Permit . ' v CITY OF TIGARD PLUMBING PERMIT
, a:. COMMUNITY DEVELOPMENT Permit #: PLM2012 -00347
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/29/2012
Parcel: 2S 101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 101
Project: Hilltop Business Center Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830 -2
Project Description: (1) sink replacement
Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC
9460 SW TIGARD AVE SUITE 101 HUNZIKER LLC
TIGARD, OR 97223 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 639 -5296 PHONE:
FAX: 503 - 684 -9015
FEES
Quantity Description Date Amount
1 ea Sink . 11/29/2012 $25.02
Specifics: 1 12 %State Surcharge - 11/29/2012 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment - 11/29/2012 $47.48
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: of A. T (/I I 1/ p /_ --70
___
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. !"f
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
11/29/2012 10:42 5036849015 WESTERN PLUMBING INC PAGE 01/03
?1umbine Permit Application y
RECEE ) V
Building Fixtures NOV 2 9 2012 FOR .OFFICE USE ONLY
City of Tigard t I r.)- u PW ?oL -- 0o341
13125 SW 11811 Div& Tiig ut4 oR 97223 CITY OF TII\{71�1'lARD plea xaoiow
: S Phone 503.639.4171 Faa 503392 .19 5 f% MIS RD
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❑ New construction I ❑ Demolition For apedat k oa meson cue cheekrat
Description I Qty, I Ea_ J Total
- V Addition /alteration/replacemeirt T D Other. • . New 1-2-family dwellings (rncindea 100 0. for each utility connection)
.- :', • = F ,S!r b tf`::w L r . ; v+,4,. ∎" •.1 ; :. ' { c ''' ;z 4i'' :::. 2 SfR (1 bath 312.70
::.; :`v: .
,. ,.e �,.� '';;h % : �:,-r1N.n: ..n : H ,•• . ,o-. ... •., - , +. +.ai . . . . ::. .. ..•) S.0,
❑ I- and 2-family dwelling 1$Commercialfindusbial SFR (2) bath 437.78
D Accessory building - Q Multi- family SF[t (3) barb 50032
Each adeitiomll bafht itchan 25.02
D Master builder D Other Fire epickler (_Eh it) Page 2
i fly. L yy .a���[[ •,��ryy,{��,��., ia •e _ -' ' e ?�+rr . •,
` � ' I ' a➢�Li2: ,� .; ,+ } .: Site n67lae]
site address: Vat 0f ). N uTi KJ:J(_ A,k. 1C) l Z:OChd(Lfl
Job s City ite s IP: 18.76
1 C Footing drain (no. linear ft.: ___) Page 2
Suite/bldg./apt. nO.: 0Q rlyect Alinp f SS+ Ca / Manufactured homeutdities 50.03
Cross Street/directions to job site: Manholes 18.76
Rain drain connector 1&76
Sanitary newer (no. linear li.: _.) Page 2 1
Storm sewer (nc linear ft: ) Page 2
Subdivision f Lai X10.; Water service No_ linear f3.: Page 2
114Th u° hoc ttann
Tax map/psroel no.: Bow preventer 31.27
e: ': ,:.,+-..�.. Baclewalarvalve 12.51
. :if�:= �,' `ai� aQ.: lf3� ;i?Vd'4'►ll��'
_�__. i � S1Y\k , waaJrer 25 .02
Dishwasher 25.02
Drinking ffoirntain 25.02
Ejectors/sump • 25.02
k-4:u n'ac4 �+c+� w •Nam.•; ea•.,.,:.:,y r
1 . ; : , :1 : ': 7' '•a^ . rw,,, ' ; '; • 4 ,, , . : - 7 .T •.
i ii? c .Tit:, =` ' :'. te ontanic 1231
i�!'- `�:...:: ��'''j� ,.rr_., . -. .r•. J ..iv; h: i��r - "'r,. .,der °;4e:a� : :i,�,..•�d�•� J ' _. � ::. •--.
Fixture/sewercap 25.02 -
Namm Floor dluin /floor sink/1mb 25.02
Garbage disposal 25.02
City /State/' lose bib 25.02
•
Phone: ( ) • Pam ( ) Ice maker 12.51
- Interoeptor/grsaaetrap 25,02
:':v >.t; , ���'p .S Y , 1 •i :, c7Co 1tixo* 1 y � ' 1 .. 7,17,
,. % ...,'e ii ?- ':•= .•l= e,•�d °`5�1. : � - n ° -: � �F� ?�`� > •.; ,�""�?;.R, ;wr
Business came: Medical gas (vain: S ) Page 2
^ Prima 12.51
Contact name:
, Roof drain (oommeraial) 1251
Address: Sink/basin/lavatory l -• 25.02 J.5. c.
OitY/Smto_L_,P: Solar omits (potable water) 62.54
phone: ( ) I Faun.:: ( ) Tuh/ahvwa /sbovrar Pan 12.51
E-mail: Urinal 25.02
:r,5` 'ai i,,V" i gx ;:..i ; ', r ,: 'r:i' t rr: a : , -n:. : *v ; : 1 : Watrs clo6et 25.02 •
• ': .�Jii,h.'�2�kXZ'.ai%''Y ":R�', ,.'tY.i.'i.:r,.:,'.u +. ^•.,r.:, .� �`;'ii_t;,. ,r.., _'� �:v:r. water beater 3752
Business name: Western Plumbing, Inc. - Water piping/DWV 5619
Address: 9460 SW Tigard Avenue SuIts 101 Other: 25.02
City /State/21P: Tigard, OR 97223 subtotal , ,
Phone: (503) 639.5296 Fax (503) 684 - 9015 Minimum permit fee: $72.50 - 10,50
CCB Lie.: 2439 Plumbing Lie. no:: 34-29PB Plan ew (2S %ofpermit fee) revi
Authorized sigaataue: ,i r xJ
State surcharge (12 %of permit fee) : Q
TOTAL YERNIIT FEE 51
Print name: Dana Jensen 4 Dam G This permit application aspires if a permit is not obtained within 150 days
. Date://._ o � , t 1 2 after it has been accepted se complete.
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PLUMBING INC
PAGE 02/03
11/29/2012 10:42 5036849015 WESTERN
Plumbing Permit Annlication - City of Tigard
Page 2- Supplemental Information
Fee Schedule:
Residential Fire Su , . ression S 'stems:
4
Footing drai , ,x,..p . in WAMEla i9;,N.E_Mt.2:7 tc VF:•:.,:i:.....':;,:::..;
n - 1 1 00' 30.03 Oto2 000 $121.90
Footing drain - each adddional 100' -----7- 3752 — 001 to 3,600 EgZUMIIIMNMMEME
— v-
9,601 to 7,200 S233.20
Sewer - 1st 100'— 62.54
7 01 and ? -,. ,- $327.54
Sewer - each additional 100' 37.12
100'
—
Water Service - 1st 62.54
Medical Gas S tems:
Water Service - each additional 100' 37.52
-',....,"? 5, •, c. wzz. .,' . '' - ":.... •:,.;' :i s -,..
Storm & Rain ' - 1st 10(7.. "---"—ii77----- ‘.‘" ° ; . - . " - . ''., SILLeg-,:' AV 7 ..',.` ': ?
SI 40 to $5,000.00 hfinimam fee $7230
Storm & Rain Drain - each adonal 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for — I
.:! l'AigiWil_Pie IViiik,....'s-i4.1.40eilja:!:,;:1),W7 each additional SI00.00 or fraction thereot to
' and inchnlino $10,000.00. 1
Inspection of eicisting plumbing or for
S10,00i.00 to $25,000.00 '' $145.50 for the first $10,000.00 earl $1.54 for
which no fee is specifically indicated 90.00/hr
each additional $100.00 or fraction therce4 to
Juiblimmdurge-L2h a r L__-_-__------. * __--_ — , -- _ ---
and inclu ' $25 000.00.
Inspections outside of normal business 90.00/1w
$25,001,00 000.0o $379.50 f t h e first —.---.- S25,000.00 and $1.45 for
hours (minimum charge -2 hors)
each additional $100.00 or frtu;tion Ittereog to
Reinspection Fees
90.00/Ix
$50 000.00.
A
Additional plan review far revisions 90.00/hr $50,001.00 and op $742-00 for tbe first 550,00000 and $1.20 for
,
(stirantu charge - 1/2 hour)
— I each additional $100.00 or fraction thereof
_
Subtotal:
E9111111erCifti Figure Work:
Are you capping, adding or replacing fixtures? if "yes", Mgc ! _ , . 4 61.00..:- ITR!‘t
please indicate work performed by fixttire. Failure to
Plan review is required for any of the following.
accuratel • re , . it fixtures could result in increased sewer fees'". Please check all that apply.
5gq :'7,577,17 Org"25.M.,771mfg El Any new commercial building with water service 2" and
, .,...;:' .;!,,,,-fttfOcc;i
great systems designed and stamped by licensed
- .••• .. 44-- hi; . 7.::•.,,,:.2:,.*: i_c ,L ... , • . '. • • ';'•:, •:"nind '1,
engineer.
: t • - /Ford
0 New exterica- plumbing site utilities for any complex structure
Bath - Tob/Shower all110
as defined in OAR9I8-780-0040
Car Wash ,
-Jacuzzi/Whirl .. .1
El Medical gas and vacuum systems for health care facilities.
Driv Thru -Each Stall
El Any multipurpose fire sprinkler System.
e
-
Cuspidor/Waiter Aspirator MIMI MIMI 0 Any complex structure as defined in OAR918
Dishwasher - Commercial
- - Domestic MIMI Submit 2 sets of plans with any of the above.
DriakingFeuntain
41 '
11111a1
8;:": i. 'i i■ .' 4 . ;;". It, i m
Bye Wash
- .......3c...ev,, , ,,,
Floor Dram/sink -2" 1
.11 n Isomehic or riser diagram is required for new buildings
- 3"
that meet the qualifications above.
- 4"
. . —
Car Wash Main
Garbage -Domestic
Disposal -Commercial I
Ell Comments regarding fixture work:
-inctuarial
Ice Mach./Refri : Drains MIMI EMIIIMMI
O ______
Oils , . ' . en &An ion 111.11.511.=.111.111M1111
Rec. Vehicle B.11 I Station MIN MEI ----
Shower -Gang Millin ME
all
Sink -Barflavatary
-Bradley .—____.--______________
a
-Connnercial E.II
*Rote: If the fixture work under this permit results in an
-service
increase of sewer EDUs, a sewer permit will be issued and
s ',, ., -, z Pool Filter NIMINIMIIM
Washer- Clothes Ell 11111 all fees assessed for the sewer increase Mat be paid before the
plumbing permit can be issued.
Water Extractor
Water Closet- Toilet MEM .11111. NM/
Urinal IMIll JI
Other Fixtures: