Permit CITY OF TIGARD PLUMBING PERMIT
IA n - COMMUNITY DEVELOPMENT Permit #: PLM2013 -00200
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/26/2013
Parcel: 2S113BA00400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 115
Project: Davidson Benefits Planning Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Add (1) breakroom sink and (1) water heater for TI.
Contractor: JAMES ROOD PLUMBING INC Owner. PORTLAND SW CENTER LLC
125 S 1ST AVE #542 BY FELTON PROPERTIES INC
HILLSBORO, OR 97123 ATTN: FELTON, MATT
520 SW 6TH AVE, STE 610
PORTLAND, OR 97204
PHONE: 503 - 547 -0491 PHONE:
FAX: 503 - 547 -0492
FEES
Quantity Description Date Amount
1 ea Floor Drain /Floor Sink/Hub 06/26/2013 $25.02
Specifics: 1 ea Sink 06/26/2013 $25.02
1 ea Water Heater 06/26/2013 $37.52
Type of Use: COM 1 12% State Surcharge - 06/26/2013 $10.51
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $98.07
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: ®N 4-730 4. /69_
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 Applieati
Building Fixtures
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City of Tigard J UN 19 2013 l 4 / 2V /- 3 . :: ° PanaitNo O fa0 /3 - / i .20 •
• 13125 SW Hall Blvd., Tigard, OR 97Z2 Plan Review Oth Permit N
phone: 503.718.2439 Fax: 503.59 DateiBy: • i 3 - , O/ A
Inspection Line 503.639.4175 vi OF TIG ARD Date Ready/By. 4ay is ,,e4111111 63 s S leme for
Internet winformation
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❑ New construction ❑ Demolition v 4.1 a ' For s +ecial information use checklist
a escription I Qty. I Ea. J Total
111 Addition /alteration/replacement ❑ Other: New 1 dwellings (includes 100 ft fbr each utility connection)
' .,•c gt 'r l 5 }, ,c - o . (: I r ` r-,; i i t E0+ i n SFR (I) bath 312.70
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❑ 1- and 2 -family dwelling P., ComtnerciaVindustrial SFR (2) bath 437.78
SFR (3) bath 50032
❑ Accessory building ❑ Multi- family Each additional batiilkitchen 25.02
❑ Master builder ID Other: Fire sprinkler (- sq ft) 1. Page 2
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P pp y f ;, ., ( - l t Y � ?' , Site utilities
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Job site address: 743 II ; ;taw.. Catch basin or area drain 18.76
Drywell, leach line, or trench drain 18.76 MIN
City/State/ZIP: 12.. _ Footing drain (no. linear ft.: !_) Page 2
i 1 e .1dg. /apt. no.: /I S Project name: Davy .- C Manufactured home utilities 50.03
` Cross street/directions to job site: P 4 S/n/ /Ai,,•G -Grp 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.: _ - ---� I;ackflow preventer 31.27
,r... r-»- entry n t , 5 . ; r r ;�. *�* -r �,. 7 ' try 4-;i:;: Backwater valve 12.51
t Y> 66 rr*+�' t' k z i 4 v t i t r f r b i 7 1+ „ t f J� (' .� i i {t k _
.bR liik i, r:' .. d k 'fit ^ r i I ,L..I {._k:t, x �.. . .3�!w.b.0 s.. Clothes washer 25.02
_ .._ Dishwasher 25.02
• . Drinking fountain 25.02
Ejectors /sump 25.02
- t r 7 rr I i i ^n• Expansion tank 12.51
�a r•� t ...: r r t o .. t r � - �. l 1E 1 ' � t Y t t 4 S t � J � to { r }t r- � r , .: :1 tank 'iii: q=1,: ::}, ., l';',4, � « . e ` • - - . ?. f :.1. ' . - .,.r Yr J�_ (l. w4! ti�',iI :,.LS._ _.:v ..v,.niw r :,
Fixture/sewer cap 25.02
Name:
Floor drain/floor si .4 ub 25.02 A 5, •.
Address: -,..--
Garbage disposal 25.02
City /State/ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
: E ,cc' interceptor/grease tra 25 02
' ti-� t jF hr iU" l +l 1 �; v ^a J„ .3y.: i 1 : :' -;r -,- n ` "_ ,i :l.:?�3 r.Y .j ti" �z;P r. -f:?. i trap
Medical gas (value: $ ) Page 2
Business name:
Primer 12 51
Contact name:
- Roof drain (commercial) 12 51
Address: Sink/basin/lavatory / 25.02 5 0/
-
City /State/ZIP: Solar units (potable water) 62 54
Phone: ( ) Fax: : ( ) Tub /shower /shower pan 12,51
• Urinal 25.02
E-mail:
�7�, L><i ate. t S t ,� r " A 1i...r I u } Y ,-7 �.r�yl�f4f "" v, t � T c. r Water closet
E 25.02 y
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)it�t:
•...:, e.tt ._t - -- i -`- ,.,r.�,u.,,. '� pis _ -. zy f..•.,;•�_,,.i.y .,, ^,�, >... ;rjt4....__�w.. Water heater 37.SZ ?. 5
P p�^
Business name: C�yq�gI r i f . d, water piping/DWV 56.29
Address: ,5 j St _ j r,, tf" Sly 2., Otter 25.02
Ci y /State/ZIP:}ij is b 17 rf.-, Subtotal 1 1! lffl
shone: ($' 1) 4/7.r 041 ei Fax: ( 3) S' ti 7.- OVG$ 2 Minimum permit fee: $72.50
1 'Y �» Plan review (25% of permit fee)
CCB Lie.: i "' Plumbing Lie. no r r .
-_ • . State surcharge (12% of permit fee) }a 5
Authorized signature: TOTAL PERMIT FEE or 9 , 07
This perm application expi ita permit is not obtained within 180 days
Print name: Date: it after it has been accepted as complete
*Fee methodology set by Tn- County Building Industry Service Board
dac 10/01/09 4.40444 671O/O7/COM /WEE) q a r 0 / //r
t
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Sul • ression S stems:
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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 $23320
Sewer - 1st 100' 112511 7 201 and : eater $327.54
Sewer - each additional 100' 37.52
water Service - 1st 100' NM 62.54 Medical Gas S stems:
Water Service - each additional 100' 37.52 4 y � 1fr�}r( / " .� ,7 Yf t R� 7.:F. 4( m,i; ,w :_iii ,,t
\ r ..1!. . ,w. F e,,, C1f l d A , !i:,,f 7 _ +a :tti l 'Y i Al rr; * 7. .., } t�1� :i:Ai �.. :iii,
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
4 t��nl'z i , c,f ,. rx ,, : r^ ^ i : : r 1 r t ) rP 1 y ( , r F t each additional $100.00 or fraction thereof, to
o' aw C it � r � ,r^ t c r t f , 4s f . L .,v y21Y r '
+,.� :.�. - r <:� � ,. r ti r ; �I1 1 ,sr.1. +� ; .� � a. ^�.�e� � � ,....., . ,err,+ r t:. d � . x1r�: „tv., r �.�1 and including $ IO,000.OU
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 char:e -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 oh:: -2 hours each additional $100.00 or fraction thereof, to
Reinspection Fees 1111. 90.00/hr I 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 char:o- 1/2 hour each additional $100.00 or fraction thereof.
Subtotal: I=
Commercial Fixture Work:
Are you capping, adding or replacing fixtures? If "yes",
please indicate work performed by fixture. Failure to
accurate] re t I rt fixtures could result in increased sewer fees * .
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is r 4 , q 1 , r i v. r4 4 i 11 ^ , T 1 4,N: i r r , '�{ 1 4 ' ,. t s"" Plan review is required for any of the following.
I� rt1 9 :ki t.LJMt iiii y � ' ; . { l t"
iir••
i ;i. ....s f .>t is 4 � a ? ,r;k1 ;l
Beptisiry�,ant Please check all that apply.
Bath -Tub/shower
❑ Any new commercial building with water service 2" and
J acuzzi/Whirlpool greater, except systems designed and stamped by licensed
Car Wash - Each Stall engineer.
- Drive Thm ❑ 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 ❑ My multipurpose fire sprinkler system.
Drinking Fountain ❑ My 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"
4" S 7 � �).� t .f-. ' -, Y ti .! ' _.tom � 1 < 1 ,,n
Car Wash Drain .u. ,:, s= h �J
Garbage ^Domestio-non food N • Isometric or riser diagram is required for new buildings
Disposal - Domestic -food related that meet the • ualifications above.
-Commercial-food related
- Industrial -food related
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Corn lot regarding fixture rk:.
Rec Vehicle Dump Station . (1 4 a " S JC '5 i
Shower -Gang
Stall .L 9. - 1• 1.... Ce wr
gt .v -Non-food related I Pi iC Via w ' ,
-
- 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:
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