Permit 4 CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00102
T ( CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/28/2013
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16280 SW UPPER BOONES FERRY RD
Project: Service Master Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30
Project Description: Install (3) washers and (1) 2" floor drain
Contractor: ADDISON PLUMBING LLC Owner: PACIFIC REALTY ASSOCIATES LP
27425 S BEAVERCREEK RD ATTN: N PIVEN
MULINO, OR 97042 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
P
PHONE: 503 - 624 -6300
HONE: 503 - 740 -8116
FAX: 503 - 632 -1168
FEES
Quantity Description Date Amount
3 ea Clothes Washer 03/27/2013 $75.06
Specifics: 1 ea Floor Drain /Floor Sink/Hub 03/27/2013 $25.02
1 12% State Surcharge - 03/27/2013 $12.01
Type of Use: COM Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $112.09
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:
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 ,71 &a- ol3 -Doo 7/
Building Fixtures RECEIVE [ FOR OFFICE USE ONLY
City of Tigard Received Q ^7 r A l /
- Date /B a p( i / Permit No.: (,l -al
U O Z
l
13125 SW Hall Blvd., Tigard OR 97223 MAR 2 7 2013 J�, • � /�,,, I� [�
Pl an Review •
/' G/, ✓'
P hone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit No.: f Il� 7
Inspection Line: 503.639.4175
TIGARD CITY OF TIGARD Date Read /B Jana: El See Page 2 for J
Internet: www.tigard or.gov N' ^1 Notified/Method: Supplemental Information
f
TYPE OF WORK� DIVISION FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. Ea 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
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 437.78
El Accessory building SFR (3) bath 500.32
ry 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: Catch basin or area drain . 18.76
/ 5t O v .1��, .dr .
i Drywell, leach line, or trench drain 18.76
City /State/ZIP: -1.5. A.Y t4 / 9 q 1 7 2 - 4
Footing drain (no. linear ft.: _ ) Page 2
Suite/bldg. /apt. no.: I Project name: 5:4_,,,,.) ) 14 _ *.a. d " Manufactured home utilities 50.03
Cross street /directions to job site: --- E7 u v s k 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
Clothes washer 3 25.02 75'
�� At Cl4 C t..0 / � “) i -CI BOY' 6i no F ion 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 A5,02
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 ❑ 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@duruslIc.com Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: Addison Plumbing Water piping/DWV 56.29
Address: 2 S 3:,e,„,-,„,......."._y_ ..-JI . Other: 25.02
City /State/ZIP: p,,,, ..,,, co- e -z Subtotal
Phone: (S`a'd) ‘Al..-- les7 Fax: (5213 ) _ ttloS! Minimum permit fee: $72.50
CCB Lic.: I .� 7 S Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature: Cr- Q TOTAL PERMIT FEE 15// o q
Print name: Date: This permit application expires if a permit is not obtained within 180 days
�y after it has been accepted as complete.
*Fee methodology set by Di- County Building Industry Service Board.
t: \Building \Permits \PLMU- PemtitApp.doc 10/01/09 440-4616T(10 /02/COM/WEB)
te r ,
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
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.
Work Performed: Capped Added Relocate q Y 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 ❑ 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.
_-
4 " Isometric or Riser Diagram •
Car Wash Drain ❑ Isometric or riser diagram is required buildings
Garbage - Domestic- non -food q red for new buildin g
Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach. /Refiig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav - Non -food related
- Bradley
- Commercial -food related
- Service
Swimming - Clothes :1) nh Filter
Washer *Note: If the fixture work under this permit results in an
• Washer
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
NI Accumulative Sewer Tally
_ 7 Tenant Name: Service Masters SWR # 2013 -00074
TIGARD Site Address: 16280 SW Upper Boones Ferny Rd PLMM # 2013 -00102
Parcel #: 2S 1113AB01201
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s value count added # added value total #s total values
Baptistry /Font 4 0 0 0 0 0
Bath: - Tub /Shower 4 0 0 0 0 0
- Jacuzzi /Whirlpool 4 0 0 0 0 0
Car Wash: - Each Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor /Water Aspirator 1 0 0 0 0 0
Dishwasher: - Commercial 4 0 0 0 0 0
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 0 1 2 1 2
- 3 inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash 6 0 0 0 0 0
Garbage Disposal:
- Domestic (to 3/4 1 -HP) 16 0 0 0 0 0
- Commercial (to 5 1 -IP) 32 0 0 0 0 0
- Industrial (over 5 11P 42 0 0 0 0 0
Ice Machine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower: - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink:
- Lay/Bar - Non -Food Related 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Com /Serv/Util - Food Related 3 0 0 0 0 0
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 3 18 3 18
Water Extractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0.2 3.2
'I'O7'ALS 0 0 0 0 4 20 4 16.8
Current Fixture Value 16.8 divided by 16 = 1.050 Current EDU 1 EDU = $4,665.00
Previous Fixture Value 0 divided by 16 = 0.000 Previous EDU
Change 16.8 divided by 16 = 1.050 over (under) S 4,898.25
Enter EDU Change Here 1.050
Notes: Credits from PL1\12011 -00260 applied to this permit, no remaining credits.
