Permit CITY OF TIGARD REVISED PLUMBING PERMIT
ii, 3 - .) 1 -13.1 • - a:-. COMMUNITY DEVELOPMENT Permit #: PLM2013 -00077
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/21/2013
Parcel: 2S102AC01100
Jurisdiction: Tigard
Site address: 12564 SW MAIN ST 100
Project: Spec Space Subdivision: BURNHAM TRACT Lot: 1
Project Description: Adding (1) dishwasher, (1) expansion tank, (2) 2" floor drains, (2) primers, (1) mop sink, (1) breakroom sink, (2)
lays, (1) shower stall, (4) water closets and (1) water heater.
Contractor: COLUMBIA MECHANICAL INC Owner: MAIN STREET LLC &
PO BOX 2164 DUDUNAKIS, MICHAEL P
WOODLAND, WA 98674 18380 RIVER EDGE LN
LAKE OSWEGO, OR 97034
PHONE: 360 - 225 -1600 PHONE:
FAX: 360 - 225 -8755
, FEES
. Quantity Description Date Amount
1 ea Dishwasher 03/11/2013 $25.02
Specifics: 1 ea Expansion Tank 03/11/2013 $12.51
. 2 ea Floor Drain /Floor Sink/Hub 03/11/2013 $50.04
Type of Use: COM 2 ea Primer 03/11/2013 $25.02
Class of Work: ALT 2 ea Sink 03/11/2013 $50.04
Type of Const: 2 ea Lavatories 03/11/2013 $50.04
Occupancy Grp: 1 ea Tub /Shower /Shower Pan 03/11/2013 $12.51
Stories: 3 ea Water Closet 03/11/2013 $75.06
1 ea Water Heater 03/11/2013 $37.52
1 12% State Surcharge - 03/11/2013 $40.53
Plumbing
1 ea Water Closet 03/11/2013 $25.02
0 12% State Surcharge - 03/11/2013 $3.00
Plumbing
Total • , $406.31
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 es irons to-OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: V Permittee Signature:
VV 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 RECEIVE,
Building Fixtures g `� FOR OFFICE USE ONLY
City Ti and MAR Received Permit 77
q 131 SW Hall Blvd., Tigard,OR 97223 1 1 20 IS Date/By: 5 it 13 ( A lypo r 3 -0 �
.1111 ° CI Date/By: soPo 01. �p57
Phone: 503.718.2439 Fax: 503.598.196 ' I'Y � TT G A p n Other Permit No.:
ML Y:
Inspection Line: 503.639.4175
TI GARD B UILDING
DN Date Ready/By: Juris: See Page 2 for
Internet: www.tigard- or.gov IS I ®
Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE V'
❑ New construction ❑ Demolition For special information use checklist 1>
Description I Qty. I Ea. I Total q�
01 Addition/alteration /replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) (�
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 9.j
❑ 1- and 2- family dwelling ❑ ComerciaUndustrial SFR (2) bath 437.78 1
m
SFR (3) bath 500.32 0
❑ 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:
Catch basin or area drain 18.76
Job site address: 1 Z S b `( s i I^-I . M A J/ SA-:-.
City/State /ZIP: Drywell, leach line, or trench drain 18.76
Footing drain (no. linear ft.: ____,) Page 2
Suite/bldg. /apt. no.: /op Project name: aP£C. o 2PPre._.t, Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 18.76
i
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: Lot no.: Fixture or item:
IT
Tax map /parcel no.: p2 I ba li d i 100 Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
_ Clothes washer 25.02 •
AO0I r A./ C /2/F ST OD F R NrS() Dishwasher I 25.02 A 5'. 0 ''' c.,
- re • i A .y3 Drinking fountain 25.02
Ejectors /sump 25.02 , `AN
❑ PROPERTY OWNER I ❑ TENANT Expansion tank t 12.51 / 2.5 /
Name:
Fixture /sewer cap 25.02 .
Floor drain/floor sink/hub g v s 7, 25.02 50.
Address:
Garbage disposal 25.02 I �`
City /State /ZIP: Hose bib 25.02 �
Phone: ( ) Fax: ( ) Ice maker 12.51 I el'
❑ APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Pall
Business name: Medical gas (value: $ ) Page 2
Primer Z 12.51 A6-. G '''
Contact name:
Roof drain (commercial) 1 12.51
Address: n•P . 41, -- thtl 25.02 . 4g
Sink/basin/lavator�r 51d11,1 1- � '� /OD
City /State /ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax:: ( ) Tub /shower /shower pan ( r ritu 1 12.51 /2•5
E -mail: Urinal \ 25.02
CONTRACTOR Water closet ;II 25.02 /
Water heater 1 37.52 37,51.
Business name: C_0 (v,. I i' 1 (A e u c,/} -1
Water piping/DW V 56.29
Address: p. O. QD x 2 1 6 41 Other: 25.02
City/State /ZIP: W OD 0 Lii1/4/-1■0 W w '1 16' 7.1 Subtotal 3/
Phone: 34 ) Z Zs , I ( O 9 Fax: (3 60 2 13--- g.7y Minimum permit fee: $72.50
Plan review (25 %of permit fee) '
CCB Lic.: i S I (Z, i/ /ro/r'f Plumbing Lic. no.: 3-7- k ',a� State surcharge (12% of permit fee) 4 ,.
Authorized signature: 7 r /14 �
e: J; ����y TOTAL PERMIT FEE �n /p ��
/ ° T his permit application expires if a permit is not obtained within 180 Jays
after it has been accepted as complete.
Print name: K�,N, E LA.1 1 Date: 3- ! I _ 3
*Fee methodology set by Tri -County Building Industry Service Board.
I:\ Building \Pennits\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 - 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
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
Baptistry/Font
CI 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.
CI Cuspidor/Water Aspirator Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial CI Any multipurpose fire sprinkler system.
Domestic CI 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
❑ 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
washt r - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
Water Closet Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF- PermitApp.doc 08/04/2011 2
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
12564 SW MAIN ST 100, TIGARD, OR, 97223
Commercial - Plumbing
320 Plumbing rough-in
03/25/2013 00:00
PLM2013-00077
FAIL
1. Correct vent back-pitched at dble lav location 905.1
2. Provide mid-story guide on 2" break room sink vent
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
12564 SW MAIN ST 100, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
04/16/2013 00:00
PLM2013-00077
FAIL
1. Provide hot water. 418.0
2. Provide cut sheet/ installation instructions for Sioux chief P trap primers 310.4
3. Remove plastic test caps from floor drain tail pieces. 310.0
Violation Summary:
Inspector Contractor