Permit �t CITY OF TIGARD PLUMBING PERMIT
• w COMMUNITY DEVELOPMENT Permit #: PLM2012 -00243
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/21/2012
I1Gi°1Fi , Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 120
Project: Southwest Center Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Relocate (1) breakroom sink
Contractor: CASCADE PLUMBING CO Owner: PORTLAND SW CENTER LLC
2416 N HAYDEN ISLAND DR BY FELTON PROPERTIES INC
PORTLAND, OR 97217 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503 - 289 -7095 PHONE:
FAX: 503 - 283 -9514
FEES
Quantity Description Date Amount
1 ea Sink 08/21/2012 $25.02
Specifics: 1 12% State Surcharge - 08/21/2012 $8.70
Plumbing
47 ea Minimum Fee Adjustment - 08/21/2012 $47.48
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
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: Permittee Signature: OA/ /�L / 69---77o/1
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 H Applicatio RR.• Ep[ D
Ko
Building Fixtures ���� 0.1:1-'1(.1 0.1:1-'1(.1 1_ ;::.. ONLY
City Of Tlg3t L� r 20 20 Received 2/ /Z f Permit N 2OI -'Da 9
Date/By; ff
- a 13125 SW Hall Blvd., Tigard, OR 97223 Ken Review
Phone: 503.639.4171 Fax: 503.5910F1010FTIGARD pare/By, Other Permit N uP0219%? - O0t3y
T I G A i. n Inspection Line: 503.639.4) 75
BUILDING DIVISION Date Ready /By; Jut See PaIIe 2 for
Internet: www,tigard-or,gov Noti TO upetemenmi latormorlon
. :.: :TYPE Or.: i .,. v . . - : Op SCHEDUL
❑ New construction ❑ Demolition For special Information use checklist.
Description [ Qty. I Ea; '
[ t
i tAddition/alteration/replacement 0 Other New I- 2- family dwellings (includes 100 It for each utility connection)
. R (1) bath 312,70
CATEGORY .OF CONSTR{JCTION, < -.. - - SF
; :. ;.: .; ;:; . � ...
❑ I- and 2- family dwelling _AEom SFR (2) bath 437.78
SFR (3) bath 500.32
❑ Accessory building ❑ Multi- family
Each additional bath/kitchen 25.02
- ❑ Master builder ❑ Other: Fire sprinkler (.__ sq. R.) Page 2
.JOB SITE INFORMATION AND- ILOCATION .:: : Site utilities:
Job site address: J 71d a. sto 1), P Catch basin or area drain 18.76
City / State/ZIP: _ Drywall, leach line, or trench drain 18.76 0 OM Footing drain (no. linear ft.: ) Page 2
Suite/bldg./apt no. IL M, Project name: ;� ,/r ;l; Manufactured home utilities 50,03
Cross street/directions to job site: �-tg
0 gI / r CJET/j Manholes 18.76
. Rain drain connector 18.76
Sanitary sewer (no. linear R: Page 2
Storm sewer (no. linear ft.: ) Page 2
Water service (no. linear ft.: - 1 Page 2
Subdivision: r Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31127 -
Backwatervalve 12.51
. - DE,soupTI oN :OF .WQRIC : .
i Clothes washer 25.02
& &CYY) s71 Dishwasher 25.02
Drinking fountain 25.02
Ejectors /sump 25.02
Expansion tank 12.51
❑; iPROPERTI°`OVVNE� ::�' CI` TI;IYANT "' , ;' .
Name: Fixture/sewer cap 1 25,02 - _
Floor drain/floor sink/hub ' 25.02
Address:
__ Garbage disposal 25.02
City /Statc/ZIP: _ Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
... .❑ APPLICANT:::.:. m CONl'ACT;PERSON terceptor /gresse 25.02
Business name: CASCADE PLUMBING COMPANY Medical gas (value: S � ) Page 2
Printer 12.51
Contact name: CRYSTAL JONES
Roof drain (commercial) 12.51
Address: 2630 N. HAYDEN ISLAND DRIVE #3 Sink/basin/lavatory ' 25.02 ,
City/State/ZIP: PORTLAND, OR 97217 Solar units (potable water) 62.54
Phone: (503) 289 -7095 l Fax: : (503) 283-9514 Tub /shower /shower pan 12.51
E -mail: CASCADEPLUM a®YAHOO.COM Urinal 25.02
25.02
:
. :. C,ipNTRACTQD -..,. •
a c ose
• ' .
