Permit •
CITY OF TIGARD argala PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2012-00059
TI G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2012
Parcel: 1S136 DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST 160
Project: Shell Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: Interior plumbing. 4/26/12,reprinted to correct tenant name from Tao Nail to Benitoite Nail.5/10/12,reprinted to
-
correct project name to Shell. "
Contractor: ATLAS PLUMBING CONTRACTORS Owner: AMERICAN INDUSTRIES INC
P.O. BOX 1352 1750 NW NAITO PARKWAY
RIDGEFIELD,WA 98642 PORTLAND, OR 97209
PHONE: 360-887-8054 PHONE: 503-478 6603
FAX: 360-887-8504
FEES
Quantity Description Date Amount
1 ea Sink 03/15/2012 $25.02
Specifics: 1 ea Water Closet 03/15/2012 $25.02
1 ea Water Heater 03/15/2012 $37.52
Type of Use: COM 1 12%State Surcharge- 03/15/2012 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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 questio OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Signatu • le/44-1/4_
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 E r PLUMBING PERMIT
COMMUNITY DEVELOPMENT ' Permit #: PLM2012 -00059
® / Date Issued: 03/16/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S136 DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST 160
Project: Benitoite Nail Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: Interior plumbing. 4/26/12, reprinted to correct tenant name from Tao Nail to Benitoite Nail.
Contractor: ATLAS PLUMBING CONTRACTORS Owner: AMERICAN INDUSTRIES INC
P.O. BOX 1352 1750 NW NAITO PARKWAY
RIDGEFIELD, WA 98642 PORTLAND, OR 97209
P
PHONE: 503 -478 -6603
PHONE: 360 - 887 -8054
FAX: 360 -887 -8504
FEES
Quantity Description Date Amount
1 ea Sink 03/15/2012 $25.02
Specifics: 1 ea Water Closet 03/1512012 $25.02
1 ea Water Heater 03/15/2012 $37.52
Type of Use: COM 1 12% State Surcharge - 03/15/2012 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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:( V� Cl te.AI� ANN Permittee Signature: _ 6
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.
a CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2012 -00059
Date Issued: 03/16/2012
TI GAR.1D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S136DCO2504
Jurisdiction: Tigard
Site address: 7275 SW DARTMOUTH ST 160
Project: Tao Nails Subdivision: HUNTER POLLOCK NO.2 , Lot: G
Project Description: Interior plumbing.
Contractor: ATLAS PLUMBING CONTRACTORS Owner: AMERICAN INDUSTRIES INC
P.O. BOX 1352 1750 NW NAITO PARKWAY
RIDGEFIELD, WA 98642 PORTLAND, OR 97209
• P
PHONE: 503 - 478 -6603
PHONE: 360 - 887 -8054
FAX: 360 - 887 -8504
FEES
Quantity Description Date Amount
1 ea Sink 03/15/2012 $25.02
Specifics: 1 ea Water Closet 03/15/2012 $25.02
1 ea Water Heater 03/15/2012 $37.52
Type of Use: COM 1 12% State Surcharge - 03/15/2012 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
Required Items and Reports (Conditions)
All
This permit is issued subject to the regulations contained in the Tigard Municipal Code, tate o OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will -xpire if work is not started within s of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law require- you to ollow the les adopted , �e Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 95 - 001 -0091. You obtain .. y of the rules
or dir questions •UNC . ailing 503.232.1987 or 1.800.332.2344.
Issu d By: 1 , I //, r I Permittee Signature: '&1440 / I l
/Ll_r� / I�
•
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.
•
Mar 1412 03:02p • Atlas Plumbing Contractor 360 - 887 -8504 p.3
Plumbing Permit A
f!" pplication ��
Site Utilities ` \�, 1 • . / 5t j 2 _ 2. 1,,1.
I ur. 01 Fl('I: i Se.: Om ,
City of T' and ! > 10 eul.ba 13125 SW Hall Blvd, Ti Q 1_► �� Permit No.: L
7111 • gard, OR t\104 1-
AQ` \C? . \ - rA a ....0 .
to \V ` �� Pla Re
O
Pho ne: 503.718.2439 Fax 503 . 59 8.1960 of \� Other Permit No.: o r^
1 c:N 1, o Inspection Line: 503.639.4175 � O Date R Da I. I -' i, /1 / t �
Internet www.tigard- or.gov C j\ \� ��: r'" Sce�.ge2for
■
Notified ,Method: / Supplemental Information
' TYPE OF WORK �) FEE* SCHEDULE
o New construction ❑ Demolition For specM Informaijon axe checklist
Description I Qty. I EL I Total
CO Addition/alteration/replacement _ ❑ Other New 1- 2-family dwellings ngs (includes 100 R for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
❑ 1- and 2- family dwelling ® Commercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 50032
❑ Master builder Each additional bath/kitchen 25.02
❑ Other: Fire sprinkler ( sq. R) Page 2
JOB SITE INFORMATION AND LOCATION. Site utilities:
Job site address: 7275 SW Dartmouth St
Catch basin or area drain 1 18.76
City. /State/ZIP: Tigard, OR 97223 Op well, leach line, or trench drain ! 18.76
Suite/bldg:rapt. no.: 160 I Project name: Tao Nails Footing drain (no. linear ft: ) p 2
Manufactured home utilities 50.03
Cross street/directions to job site: Manholes Af] C 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear R: _) Page 2
Storm sewer (no. linear R: _) Page 2
Water service (no. linear R: ,_) Page 2
Subdivision: I Lot no.: Fixture or item:
Tax map/parcel no.: 1S136DCO2504 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater salve 12.51
Install plumbing fixtures for new tenant Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
' Ejectors/sump 25.02
® PROPERTY OWNER . [ 0 TENA.riT Expansion tank
12.51
Name: American Industries Inc Fixture/sewer cap 25.02
Address: 1750 NW Front Ave Ste 106 Floor drain/floor sink /hub 25.02
' Garbage disposal 25
City/State/Z2 IP: Portland, OR 97209
Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51 '
® APPLICANT ❑ CONTACT PERSON • Interceptor/grease trep 25.02
Business name: Atlas Plumbing Contractors Medical gas (value: S _ ) Page 2
Contact name: Travis Zea Primer 12.51
Address: P.O. Box 1352
Roof drain (commercial) 12.51
Sink/basin/lavatory 1 25.02 25.02
City /State/ZIP: Ridgefield, WA 98642 Solar units (potable water) I 62.54
Phone: (360 ) 430 -5765 I_ Fax:: (360) 887 -8504 Tub/shower /shower pan 12.51
E -mail: tavis(a atlasplambingeontractors.com Urinal 02
CONTRACTOR . Water closet 1 25.02 25.02
Business name: Atlas Plumbing Contractors Water heater 1 37.52 37.52
Water piping/DWV 56.29
Address: PO Box 1352
Other . i 25.02
City/State/ZIP: Ridgefield, WA 98642 Subtotal 87.56
Phone: (360) 887 -8054 1 Fax: (360) 887 -8504 Minitntun permit fee: $72.50
CCB Lic.: 165718 Plumbing Lic. no.: PB149 Plan review (25 %of permit fee) -
Authorized signature: � �� State surcharge (12% of permit fee) /() .5
TOTAL PERMIT FEE q 6 , rl
I Print name: Travis Zea I Date: 3/14/2012 I This Permit application u npins If a permit is notobtaiued within ISO days
atttr 11 has bee accep as c
•Fee methodology se. by Tri -Comity Building Industry Service Board.
tti uildiastekrmnsTLSW- remw,bpmc carom 440 461 67(10/02 /CO6ywFa)
Mar 1512 08:51a Atlas Plumbing Contractor 360 - 887 -8504 p.3
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities 1 . Qty.. - Fee (ea) Total Square Footage: Permit Fee:
50.03
Footing drain " I 100' 0 to 2,000 $121.90 2,001 to 3,600 $169.69
Footing drain - each additional 100' 37.52 _ 3.601 to 7.200 $23320
Sewer- 1st 100' 62.54 - 7 ,201 and greater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 Medical Gas Systems:
Water Service - each additional 100' - 37 Valuation: Permit Fee -
Storm dt Rain Drain -1st 100' 62 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to 51 0,000.00 $72.50 for the first $5,000.00 and $1.52 for
Fee (es) Total each additional $100.00 or fraction thereof, to
Other Inspections or Fees Qty. and including $10,000.00.
Inspection of Basting plumbing or for $10,001.00 to $25,000.00 S148.50 for the first S10,000.00 and $1.54 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 525,001.00 to $50,000.00 $379.50 for the first $25,000.00 and S1.45 for
hours (minimum charge - 2 hours) each additional 5100.00 or fraction thereof, to
Reinspection Fees 90.001hr and including $50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and $120 for
90.00 /hr
Additional plan review for revisions each additional $100.00 or fraction thereof
(minimum chatgc- 1/2 hour)
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
Quantiv by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Added c a d n ee Plan review is required for any of the following.
Work Performed: _ Please check all that apply.
Baptistry/Font ❑ Any new commercial building with water service 2" and
Bath - Tub/Shower greater, except systems designed and stamped by licensed
-Jacuzzi/Whirlpool engineer.
Car Wash -Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive Thru as defined in OAR918 - 780 - 0040.
Dis washer er om ❑ Medical gas and vacuum systems for health care facilities.
Dshwasher sher - CComme mercial
- Domestic ❑ My multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780-0040.
Eye Wash Submit 2 sets of plans with any of the above.
LloorDrainlsinit -2"
- 4" Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestic - food Garbage
- Domestic - non - food that meet the qualifications above.
ood related ,
- Commercial -food related
- Industrial -food related
Ice Mech./Rcfrig. Drains Comments regarding fixture work:
Oil Separator (Gas Station) -
Rec. Vehicle Dump Station No capping of fixtures, just adding new.
Shower -Gang
-Stall
•
Sink/Lav -Non -food related I
- Bradley
-Commercial- rood related
- Service
Swimming Pool Fitter *Note: If the fixture work under this permit results in an
Washer - Clothes Close increase of sewer EDUs, a sewer permit will be issued and
Water C
Water
Extractor fees assessed for the sewer increase must be paid before the
t - Toilet 1
Urinal plumbing permit can be issued.
Other Fixtures: 1
•
http: / /www.tigard -or.gov/ city_ haWdepartments /cd/docs/PLMU- Permit Ap2doc
Mar 14 12 03:02p Atlas Plumbing Contractor 360- 887 -8504 p.1
P
CONTRACTORS
31020 NW 51st Avenue
PO Box 1352
Ridgefield, WA 98642
Fax: 360 - 887 -8504
Phone: 360- 887 -8054 ext. 105
FAX TRANSMITTAL FORM
To: City of Tigard
•
Attn: Permitting
From: Clarke Burkhart
Date Sent: 3/14/2012
Phone:
Fax: 503 598 1960
Number of Pages: 4 including cover page
Attached are 2 p1 hing_permit ap. 'cations and a payment authorization form for 7275
SW Dartmouth t. Please fax or email receipt(s) bac .
Thank You,
Clarke Burkhart
360 -921 -1881 (Direct)
Clarice@atlasplumbingcontractors .corn