Authorized Name /Signature: Debbie . \damski Date: 3/27/2013
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. I f credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
1:\ Building \Scwer Tally \Sewer CallySheet- 4665.xls 07/01/12
Accu mulative Sewer Tally
1 111 Q : enant Name: SPEC 51';ACI? * * RI?V ISI {D * ** SWR #
TIGARD Site Address: 16280 SW UPPI {R BOONI;.S l:E.RRY RD PLMM # PLM2011 -00260
Parcel #: 2S113AB01201
Fixture Value Previous Previous Credits Capped Fixture Fixture New New
# value count capped #s value count added # added value total #s total values
Baptistry /Font 4 0 0 0 0 0
Bath: - Tub /Shower 4 0 0 0 0 0
- Jacuzzi /Whirlpool 4 0 0 0 0 0
Car Wash: - Each Stall 6 0 0 0 0 0
- Drive through 16 0 0 0 0 0
Cuspidor /Water Aspirator 1 0 0 0 0 0
Dishwasher: - Commercial 4 0 0 0 0 0
- Domestic 2 0 0 0 0 0
Drinking Fountain 1 0 0 0 0 0
Eye Wash 1 0 0 0 0 0
Floor Drain /Sink: - 2 inch 2 0 0 0 0 0
- 3 inch 5 0 0 0 0 0
- 4 inch 6 0 0 0 0 0
- Car Wash 6 0 0 0 0 0
Garbage Disposal:
- Domestic (to 3/4 I'll 16 0 0 0 0 0
- Commercial (to 5 HP) 32 0 0 0 0 0
- Industrial (over 5 1 -IP) 42 0 0 0 0 0
Ice Alachine /Refrigerator Drain 1 0 0 0 0 0
Oil Sep (Gas Station) 6 0 0 0 0 0
Rec. Vehicle Dump station 16 0 0 0 0 0
Shower: - Gang (per head) 1 0 0 0 0 0
- Stall 2 0 0 0 0 0
Sink:
- Lay/Bar - Non -Food Related 2 0 0 0 0 0
- Bradley 5 0 0 0 0 0
- Com /Serv/Util - Food Related 3 0 1 3 0 -1 -3
Swimming Pool Filter 1 0 0 0 0 0
Washer - Clothes 6 0 0 0 0 0
Water Extractor 6 0 0 0 0 0
Water Closet - Toilet 6 0 0 0 0 0
Urinal 6 0 0 0 0 0
Previous EDU Count 0 0
Capped EDU Credit 0
'I'O'I'ALS 0 0 1 3 0 0 -1 -3
Current Fixture Value -3 divided by 16 = -0.2 Current 13DU 1 EDU = $4,500.00
Previous Fixture Value 0 divided by 16 = 0.0 Previous EDU
Change -3 divided by 16 = -0.2 over (under) $ (900.00)
Enter EDU Change Here -0.2
Notes: ** *CREDIT * ** 3/27/13, CRI :DI'I'S , \PPI,1I?D TO SWR2013- 00074, dra
Authorized Name /Signature: BR. \NDIFN'1', \GGAR'T Date: 8/12/2011
Building Division
Note: The property owner shall retain the ORIGINAL sewer tally record. If credits exist, this document will serve as a voucher which must be
submitted to the City of Tigard Building Division to redeem credits towards future system development charges.
I:\ Building \ Sewer Tally \ScwerTallyShcet- 4500.xls 07/01/11
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
16280 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Plumbing
399 Plumbing final
04/30/2013 00:00
PLM2013-00102
FAIL
1. Cannot have shut off valve with handle, code requires shut off with screw stop. 1007.6
2. Remove A/W box knock outs. And provide trim covers. 310.4
3. Verify that flashing for VTR has been installed. ( see last inspection)
4. Provide access cover for primer assembly. 1007.6
Violation Summary:
Inspector Contractor