Permit CITY OF TIGARD PLUMBING PERMIT
111 = COMMUNITY DEVELOPMENT Permit #: PLM2013 00084
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/14/2013
Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 6650 SW REDWOOD LN 355
Project: Spec Space Subdivision: 1996 -048 PARTITION PLAT Lot: 2
Project Description: Relocating (1) dishwasher and (1) breakroom sink
Contractor: ADDISON PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES
27425 S BEAVERCREEK RD ATTN: N PIVEN
MULINO, OR 97042 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 740 -8116 PHONE:
FAX: 503 - 632 -1168
FEES
Quantity Description Date Amount
1 ea Dishwasher 03/14/2013 $25.02
Specifics: 1 ea Sink 03/14/2013 $25.02
1 12% State Surcharge - 03/14/2013 $8.70
Type of Use: COM Plumbing
Class of Work: ALT 22 ea Minimum Fee Adjustment - 03/14/2013 $22.46
Type of Const: Plumbing
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:
jk i t Permittee Signature:
( 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 FOR OFFICE USE ONLY
-
City of Tigard
Received
a 131 ll
SW Hall Blvd., Tigard, OR 97223 Date /By: �� 1 D �' � I Permit No.t 0 Sy
Plan Review ^ S
Phone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit / J 1 3 ' U+ 4
T I G A R D Inspection Line: 503.639.4175 Date Ready /By: Jeri); H See Page 2 for
Internet: www.tigard or.gov Notified/Method: '1/ Supplemental Information
TYPE OF WORK FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. I Ea. I Total
® Addition /alteration /replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 312.70
❑ I- and 2- family dwelling ® Commercial /industrial SFR (2) bath 437.78
building SFR (3) bath 500.32
❑ Accessory g ❑ 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 �, 1: jP /0,5 0 w� 1Z-e.,4 tame) L Catch basin or area drain 18
0 , L /111,:7•, " /n be
City / State/ZIP: T r t D Drywell, leach line, or trench drain 18.76
V Footing drain (no. linear ft.: _) Page 2
uite Idg. /apt. no.: 5 5" 1 Project name: Pet l -3.53--- Spe ._ Manufactured home utilities 50.03
Cross street /directions to job site: J ce �( u e, %a 7 k1, � Manholes 18.76
7 v ) 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: 1 Lot no.: Fixture or item:
Tax map /parcel no.: Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Dishwasher ( 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: PacTrust Properties Fixture sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkway #300
Garbage disposal 25.02
City /State/ZIP: Portland, Oregon 97224 Hose bib 25.02
Phone: (503)624 -6300 Fax: (503)624 -7755 Ice maker 12.51
❑ APPLICANT 4 CONTACT PERSON Interceptor /grease trap 25.02
Business name: Durus Construction, LLC Medical gas (value: $ ) Page 2
Primer 12.51
Contact name: Steve Adams
Roof drain (commercial) 12.51
Address: 15836 Upper Boones Fry Rd
Sink/basin/lavatory / 25.02
City /State /ZIP: Lake Oswego, Oregon 97035 Solar units `
(potable water) 62.54
Phone: (503) 320 -8601 Fax: : (503) 684 -8144 Tub /shower /shower pan 12.51
E -mail: steve @durusllc.com Urinal 25.02
Water closet 25.02
CONTRACTOR
Water heater 37.52
Business name: Addison Plumbing Water piping/DWV 56.29
Address: 2 7 47.S' S. g,..„,,NC,- . -2¢aG. 9.-<3 Other: 25.02
City /State/ZIP: p \< otg- g704-2- Subtotal
Phone: Sa Fax: Sct3 Minimum permit fee: $72.50
( $ )biz - 1 Ls-7 ( )63Z i r bG
CCB Lic.: 1 St -, S i- Plumbing Lic. no.: 3 - ,. t4 P
i 6 Plan review (25 % of permit fee)
State surcharge( 12% of permit fee)
Authorized signature: &-v....‘,..4 ,A TOTAL PERMIT FEE SS t
Print name: ,a Vtitl6,r@ Date: j �y T his permit application expires if a permit is not obtained within� O days
/ / after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
1: \ Building \ Penn its \PLMU- PermaApp.doc 10/01/09 440 -4616T( I0 /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 - 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
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
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 *.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review is required for any of the following. Performed: Capped Added Relocate 9 y ow g
Baptistry /Font Please check all that apply.
Bath Tub /Shower ❑ Any new commercial building with water service 2" and
- Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
- Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor /Water Aspirator as defined in OAR918- 780 -0040.
Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities.
- Domestic f ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040.
Eye Wash
Floor Drain/sink - 2" Submit 2 sets of plans with any of the above.
-3
Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage - Domestic- non -food q g
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 f
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer - Clothes
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: \Documents and Settings \Steve Adams\My Documents \STEVE ADAM2\DURUS\2013\PLMF- PermitApp.doc
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
6650 SW REDWOOD LN 355, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
05/07/2013 00:00
PLM2013-00084
PASS - No C of O
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
6650 SW REDWOOD LN 355, TIGARD, OR,
97224
Commercial - Plumbing
399 Plumbing final
05/07/2013 00:00
PLM2013-00084
PASS - No C of O
Violation Summary:
Inspector Contractor