Permit CITY OF TIGARD PLUMBING PERMIT
1111 g COMMUNITY DEVELOPMENT Permit#: PLM2013 00388
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/30/2013
Parcel: 25101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 200
Project: Washington County Clinic Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830-2
Project Description: Replace(1)new breakroom sink. No change in EDU's
Contractor: WESTERN PLUMBING Owner: HILLTOP BUSINESS CENTER LLC
9460 SW TIGARD AVE SUITE 101 HUNZIKER LLC
TIGARD, OR 97223 9430 NW KAISER RD
PORTLAND,OR 97231
PHONE: 503-639-5296 PHONE:
FAX: 503-684-9015
FEES
Quantity Description Date Amount
1 ea Sink 10/30/2013 $25.02
Specifics: 1 12%State Surcharge- 10/30/2013 $8.70
Plumbing
Type of Use: COM 47 ea Minimum Fee Adjustment- 10/30/2013 $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 ques'•-- • •- by calling 503.232.1987 or 1.800.332.2344.
Issue, By: / ! Permittee Signet e:
Call 503.639.4175 by 7:00 a.m.for the next available in pection 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.
10/29/2013 10:42 5036849015 WESTERN PLUMBING INC PAGE 01/03
Plumbing Permit Application
Building Fixtures RtCEI v�1
E3 I,OR (O1 11(E L`.E 011.1
• 13125 of Turd OR 97x23 q 9 2Q13 /0 3c /h ( , 1j Permit 14o.: I'1.h1.el .)Mg
II Phone. 309.639.4171 Fax: 50 i.59A 19tI T LI y d1��Nonni/4p: f 3't� '
1 IC. tl t 1 Inspection Line: 503.639.4I73 fide: t3 See Page
Internet www.tigard-org �Y GFTlGARD �yj(3 sup n taxiIntbxmatron v
writ Q New constrnation !! !„ , itian For apedol b�,►atioe use e>4aoklist 1.
1_-- - Description 1 Qty. 1 Ea. 1 Total
Additiott/aharatiodreplacoment []Other *Pew 1-2-renrRy dwe6ln (includes 100 ft.for eacch utility connection)
CA1180ORY QF CONSTRUCTION SFR(1)bath 312.70
❑1-and 2-lltmily dwelling tACouxmeraial/iddustrial SFR(2)bath 437.78
\ $ R(3)bath 50032
0 Accessory building ❑Multi-family
Each additional bdh A it hen 25.02
q Master builder Q Other Fre sprinkler(._s4"0:) Page 2 03
JOB SITE INFO11MATR�iQ A i D OCl !*W Sec*Mies:
r. �� Catch basin or area drain 18.76
Job she addre�:` � ; ���-Li 1/�Y �7 C.t�/la 1 Drywell,leach kw,or tench drain 18.76
City/Statelz.1P` ' --
Footing drain(no.linear ft.: Page 2
Suite/bldg./apt.no.: P1+ojoct name: k Manufactured hamme utilities 50.03 .
Cross street/diteedoes to job sit t /� - 0.47(21‘571/ Manholes 18.76
_1....1 p.)t C-- Ram drain connecter 13.76
Senitary sewer(no.linear R:„___) Page 2
Storm sewer(no,lines ft.:____) Page 2
Water services(no.linear A.:_) 1 Page 2
Subdivision: I Lea no.: mature or item: -
$addlow prevrenter 31.27 f
Tea map/pared no.: ?
e.ilk VoItlf,. Backwater valve ...._ 12.51 _
. Clothes washer 25.02 .
-_ _. - h t]irlr+raeber 25.02
\ ` 1
cc L 'L..r'�'Ja iJc �. �\-- Drinking fountain 25.02
Ejectors/sump
25.02
?, 1'( A1F� j
a TENANT Expansion tank 12.51 d
Name: Fixture/sewer cap 25.02 'IC
Floor drain/floor sl 'hub 25.02 _
Address: -
Garbage 25-02
City/State/ZIP: Hose Wb 25.02
Phone_( ) Fax:( ) Ice maker 12.51
3 AFPL1GA1VT -a cortracr' ,'' Interceptor/grease rap 25.02
•
Business name: Medical gar(value.S ) Page 2
Primer 12.51
Contact name: Roof drain(commnercial) 12.51
Address: Sinklbasinilavatory \ 25.02 c �.0
•
Qty/State/ZIP- solar omits(potable water) 62.54
Phone:( ) Fes:( ) Tub/shower/shower pan 12.31
E-mail: Urinal 23.02
Water closet 2102
_
- Water beater 37.32
Business name:Western Plumbing,Inc_ Water piping/DW V 36.29
Address:9460 SW Tigard Avenue Suite 101 Other. 25.02 . .
City/Stet/ZIP:Tigard,OR 97223 Subtotal 19,E C .
Phone:(503)6392% Farr.(503)684-9015 1 permit fea 572.50 10'50
CCB Lie.:2439 Plumbing Lie.no.:34-29P11 Plan review (25e,6 of permit fee)
State surcharge(12%of permit fee) ;lb
..Authorized signature: �, / , •, TOTAL.PERWF FEE \ 91C�, .
,/ 11 <<
Print name:Dana J I Date:/f/C ////3j 7�permit application empires ___ h s.ebtained w fn 150 days
/ •F..r.n-rh.vinlnnv wt Iv.1"..rro.�..IA.0 Tn %w v.Ft...A 11,
10/29/2013 10:42 5036849015 WESTERN PLUMBING INC PAGE 02/03
Plumbing Permit Application - City of Tigard
Page 2-Supplemental Information .
. ,
Fee Schedule: Residential Fire Suppression Systems:
sieIriilss
•
tgaiiiiiiitatiii*.i:''::.:,-:.,.,:pittodtligite:!;...••:„.,1.•....,.. .. -.,:.:.-: ..,,
Footing drain-1 100' • 50.03 0 to 2.000 $12190
Footing drain-each additional 100' 1 : 37.52 . 2,001 to 3,600 $169.69
3,601 to 7,200 T233.20
Sewer-lid 100' 62.54 ,7,201 and greeter $327.54
-
Sewer-each additional 100' ' 37.52 _
,
•
Water Service-1st 100' I ' 62-54
.... . Medical Gag Systems:
Water Service-eadi additional 100'
tonn
'ANAi i di*i IIriwijini=,ll 0
- SeRain Drain-111100' 6254 , $1.00 o$5,000.00
Storm&Rein Drain-each additional 100t : 37.52 $5,001.00 to$10,000.00 $72.50 fbr the first$5.000.00 and$1.52 for
'Iiiiiiiiiii :k;-."-Vieri;;H: -''14- 7-'..':':lree#4 . •Ttgal•-:, each additional$100.00 or fraction thereof.to
.' • • ••---- • •,,-, . .a. , , . .,•• •.• ....','.. . . :.'.... .. and including$10.000.00.
Impaction of existing plumbing or fir $10,001.00 to$25,000.00 $145.50 hr the first$10,000.00 and$1.54 fbr
which no he is specifically indicated 90.00/hr each additional$100.00 or fraction thereof to
(minimum charge-1/2 howl ''
, and including S25,000.00.
Inspections outside of normal business : 90.00/hr .'$25,001.00 to$50,000.00 $379.50 for the first S25,000_00 and$145 f
have(minimum charge-2 hours) _
each additional$100.00 or Radon tbeivog to
, .....
Reinspedion Fess . 90.00/hr and indicting$50,000.00.
-
Additional plan review for revisions . 90.00/hr $50,001.00 and up $742.00 for**first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) . - each additional$100.00 or fraction thereof
' .
Snbtotok
. .
• .
. .
C°111MIDIAUngrtaffici:
Are you capping,adding or replacing fixtures? If"yea", .::'!:•::::.:A0.00.44t4..'.. AiinriiiibikliftlOtiOUtilitai. :•:! .-
please Indicate work performed by failure.. Failure to Plan review la required for any of thc following.
accurately report fixtures could result in increased sewer fees*. Plc=check all that apply.
,.,.. .. .,.•. . • ..
• .. . . ' '
0 Any new ccanmacial building with wasa service 2"and
greater,except systems designed and stamped by licensed
engineer.
/*dishy/Font . 0 New exterior plumbing site utilities fir any complex structure
Bath -Tab/Shower .
. as defined in CIAR918-780-0040.
-,1acirr2i/Whhipool . .
0 Metrical gas and vacuum systems for health care factlitimi.
Car Wash -Each Stall
'-Drive Thru 0 Any multipurpose fire sprinkler system.
CuspklorriVider Asphator .' 0 Any complex stud=im defined in CLAR918-780-0040.
Diahwasher -commercial .
-Donicatic Submit a sets of plans with any of the above.
-,
-Dinking Fountain •
Eye Wash ;;;.: .',:•....'.:.:::;:!•:.,40001.i.k0.0.",0000:11$141**•.,.''''";-',•,,:.:..,...., .,:
Floor Drain/sink -2" '
. . b Isometric or riser diagram is requited for new buildings
-r that meet thesnalifimiions above..
-4-
Car Wash Drain .
Cdnimgc -Domestic
Disposal -Conumnial .
-Industrial _ Comments regarding fixture work:
... , •
Ice Idacii/Refrig.Drain
0i, ... ._( jGas Station . 1) 1.) 3 4 , , ( .. , L.—Ac—t.A.-
Rte.Vehicle Dump Station
' ...Va.-1-v, 4.4-• -
Shower -Gang
& !
410
Sink -Ber/Lavatory ,
X 1
-firmiley , -,. •
. -Commatial *Notc If the fixture work under this permit results in an
-Service increase of sewer Ellis,a sewer permit will be issued and
.
Swimming Pool Filter .
fees assessed for the sewer increase must be paid before the
Washer-Clothes .
Water Extractor plumbing permit ems be issued.
Water Closet-Toilet
Urinal •
_
Other Frxiarca:
. .
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7360 SW HUNZIKER RD 200, TIGARD, OR,
97223
Commercial - Plumbing
399 Plumbing final
2013-11-22 (null)
PLM2013-00388
PASS - No C of O
Violation Summary:
Inspector Contractor