Permit n CITY OF TIGARD PLUMBING PERMIT
111- 8 : COMMUNITY DEVELOPMEN Permit #: PLM2013 00153
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/16/2013
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10170 SW NIMBUS AVE H7
Project: Children of the Sea Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: (1) backflow preventer
Contractor: BEAVERTON PLUMBING INC Owner: HANSON, RONALD D
13980 SW TV HWY ROBINSON, CONSTANCE A
BEAVERTON, OR 97005 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 643 -7619 PHONE:
FAX: 503 - 643 -7620
FEES
Quantity Description Date Amount
1 ea Backflow Preventer 05/16/2013 $31.27
Specifics: 1 12% State Surcharge - 05/16/2013 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 05/16/2013 $41.23
Type of Use: COM Plumbing
Class of Work: OTR
Type of Const:
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: i / // Q - J4J A � Permittee Signature: °Ai P ,
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.
From: 05/15/2013 15:42 #078 P.002/004
Plumbing Permit AppLc l ag , i' l p F
jm Building Fixtures
City of Tigard MAY 1 2013 Received S /�9 / F1�l�F)( �/�J
i i
g Date/By: Permit No.
• 13125 SW Hall Blvd., Tigard, OR Plan Review
' TI AR®
C Phone: 503.718.2439 Fax: 503 01 6Q Date BY: Other Permit No.:
Inspection Line: 503.639.4175 �� ae� pqp 1 u � r.
TIGARD �I� -utvC; DIVIS1'! DateReady /By: I [� $eege2for
Internet: www.tigard-or.gov Notified/Method: 11 Supplemental Information
TYPE OF WORK FEE* SCHEDU
❑ New construction ❑ Demolition For special Information use checklist
Description I 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 (1) bath 312.70
❑ 1- and 2- family dwelling ® Commercial /industrial SFR (2) bath 437.78
❑ Accessory building ❑ Multi- family SFR (3) bath 500.32
Each additional bath/kitchen 25.02
❑ Master builder 0 Other Fire sprinkler ( sq. ft.) Page 2
JOB. SITE INFORMATION AND LOCATION . Site utilities:
Job site address: 10170 SW NIMBUS ST 11-7 Catch basin or area drain 1 8.76
Drywell, leach line, or trench drain 18.76
City/State/ZIP: PORTLAND, OR 97223 Footing drain (no. linear ft.: _ ) Page 2
Suite/bldg. /apt. no.: I Project name: CHILDREN OF THE SEA 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 1 31.27 31.27
DESCRIPTION OF • WORK'
Backwater valve 12.51
Clothes washer 25.02
REMOVE BROKEN AND INSTALL NEW BACKFLOW PREVENTER . Dishwasher 25.02
THIS WILL BE A 1/2" WATTS/ 009QT Drinking fountain 25.02
Ejectors/sump 25.02
®- 'PROPERTY: Ii =TE NANT: - • Expansion tank 12.51
Name: DAVID JENKINS Fixture/sewer cap 25.02
Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City/ State/ZIP: Hose bib 25.02
Phone: (503) 901.0399 Fax: ( ) Ice maker 12.51
_ . ' 0. APPLIC,tNT _ 0 ;CONTACT.P ERSON interceptor /grease trap 25.02
Business name: Medical gas (value: $ _ ) Page 2
Contact name: Primer 12.51
Roof drain (commercial) 12.51
Address:
Sink/basin/lavatory 25.02
City/State/ZIP: Solar units (potable water) 62.54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
-- Water closet 25.02
.. . CONTRACTOR -
Water heater 37.52
Business name: BEAVERTON PLUMBING, INC Water piping/DWV _ 56.29
Address: 13980 SW TUALATIN VALLEY HWY. Other: 25.02
City/State/ZIP: BEAVERTON, OR 97005 Subtotal
Phone: (503) 643.7619 Fax: (503) 643.7620 Minimum permit fee: $72.50 72.50
CCB Lic.: 12889 Plumbing Lic. no.:'1 �-' P 3 Plan review (25% of permit fee)
�
State surcharge (12% of permit fee) 8.70
Authorized signature: . ` TOTAL PERMIT FEE 81.20
Print name: MEGAN E. GRADY Date: 5/15/13 Thu 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.
L 9uilding \Permits \PLMIJ- PermitApp.doc 10/01/09 440- 4616T(10/02/COM/WEB)
From: 05/15/2013 15:42 #078 P.003/004
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: - Residential Fire Suppression Systems:
;Site a : tilllities 4h ;,, Bei.fea> Total SquareFoota 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 _
Valuatiijnci.:. er nik; ee: - : `: ` •
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
each additional $100.00 or fraction thereof, to
p e Qty - Fee_(ea) Total and including l $1 000 0 o
0.-.Ins c ons orFees:.
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 90.00/1u 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 *.
Qtiant,t�:tiy Fixture Type " evlew;for Plu i n s ta l la t on
Future TYrire for Replace/ Plan review is required for any of the following.
Work Performed Capped; Added. Relocate e9 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.
-3
Car wash Drain = ;;:Isometric s Ri es 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 MachiRefrig. 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 Pool Filter *Note: If the fixture work under this permit results in an
Washer - Clothes P
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:
http: / /www.tigard- or.gov/ city_hall / departments /cd /docs/PLM F- PennitAppyoc
From: 05/15/2013 15:41 #078 P,.001/004
S.F 4 D 4 y6� S, Y ,�t j 7 , . 3 K 3 { F B: l T.,? 7, x,�k`;F ,,+• Tr �.. •+. '" . ........ ........a... -,#.r e.Cr. 'r< Y I.0 . ` a „"N i.ku L i - t 47 r S . . .
13980 SW Tualatin Valley Hwy_
Beaverton OR 97005
503.643.7619
Fax 503.643.7620
CCB## 012889
meaan@beavertonplumbing.com
TO: FROM: MEGAN GRAbY
COMPANY : CITY OF TIGARD DATE: 05 -15 -13
FAX #: 503.598.1960 TOTAL NUMBER OF PAGES 4
PHONE #: 503.718.2439 REF:
PLUMBING PERMIT APPLICATION
To Whom it may concern,
Attached is the plumbing permit application and cc authorization for the Children of the Sea job.
Please call me at any time if you have any questions.
Also, please send a cc receipt once processed.
incerely,
E
Megan Grady _
Beaverton Plumbing, Inc
503.643.7619 (Ph), 503.643.7620 (F)
megan@beavertonplumbing.com
,:a
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
10170 SW NIMBUS AVE H7, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
05/23/2013 12:19
PLM2013-00153
PASS - No C of O
Violation Summary:
Inspector Contractor