Permit 3111 4: ..�� CITY OF TIGARD PLUMBING PERMIT
-- COMMUNITY DEVELOPMENT Permit#: PLM2013-00263
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2013
Parcel: 2S 113AB00500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD 310
Project: Sterling Bank Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: (1)dishwasher,(1)sink and(1)water heater for TI for new tenant.
Contractor: MIKE PATTERSON PLUMBING Owner: G&S FC LLC
15028 S MITCHELL LN 16083 SW UPPER BOONES FERRY RD,
OREGON CITY, OR 97045 STE
TIGARD, OR 97224
PHONE: 503-632-7374 PHONE:
FAX: 503-632-5647
FEES
Quantity Description Date Amount
1 ea Dishwasher 07/31/2013 $25.02
Specifics: 1 ea Sink 07/31/2013 $25.02
1 ea Water Heater 07/31/2013 $37.52
Type of Use: COM 1 12%State Surcharge- 07/31/2013 $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:
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.
•
Jul.29.2013 03:00 PM Mike Patterson Plumbing 5036325647 PAGE. 2/ 2
Plumbing Permit AnnlicatkRn ED
Building Fixtures JUL 29 2013 1.-oft 01 i••lc i.: Isl.: u\l.\
City of Tigard ® �;'� Permit Nn/�L�y2pj3'QQad
.�,-• 13125 SW Hall Blvd.,Tigard,OR 972 �TIG�►RD I�
t0 Phut Rcvicw 13-ea 70
Phone: 503.718.2439 Fax: 503,5 t �1 n' Other PamnilS
!r it
Inspection Line: 503.639.4175 �' ®IIVG 131 V I vlOrVDale Rn ®CsK� z for
Imom& www. d-or ov ��vd 7 3/
1� •g Notified/Method/� //� Supplemental Information
,. '. -,,�,.- .;��.^+4.;�./.}..l.n �:C�r - . :°� R rw.'��� . r„�:;'•!' i. ..i.+;ir
❑New construction ❑Demolition Far special information use checklaL
_-._..r....._,...,._.-..,. Description I Qty. I Ea, I Total
®Addition/alteration/replacement ❑Other: New 1.2-family dwellings(includes 100 ft.for eaoh utility connection) W
`' :; SFR 1)bath 312.70
_SFR
(2)bath 437.78
❑ 1-and 2-family dwelling ®Commercial/industrial
❑Accessory building SFR(3)bath 500.32
ry g ❑M�tti-family Each acWitiontil bath/kitchen 25.02
❑Master builder YrNpt y❑yyOther: �h1 Fire spruilcicr(__sq.ft.) Page 2 IA
,''1' Jr' („i»*',ti`'`!9,"���„ **:'. "M";M.h 'f":''' ' no, c, 4! Slt7itiliti.7. __..-...._.--
Job sitc address:16083 SW Upper Boones Ferry Rd Catch hasin or area drain 18.76
City/State/Z1P:Tigard,OR 97224 Drywall,leach line,or trench drain 18.76
Footing drain(no.linear It.:,,,,,,,,-) Page 2
Suite/bldg./apt.no.: . .(O I Project name:Bartel-Sterling 3"111r Manufactured home utilities 50.03
Cross street/directions to job site S L/N Manholes 18,76
Rain drain oonneotor 18.76
-�-- -- Sanitary sewer(no,linear ft.:_) Page 2
Storm sewer(no.linear ft: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or item:
Tax map/parcel no.: preventer T^- 31.27,- --
.-1�-s" \ rj i( ,;1 F '*00/2^^i 43 *( L e f i c r i Backwater valve 12.51
Clothes washer 25.02
Tenant Improvement -Sterling Bank 3'u Floor niahwaaher 1 25.02 25.02
Drinking fountain 25.02 - --
J jectors/stunp 25.02
' ',iA:4 * ! ',o n i I1', 4_ : : 4'._ii..'s a ."1 Rxpanainntank 12.51
Name:
Fixture/Kowa onp 25.02
Flour druin/Iluur sink/hub 25.02
Address:
Garbage disposal 25.02
City/State/ZIP: !lose bib 25.02
Phone:( ) Fax:( ) lee maker 12.51
., M,;-�•r,. .' :, *' I11ter tor/ se any 25.02
:i��r:. �':�., ;lr.7•h �`�;:'�i. rr.:•,A;;,L?"J.� t.y..! sc :�`-�`,.5",i i � i�a
