Permit . - Building Fixtures {]�t�P�� FW.-''''''
• 9
Plumbing Permit Auuli FOR OFFICE USE ONLY
•
• City
C1 o0o Permit No x'
Il
DateByyJ L 2 . �6 1'. 021 0 6 - 00_2,04
of Tigard
to 13125 SW Hall Blvd., Tigard, OR 9223 ( ti, Plan Review
0 Phone: 503.639.4171 Fax: 503.598:1960 Date/By Other Permit No.
Inspection Line: 503.639.4175 k
T I G A K 13 �. i �� f Date Ready/By. ®See Page 2 for
Internet: www.tigard- or.gov� � 'i I � x _ 1`c� Notified/Method 1 n 7(r Supplemental Information
• TYPE -p OTk1 N ' ' ' FEE* SCHEDULE
❑ New construction F ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
�fQ Addition /alteration/replacement ❑ Other: New 1 -2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CO NST CT1ON SFR (I) bath 249.20
❑ 1- and 2- family dwelling commercial /industrial SFR (2) bath 350.00
❑ Accessory building < <<< Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
Fire sprinkler ( sq. ft.) Page 2
JOB SITE' INFORMATION AND LOCATION Site utilities
Job site address: /(25 5 �� fccl Cleo ii/Z Catch basin or area drain 16.60
City/State/ZIP -./";_>( re .4 OR 97 223 Ste -/e° X30 Drywell, leach line, or trench drain 16.60
Su Id /a t. no : �3 �1� � 'o� Footing drain (no. linear ft.: ) Page 2
g. p Q Project name:
Manufactured home utilities 110.00
Cross street /directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: . I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK , - Back flow preventer Page 2
p ,,,,,,,,..4, 91i S, dc Backwater valve 16.60
E� ebl r `\ 4(711- n cl Co /ft( 4 oY l � 5 Clothes washer 16.60
Reloec / e ye t✓Gi l 549(x)Pr �j t 1 Dishwasher 16.60
Eye
0 PROPERTV OWNER.' I : ❑ TENANT . Drinking fountain 16.60
Ejectors/sump 16.60
Name: Expansion tank 16.60
Address: Fixture /sewer cap 16.60
City /State /ZIP: Floor drain/floor sink/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
' ❑ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory i 16.60
Phone:
( ) I Fax: : ( )
Tub /shower /shower pan / , 16.60
E -mail: Unnal 16.60
CONTRACTOR Water closet 16.60
Business name r ---. Water heater 16.60
1-,-)A Address: ) a ,,„‘ 9 9 Other:
City /State /ZIP c,/ ,, 97z) Subtotal
S CS °' Minimum permit fee: $72.50
Phone: (5k) )(p) _ 5/ / 7 2 Fax: (S 6) -"T Residential backflow minimum permit fee: $36.25
CCB Lic.: / 2 7.) 1 ' Plumbing Lie. no.: 3^ 251 PB Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized sign ..,›-Z-- �i 7
. - TOTAL PERMIT FEE 3 i2
Print name. l! ` #Pl 7 s Date %/� j2 This permit application expires if a permit is not obtained it in
111 180 days after it has been accepted as complete.
*Fee methodology set by Tn-County Building Industry Service Board.
1 \Bwlding\Permtts\PLMF- PemntApp doe 04/06/06 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard "
'. .
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities . . Q ty Fee (ea) Total Square Footage: Permit - Fee: -
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 to 7,200 $220.00
Sewer - 1st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 .
Valuation: Permit Fee:
Storm & 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
Fixture o f Item ' - Qty. Fee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Back Flow Prevention Device each additional $100.00 or fraction thereof; to
(minimum permit fee $36.25) 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
each additional $100.00 or fraction thereof; to
Inspection of existing plumbing or
and including $50,000.00.
specially requested inspections - per hour 72 50
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures -
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
- Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
- Previous Capped Added Existing ' ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive Thru facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain
❑ Any NFPA 13 - D multipurpose fire sprinkler system.
Eye Wash /
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal -Commercial three (3) or more stories in height.
- Industrial •
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink -Bar/Lavatory 1
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
I \Bwlding\Permits\PLM- PermhApp doe 07 /06/05
CITY OF TIGARD `'
BUILDING DIVISION PERMIT #: PLM2000 -00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 512/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175 ill ..
INSPECTION WORKSHEET FOR DATE: 8/8/2006 TIME: 7:06AM PAGE: 80
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: Relocate (1) sink & (1) eyewash unit. Extend hot & cold water lines. 6- 16.2006
2ND TIME relocating sink and eyewash unit.(old location was in from of equipment)
OWNER: AMB PROPERTY L p, PHONE #:
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 630.4492
Inspection Request Scheduled For: Date: 8/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 034533 -01 503 -407 -4755 N
Corrections /Comments /Instructions:
fro
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I" ,, Date : Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1 2/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/19/2006 TIME: 7:05AM PAGE: '19
SITE ADDRESS: 10575 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: Relocate (1) sink & (1) eyewash unit. Extend hot & cold water lines. 6-16 -2006
2ND TIME relocating sink and eyewash unit.(old location was in from of equipment)
OWNER: AMB PROPERTY L P, PHONE #:
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 630
•
Inspection Request Scheduled For: Date: 6119/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 031929 -01 503- 572 -8246 Y
Corrections /Comments /Instructions:
7 .3 4 / 0)2-e ,_47vt%
•
54.-PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Phone #: (503) 718 -
p �- roc Date: i � P ( ) ��
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM200600206
13125 SW Hall Blvd., Tigard, OR 97223 '- DATE ISSUED: 5/1212006
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 'IL
INSPECTION WORKSHEET FOR DATE: 5/24/2006 TIME: 7:12AM PAGE: 69
SITE ADDRESS: 10;76 SW CASCADE AVE 130 CLASS OF WORK:
SUBDIVISION: CASCADE BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: HEMCON
DESCRIPTION: Relocate (1) sink & (1) eyewash unit. Extend hot & cold water lines.
OWNER: AMB PROPERTY L. P, PHONE #:
CONTRACTOR: CASCADE MECHANICAL SYSTEMS INC PHONE #: 630 -4492
Inspection Request Scheduled For: Date: 5/2.4 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough•in 030455 -01 503 -672 -0246 N
•
Corrections/Comments/Instructions:
•
MM ./ Atie
`PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector) 7 Date: I Phone #: (503) 718-
.