Permit q CITY OF TIGARD PLUMBING PERMIT
a COMMUNITY DEVELOPMENT Permit #: PLM2012 -00187
T l G AR D 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/10/2012
Parcel: 2S 112AC01500
Jurisdiction: Tigard
Site address: 7319 SW KABLE LN 600
Project: Solestruck Subdivision: FANNO CREEK ACRE TRACTS Lot: 23, PT 2
Project Description: Relocation and replacement of existing fixtures. No change to EDU's
•
Contractor: CASCADE PLUMBING CO Owner: PACIFIC REALTY ASSOCIATES
2416 N HAYDEN ISLAND DR ATTN: N PIVEN
PORTLAND, OR 97217 15350 SE SEQUOIA PKWY #300
• PORTLAND, OR 97224
PHONE: 503 - 289 -7095 PHONE: 503 624 -6300
FAX: 503 - 283 -9514
FEES
Quantity Description Date Amount
1 ea Dishwasher 07/10/2012 $25.02
Specifics:" 2 ea Floor Drain/Floor Sink/Hub 07/10/2012 $50.04
1 ea Ice Maker 07/10/2012 $12.51
Type of Use: COM 1 ea Sink 07/10/2012 $25.02
Class of Work: ALT 2 ea Lavatories 07/10/2012 $50.04
Type of Const: 2 ea Water Closet 07/10/2012 $50.04
Occupancy Grp: 1 ea Water Heater 07/10/2012 $37.52
Stories: 1 12% State Surcharge - 07/10/2012 $30.02
Plumbing
Total $280.21
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 Notif - - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- Inl -0Q90. You may obtain a copy of the rules
or direc uestions to O C b g 503.232.1987 or 1.800.332.2344. 411111 Issu d By: , / � /` Permitter JP
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Call 503.639.4175 by 7:00 a.m. for the next available Ins .ection 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.
Plumbing Permit Application
Building Fixtures RECEIVED
City of Tigard Received 7 y, / A Permit No.: / fa 00/59
lig - Date/By: a 13125 SW Hall Blvd. Tigard OR 9 '
Phone 503.639.4171 Fax: 503.599:1960 9 2012 Plan Review
pg Other Permit No.:
Inspection Line: 503.639.4175
1' I G , 1.1: 0 Date Ready/By: huffs: See Page 2 for
Internet: www.ti -0r. v
go CITYOFT[GARD Notitied/Methott Supplemental Information
• /; 1O •
_ . .. , ....< ,'f!l'PE' *.: :;�lE 8C1E1<'Eb(f
CI Ncw construction ❑ Demolition For special inform ion use checklist '
Description I Qty. I Ea. , - Total
_41 • ddition/altcration/replacement ❑ Other New t -2- family dwellings (includes 100 ft. for each utility connection) ,
...' ..:.. CATEOORY':OF. ITON ..
' SFR (1) bath 312.70
❑ I- and 2- family dwelling ?ommercial/inditstrial SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi - family
Each additional bath/kitchen 25.02
❑ Master builder 0 Other Fire sprinkler (__ sq. R) Page 2
. JOB SITE INFORMATION.ANDsLOCATION.. :' .;' Site utilities
Job site address: / 3161 n.) La Catch basin or arcs drain 18.76 rywe
City/State/ZIP: i / Drywell, leach line, or trench drain 18.76
Q Footing drain (no. linear R: ) Page 2
Suite/bldg. /apt. no.: / NO Project name: So , 1 vat..., Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
Rain drain connector 18.76
Sanitary sewer (no. linear ft: _) Page 2
• Storm sewer (no. linear IL: __J Page 2
Water service (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Fixture or item: -
Tax map/parcel no.: Backflow preventer 31.27
valve .. :: �
. .:. �'.° : ' D>E��1�. `f[ON "OF`7t{'bkIC ' ,,. . . ; : -
' / v; :..:,.;. Backwater Val Clothes washer 1 25.02
1
_' 0 (7�''1 /., ..,..:40 / ,/ice Dishwasher 25.02 ,c:25. 02.
gi1[' 1 S4 ryP• e.. 2 Drinking fountain 25.02
J' Ejectors/sump 25.02
• [] "PROPERTY. "OWNER - • • .D TENANT Expansion tank
Name: Fixture/sewer cap 25.02
Floor drain/floor sink/hub a 25.02 56. Oil
Address:
Garbage disposal 25.02 -
City /State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker - _ ( 12.51 , +a .51
• .., . lnteree 25.02
[] APPLICAN C. ]. CONTACT PERSON Ptor /o ease trap -
Business name: CASCADE PLUMBING COMPANY Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: CRYSTAL JONES -
Roof drain (commercial) 12,51
Address: 2630 N. HAYDEN ISLAND DRIVE #3 Sink/basin 25.02 5 ,Q
City /State/ZIP: PORTLAND, OR 97217 Solar units (potable water) 62.54
Phone: (503) 289 -7095 Fax: : (503) 283 -9514 Tub /shower/shower pan 12.51
Urinal • 25.02
E -mail: CASCADEPLUM@YAHOO.COM
. .. c
Water Water lOSet 25 02
Wert heater , 37.52 "-/.
Business name: CASCADE PLUMBING COMPANY Water P�P SN , in WV 56.29
Address: 2630 N. HAYDEN ISLAND DRIVE #3 Other. 25.02
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City/State/ZIP: PORTLAND, OR 97217 Subtotal /JD. r9',
Phone: (503) 289 -7095 Fax: (503) 283 -9514 Minimum permit fee: 172.50
CCB I.ic.:120893 A Plumbing Lic. no.: 34.412PB - Plan review (25% of permit fee)
um
State surcharge (12% of permit fee) 361r CZ
Authorized signature: �� TOTAL PERMIT FEE bl.$Q '-(
Print name: CRYS'T'AL JON ' r Date: This permit appliwdon expires if a permit Is not obtained within ISO days
after it has been accepted as complete
L� ��� 'Fee methodology set by Tr - w
Couy Building Industry Service Board,
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site UtsTities . :.: _. _ . .. ota� . .. F .. _
:., .• .....:, - . ..: : .; . ,Qty: •.� : = .1 ?e,� (ea)�: ,: ;s ..Square .Fo er .. ..:: .Per>Qtut•• =:,.. : �:.:::: •:
. • • : ;.;.,..
Footing drain - 1 100' 50.03 0 to 2,000 $121.90
Footing drain - each additional 100' 37.52 2.001 to 3.600 $169.69
3601 to 7 ,200 $233.20
Sewer - 1st 100' 62.54 7 ,201 and J. eater $327.54
Sewer - each additional 100' 37.52
Water Service - 1st 100' 62.54 _ Medical Gas Systems:
Water Service - each additional 100' ' 37.52 i " ::, .. ;
.V'�aattoh. .:�:.: . d : •:Pe'rmllt: ee. ; ' _ ;. ;::,. <_::....:- >`:::,:
Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee 572.50
Storm & Rain Dram - each additional 100' 37.52 $5,001.00 to 510,000.00 $72.50 for the first 55,000.00 and $1.52 for
....__...:._.,...: •....;.......::: _;:.• • -..: ...•. . �:. each additional $100.00 or fraction thereof: to
•. .. Total ":;
Q ,., . ;.. (e.
Other. �lsp_ectton Fees° .. ..• . , . . • .. and including $10,000.00.
Insp i onectt of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10.000.00 and $1.54 for
which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to
(minimum charge - I/2 hour) and including $25.000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the fast $25,000.00 and $1.45 for
hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof; to
Reinspection Fees 90.00/hr and including S50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up 5742,00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof
(minimum charge - 1/2 hour) -
Subtotal:
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Commercial Fixture Work: .
Are you capping, adding or replacing fixtures? If "yes",
please indicate work performed by fixture. Failure to
• accurately resort fixtures could result in increased sewer fees *.
Qiinti by ire'h'IPe : ' ='D ili "Review Plumbiung •
reduce Type for .: •:• •• • :: • . • • • , .: aar Plan review is requ for any of the following
Work Performed: • CAS '� Reloeato Please check all that apply.
Ba.ti /Font El Any new commercial building with water service 2" and
Bath -J acuz power - greater, except systems designed and stamped by licensed
Jacurti/whiripool engineer.
Car wash - Doh Star ❑ New exterior plumbing site utilities for any complex structure
Drirator as defined in OAR918- 780 -0040.
Di s Dishwasher D wa Coommemore rcial ❑ Medical gas and vacuum systems for health care facilities.
er C
- Domestic - ❑ Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OA1t918- 780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
.
metric or ° .
�`xsa - Ri;eer`D�la�iaim °
Car wash Drain • U Isometric or riser diagram is required for new buildings
Garbage Domestic -son -food
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Disposal - Domestic -food related that meet the qualifications above. 1
-Commercial -food related
- Industrial -food related
Ice Mach/Raffia. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang -
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial- food related
- Service _
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Water ' - Clothe Closet - Toilet tor - increase of sewer EDUs, a sewer permit will be issued and
Water C
War t fees assessed for the sewer increase must be paid before the
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Urinal plumbing permit can be issued.
_
Other Fixtures:
C:\Documents and Settings \Cascade Plumbing\My Documents \DownloadgPLMU- PermitApp.doc
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