Permit CITY OF TIGARD PLUMBING PERMIT
or 2 COMMUNITY DEVELOPMENT Permit#: PLM2013-00328
•
TIGARD 1312 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/17/2013
5
Parcel: 2S 102AA00600
Jurisdiction: Tigard
Site address: 11940 SW PACIFIC HWY A
Project: Pacific Plaza Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: Replacing 65 ft.of sanitary sewer.
Contractor: DETEMPLE COMPANY INC Owner: ALPROP LLC
1951 NW OVERTON ST 6149 SW SHATTUCK RD
PORTLAND, OR 97209 PORTLAND,OR 97221
PHONE: 503-227-2641 PHONE:
FAX: 503-274-7686
FEES
Quantity Description Date Amount
65 If Sewer Service 09/17/2013 $62.54
Specifics: 1 12%State Surcharge- 09/17/2013 $8.70
Plumbing
Type of Use COM 10 ea Minimum Fee Adjustment- 09/17/2013 $9.96
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:
•
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.
•
SEP/13/2013/FRI 05: 17 PM FAX No. P. 002
Plumbing Permit Applicati itEcEyV ED Site Utilities
FOR Ob'I.7(:l• USE ONLY
City of Tigard ti L P 16 2013 Received
III DateB : PermitNo.: nl ,,,, �p
u 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ` ��� �,3_� a'--
2 Phone: 503.718.2439 Fax: 503.eiTroF TI Date/By: Other Permit No.:
Inspection Line, 503.639.4175 CARD °
''"^'�° Internet: www.tigard-or.gov BUILDING DIVISION Nortifi Ready/ay:ehd: "e' S lia fie neme 2 for
`� y'. 1. � «M 1 ,1 rT y SuU l information
�..��-,- � omen
['New construction ❑Demolition For special Information use checklist -
Description 1 Qty. I Ea. I Total _
®Addition/alteration/replacement hK{ t�]¢►e�❑Other New 1-2-family dwellings(includes 100 ft.for each utility connection)
�.�.l „„� , �-21/1" '� o a c s) ti J �d.,w��: ,� {m SFR 1
, ��, , ' Obath _ 312,70
❑ 1-and 2-family dwelling ®CommerciaVindustrial SFR(2)bath 437.78
❑Accessory building ❑Multi-family SFR(3)bath 500.32
❑Master builder Each additional bath/kitchen _ 25.02
�_ ,rw Other:
Fire sprin der sq.ft.) Page 2
r. T
� I ( s ,ft.
tj,. �?taC4 '?� �+ ' *�� ,; ! .ii :..;-,rioH•, .' '- „r' . Sitcutilitles:
Job site address:11940 SW Pacific Highway Catch basin or area drain 18.76
City/State/ZIP:Tigard OR 97223 -
Drywell,leach line,or trench drain 18.76
Footing drain(no,linear ft.: ) Page 2
Suite/bldg./apt_no.: I Project name:99111&Hall Waste Line Manufactured home utilities 50.03
Cross Street/directions to job site: Manholes 18,76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:(1;) ,1 Page 2
_Storm sewer(no.linear ft.: ) Page 2
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• Water service(no.linear ft.: ) Page 2
Subdivision: Lot no.: Fixture or Item:
Tax map/parcel no.: Baekflow preventer 31.27
1 + �` "� ' ar "" ,x Backwater valve 12.51
Replace ro'Af 65'of $ s Jolt a','r ,t ' �.� 'Ho- . .y '`%.hid-F-:-- r.
p approxiately waste line Clothes washer 25.02
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
4p'IS M rE'. n iQ °"` _ z_. .�, tiler r K - ti:•`,i
Expansion tank 12.51 4 ; .4 A: ,. l r, 1). , �
Name:ARM Property Management Fixture/sower cap 25.02
Address:6149 SW Shattuck Road Floor drain/floor sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP:Portland OR 97221 Hose bib 25.02
Phone:(503)519-1111 Fax:( ) Ice maker 12.51
._. Interceptor/gease trap k" �� r A ��* . , � 25.02
Business name:DeTemple Company,Inc Medical gas(value:$ ) page 2
Primer 12.51
Contact name:Julie Prabucki _
Roof drain(commercial) 12.51
Address;1951 NW Overton St
Sink/basin/lavatory 25.02
City/State/ZIP;Portland OR 97209 Solar units(potable water) 62.54
Phone:(503)227-2641 Fax::(503)274-7686 Tub/shower/shower pan 12.51
E-mail:j.prabucki®detemple.com Urinal 25.02
i ;�y}� � 3� .` - v � .. Water closet 25.02
ri.
s f�T 4 ;5.j°, ♦iQ .1'.�: • ,� .'ti`T Ly�;-,s ..; 0 k+-1,o- r .. .'.Y Water heater 37,52
Business name:Same as Applicant Water pipingJDVIrV 56.29
Address: Other: 2$.Q2
City/State/ZIP: • Subtotal 37.52
Phone:( ) Z Fax:( ) / _ Minimum permit fee: $72.50 72.50
CCB Lic.:2510 Plumbing Lic.no.:26-25P13 ✓ Plan review (25%of permit fee)
State surcharge(12%of permit fee) 8.70
Authorized Si: i re: .TW/ d 1)/4161,44/44 TOTAL PERMIT FEE 81.20
Print name' bete:09/13/13
This permit application expires it a permit is not obtained within 180 days
after it has been accepted ee complete.
•Pee methodology set by Tri-County Building Industry Service Board.
l:1BuildiMkPo rcluta1PLMU-PermitApp.doc 10/01/09 440.4616T(10/02/COMIWEn)
SEP/13/2013/FRI 05: 17 PM FAX No, P. 003
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su► ressroa S stems:
' � � '..q" F i i � � 4.....r
`,„.1, �",a Q ,4-m ,... � - t `i:•:'x:+,;;"d` .,,r,,,''yym=',
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
Sewer-Ist 100' 62.54 3.601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 1 37.52 37.52
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52 a i ��
,' ti 1 ii a 1' - .a r i, i
Storm&Rain Drain-1st IN' r ' e 0 3 `= ,
62.54 4: 4 . :t... .F . _,
$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
(4,6 t VEli'I r •,cf� kt�r`p l AZ;, :c 7P) .'r•i(-�� each additional$100.00 or fraction thereof,to
Inspection of existing plumbing or for and including$10,000.00,
$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 s 90.00/r and includin:$50.000.00.
Additional plan review for revisions 90.00/4 $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*.
�t :ry A I Quantty;biFi tuitt I'y�e,. 4, ",a /.. -3 �, ., Y r k X41
F tdE ftltlw� * ;r _ ..i 0,, .. .. r r �
Atni k'Prrforcnie ;, ` capp'ottr•,, AadS�: ltorocote - Plan review is required for any of the following,
Baptistry/Font Please check all that apply,
Bath -Tub/Shower _ – ❑ Any new commercial building with water Service 2"and
-Jamul/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"
-
4 i
Car Wash Drain � ,..a �� '1.911 �' o " 6. +, �, `•�
Garbage -Domestic-non-food
El or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Conunercial-food related
-Industrial-food related
Ice Mach./Refrig.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 '
washer-Clotl,es *Note: If the fixture work under this permit results in an
• 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.
hup;//www,tigard-or.gov/city hall/departments/ed/docs/PLMU-PermitAp2doc