Permit �r CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit #: PLM2013 -00121 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2013
Parcel: 1 S136CC00100
Jurisdiction: TIGARD
Site address: 8200 SW PFAFFLE ST
Project: Westside Christian High School Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: Interior plumbing for remodel and addition. (4/16/13, fixtures on page P2.03 not included in scope of work at this
time)
Contractor: TAPANI PLUMBING Owner: WESTSIDE CHRISTIAN HIGH SCHOOL
PO BOX 2350 4565 CARMEN DRIVE
BATTLE GROUND, WA 98604 LAKE OSWEGO, OR 97035
PHONE: 503 - 697 -4711
HONE: 360 - 687 -3983
FAX: 360- 687 -4494
FEES
Quantity Description Date Amount
1 ea Catch Basin or Area Drain' 05/15/2013 $18.76
Specifics: 1 ea Backflow Preventer 05/15/2013 $31.27
2 ea Clothes Washer 05/15/2013 $50.04
Type of Use: COM 2 ea Dishwasher 05/15/2013 $50.04
Class of Work: ADD 3 ea Drinking Fountain 05/15/2013 $75.06
Type of Const: 2 ea Expansion Tank 05/15/2013 $25.02
Occupancy Grp: 12 ea Floor Drain /Floor Sink/Hub 05/15/2013 $300.24
Stories: 2 ea Ice Maker 05/15/2013 $25.02
5 ea Primer 05/15/2013 $62.55
• 22 ea Roof Drain (Commercial) 05/15/2013 $275.22
20 ea Sink 05/15/2013 $500.40
11 ea Lavatories 05/15/2013 $275.22
7 ea Tub /Shower /Shower Pan 05/15/2013 $87.57
4 ea Urinal 05/15/2013 $100.08
10 ea Water Closet 05/15/2013 $250.20
2 ea Water Heater 05/15/2013 $75.04
Total $3,298.59
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 Notifica ' 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 estions to O C • • • Iling 503.232.1987 or 1.800.332.2344.
Issued y: • 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 Applicatio
Building Fixtures 'RECEIVED FOR OFFICE USE ONLY
City of Tigard Received [/
II . y g APR 1 6 2013 Date /B 7 , /7 �• / Permit No.: I L��O /3- 9° /Q,/
• 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.598. O ther Perm No.:
Inspection Line: 503.639.4175 �Y OFTIGAR Date /By: i gay(' 13 i / 3 -� D
T I G A R D Date Ready/;Y: ,./ tons: El See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISIOP Notified /Method: 7 Supplemental Information
TYPE OF WORK ' ,,... Vwt 0/ �, FEE* SCHEDULE
❑ New construction ❑ Demolition i For special information use checklist.
Description I Qty. I Ea. I Total
Ix Addition/alteration /replacement ❑ Other: New I- 2- family dwellings (includes 100 II. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
❑ I- and 2- family dwelling [ii 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: Bo■LJ O eta PE%tc-r l- LC-
Catch basin or area drain 18.76 I8.7(O
Drywell, leach line, or trench drain 18.76
City/State /ZIP:
\ Footing drain (no. linear ft.: _) Page 2
Suite /bldg. /apt.no.: I Project name: (OVA -Si C *a l 0 - 7�s.J 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
Stone sewer (no. linear ft.: _) Page 2
Water service (no. linear ft.: _) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map /parcel no.: I , i ,3( e / 0 01 CO Backflow preventer i 31.27 31.
DESCRIPTION OF WORK Backwater valve 12.51
`` Clothes washer it X 25.02 5 oV
C�vk O\ )rxgth� Dishwasher sC a. 25.02 X
Y p 7413 Drinking fountain 3 25.02 75•
6/h(Q - �CUi�!/ )�O� Of_ p(,UOle�c � 1 e_ Ejectors /sump 25.02
® PROPERTY OWNER I ❑ TENANT Expansion tank /2 k 12.51 Ac.o.2
Name: 61 e 4,e (J'. .k � YklC�t, SC�vJ� Fixture /sewer cap 25.02 �'r
Address: 45.c5 �itrM 0n v.. Floor drain /floor sink /hub f �� ' 25.02 �00. `I
Garbage disposal 25.02
City/State /ZIP: L twtO OR Hose bib 25.02
Phone: ( 503) 64'7 - 97) u Fax: (S03) G4 - 46-0 5 Ice maker a , 12.51 25.0
55 APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02
Business name: 1 �G�; f 1vh. , Inc. Medical gas (value: S ) Page 2
Contact name: L a rs )46,4 C.* -SOr\ Primer S 12.51 b�. ...5
SE. Roof drain (commercial) ..?,2_ ... ..13-- - 12.51 a 7 S". A2
Address: 2.‘t11 SE. \2 - AV G Sink/basin/lavatory 3 - " 25.02 7 7 6%42.
Cit /ZIP: Soak" G G otna f vja q6O1 Solar units (potable water) 62.54
Phone: ( 36- Gin - 3q $3 Fax: : (360) G 7 -1-44 K L{ Tub /shower /shower pan / 12.51 ? 7. S7
E -mail: Urinal q 25.02 loo. v g'
CONTRACTOR Water closet /C:, fir 25.02 Pgti. AO
Water heater 2 X 37.52 15
Business name: f pi ,n; PIVti6„, ,) Water piping/DWV 56.29
Address: Z183 SL Il & Av Other: (t) f I Os U1 6/ 25.02 X00• /r'0
City /State /ZIP: 3 � Grotm , l inlik €4809 _ �/ Subtotal . 2 t y v i, 6
Phone: (.CO) 3' On - " 39$S Fax: IQ) .6$?- 44gLf AQCI+ F,` (,oc
CCB Lie.: 604S8 Plumbing Lic. no.: 37- 26q P$ Plan review (25% of pennit fee) 4,,, y 7
� State surcharge (12% of permit fee) k,t , �3
Authorized signature: //p4 ` - TOTAL PERMIT FEE 3, mit , 63
Print name: L Qi Rc c x s e, \ Date: 4/161,3 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by - I - ri- County Building Industry Service Board.
I:1Building PermitsTLMU- PermitApp.doe 1001.09 440- 4616T(1002,CONIVEB)
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 S121.90
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 S327.54
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 51.00 to 55,000.00 Minimum fee S72.50
Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to S10,000.00 S72.50 for the first $5,000.00 and $1.52 for
Other Inspections or Fees Qty. Fee (ea) Total each additional SI00.00 or fraction thereof, to
and including $10,000.00.
Inspection of existing plumbing or for S10,001.00 to S25,000.00 S 148.50 for the first S10,000.00 and S I.54 for
which no fee is specifically indicated 90.00/hr each additional 5100.00 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 S50,000.00 S379.50 for the first $25,000.00 and S1.45 for
hours (minimum charge - 2 hours) each additional S100.00 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 5742.00 for the first $50,000.00 and $1.20 for
(minimum charge - 1/2 hour) each additional S 100.00 or traction 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 Reply "/ Plan review is any required for of the following. Performed: Capped Added Relocate 9 y g'
Baptistry/Font Please check all that apply.
-
Bath Tub /Shower ❑ Any new commercial building with water service 2 and
- Jacuzzi /Whirlpool ( I greater, except systems designed and stamped by licensed
Car Wash - Each Stall engineer.
- Drive Thou ❑ 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 3 ❑ Any complex structure as defined in OAR9 I 8- 780 -0040.
Eye Wash
Floor Drain /sink - 2" (0 9(i Submit 2 sets of plans with any of the above.
-4"
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic- non -food • ❑ Isometric or riser diagram is required for new buildings
Disposal - Domestic -food related that meet the qualifications above.
- Commercial -food related
- Industrial -food related
Ice Mach. /Refrig. Drains a,
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink /lay - Non -food related 3 Zo 3
- Bradley
- Commercial -food related
- Service
Swimming Pool Filter
Washer - Clothes I (A) *Note: If the fixture work under this permit results in an
Water Extractor increase of sewer EDUs, a sewer permit will be issued and
Water Closet - Toilet 3 7 /p fees assessed for the sewer increase must be paid before the
Urinal r452-2(
) 7, plumbing permit can be issued.
Other Fixtures:
T: \Projects \Active Jobs \westside christian high school \Project Managing \PPrmits \PLMF- PenmitApp.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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
2013-12-20 00:00:00
PLM2013-00121
FAIL
1. Provide information regarding primer location for mechanical room hub drain.
203.0/310.4
2. Locate p trap primer for emergency eyewash/shower floor drain.102.2.2
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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
2013-12-23 00:00:00
PLM2013-00121
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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
335 Rain drain
06/06/2013 00:00
PLM2013-00121
PART
NOTE: 8" underslab tied to 12" existing, rough/test with water pass. Rest of R/D to
come.
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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
305 Plumbing underslab
06/11/2013 00:00
PLM2013-00121
PART
NOTE mens/womens bathrooms, behind kitchen underslab rough/test pass
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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
305 Plumbing underslab
06/06/2013 00:00
PLM2013-00121
PART
2" 3-ea locations near auditorium, rough/test with water, ok for cover, rest to come.
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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
305 Plumbing underslab
06/06/2013 00:00
PLM2013-00121
PART
2" 3-ea locations near auditorium, rough/test with water, ok for cover, rest to come.
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
8200 SW PFAFFLE ST, TIGARD, OR, 97223
Commercial - Plumbing
305 Plumbing underslab
06/14/2013 00:00
PLM2013-00121
FAIL
1. Provide acid tank listing and installation instructions. 310.4
Inspected acid waste piping from bldg to tank, tank to downstream tie-in and tank 2" vent
to bldg only. Rough/test with water. Ok
Violation Summary:
Inspector Contractor