Permit CITY OF TIGARD PLUMBING PERMIT
$ COMMUNITY DEVELOPMENT Permit #: PLM2012 -00218
T [GA It 0 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Triangle Point Subdivision: YARNS ACRES Lot: 9
Project Description: (5)sink; (2)urinal and (7) water closets
Contractor: CASCADE PLUMBING CO Owner: TRIANGLE POINTE LLC
2416 N HAYDEN ISLAND DR 901 NE GLISAN ST, #100
PORTLAND, OR 97217 PORTLAND, OR 97232
PHONE: 503 - 289 -7095 PHONE:
FAX: 503 - 283 -9514
FEES
Quantity Description Date Amount
5 ea Sink 08/02/2012 $125.10
Specifics: 2 ea Urinal 08/02/2012 $50.04
7 ea Water Closet 08/02/2012 $175:14
Type of Use: COM 1 12% State Surcharge - 08/02/2012 $42.03
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
•
Total $392.31
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: L itt v Permittee Signature: PePPD6017110
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.
Plumbing Permit Application RECEIVED •
Building Fixtures FOR OFFICE USE ONLY :
CI of Tigard AUG Il 1 2012 Received
DateBy: 8 f a'/ l Y c a 4-- Permit No,; pe,p faaa % 09a1 8
n 13125 SW Hall Blvd., Tigard, OR 972 A p Plan Review
' : ; Phone: 503.639.4171 Pax: 503.598. OFTTIGARD Date/By: Other Perreit N P a,._ 001
I`IC AKD
Inspection Line: 503.639.4175 BUILDING WJ DIVISION e d/ Internet: www,tigard -or.gov 1 Nat Notified/Method:
ed/Meth od:
1 tla � Su! r ®SeepplemnmPent I For
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TYPE OF. WORK FEE° SCHEDULE
❑ New construction ❑ Demolition for special injormallon use checklist
Description Qty. I Ea. Total
7i • ddition/alteration/replaccment ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION . . SFR (I) bath 312.70
❑ I - and 2- family dwelling .7:15 ommercial/industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder 0 Other: Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION . Site utilities:
Job site address: 3 J , / J Catch basin or area drain 18.76
City /State/LIP: /� Drywall. leach line, or trench drain 18,76
I 1 Ole_
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project name: r i I !L , d 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 ft.: _ ) Page 2
Water service (no. linear ft.; . ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
• DESCRIPTION. OF WORK • ••• Backwater valve 12,51
I, Clothes washer 25.02
0 t/ e.. - II , . I. .t.at 0 " • . l Dishwasher 25.02
4 • i • ., -' 1 Drinking fountain 25.02
Ejectors/sump 25,02
❑ PROPERTY OWNER • • ❑ TENANT • • Expansion tank 12.51
Name; Fixture/sewer cap 25.02
Address:
Floor drain / Foor sink/hub 25.02
' Garbage disposal 25.02
City /State/ZIP: Nose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
0 APPLICANT ❑CONTACT PERSON interceptor /grease trap 25.02
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/lavatory 5 25.02 126, ,
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
E -mail: CASCADEPLUM@YAHOO.COM Urinal 25.p2 cfQ, y
CONTRACTOR • : Water closet 7 25 ti 0, j4
Water heater 37.52
Business name: CASCADE PLUMBING COMPANY Water piping/DWV 56.29
Address: 2630 N. HAYDEN ISLAND DRIVE #3 Other: 25.02
City /State/ZIP: PORTLAND, OR 97217 Subtotal 35p.2$'
Phone; (503) 289 -7095 Fax: (503) 283 -9514 Minimum permit fee: $72,50
CCB Lie.: 120893 + Plumbing Lic. no.: 34 -412P6 Plan review (25% of permit fee)
State Surcharge (12% of permit fee) 1 1X ° p.3
Authorized signature: ' 1 il f�, R (i I - TOTAL PERMIT FEE 31cf 31
Print name: CRYSTAL J e ES , V Date: This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete. '
j n ^, s � X ape Q fl To �, ` 'Fee mcthodatp� set by Tri County Building Industry Service Board.
I: llding \Penn(rswLMU- PPc 10/01!09 �+JI�/ /, aad6I6T oroaCOM/WEB)
60/10 39tid 3aVOSGD b1S6E8ZE05 01 :11 Z'0Z /10/80
Plumbing Permit Application =City of Tigard
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Page 2- Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Siti•E:ViflitieS.4:11te '0 H:!(*::' ' .sT9t!. Square Footage Piriiiiiti
Footing drain - l' 100' 50.03 0 to 2,000 5121.90
Footing drain - each additional 100' 37.52 2,001 to 3.600 $169,69
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' 37.52 Nai : H
Storm & Rain Dram - 1st 100' 62.54
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to 510,000.00 $72.50 for the first $5,000.00 and $1.52 for
Other Inspection or Fees ::'...96.';:''.?: ":Tei:Oiir' l'. TAMP '' each additional 5100.00 or fraction thereof to
and including 510.000.00.
Inspection 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 5100.00 or fraction thereo to
(minimum charge - 1/2 hour)
and includink$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $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 550,000.00.
Additional plan review for revisions 90.00/br $50,001.00 and up $742.00 for the first $50,000.00 and $120 for
(minimum charge-1/2 hour) each additional $100.00 or fraction thereof
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*.
' .7" InstallatiOiii" ' 7
. Work PeiforliieC : '' , : 6inlid - • . 'Atkiiid ' 'Relocate • Pl an review is required for any of the following.
Bamisty/Font Please check all that apply,
Bath - Tub/Shower 1:1 Any new commercial building with water service 2" and
-Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash - Each Stall • engineer.
- Drive Thu 0 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918
Dishwasher 'Commercial 0 Medical gas and vacuum systems for health care facilities.
-
- Domestic 0 Any multipurpose fire sprinkler system.
Drinking Fountain 0 Any complex structure as defined in OAR918
Eye Wash
Floor Drain/sink - 2" . Submit 2 sets of plans with any of the above.
.3"
. : ,, :.. , •::7•":! , '' : ,, I or Riser Diagram ... • ...
Car Wash Drain
Garbage -Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal - Domestic - food related that meet the qualifications above.
Commercial-food related 1
-Industrial-food related
Ice Mach./Refrig. Mains
Oil Separator (Gas Station) _ Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related W.
-Bradley
-Conmurcial- food related
-
-Service
Swimming Pool Filter
- Washer - Clothes *Note: If the fixture work wider this permit results in an
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet '1 fees assessed for the sewer increase must be paid before the
Urinal 7-- plumbing permit can be issued.
Other Fixtures: _...
C:\Documents and Settings \Cascade Plumbing\My Documents\DownloadgPLMU-PermitApp.doe
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08/01/2012 11:10
= == COVER PAGE = ==
TO:
FROM: CASCADE
FAX: 5@32839514
TEL:
COMMENT: