Permit CITY OF TIGARD PLUMBING PERMIT
- 13 " .- COMMUNITY DEVELOPMENT Permit#: PLM2013-00318
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2013
Parcel: 2S 101 DC03800
Jurisdiction: TIGARD
Site address: 7190 SW SANDBURG ST 10
Project: Spec Space Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Move(1)breakroom sink
Contractor: WESTERN PLUMBING Owner: MCCORMACK PROPERTIES LP
9460 SW TIGARD AVE SUITE 101 7190 SW SANDBURG ST
TIGARD, OR 97223 TIGARD,OR 97223
PHONE: 503-639-5296 PHONE: 503-624-4649
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Sink 09/12/2013 $25.02
Specifics: 1 12%State Surcharge- 09/12/2013 $8.70
Plumbing
Type of Use COM 47 ea Minimum Fee Adjustment- 09/12/2013 $47.48
Plumbing
Class of Work: ALT
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature,07/274:4
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
09/12/2013 12:07 5036849015 WESTERN PLUMBING INC PAGE 01/03
Phimbine Permit Anolica 11;4 t ",E1, Ir. rl
Bitilding Fixtures . . li i. ) rol: oi r:c - L:s1:
Qy of Tigard EP 1 2 2013 =B,: 9/a- /3 rb
"-- ) 11crmil NG.' zt-/-1-6/3-ao31
.....-- 13125 .,SW Bali Blvd Tigard,OR Yi•_
Plan Review
NJ .at Phone: 5016394171 Rua E960 Date03j: Other Pannit No.; iazdadietg-Vaga
- , Inspection Line 503.639A175
5°34t91-1 Y OF TIGARD Data Ready/By: _
Ads 62 sce Page 2 far
Sapplamentsd Infornmtion
116\ /-' Internet www.6gard-er.goy pull niNG DivisioN mittr41"k, _,. :. , .........,, ,.....,-
, ........;:: :...,. ,, . ,-.. -.. ,: ::,;4'.5 q'::,1,..-,:.,. .j:':::'.. .: '''T:;:,......:„'!: ;.4.•:',..., .:,'-..",‘,'.',.' ::•:,..- , .
E3 New construction 0 Densolitio. a
:Desaird' ion I Qty. 1 Ea. I Total
0 Addition/alterationtreplacement 0 Otber: New 1-2-tordly dmilinga(includes 100 11.ter each utility connection) ,
. : ;- ..:):',1-,',-.'....J-.•.:':-1':::- 6iiiirki0,:irip!ON_$*02.01;:- '-. .. :.::.' :.::'.'' - : .1...; SFR(I)bath I 312.70
SFR(2)bath 437.78
0 I-ax0 2-fiur11y dwelling 0 Contmercialruidnezial
- SFR(3)balb 50032
C".1 Accessory building 0 Multi-family
Each additions]batMcitchen - 25:02
iD Master builder El Other
lira sprbsidor(____sq.fi.) Page 2
at,iiiiiiiieic,00-.0400)1: : . ' " ' : ‘ :. Site wafts'
Catch basin or arta drain 1&76
ti\V kb site addres \AAC/1 S.13 altrek10 iiqk_r ' 'Wk02i4 SU1141/4/n Dir„----7-u,icathlim crucuch drain
18.76
CitY/StThdZIR-cooscl, .cV!Gt-1- ?) u . Panting churn(no.linear ft:_) Page 2
StiteAkI8JaPt W.: 70 I Prciect namc \ Manufactured Immo utilities 50.03
Cross strect/directions to job site. Pc_e_ gaq- Manholes 18.76
Rain drain conneeor 18.76
Saldtary sewer(no.linear ft:- Page 2
-
Storm newer(no.linear ft.:_ ) Page 2
Wider service(no. heart:_,) Page 2-Subdivision: Lot no: 'Fixture or Sem
Badcflow promisee 31.27
Tesmap/parcel no.:
-
12.51
. : • 1.r...'!: • ; : :.: :0 **.",.0#1.P4'.: -:'. ' I cubes%vadat 25.02 V.
Dishwasber 25.02
Drinking ibuntain 25.02
.-
Fjectorahaunp 25.02
- ''•'.-''..:7.1tf*iii*iiiiiiiii***::,.:::.::::', ir -.[.:..:: .;;:10-*040t:',::::'' ,,:.1 ':...2.':, EzPamicintunk 12.51
Fn/sew er cap 25.02
Name
Floor drain/floor sinkilmb 25.02
Address:
Garbage disposal 25.02
City/State/ZIP
_ Hose bib 25.02
Phone'( ) Far(. ) ; Ice maker 12.51
' tif'61kiAt't;Oittiteit. . :'--'7, IntetenlAnntrcann Mg)
..:.j 3:0Y000147-':'': ''' ' ::: . .,,L._ , . , . .,, .: . , _ • 2502
Business
Medical gas(vat=S ) Page 2
name:
Primer 12.51
Contact name:
Roof drain(connuereial) 12.51
Address: _
Sishibasiniktvatory j 25.02
Oty/Stateilll': Sots:units(potable water) 62.54 -
Phone( ) I Fax:( ) Tublabower/shower pan 12.51
V
E-mail: Urinal 25.02
25.02
':' '',':-: '':';'.;•. :!.;,;.:..1. :.,;.,.:. ,:.:'.. :, "' '' •' ''"''" ::■!„...1:...:.:''':'..:'. ,:::.-, ,:.. .;, : ,.., ',:. ,. .:v Water closet
, -
3732
Business name:Westeni Plumbing,In
,Water pipinWDWV 54.29
OkLi Address:9460 SW Tigard Avaanre Suite 101 Other: 25.02
City/StaterZIP:NMI,OR 97223
tinbtotal-Phone:(503)639-6296 Froc(503)604-9015 Mm=permit feet $72.50
Flan review
CCB Lic.:2439 Plumbing Lie.no.:34-29PB &permit
Authorized signature: lajlifan&(
ked7
:
i St*.surchargeTCfr(12eAAL PERMITaPenuit 'ik21:1Cla)
. (f)/LQ/j,„ I Tido permit Applicata expires If a parudt n not atuataed wain 180 days 0.)
print name:Dana Jensen
on...tivaAttultlr:rt..-sTrat::tttp..„4,,A
09/12/2013 12:07 5036849015 WESTERN PLUMBING INC PAGE 02/03
Plumbing Permit Anulication -City of Tigard
Page 2-Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
s.:106failliie.7 ...,':-: ::::':..!:',';:;'::-'1'"Ak$:". .7:404.07:ce:r#OF;: ')•"-''''''''''':-"" -''':.'.. ...... ..iiik5F-
iosienci;in--0 100' 50.03 0 to 2,000 $121.90
- -
' 2,001 to 3,600 3169.69
Footing drain-each additional 100' . 3732 -
3,601 to 7,200 $233.20
Sewer-Id 100' 6254 7,201 and greater $327.54
_ . .
Sower-each additional 100' 37.52
Water Service-1st 100' 2.54 ----7- Medical Gas steuxs:
_
Water Service-each adernional 100 3732
4 :::-Vrittalki44.-". . :::',15..ftlitactie:.'-;"::::'I''',:. -', . ; •-. ':':,: ',
Strain&Rain Drain-lst 100' 62.54 SLOO to$5,000.00 Maim=he t72.50
Storm a Rain Drain-each addidemi 100' -- 37.52 35,001.00 to 310,000.00 372.50 for the first$5,000.00 and$1.52 for
each additional$100.00 Of*action thereat to
I T 0 l i 0- 'iiitiOatthOlAVOIrlitaXi ‘.I-I:.917'''': '" et - ;- - - and including$10,000.00.
Inspection of existing plumbing or for 310.001.00 to$25,000.00 $143.50 fbrthe first$10,000.00 and 3134 for
which no the is specifically indicated 90.00/hr each additional$100.00 or fiaction thereat to
.(minks=charge-1/2 hour) and inchufmg 325,000.00.
Inspeetiona outside of normal hethness 90.00/11r $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 thereot to
Reimpoction Fees 90.00/hr and inehefing$50,000.00.
Additional $50,001,00 and up 374100 for the Stet$50,000.00 and$1.20 for
plan review for revisions 90.130/17
(minimum charge-1/2 hoer) each addilional$100.00 or fraction thereof.
Subtotal:
...deem . ..
Commercial Fixture Work;
Are you capping,adding or replacing fixture? If"yes",
., ..•;.- ,.:,
: ::,..!;:141:0040. „0401,01silibillitlhittteta , ,
please indicate work performed by&ram Failure to Phe review is required for any of the following
accurately report frames could result in increased sewer fees*. Please check all that apply.
' :‘.:;.,:.-..1:;',..: : ::..:•-: :"..,..:-. ..:. s.:.:;'0 .,:,.,,-,44 pliaii4Orioi: :i..7;.:....,„,7, 0 Any new commercial building with Neter service 2"and
I.,': ',.•I''',t- ...I.,-.. :'..--1 -...: 41.. f*I,'' greater,except systans designed and stamped by licensed
:.„ '.,.,..„: ,.., :.. ,,:•:.: ::'. .-;: .ioiteproai: .'-oiiiiii'. "1406'Abligthile engineer.
/Font 0 New exterior plumbing site utilities for any complex Stntallre
Bath -Tub/Shower
' as dermal in OAR918-780-0040.
-Jacuati/Whirtpool ID Medical gas and vacuum systems for health care ficilites.
Car Wash -Each Stall 0 Any multipmpose BM sprinkler system.
-Driven= . 0 Any=pies structure as defined in OAR918-780-0040.
.__ idor/Witter Amirstor \
Dishwasher -Commercial __ Submit 2 sets of plans with any of the above.
-Domestic .
Drinking Fountain
_E.,, Wash 1 ', :,:i.::::'::1'.:,:::•':*.,*(1400t1WOrc '_, „, , .;'- 'I...:.• :''','•:
Floor Drain/sink -2" U isometric or riser diagram is required for new buildings
3"" - that meet the qualiftcalions above..
-
Car Wash Drain : —
Garbage -Domestic
Disposal -Commercial
-Inohntrial Comments regarding fixture work:
- .. ..
Ice Idach./Refiig.Drains .
Oil Separator(Gas Mon) . .
Roc..Vehicle Dump Station
Shower -Gang ,
-Stall ------- ---
Sink. -aralLavaSacy
-Bradley
. -Cormnweial *No If the fixture work under this permit results in an
-Service - increase of sewer EDlls,a sewer permit will be issued and
Swimming Pool Filter . ... . fees assessed for the sewer Increase must be paid before the
'Washes:-Gott=
Water Marae -.is - . permit can be issued.
l
Water Closet-Tenet
_
Urinal - -
, Other Figures: