in an
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter - plumbing permit can be issued.
Washer - Clothes ,
Water Extractor
Water Closet - Toilet -
Urinal
Other Fixtures: -
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ostildinatPecmiuWlMAemtifApp.aoc 12/21106
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