Loading...
Permit a CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT Permit#: PLM2012 -00377 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/03/2013 Parcel: 1S126BC01506 Jurisdiction: Tigard Site address: 9020 SW WASHINGTON SQUARE RD 410 Project: MacDonald Environmental Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: Add (1) breakroom sink Contractor: GRIDLINE PLUMBING Owner: WYSE INVESTMENT SERVICES 4343 SE 37TH 1501 SW TAYLOR ST STE 100 PORTLAND, OR 97202 PORTLAND, OR 97205 PHONE: 503 - 771 -8790 PHONE: 503 - 294 -0400 FAX: FEES Quantity Description Date Amount 1 ea Sink 12/31/2012 $25.02 Specifics: 1 12% State Surcharge - 12/31/2012 $8.70 Plumbing Type of Use: COM 47 ea Minimum Fee Adjustment - 12/31/2012 $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: 1 -1 : ./ 1 7 /. 0r7c. Permittee Signature: 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 Application Building Fixtures RECEIV 1 FOR OFFICE USE ONLY City of Tigard Received 1 2012 3/ /� DateBy:. PermitNoPZ/'�/02 40 - 00.77 DEC • 13125 SW Hall Blvd., Tigard, OR 97223 3 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Dat e/By Other Permit 6'e. ffa© /a'/j0 Inspection Line: 503.639.4175 CITY OF TIGAR +n D Date Ready/By: L Jwi I El See Page 2 for Internet: www.tigard-or.gov BUILDING DIVISIO Notified/MethodO3 T I G A R D 3 / .1 ' 7�" Supplemental Information TYPE OF WORK ,TEP t� FEE* SCHEDULE 0 O ❑ New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ion/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 d ❑ 1- and 2- family dwelling rcial /industrial SFR (2) bath 437.78 SFR (3) bath 500.32 &3 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 v JOB SITE INFORMATION AND L ATION Site utilities: Job site address: 9 JW l 5X1 , 5ezere rd , Catch basin or area drain 18.76 City /State /ZIP: / � j O � Drywell, leach line, or trench drain 18.76 / vvv""" / Footing drain (no. linear ft.: _) Page 2 Suite/bldg./apt. no.: 4/ p Project nameAte, iiera / -A/A40 / 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: I Lot no.: Fixture or item: Tax map /parcel no.: Backflow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 � j ,��r,� `- Clothes washer 25.02 4417? ` / - /de / '-t ,c>2/e. Dishwasher 25.02 Drinking fountain 25.02 Ejectors/sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 ❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: Medical gas (value: $ ) Page 2 Primer 12.51 Contact name: Roof drain (commercial) 12.51 Address: ink/biOn/lavatory Appo/ f yC / 25.02 ,25 JJ 2I.- City /State /ZIP: Solar units (potable water) 62.54 Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51 E -mail: Urinal 25.02 Water closet 25.02 CONTRACTOR n Water heater 37.52 Business name: 6 / ) r ,d #q S Water piping/DWV 56.29 Address: ¢3Lt3 7 x ---- Other: 25.02 City/State /ZIP: n 977.--02-- Subtotal 0 2 ��� 02- Phone: (J ?) 7/ 2p- 7QD / Fax: ( 7 3) 77/ /eV 3 Minimum permit fee: $72.50 7, 7 . 50 Plan review (25% of permit fee) CCB Li n ' ¢ Plumbing Lic. no. :� �� State surcharge (12% of permit fee) Authorized l d signature: � � TOTAL PERMIT FEE f , . Print name '/ an Cam Date: ��' 3/-/2_ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri - County Building Industry Service Board. 1. \ Building \Permits\PLMU- PermitApp.dac 10 /01/09 440- 4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: JSitettilities Qty. Fee (ea) , Total Square Footage: Permit Fee: 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 3,601 to 7,200 $233.20 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 Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee: $1.00 to $5;000.00 - "', Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 . $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to P 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 $100.00 or fraction thereof, to (minimum charge- 1/2 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 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/hr ' $50,001.00 and lip ' ' • ' $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 fixtures could result in increased sewer fees * . Plan Review for Plumbing Installations;. , -,: > _ . Quantity by Fixture Type Plan review is required for any of the following. Fixture Type for Replace/ ' Please check all that apply. Work Performed: Capped Added Relocate 1 Baptistiy/Font ❑ Any new commercial building with water service 2" and greater, except systems designed and stamped by licensed Bath: - Tub /Shower Jacuzzi/Whirlpool engineer. Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure Drive tall as defined in OAR918- 780 -0040. Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities. Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system. -Domestic ❑ Any complex structure as defined in OAR918 -780 -0040. i Drinking Fountain Eye Wash Submit 2 sets of plans with any of the above. • Floor Drain/sink: - 2" - 3" Isometric or Riser Diagram ❑ Isometric or riser diagram is required for new buildings -Car Wash Drain that meet the qualifications above. Garbage - Domestic non -food , Disposal: - Domestic food related -Commercial food related - Industrial food related Ice Mach./Refrig. Drains Comments regarding fixture work: Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower: -Gang , -Stall ' Sink: - Lav/Bar non -food related / __ - - Bradley '. - Com/Serv/Util food related , - Service ' *Note: 'If the fixture work under this permit results in an Swimming Pool Filer ' increase of sewer EDUs, a sewer permit will be issued and Washer - Clothes Water Extractor fees assessed for the sewer increase must be paid before the Water Closet Toilet plumbing permit can' be issued.. Urinal • Other Fixtures: 1: \Building\Permits\PLMF- PermitApp.doc 08/04/2011 2