Permit CITY OF TIGARD PLUMBING PERMIT
111 t ! COMMUNITY DEVELOPMEN Permit #: PLM2013 00215
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/01/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9699 SW WASHINGTON SQUARE RD C10
Project: Portland Seafood Company Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Install 75 gal grease interceptor
Contractor: APOLLO DRAIN & ROOTER SERVICE Owner: PPR WASHINGTON SQUARE LLC
2208 NW BIRDSDALE #8 PO BOX 847
GRESHAM, OR 97030 CARLSBAD, CA 92018
•
PHONE: 503 - 239 -8801 PHONE:
FAX: 503 - 669 -9568
FEES
Quantity Description Date Amount
1 ea Interceptor /Grease Trap . 07/01/2013 $25.02
Specifics: 1 12% State Surcharge - 07/01/2013 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment - 07/01/2013 $47.48
Class of Work: ALT
Plumbing
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 !cation Ce - Those les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or ect questions to OUNC • c• ing 03. 2.1987 or 1.800.332.2344.
ssued By: // Permittee Signature: m s p
t
l c 1� e vikeittY
_ 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
Building Fixtures RECEIVED
City Tigard Received
Date/By: 7 l 1 - l� l^/3_OO n s-
CI of Ti and Re eive Permit No.: (� OfIJ p�(
n 13125 SW Hall Blvd., Tigard, OR 972J L 01 2013 Plan Review
' 0 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 C OFTIGARD D ate Ready/By: Ju ris: El See Pa e 2 for
TtGAKD y Y g
Internet: www.tigard or.gov B Notified/Method: Supplemental Information
. . TYPE O F I�GDNISION FEE SCHEDULE
❑ New construction 0 Demolition For special information use checklist
Description I Qty. I Ea. I Total
FQ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
•• • ..CATEGORY OF CONSTRUCTION SFR (1) bath 312.70
El 1- and 2- family dwelling pl. 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:
/ a 6\ S W c) 1 _ Catch basin or area drain 18.76
G
Job site address: b ln) v�.t`w'{ 7) 0 5RUCvV1-C.
City /State /ZIP: -1-Z3 a 0 it q -12_23
Drywell, leach line, or trench drain 18.76
t�� `` Footing drain (no. linear ft.: _) Page 2
Suite/bldg. /apt. no.: I Project name: Pevtt PNc - OOU Manufactured home utilities 50.03
Cross street/directions to job site: C2, tM r4 v. y Manholes 18:76
- 1 y J� 1l !! 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 25.02
rN Sr7a 11 1 o 4�y r. &St ToJ +C✓C97+O1 Dishwasher 25.02
�`JJ 1 Drinking fountain 25.02
Ejectors /sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
_\ s e \ Fixturc/scwcr cap 25.02
?OVA O a 11� o C) CO tM rawly Floor drain/floor sink/hub 25.02
Address:
Garbage disposal 25.02
City /State /ZIP: Hose bib 25.02
Phone: ( ) Fax: ( ) Ice maker 12.51
. at APPLICANT . ' ❑ CONTACT PERSON . Interceptor /grease trap % 25.02
Business name:
Medical gas (value: $ ) Page 2
Primer 12.51
Contact name:
Roof drain (commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State /ZIP: Solar units (potable water) 62.54
Phonc: ( ) Fax: : ( ) Tub /shower /shower pan 12.51
E -mail: Urinal 25.02
Water closet 25.02
CONTRACTOR
' Water heater 37.52
Business name: p po I 1 0 p`vw Water piping/DWV 56.29
Address: 2 _D 9 I f l,tJ 5%.y. v d l t_ g v, g Other: 25.02
City/State /ZIP: 0.� ii(,GSk kvvl OK- 11 C40 Subtotal
Phone: (Sp3) z9 Z 65 ' Fax: ( ) Minimum permit fee: $72.50 7�j
CCB Lic.: L-( Cj 9 ( B Plumbing Lic. no.: A "5 6.3 PP) Plan review (25% of permit fee)
State surcharge (12% of permit fee) g,7-4'
Authorized signature D1) iNte S ? ( -c.A- TOTAL PERMIT FEE 8l .
Print name: J/yrrNe> 1 C `e w. -u--.5 Date: '') - 1 - 1 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 Tri- County Building Industry Service Board.
I:\ Building \Permits\PLMU- PermitApp.doc 10 /01/09 440- 4616T(l0 /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 - Is 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
Storm & Rain Drain - 1st 100' 62.54 Valuation: Permit Fee:
$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 ec
Ins tions or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to
l� 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 ❑ Any new commercial building with water service 2" and
greater, except systems designed and stamped by licensed
Bath: -Tub/Shower
engineer.
- Jacuzzi/Whirlpool
Car Wash: Each Stall ❑ New exterior plumbing site utilities for any complex structure
Drive tall as defined in OAR918- 780 -0040.
Cuspidor/Water Aspirator ❑ Medical gas and vacuum systems for health care facilities.
Dishwasher: Commercial ❑ Any multipurpose fire sprinkler system.
Domestic ❑ 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: -Lay/Bar non -food related
- Bradley
- Com/Serv/Util food related
- Service *Note: If the fixture work under this permit results in an
Swimming Pool Filer increase of sewer EDUs, a sewer permit will be issued and
Washer - Clothes fees assessed for the sewer increase must be paid before the
Water Extractor
WaterCloset - Toilet plumbing permit can be issued.
Urinal
Other Fixtures:
I:\Building\Permits\PLMF _PermitApp.doc 08/04/2011 2
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9699 SW WASHINGTON SQUARE RD 010, 2013 -11 -27 (null)
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2013 - 00215
Inspection Type: Result:
399 Plumbing final PASS - No C of 0
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9699 SW WASHINGTON SQUARE RD 010, 2013 -11 -25 (null)
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2013 - 00215
Inspection Type: Result:
399 Plumbing final FAIL
Comments:
1. Provide photos of corrections, #1 thru #5 dated 11/20/13, as requested.
Violation Summary:
Inspector Contractor