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
Phone: (503) 289 -7095 Fax: (503) 283 -9514 Minimum permit fee: $72.50 7, -
CCB Lie.: 120893
4 ,,,
Plumbing Lic. no.: 3434.412P13 4 1 _ Plm, review (25% permit fee)
_ State surcharge (12% of permit fee) . 70
Authorized signature: A I` . / A �_ % TOTAL PERMIT FEE °r- a Q
Print name: CRYSTAL. EES
( F Date: I Thq permit application capita ifs permit is not obtained within 180 days
a fte r it has b een a ccep ted as eompkte
- P btCLS ` FAX n 34c-14- "Fee methodology set by Tit -County Building Industry Service Board
I: t4inyl?ermiu\PLMU- PermitApp.doc 10101/09 !I/ 440- 4416T(10/02 /COM/w[Bf
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information •
Fee Schedule: Residential Fire Suppression Systems:
e . tihtt "':.: ::.: - Fc - ., ..
� -�; .:.. ...... •: . �: ..:... ..
lt S ... irate g . t
Footing drain .1" 100' 50.03 0 to 2,000 $121.90
Footing drain • each additional 100' 37,52 • 2.001 to 3,600 _ S 169.69
Sewer - 1st 100' 62.54 3.601 to 7,200 $233.20
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 _.: -.... ;•_: •_ . ., .:. :..... ...�
Storm & Rain Drain -1st 100' 62.54
u�tion: . :r .: Fermxt..Fee::
51.00 to $5,000.00 Minimum fee 572.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000,00 $72.50 for the first $5,000.00 and S 1.52 for
Other.'Inspections olrFees - • • :(!)' * . - . !et. {a) ' . ' Tot•l'':. each additional S100.00 or fraction thereof, to
and including $10,000,00.
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 S 100.00 or fraction thereof to
(minimum charge - 12 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 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 $50,000.00.
Additional plan review for revisions 90.00/h $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) • each additional $100.00 or fraction thereof.
• Subtotal:
Commercial Fixture Work: •
Are you capping, adding or replacing fixtures? If "yes ", .
please indicate work performed by fixture. Failure to .
accurately report futures could result in increased sewer fees *.
Ouamtlt by Fixture f vpe
Plan• Review::for;Pluiio m ins an Installations .
YPe fir .
Futlure T ...... 14ee1nctl. � .
Work Performidt . • ••••-: Capped Adited • Relocate Plan review is required for any of the following.
Bapustry/Font Please check all that apply.
Bath - Tub/Shower ❑ Any new commercial building with water service 2" and
- Jacuzzi/Whiripool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru _ ❑ New exterior plumbing site utilities for any complex structure
C uspidor/Water Aspirator as defined in OAlt91$- 780 0040.
Dishwasher - Commercial • ❑ Medical gas and vacuum systems for health care facilities.
- Domestic ❑ Any multipurpose firs; sprinkler system,
Drinking Fountain ❑ Any complex structure as defined in QA.R918- 780 -0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
Car sometric "or:RiserDiagram ..:::... ....... =:.
Wash Dram ❑ Isometric or riser diagram required g
Garbage - Domestic - non -food gram is r iced for new buildings
Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach,/Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
_ Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related J
- Bradley
•Commercial- food related •
- Service
Washer n Clothes Filter *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:1Documents and Settings\Cascade Plumbing My Documents\DownloadeLMU- PermitApp.doc
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08/20/2012 15:46
= == COVER PAGE = ==
TO:
FROM: CASCADE
FAX: 5032839514
TEL:
COMMENT: