Permit .c .. AV.
. CITY OF TIGARD PLUMBING PERMIT NI
` COMMUNITY DEVELOPMENT Permit #: PLM2013 -00020
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/15/2013
Parcel: 1 S135DD00700
4
Jurisdiction: Tigard
Site address: 11710 SW WARNER AVE 1
Project: Nelson Apartments Subdivision: HOFFARBER TRACTS Lot: 38
Project Description: Replace (4) kitchen sinks, (4) lays, (4) water closets & (1) clothes washer in communal laundry room of 4 -plex.
Contractor: M B PLUMBING Owner: NELSON, DAVID
7112 NE 65TH PLACE 9620 N LOMBARD ST
., VANCOUVER, WA 98661 PORTLAND, OR 97203
PHONE: 503 - 804 -0262
HONE: 360 - 608 -9521
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 01/15/2013 $25.02
Specifics: 4 ea Sink 01/15/2013 $100.08
4 ea Lavatories 01/15/2013 $100.08
Type of Use: MF 4 ea Water Closet 01/15/2013 $100.08
Class of Work: ALT 1 12% State Surcharge - 01/15/2013 . $39.03
Type of Const: Plumbing
Occupancy Grp:
Stories:
Total $364.29
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 if —work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification : ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of/ e rules
or erect questions to O■ NC , :fling 503.232.1987 or 1.800.332.2344.
Issued By: / 1/a/a4A4,
Permittee Signature: / //
. .:�/8:—.■.. - !� —
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 Received
RECE IVED /i City of Tigard Date/By: / /� ()..b Permit No.: 4
a 13125 SW Hall Blvd., Tigard,OR 97223
Phone: 5037182439 Fax: 503 9 Plan Review
0 . . . Other Permit No.:
Inspection Line: 503.639.4175 � � 20 Date Re
TIGARD p Date Ready/By: Sufis: ® See Page 2 for
Internet: www.tigard or.gov C ITY OF TIGARD Notified/Method: Supplemental Information
TYPE DIVISION I FEE* SCHEDULE
A CNN* t+�
❑ New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New l- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
❑ 1- and 2- family dwelling ❑ Commercial/industrial 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. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: I I 1 1 0 5 IA l t 6i- Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76
Tl5 Curd R - 70692_
City /State /ZIP: � Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Wain 61( .�p l i 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
1 i Di s
t +S 4 S k5 Di
shwasher I 25.02 aj o7^
r �� ) a CC- Cie./G-11 � 1 t'1 Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY , OWNER I ❑ TENANT Expansion tank 12.51
Name: S h e rn r IV I eJ.. on Fixture /sewer cap 25.02
Address: g 1 1 2_ J a rnaJ Floordrain/floor sink/hub 25.02
Garbage disposal 25.02
City /State /ZIP: T u b n 692- Hose bib 25.02
Phone: ( 3) -720 -30 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:
oof drain (commercial) 12.51
Address:
Si asi avatory R 25.02 ate. //P
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
CONTRACTOR Water closet 4 25.02 /00. S
Water heater 37.52
Business name: M 6 `- 1 Li. m b 119 Water piping/DWV 56.29
Address: 7/ / X kit_ L5 & P(, Other: 25.02
City /State /ZIP: vr40C0t.L %¢ &.)4 7g(4/ _ Subtotal 3 9.5• , P
Phone: ( 340) Cep - 95 Fax: ( ) Minimum permit fee: $72.50 ----
CCB Lic.: P tubing Lic. no.: Plan review (25% of permit fee) l
State surcharge (I2% of permit fee) 4 7.03
Authorized signatur • _ III I TOTAL PERMIT FEE 34y, A9
•
t./
Print name: 5 h ► r I e '0 I I sv/yam f 1 Date: I/i 5 )✓✓✓mil 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.
I:\ Building \Permits\PLMU- PermitApp.doc 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:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I' 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
Valuation: Permit Fee:
Storm & Rain Drain - 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 $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 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 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
❑ Any new commercial building with water service 2" and
Baptistry/Font 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.
Drinking Fountain
Eye Wash Submit 2 sets of plans with any of the above.
Floor Drain/sink: - 2"
3" Isometric or Riser Diagram
4 " ❑ Isometric or riser diagram is required for new buildings
- Car Wash Drain
Garbage Domestic non - food that meet the qualifications above.
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 Filter increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
WaterCloset - Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
L:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
City of Tigard • COMMUNITY DEVELOPMENT DEPARTME
Request Permit Action
q AUG 8 2013
-r l(i A it I) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov_
OITYOrTIGARD
TO: CITY OF TIGARD
BUILDING DIVISION
Building Division Services Supervisor
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov V I ;1
?Z-03 :s•.,.
FROM: ❑ Owner El Applicant ❑ Contractor K City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) /\)/ -
Mailing Address:
City/State/Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
F CANCEL/VOID PERMIT APPLICATION.
FUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: P LH p9Q l ,,- cc a AO
Site Address or Parcel#: C 7 i 0 ID-Up 1-00=1- .0t/2, 4 QE--
Project Name: E-1_40 t.) 1-P(327`t--1i,J%.S
Subdivision Name: Lot#:
EXPLANATION: ke_ ( 1 p ,4 3 6-R n0�T r i 0 0 OD H l b P l-t n— ,t-
m € ? Lt./3 Ll eit,Yaf D PU.iI-i6>:2 , '61/s Ltype Fc LyetS 0_4.H PcE. -c.r
Lt_01)42 PL.i l 13- o a a 0, loo ' f-i..5 v -a� REr14_t.r7:it.7 .
Signature: - 'I/ _A.-1...fi:.i Date: gIg113
Print Name: — )t 4,1 1 € 4 b 4 - ,/4/
Refund Policy
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80%of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80%of the land use application fee for issued permits.
d) not more than 80%of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80%of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the onginal Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to S s Admin: Date ,Q®Q= ■ Rte to Bld• Admin: Date Aall B,t��
Refund Processed: Date ^/ 9 By ,: Invoice Processed: Date By
Permit Canceled: Date 9/23 7//5 By i%''•II11 -arcel Tag Added: Date By
Receipt# Date Method Amount$
I:\Building\Forms\RegPermitAction.doc Rev 05/25/2012
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PLM2013-00020
9/23/2013
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❑ Case Number Street Name Suffix Unit# Case Status Active Task Opened
❑ FLt12o13-013020 11710 WARNER AVE 1 Void 01/15/2013
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Record ID:PLi12013-00020
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Itospecttan Detail Li Conditions(0) Documents(o) -
Case# Inspection Type• Address
PLL12013-00020 320 Plumbing rough-in 11710 SW WARNER AVE,1 TIGARD,OR 97223
Request Date Requesters Phone
'0312712013 CI , 503-367-3626
Request Comment
II 153267-01 503-367-3626
Scheduled Date• Scheduled Time
032811013 12 12 ■ : 00 • AM
Inspection Date Status• Department•Current Department Inspector•Current User
03282013 i2° FAIL • Building George Heimos •
Result Comment[i Standard Comments
t Provide Oregon journeyman license of individual doing work 103.2-1.6
2 Provide contractors business license 103.226
check spelling
•
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Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11710 SW WARNER AVE 1, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
06/18/2013 00:00
PLM2013-00020
FAIL
Unit #1
1. caulking required on fixture(s) at: kitchen sink. 310.4/407.2
2. Both Kitchen sink strainer baskets leaking. 310.0
3. Caulk toilet 310.4/407.2
5. Caulk lav. 310.4/407.2
6. Tub/shower not working properly both come on at same time.
7. Tub hot water comes on first, not cold water, needs correcting. 415 0
Unit #2
1. Caulk toilet 310.4/407.2
2. Caulk lav. 310.4/407.2
3. Tub/shower handles not working properly and loose 310.4
4. Provide manufacturers installation instructions for tub valve. 310.4
Unit #3
1. Caulk toilet. 310.4/407.2
2. Provide manufacturers installation instructions for tub valve. 310.4a
3. Tub hot water comes on first, not cold water, needs correcting. 415 0
4. Both Kitchen sink strainer baskets leaking. 310.0
5. Kitchen drain stopped up. 310.0
Unit #4
1. Both Kitchen sink strainer baskets leaking. 310.0
2. Caulk toilet 310.4/407.2
3. Caulk lav. 310.0/497.2
4. Caulk right outside hose bibb. 310.4/407.2
5. Secure right outside hose bibb. 407.2 9
6. Back flow protection required for right ouside hose bibb. 603.0
7. Expose/locate outside sanitary
cleanout. 718.3/719.1
8. Expose/locate outside storm cleanout. 1101.12
9. water pressure exceeds maximum of 80 PSI, PRV required (85). 608.2
There may be more corrections.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11710 SW WARNER AVE 1, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
06/18/2013 00:00
PLM2013-00020
FAIL
Unit #1
1. caulking required on fixture(s) at: kitchen sink. 310.4/407.2
2. Both Kitchen sink strainer baskets leaking. 310.0
3. Caulk toilet 310.4/407.2
5. Caulk lav. 310.4/407.2
6. Tub/shower not working properly both come on at same time.
7. Tub hot water comes on first, not cold water, needs correcting. 415 0
Unit #2
1. Caulk toilet 310.4/407.2
2. Caulk lav. 310.4/407.2
3. Tub/shower handles not working properly and loose 310.4
4. Provide manufacturers installation instructions for tub valve. 310.4
Unit #3
1. Caulk toilet. 310.4/407.2
2. Provide manufacturers installation instructions for tub valve. 310.4a
3. Tub hot water comes on first, not cold water, needs correcting. 415 0
4. Both Kitchen sink strainer baskets leaking. 310.0
5. Kitchen drain stopped up. 310.0
Unit #4
1. Both Kitchen sink strainer baskets leaking. 310.0
2. Caulk toilet 310.4/407.2
3. Caulk lav. 310.0/497.2
4. Caulk right outside hose bibb. 310.4/407.2
5. Secure right outside hose bibb. 407.2 9
6. Back flow protection required for right ouside hose bibb. 603.0
7. Expose/locate outside sanitary
cleanout. 718.3/719.1
8. Expose/locate outside storm cleanout. 1101.12
9. water pressure exceeds maximum of 80 PSI, PRV required (85). 608.2
There may be more corrections.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11710 SW WARNER AVE 1, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
06/18/2013 00:00
PLM2013-00020
FAIL
Unit #1
1. caulking required on fixture(s) at: kitchen sink. 310.4/407.2
2. Both Kitchen sink strainer baskets leaking. 310.0
3. Caulk toilet 310.4/407.2
5. Caulk lav. 310.4/407.2
6. Tub/shower not working properly both come on at same time.
7. Tub hot water comes on first, not cold water, needs correcting. 415 0
Unit #2
1. Caulk toilet 310.4/407.2
2. Caulk lav. 310.4/407.2
3. Tub/shower handles not working properly and loose 310.4
4. Provide manufacturers installation instructions for tub valve. 310.4
Unit #3
1. Caulk toilet. 310.4/407.2
2. Provide manufacturers installation instructions for tub valve. 310.4a
3. Tub hot water comes on first, not cold water, needs correcting. 415 0
4. Both Kitchen sink strainer baskets leaking. 310.0
5. Kitchen drain stopped up. 310.0
Unit #4
1. Both Kitchen sink strainer baskets leaking. 310.0
2. Caulk toilet 310.4/407.2
3. Caulk lav. 310.0/497.2
4. Caulk right outside hose bibb. 310.4/407.2
5. Secure right outside hose bibb. 407.2 9
6. Back flow protection required for right ouside hose bibb. 603.0
7. Expose/locate outside sanitary
cleanout. 718.3/719.1
8. Expose/locate outside storm cleanout. 1101.12
9. water pressure exceeds maximum of 80 PSI, PRV required (85). 608.2
There may be more corrections.
Violation Summary:
Inspector Contractor