efr/ Business name: 6e-�QTEL r -Areiz ef-c, � �,pM°dieal gas(value;$ ) Page 2 n ._ w 12.51
0 contact jE1// -J I�f Q f w 7 , Roof drain(eommereial) 12.51
Address; _ } �Sink/basin/lavatory 1 25.02 25.02
(/ City/Stan/Z1P; J Solar units(potable water) 62.54
/ Phone; Fax:: Tub/shower/shower pan 12.51
<.� CSo3) �So- yD�y �lose-yro y
E-mail: Urinal 25.02
;.7;- .,•.:
25,(2 t7 \L.T •.,.t". d,1trt: i `t;. r -.ir -tr: - ' Water clo set
Waterlteuler 1 37.52 37„52
Business name,Mike Patterson plumbing �- '""Wc
A Waltz ptptng/DW V 56.29
Address:15028 S.'Mitchell Ln Other: 25.02
City/State/ZIP:Oregon City,OR 97024 Subtotal 87.56
r - Phone:(503)632-7374 Fax:(503)632-5647 Minimum permit fee: $72.50
∎41. CCB Lie.:81746 j .2-/ / Plumbing ^Lie.no.:3-359PB Plan review (25%of permit tee)
State surcharge(12%of permit fee) 10.51
Authorized signature: � 1
� VIJI �� ,i ,e' TOTAL PERMIT FF.F:
Print name:Jennifer Be':,en -�_ Date:07/29/2013 I This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
"Pee methodology sot by Tri.County Building Industry Service Board.
1:tlluiWingWormia'JlMal•rcrmiIApp.aloc ID/01/09 440•saluTt10r02/COM/weR) 9-G/ 0/
Jul. 30.2013 08:30 AM Mike Patterson Plumbing 5036325647 PAGE. 2/ 2
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information
Fee Schedule: µ �+ Residential Fire Suppression Systems:
1.
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-let 100' 62.54 7.201 and greater $327,54
Sewer-each additional 100' 3732
Water Service-hit 100' 62.54
Medical Gas Systems:
Water Service-each addonal 100' 3732
sterol&Rau,Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Stoma&Rain lhain-each additional 100' 37.52 $5,1101.00 to$10,000.OU $72.50 for the first$5,000.00 and$1,52 for
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 90,1/0/hr and including$50,000.00.
Additional plan review for revisions 90,00/hr $50,001.00 and up $742.00 for the Goat$50,000.00 and$1.20 for
(minimum charge—1/2 hour) v 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 Fitttur&r'p� ,9 , rr nrr S r
Flrtune T fen eRl,. ,1,
Plan review is required
for any of the following.
•Work Py droned:` ( tee
Please chock all that apply.
Baptistry/Font
Rath Tub/Shower El Any new commercial building with water service 2"and
Jnnuaai/Whirlpoel greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
Drive 3•hru 171 New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR9I 8-780-0040,
Dishwasher -Commercial . ' El Medical gas and vacuum systems for health care facilities.
-Domestic / El 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„
-4"
Cur Wash Drain
Garbage -Derne,t;N Hutt-lied ❑ isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Cummereiul—food elated
d ndustrial-food related
Ice Mach./Refrig.Drains _
Oil Separator(Gas Station) ., Comments regarding fixture work:
Ree.Vehicle Dwt p Station "Other"fixture is a water heater
Shower -Gang
-Stall
Sink/Lav -Nun-fund related 1
-Bradley
-Commercial-fond related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes er 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: 1
http://www.tigard-or.gov/city_hall/departments/cd/docs/PLMF-PermitApeloc